A Double-Edged Sword: Lactation Consultants' Perceptions of the Impact of Breast Pumps on the Practice of Breastfeeding

PubMed Central

Buckley, Kathleen M

2009-01-01

This qualitative descriptive study examined the beliefs and experiences of 12 lactation consultants regarding the impact of breast pumps on breastfeeding practices. Interview topics on breast pumps included types and patterns of use, mothers' experiences, and advantages and risks. The lactation consultants reported an increase in the use of breast pumps due to improved marketing, a change in society's view of pumps as a necessity rather than a luxury, and the impact of birthing technology. Reasons given for this increased use were mothers' need to have greater control over the breastfeeding process and to quantify the amount of breastmilk. Concerns were expressed regarding an overdependency on breastfeeding technology by some lactation consultants and mothers. PMID:20190850

Extending lactational amenorrhoea in Manila: a successful breast-feeding education programme.

PubMed

Benitez, I; de la Cruz, J; Suplido, A; Oblepias, V; Kennedy, K; Visness, C

1992-04-01

An experimental breast-feeding education programme conducted at the Philippine General Hospital in Manila demonstrated that women could be motivated to improve their breast-feeding practices and lengthen their period of lactational amenorrhoea in comparison to a control group. Mothers who participated in the programme breast-fed their babies more frequently, delayed the introduction of regular supplements, used fewer bottles and pacifiers and maintained night feeding longer than mothers who were not exposed to the positive breast-feeding messages. The programme was successful in lengthening the period of amenorrhoea among women with elementary, high school, or technical school education, but not among college-educated women. Different educational approaches may be necessary for women of different education levels.

Effect of maternal Chlorella supplementation on carotenoid concentration in breast milk at early lactation.

PubMed

Nagayama, Junya; Noda, Kiyoshi; Uchikawa, Takuya; Maruyama, Isao; Shimomura, Hiroshi; Miyahara, Michiyoshi

2014-08-01

Breast milk carotenoids provide neonates with a source of vitamin A and potentially, oxidative stress protection and other health benefits. Chlorella, which has high levels of carotenoids such as lutein, zeaxanthin and β-carotene, is an effective dietary source of carotenoids for humans. In this study, the effect of maternal supplementation with Chlorella on carotenoid levels in breast milk at early lactation was investigated. Ten healthy, pregnant women received 6 g of Chlorella daily from gestational week 16-20 until the day of delivery (Chlorella group); ten others did not (control group). Among the carotenoids detected in breast milk, lutein, zeaxanthin and β-carotene concentrations in the Chlorella group were 2.6-fold (p = 0.001), 2.7-fold (p = 0.001) and 1.7-fold (p = 0.049) higher, respectively, than those in the control group. Our study shows that Chlorella intake during pregnancy is effective in improving the carotenoid status of breast milk at early lactation.

Postpartum Remodeling, Lactation, and Breast Cancer Risk: Summary of a National Cancer Institute–Sponsored Workshop

PubMed Central

2013-01-01

The pregnancy–lactation cycle (PLC) is a period in which the breast is transformed from a less-developed, nonfunctional organ into a mature, milk-producing gland that has evolved to meet the nutritional, developmental, and immune protection needs of the newborn. Cessation of lactation initiates a process whereby the breast reverts to a resting state until the next pregnancy. Changes during this period permanently alter the morphology and molecular characteristics of the breast (molecular histology) and produce important, yet poorly understood, effects on breast cancer risk. To provide a state-of-the-science summary of this topic, the National Cancer Institute invited a multidisciplinary group of experts to participate in a workshop in Rockville, Maryland, on March 2, 2012. Topics discussed included: 1) the epidemiology of the PLC in relation to breast cancer risk, 2) breast milk as a biospecimen for molecular epidemiological and translational research, and 3) use of animal models to gain mechanistic insights into the effects of the PLC on breast carcinogenesis. This report summarizes conclusions of the workshop, proposes avenues for future research on the PLC and its relationship with breast cancer risk, and identifies opportunities to translate this knowledge to improve breast cancer outcomes. PMID:23264680

Septic disruption of lactiferous ducts with heterogeneous carcinoma of the breast in a lactating woman.

PubMed

Naim, Mohammed; John, Vanesa T; Gaur, Kavita; Anees, Afzal

2010-08-06

This report documents the diagnostic histopathological features of heterogeneous breast carcinoma following sepsis and disruption of the lactiferous ducts in a lactating woman and discusses the pathogenesis. Sections from the nipple revealed disrupted collecting lactiferous ducts presenting with intraduct precarcinoma and carcinoma of the epidermoid type, and attached reparative sprouts lined by lactiferous cells. Breast lobules showed generalised benign adenotic change with various foci of carcinoma microscopically identifiable as intraduct primitive lactiferal ectodermal carcinoma, lactating carcinoma, primitive neuroendocrine carcinoma and myoepithelioid granulomatous carcinoma. The findings led to the conclusion that the lactiferous ducts are susceptible to sepsis and disruption, which may predispose a patient to breast carcinoma. The pattern of carcinoma suggested that lactiferous epithelial cells behaved colonially, with different metaplastic changes, precarcinoma and carcinoma.

Clinicopathologic Characteristics and Prognosis of Breast Cancer Patients Associated with Pregnancy and Lactation: Analysis of Case‐Control Study in Japan

PubMed Central

Ishida, Tsunehiro; Kasumi, Fujio; Sakamoto, Goi; Makita, Masujiro; Tominaga, Takeshi; Simozuma, Kohjiro; Enomoto, Kohji; Fujiwara, Kiyoshi; Nanasawa, Takeshi; Fukutomi, Takashi; Hirota, Teruyuki; Fukuda, Mamoru; Miura, Shigeto; Koyama, Hiroki; Inaji, Hideo; Sonoo, Hiroshi

1992-01-01

Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation were clarified by means of a case‐control study of matched non‐pregnant and non‐lactating patients with breast cancer. From 18 institutions in Japan, a total of 192 subjects with breast cancer diagnosed during pregnancy (72 cases) and lactation (120 cases) were collected between 1970 and 1988, accounting for 0.76% of all breast cancer patients. The duration of symptoms was longer and tumor size was larger in the study subjects. Although the disease‐free interval was longer than that in the control patients, the survival time was shorter. There was no characteristic difference in histologic type. Vascular invasion and lymph node metastasis were found more frequently in the subjects. The positive rates of estrogen receptor and progesterone receptor were lower in the subjects. The 5‐ and 10‐year survival rates of the study patients were 65% and 55%, respectively, and these survivals were significantly lower than those of the control (P < 0.001). The survival rates were poorer in the subjects, in accordance with stage and lymph node metastasis. The results suggest that most of the patients with breast cancer diagnosed during pregnancy and lactation are in a more advanced stage because of a delay in detection and diagnosis, and hence have unfavorable prognosis. Therefore, it is important to diagnose and treat early for improvement of prognosis in patients with breast cancer during pregnancy and lactation. PMID:1483929

Choline intakes exceeding recommendations during human lactation improve breast milk choline content by increasing PEMT pathway metabolites.

PubMed

Davenport, Crystal; Yan, Jian; Taesuwan, Siraphat; Shields, Kelsey; West, Allyson A; Jiang, Xinyin; Perry, Cydne A; Malysheva, Olga V; Stabler, Sally P; Allen, Robert H; Caudill, Marie A

2015-09-01

Demand for the vital nutrient choline is high during lactation; however, few studies have examined choline metabolism and requirements in this reproductive state. The present study sought to discern the effects of lactation and varied choline intake on maternal biomarkers of choline metabolism and breast milk choline content. Lactating (n=28) and control (n=21) women were randomized to 480 or 930 mg choline/day for 10-12 weeks as part of a controlled feeding study. During the last 4-6 weeks, 20% of the total choline intake was provided as an isotopically labeled choline tracer (methyl-d9-choline). Blood, urine and breast milk samples were collected for choline metabolite quantification, enrichment measurements, and gene expression analysis of choline metabolic genes. Lactating (vs. control) women exhibited higher (P < .001) plasma choline concentrations but lower (P ≤ .002) urinary excretion of choline metabolites, decreased use of choline as a methyl donor (e.g., lower enrichment of d6-dimethylglycine, P ≤ .08) and lower (P ≤ .02) leukocyte expression of most choline-metabolizing genes. A higher choline intake during lactation differentially influenced breast milk d9- vs. d3-choline metabolite enrichment. Increases (P ≤ .03) were detected among the d3-metabolites, which are generated endogenously via the hepatic phosphatidylethanolamine N-methyltransferase (PEMT), but not among the d9-metabolites generated from intact exogenous choline. These data suggest that lactation induces metabolic adaptations that increase the supply of intact choline to the mammary epithelium, and that extra maternal choline enhances breast milk choline content by increasing supply of PEMT-derived choline metabolites. This trial was registered at clinicaltrials.gov as NCT01127022. Copyright © 2015 Elsevier Inc. All rights reserved.

Lactational changes in concentration and distribution of ganglioside molecular species in human breast milk from Chinese mothers.

PubMed

Ma, Lin; Liu, Xihong; MacGibbon, Alastair K H; Rowan, Angela; McJarrow, Paul; Fong, Bertram Y

2015-11-01

Gangliosides play a critical role in human brain development and function. Human breast milk (HBM) is an important dietary source of gangliosides for the growing infant. In this study, ganglioside concentrations were measured in the breast milk from a cross-sectional sample of Chinese mothers over an 8-month lactation period. The average total ganglioside concentration increased from 13.1 mg/l during the first month to 20.9 mg/l by 8 months of lactation. The average concentration during the typically solely breast-feeding period of 1‒6 months was 18.9 mg/l. This is the first study to report the relative distribution of the individual ganglioside molecular species through lactation for any population group. The ganglioside molecular species are made up of different fatty acid moieties that influence the physical properties of these gangliosides, and hence affect their function. The GM(3) molecular species containing long-chain acyl fatty acids had the most prominent changes, increasing in both concentration and relative distribution. The equivalent long-chain acyl fatty acid GD(3) molecular species typically decreased in concentration and relative distribution. The lactational trends for both concentration and relative distribution for the very long-chain acyl fatty acid molecular species were more varied. The major GM(3) and GD(3) molecular species during lactation were d40:1 and d42:1, respectively. An understanding of ganglioside molecular species distribution in HBM is essential for accurate application of mass spectrometry methods for ganglioside quantification.

Cloning of HSP90, expression and localization of HSP70/90 in different tissues including lactating/non-lactating yak (Bos grunniens) breast tissue.

PubMed

Liu, Penggang; Yu, Sijiu; Cui, Yan; He, Junfeng; Yu, Chuan; Wen, Zexing; Pan, Yangyang; Yang, Kun; Song, Liangli; Yang, Xue

2017-01-01

The aim of this study is to investigate the expression and localization of HSP70/90 in different tissues and explore the regulation effects of HSP70/90 at lactation period of female yaks. HSP90 mRNA was cloned from the heart samples of female yaks, Quantitative real-time (qRT-PCR), Western blotting (WB), immunohistochemistry and immunofluorescence assays were utilized to analyze the expressions of HSP70/90 mRNA and protein in different tissues. Sequence analysis showed that HSP90 is a conserved molecular chaperone of female yaks. The qRT-PCR, WB results showed that the expressions of HSP70/90 mRNA and protein were significantly different in different tissues, and 3-fold higher expression during the lactation period than the non-lactation period of breast tissue (P < 0.01). Immunohistochemistry and immunofluorescence assays results showed that HSP70/90 were located in the cardiac muscle cells, cerebellar medulla, theca cells lining at the reproductive system, and the mammary epithelia of the breasts. In addition, the expression level of HSP70 was higher than those of HSP90 in all examined tissues. Therefore, our results strongly suggest that the expression and localization of HSP70/90 could provide significant evidence to further research in tissue specific expression, and lactation function of female yaks.

Micronutrient supplements during pregnancy and/or lactation in Malawi and Ghana increase breast milk B-vitamins [abstract

USDA-ARS?s Scientific Manuscript database

There are few data available on the effect of micronutrient (MN) supplementation interventions during pregnancy/lactation on breast milk (BM) MN concentrations. Exclusive breast feeding is recommended fort 6mo and BM-MN concentrations are important determinants of infant MN status, growth and devel...

Ultrasound-Guided Percutaneous Catheter Drainage of Large Breast Abscesses in Lactating Women: How to Preserve Breastfeeding Safely.

PubMed

Falco, Giuseppe; Foroni, Monica; Castagnetti, Fabio; Marano, Luigi; Bordoni, Daniele; Rocco, Nicola; Marchesi, Vanessa; Iotti, Valentina; Vacondio, Rita; Ferrari, Guglielmo

2016-12-01

Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess. A pigtail catheter was inserted into the fluid collection using the Seldinger technique under US guide and connected to a three stop way to allow drainage and irrigation of the cavity until its resolution. All procedures have been found safe and well tolerated. No recurrence was observed and breastfeeding was never interrupted. The described technique allows to avoid surgery and to preserve breastfeeding in well-selected patients with a safe, well-tolerated and cost-effective procedure.

Ketones and lactate increase cancer cell “stemness”, driving recurrence, metastasis and poor clinical outcome in breast cancer

PubMed Central

Tsirigos, Aristotelis; Lin, Zhao; Pavlides, Stephanos; Wang, Chengwang; Flomenberg, Neal; Knudsen, Erik S; Howell, Anthony; Pestell, Richard G

2011-01-01

Previously, we showed that high-energy metabolites (lactate and ketones) “fuel” tumor growth and experimental metastasis in an in vivo xenograft model, most likely by driving oxidative mitochondrial metabolism in breast cancer cells. To mechanistically understand how these metabolites affect tumor cell behavior, here we used genome-wide transcriptional profiling. Human breast cancer cells (MCF7) were cultured with lactate or ketones, and then subjected to transcriptional analysis (exon-array). Interestingly, our results show that treatment with these high-energy metabolites increases the transcriptional expression of gene profiles normally associated with “stemness”, including genes upregulated in embryonic stem (ES) cells. Similarly, we observe that lactate and ketones promote the growth of bonafide ES cells, providing functional validation. The lactate- and ketone-induced “gene signatures” were able to predict poor clinical outcome (including recurrence and metastasis) in human breast cancer patients. Taken together, our results are consistent with the idea that lactate and ketone utilization in cancer cells promotes the “cancer stem cell” phenotype, resulting in significant decreases in patient survival. One possible mechanism by which high-energy metabolites might induce stemness is by increasing the pool of Acetyl-CoA, leading to increased histone acetylation and elevated gene expression. Thus, our results mechanistically imply that clinical outcome in breast cancer could simply be determined by epigenetics and energy metabolism, rather than by the accumulation of specific “classical” gene mutations. We also suggest that high-risk cancer patients (identified by the lactate/ketone gene signatures) could be treated with new therapeutics that target oxidative mitochondrial metabolism, such as the anti-oxidant and “mitochondrial poison” metformin. Finally, we propose that this new approach to personalized cancer medicine be termed �

Lactation in the Human Breast From a Fluid Dynamics Point of View.

PubMed

Negin Mortazavi, S; Geddes, Donna; Hassanipour, Fatemeh

2017-01-01

This study is a collaborative effort among lactation specialists and fluid dynamic engineers. The paper presents clinical results for suckling pressure pattern in lactating human breast as well as a 3D computational fluid dynamics (CFD) modeling of milk flow using these clinical inputs. The investigation starts with a careful, statistically representative measurement of suckling vacuum pressure, milk flow rate, and milk intake in a group of infants. The results from clinical data show that suckling action does not occur with constant suckling rate but changes in a rhythmic manner for infants. These pressure profiles are then used as the boundary condition for the CFD study using commercial ansys fluent software. For the geometric model of the ductal system of the human breast, this work takes advantage of a recent advance in the development of a validated phantom that has been produced as a ground truth for the imaging applications for the breast. The geometric model is introduced into CFD simulations with the aforementioned boundary conditions. The results for milk intake from the CFD simulation and clinical data were compared and cross validated. Also, the variation of milk intake versus suckling pressure are presented and analyzed. Both the clinical and CFD simulation show that the maximum milk flow rate is not related to the largest vacuum pressure or longest feeding duration indicating other factors influence the milk intake by infants.

Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network.

PubMed

Hall Moran, Victoria; Lowe, Nicola; Crossland, Nicola; Berti, Cristiana; Cetin, Irene; Hermoso, Maria; Koletzko, Berthold; Dykes, Fiona

2010-10-01

There is considerable variation in reference values for micronutrient intake during lactation across Europe. The European Micronutrients Recommendations Aligned project aims to harmonize dietary recommendations throughout Europe. Recommended nutrient intakes during lactation are based on limited data and are often extrapolated from known secretion of the nutrient in milk with adjustments for bioavailability, so that differences between values can be partly ascribed to differences in methodological approaches and how these approaches were applied. Few studies have considered the impact of lactation on the mother's nutritional status. Rather, focus has been placed on the influence of maternal nutritional status on the composition of her breast milk. Most common nutritional deficits in breast milk are the result of maternal deficiencies of the water-soluble vitamins, thiamine, riboflavin and vitamins B6 and B12. Other than maternal vitamin A status, which to some extent is reflected in breast milk, concentrations of fat-soluble vitamins and most minerals in breast milk are less affected by maternal status. Factors relating to suboptimal maternal nutritional status during lactation include maternal age, diet and lifestyle factors and spacing of consecutive births. Recent research is providing new knowledge on the micronutrient requirements of lactating women. Identifying needs for research and improving understanding of the differences in values that have been derived by various committees and groups across Europe will enhance transparency and facilitate the application of dietary recommendations in policy-making decision and their translation into recommendations for lactating women. Given the wide variation in breastfeeding practices across Europe, making nutritional recommendations for lactating women is complex and challenging. Thus, it is crucial to first examine the cultural practices within and across European populations and to assess its relevance before

Maternal and Infantile Adiponectin as Marker for Anthropometric Parameters of Lactating Mothers and their Breast-Fed Infants.

PubMed

Fakhreldin, Ahmed Ragab

2018-01-01

Breast milk adiponectin could play a role in the regulation of infants' growth during lactation. The aim is to evaluate adiponectin concentration in human milk and to investigate its relationship with serum adiponectin concentration in lactating mothers and their breastfed infants and with anthropometric parameters of infants and mothers. Sixty healthy term infants and their healthy lactating mothers are included at infant age of 1 month then repeated again at the age of 4 months. All subjects included in this study were subjected to history, clinical examination, investigations including serum level of adiponectin of infants and their mothers by RIA test, human milk level of adiponectin by ELISA test. There was a significant decrease in serum adiponectin of infant and mothers and maternal breast milk at the age of 4 months when compared to them at the age of 1 month. There was a significant positive correlation between infant serum adiponection, maternal serum adiponectin and breast milk adiponectin at infant's age of 1 month and at infant's age of 4 months. There was a significant negative correlation between maternal serum adiponectin and BMI of mothers. There was a significant negative correlation between infant serum adiponectin and their weight and length of infants at the age of 1 month and at the age of 4 months. There's a metabolic link between mothers and their infants through breast milk during the first 6 months of life. A gradual decline in adiponectin level in maternal breast milk is associated with a gradual increase in infant growth up to 6 months of age.

Retinol, α-tocopherol, and selected minerals in breast milk of lactating women with full-term infants in South Korea

PubMed Central

Kim, Hyesook; Jung, Byung-Mun; Lee, Bum-Noh; Kim, Yun-Je

2017-01-01

BACKGROUND/OBJECTIVES This study was performed to measure fat-soluble vitamins and minerals in breast milk of Korean lactating mothers who exclusively breastfed their babies. SUBJECTS/METHODS Breast milk samples were collected from 334 mothers. Concentrations of retinol and α-tocopherol were analyzed by high performance liquid chromatography ultraviolet spectrometry while concentrations of minerals were measured by inductively coupled plasma optical emission spectrometry. RESULTS Retinol and α-tocopherol contents of breast milk were 39.58 ± 19.64 µg/dL and 0.23 ± 0.13 mg/dL, respectively. Average sodium, potassium, calcium, phosphorus, and magnesium levels in breast milk were 11.11 ± 5.16, 38.56 ± 9.01, 27.87 ± 6.10, 13.56 ± 3.30, and 3.05 ± 0.65 mg/dL, respectively. Contents of trace elements such as iron, zinc, copper, and manganese were 40.26 ± 46.21, 98.40 ± 62.47, 24.09 ± 9.03, and 0.90 ± 1.63 µg/dL, respectively. Fat-soluble vitamin concentration was positively correlated with total fat in milk samples, but no significant differences were observed in levels of retinol, α-tocopherol, or minerals based on whether or not lactating women were taking dietary supplements. CONCLUSIONS Micronutrient contents of breast milk samples from Korean lactating women were comparable to those of other nations. Retinol and α-tocopherol levels were correlated and also with total fat in breast milk. PMID:28194267

Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria.

PubMed

Egbuonu, I; Ezechukwu, C C; Chukwuka, J O; Ikechebelu, J I

2005-07-01

The objective of this study was to determine the exclusive breast-feeding practices, return of menstruation, sexual activity and contraceptive practices among breast-feeding mothers in the first six months of lactation. The study was based in Onitsha, South Eastern Nigeria. A structured questionnaire was used to obtain data from breast-feeding mothers on their age, educational attainment, breast-feeding practices, return of menstruation, sexual activity and contraceptive practices within the first six months of lactation at intervals of 6 weeks, 10 weeks 14 weeks and 6 months post delivery. Analysis of the information obtained showed that out of the 178 mothers who participated in the study 81% of the mothers were within the ages of 20 - 34 years. While all the mothers had formal education, the majority (59%) had secondary education. Seventy-three percent initiated breast-feeding within one hour of delivery. On discharge from hospital, all of them had already established breast-feeding which continued up to six weeks and dropped to 97.8% at six months. Exclusive breast-feeding which was practised by 100% on discharge dropped to 3.9% at six months. The feeding regimen was on demand as practised by 98.9% of the mothers. Menstrual flow had returned in 33.8% of the mothers by 6 weeks of lactation, and had risen to 70.2% at six months. There was more prolonged lactational amenorrheoa in exclusively breast-feeding mothers than in those who were not. By 6 weeks post delivery 31.6% of the mothers had resumed sexual activity and this rose to 93.6% at six months. With the resumption of sexual activity only 5% of the mothers resorted to contraceptive practices other than lactational amenorrhea and this increased to 54% at six months. There was no pregnancy in any of these women during the six months period. While appreciating the role of lactational amenorrhea in child spacing and considering the early return of sexual activity among the mothers the practice of introducing

A new role of SNAI2 in post-lactational involution of the mammary gland links it to luminal breast cancer development

PubMed Central

Castillo-Lluva, Sonia; Hontecillas-Prieto, Lourdes; Blanco-Gómez, Adrián; Sáez-Freire, María del Mar; García-Cenador, Begoña; García-Criado, Javier; Pérez-Andrés, Martín; de Matos, Alberto Orfao; Cañamero, Marta; Mao, Jian-Hua; Gridley, Thomas; Castellanos-Martín, Andrés; Pérez-Losada, Jesús

2015-01-01

Breast cancer is a major cause of mortality in women. The transcription factor SNAI2 has been implicated in the pathogenesis of several types of cancer, including breast cancer of basal origin. Here we show that SNAI2 is also important in the development of breast cancer of luminal origin in MMTV-ErbB2 mice. SNAI2 deficiency leads to longer latency and fewer luminal tumors, both of these being characteristics of pre-tumoral origin. These effects were associated with reduced proliferation and a decreased ability to generate mammospheres in normal mammary glands. However, the capacity to metastasize was not modified. Under conditions of increased ERBB2 oncogenic activity after pregnancy plus SNAI2 deficiency, both pretumoral defects-latency and tumor load- were compensated. However, the incidence of lung metastases was dramatically reduced. Furthermore, SNAI2 was required for proper post-lactational involution of the breast. At three days post-lactational involution, the mammary glands of Snai2-deficient mice exhibited lower levels of pSTAT3 and higher levels pAKT1, resulting in decreased apoptosis. The presence of abundant non-involuted ducts was still present at 30 days post-lactation, with a greater number of residual ERBB2+ cells. These results suggest that this defect in involution leads to an increase in the number of susceptible target cells for transformation, to the recovery of the capacity to generate mammospheres, and to an increase in the number of tumors. Our work demonstrates the participation of SNAI2 in the pathogenesis of luminal breast cancer, and reveals an unexpected connection between the processes of post-lactational involution and breast tumorigenesis in Snai2-null mutant mice. PMID:26096931

ERRα Regulated Lactate Metabolism Contributes to Resistance to Targeted Therapies in Breast Cancer

PubMed Central

Park, Sunghee; Chang, Ching-yi; Safi, Rachid; Liu, Xiaojing; Baldi, Robert; Jasper, Jeff S.; Anderson, Grace R.; Liu, Tingyu; Rathmell, Jeffrey C.; Dewhirst, Mark W.; Wood, Kris C.; Locasale, Jason W.; McDonnell, Donald P.

2016-01-01

Summary Imaging studies in animals and in humans have indicated that the oxygenation and nutritional status of solid tumors is dynamic. Further, the extremely low level of glucose within tumors, while reflecting its rapid uptake and metabolism, also suggests that cancer cells must rely on other energy sources in some circumstances. Here we find that some breast cancer cells can switch to utilizing lactate as a primary source of energy, allowing them to survive glucose deprivation for extended periods, and that this activity confers resistance to PI3K/mTOR inhibitors. The nuclear receptor, estrogen-related receptor alpha (ERRα), was shown to regulate the expression of genes required for lactate utilization and isotopomer analysis revealed that genetic or pharmacological inhibition of ERRα activity compromised lactate oxidation. Importantly, ERRα antagonists increased the in vitro and in vivo efficacy of PI3K/mTOR inhibitors, highlighting the potential clinical utility of this drug combination. PMID:27050525

Duration of breast milk expression among working mothers enrolled in an employer-sponsored lactation program.

PubMed

Ortiz, Joan; McGilligan, Kathryn; Kelly, Patricia

2004-01-01

Maternal employment has been one of the greatest barriers to breastfeeding. Women are increasingly solving this problem by expressing milk at work and taking it home to their infants. The objective was to determine duration of breast milk expression among working mothers enrolled in an employer-sponsored lactation program. Retrospective reviews were conducted on the lactation records of 462 women employed by 5 corporations in order to describe and characterize their experiences. The lactation program included the employees' choice of (a) a class on the benefits of breastfeeding; (b) services of a certified lactation consultant (CLC); and (c) private room in the workplace with equipment for pumping. Breastfeeding was initiated by 97.5% of the participants, with 57.8% continuing for at least 6 months. Of the 435 (94.2%) who returned to work after giving birth, 343 (78.9%) attempted pumping milk at work, and 336 (98%) were successful. They expressed milk in the workplace for a mean of 6.3 months (SD = 3.9, range 2 weeks to 21 months). The mean age of infants when the mothers stopped pumping at work was 9.1 months (SD = 4.1, range 1.9 to 25 months). Most of the women who pumped their milk at work were working full time (84.2%). The mean postnatal maternity leave was 2.8 months. The proportion of women who chose to pump at work was higher among women who were salaried than among those who were paid hourly wages (p < 0.01). Company-sponsored lactation programs can enable employed mothers to provide breast milk for their infants as long as they wish, thus helping the nation attain the Healthy People 2010 goals of 50% of mothers breastfeeding until their infants are 6-months-old.

Arsenic in the breast milk of lactating women in arsenic-affected areas of West Bengal, India and its effect on infants.

PubMed

Samanta, Gautam; Das, Dipankar; Mandal, Badal K; Chowdhury, Tarit Roy; Chakraborti, Dipankar; Pal, Arup; Ahamed, Sad

2007-10-01

Two hundred and twenty-six breast milk samples were collected from lactating women from 3 blocks of North-24 Paragans, one of the arsenic-affected districts of West Bengal, India. Out of 226 samples, only in 39 samples arsenic was detected. Urine, hair, and nail samples were also analyzed to know the arsenic body burden of the lactating women. Arsenic in drinking water was also analyzed. Principle component analysis (PCA) revealed that hair and nail arsenic was highly correlated with water arsenic concentrations, whereas arsenic in urine and breast milk did not cluster with water arsenic. Our present study indicated that among the lactating women who had high arsenic body burden and arsenical skin lesions, they had elevated level of arsenic in their breast milk. Arsenic in hair, nails, and urine samples of infants were analyzed, and the results showed significantly high-body burden of infants in those areas. PCA showed the age-dependent relationship between the hair and nail arsenic concentrations of the mothers and their babies.

Maternal Blood, Plasma, and Breast Milk Lead: Lactational Transfer and Contribution to Infant Exposure

PubMed Central

Roy, Ananya; Amarasiriwardena, Chitra J.; Smith, Donald; Lupoli, Nicola; Mercado-García, Adriana; Lamadrid-Figueroa, Hector; Tellez-Rojo, Martha Maria; Hu, Howard; Hernández-Avila, Mauricio

2013-01-01

Background: Human milk is a potential source of lead exposure. Yet lactational transfer of lead from maternal blood into breast milk and its contribution to infant lead burden remains poorly understood. Objectives: We explored the dose–response relationships between maternal blood, plasma, and breast milk to better understand lactational transfer of lead from blood and plasma into milk and, ultimately, to the breastfeeding infant. Methods: We measured lead in 81 maternal blood, plasma, and breast milk samples at 1 month postpartum and in 60 infant blood samples at 3 months of age. Milk-to-plasma (M/P) lead ratios were calculated. Multivariate linear, piecewise, and generalized additive models were used to examine dose–response relationships between blood, plasma, and milk lead levels. Results: Maternal lead levels (mean ± SD) were as follows: blood: 7.7 ± 4.0 μg/dL; plasma: 0.1 ± 0.1 μg/L; milk: 0.8 ± 0.7 μg/L. The average M/P lead ratio was 7.7 (range, 0.6–39.8) with 97% of the ratios being > 1. The dose–response relationship between plasma lead and M/P ratio was nonlinear (empirical distribution function = 6.5, p = 0.0006) with the M/P ratio decreasing by 16.6 and 0.6 per 0.1 μg/L of plasma lead, respectively, below and above 0.1 μg/L plasma lead. Infant blood lead level (3.4 ± 2.2 μg/dL) increased by 1.8 μg/dL per 1 μg/L milk lead (p < 0.0001, R2 = 0.3). Conclusions: The M/P ratio for lead in humans is substantially higher than previously reported, and transfer of lead from plasma to milk may be higher at lower levels of plasma lead. Breast milk is an important determinant of lead burden among breastfeeding infants. Citation: Ettinger AS, Roy A, Amarasiriwardena CJ, Smith DR, Lupoli N, Mercado-García A, Lamadrid-Figueroa H, Tellez-Rojo MM, Hu H, Hernández-Avila M. 2014. Maternal blood, plasma, and breast milk lead: lactational transfer and contribution to infant exposure. Environ Health Perspect 122:87–92; http://dx.doi.org/10.1289/ehp

Changes over lactation in breast milk serum proteins involved in the maturation of immune and digestive system of the infant.

PubMed

Zhang, Lina; de Waard, Marita; Verheijen, Hester; Boeren, Sjef; Hageman, Jos A; van Hooijdonk, Toon; Vervoort, Jacques; van Goudoever, Johannes B; Hettinga, Kasper

2016-09-16

To objective of this study was to better understand the biological functions of breast milk proteins in relation to the growth and development of infants over the first six months of life. Breast milk samples from four individual women collected at seven time points in the first six months after delivery were analyzed by filter aided sample preparation and dimethyl labeling combined with liquid chromatography tandem mass spectrometry. A total of 247 and 200 milk serum proteins were identified and quantified, respectively. The milk serum proteome showed a high similarity (80% overlap) on the qualitative level between women and over lactation. The quantitative changes in milk serum proteins were mainly caused by three groups of proteins, enzymes, and transport and immunity proteins. Of these 21 significantly changed proteins, 30% were transport proteins, such as serum albumin and fatty acid binding protein, which are both involved in transporting nutrients to the infant. The decrease of the enzyme bile salt-activated lipase as well as the immunity proteins immunoglobulins and lactoferrin coincide with the gradual maturation of the digestive and immune system of infants. The human milk serum proteome didn't differ qualitatively but it did quantitatively, both between mothers and as lactation advanced. The changes of the breast milk serum proteome over lactation corresponded with the development of the digestive and immune system of infants. Breast milk proteins provide nutrition, but also contribute to healthy development of infants. Despite the previously reported large number of identified breast milk proteins and their changes over lactation, less is known on the changes of these proteins in individual mothers. This study is the first to determine the qualitative and quantitative changes of milk proteome over lactation between individual mothers. The results indicate that the differences in the milk proteome between individual mothers are more related to the

Lactational mastitis caused by Streptococcus lactarius.

PubMed

Tena, Daniel; Fernández, Cristina; López-Garrido, Beatriz; Pérez-Balsalobre, Mercedes; Losa, Cristina; Medina-Pascual, María José; Sáez-Nieto, Juan Antonio

2016-08-01

Human infections caused by Streptococcus lactarius have not been previously reported. In the present report, we describe a lactational mastitis caused by this organism. The infection occurred in a 28-year-old breast-feeding female, with a 10-days history of moderate pain on the right breast. The patient was cured after antibiotic treatment with levofloxacin for 21 days. Our case shows that S. lactarius should be considered as a cause of lactational mastitis. The introduction of molecular microbiology techniques can be extremely useful for knowing the implication of streptococci in lactational mastitis. Copyright © 2016 Elsevier Inc. All rights reserved.

[Length of lactational amenorrhea in an urban population of Temuco, Chile].

PubMed

Valdés, Patricio; Sierralta, Pablo; Ossa, Ximena; Barría, Angélica

2002-01-01

Studies done in Santiago, Chile show that menses return before the sixth month of puerperium in 50% of lactating women, even in those that continue with exclusive breast feeding. To study the length of lactational amenorrhea in a group of women living in Southern Chile. One hundred fourteen women giving exclusive breast feeding, were followed from the third postpartum month, to determine the length of lactational amenorrhea. Its relationship with general characteristics of the mothers and children and breast feeding pattern was also studied. Sixty six women (58%) recovered their menses before the 6th postpartum month and their length of lactational amenorrhea was 101 +/- 5 days. In the rest of the sample, the length was 277 +/- 10 days. No differences in characteristics of the mothers and children or breast feeding pattern, were observed between these two groups. A short lactational amenorrhea is common in the Chilean population. Clinical characteristics or pattern of breast feeding do not explain the length of LA in this population.

High-Fructose Corn-Syrup-Sweetened Beverage Intake Increases 5-Hour Breast Milk Fructose Concentrations in Lactating Women.

PubMed

Berger, Paige K; Fields, David A; Demerath, Ellen W; Fujiwara, Hideji; Goran, Michael I

2018-05-24

This study determined the effects of consuming a high-fructose corn syrup (HFCS)-sweetened beverage on breast milk fructose, glucose, and lactose concentrations in lactating women. At six weeks postpartum, lactating mothers ( n = 41) were randomized to a crossover study to consume a commercially available HFCS-sweetened beverage or artificially sweetened control beverage. At each session, mothers pumped a complete breast milk expression every hour for six consecutive hours. The baseline fasting concentrations of breast milk fructose, glucose, and lactose were 5.0 ± 1.3 µg/mL, 0.6 ± 0.3 mg/mL, and 6.8 ± 1.6 g/dL, respectively. The changes over time in breast milk sugars were significant only for fructose (treatment × time, p < 0.01). Post hoc comparisons showed the HFCS-sweetened beverage vs. control beverage increased breast milk fructose at 120 min (8.8 ± 2.1 vs. 5.3 ± 1.9 µg/mL), 180 min (9.4 ± 1.9 vs. 5.2 ± 2.2 µg/mL), 240 min (7.8 ± 1.7 vs. 5.1 ± 1.9 µg/mL), and 300 min (6.9 ± 1.4 vs. 4.9 ± 1.9 µg/mL) (all p < 0.05). The mean incremental area under the curve for breast milk fructose was also different between treatments (14.7 ± 1.2 vs. -2.60 ± 1.2 µg/mL × 360 min, p < 0.01). There was no treatment × time interaction for breast milk glucose or lactose. Our data suggest that the consumption of an HFCS-sweetened beverage increased breast milk fructose concentrations, which remained elevated up to five hours post-consumption.

The Effect of Hollyhock (Althaea officinalis L) Leaf Compresses Combined With Warm and Cold Compress on Breast Engorgement in Lactating Women: A Randomized Clinical Trial.

PubMed

Khosravan, Shahla; Mohammadzadeh-Moghadam, Hossein; Mohammadzadeh, Fatemeh; Fadafen, Samane Ajam Khames; Gholami, Malihe

2017-01-01

Breast engorgement affects lactation. The present study was conducted to determine the effect of hollyhock combined with warm and cold compresses on improving breast engorgement in lactating women. Participants included 40 women with breast engorgement divided into intervention and control groups, with participants in both groups being applied routine interventions and warm compress before nursing and a cold compress after nursing; however, the intervention group was also applied hollyhock compress. Both groups received these treatments 6 times during 2 days. The data collected were analyzed in SPSS-16 using a generalized estimating equation. According to the results, a significant difference was observed in the overall breast engorgement severity in the intervention group (P < .001). The severity of breast engorgement was also found to have a significant relationship with time (P < .001). According to the findings, hollyhock leaf compress combined with performing routine interventions for breast engorgement can improve breast engorgement. © The Author(s) 2015.

Maternal blood, plasma, and breast milk lead: lactational transfer and contribution to infant exposure.

PubMed

Ettinger, Adrienne S; Roy, Ananya; Amarasiriwardena, Chitra J; Smith, Donald; Lupoli, Nicola; Mercado-García, Adriana; Lamadrid-Figueroa, Hector; Tellez-Rojo, Martha Maria; Hu, Howard; Hernández-Avila, Mauricio

2014-01-01

Human milk is a potential source of lead exposure. Yet lactational transfer of lead from maternal blood into breast milk and its contribution to infant lead burden remains poorly understood. We explored the dose-response relationships between maternal blood, plasma, and breast milk to better understand lactational transfer of lead from blood and plasma into milk and, ultimately, to the breastfeeding infant. We measured lead in 81 maternal blood, plasma, and breast milk samples at 1 month postpartum and in 60 infant blood samples at 3 months of age. Milk-to-plasma (M/P) lead ratios were calculated. Multivariate linear, piecewise, and generalized additive models were used to examine dose-response relationships between blood, plasma, and milk lead levels. Maternal lead levels (mean±SD) were as follows: blood: 7.7±4.0 μg/dL; plasma: 0.1±0.1 μg/L; milk: 0.8±0.7 μg/L. The average M/P lead ratio was 7.7 (range, 0.6-39.8) with 97% of the ratios being >1. The dose-response relationship between plasma lead and M/P ratio was nonlinear (empirical distribution function=6.5, p=0.0006) with the M/P ratio decreasing by 16.6 and 0.6 per 0.1 μg/L of plasma lead, respectively, below and above 0.1 μg/L plasma lead. Infant blood lead level (3.4±2.2 μg/dL) increased by 1.8 μg/dL per 1 μg/L milk lead (p<0.0001, R2=0.3). The M/P ratio for lead in humans is substantially higher than previously reported, and transfer of lead from plasma to milk may be higher at lower levels of plasma lead. Breast milk is an important determinant of lead burden among breastfeeding infants.

Lactation and reproduction*

PubMed Central

Thomson, A. M.; Hytten, F. E.; Black, A. E.

1975-01-01

The authors review the literature on the effect of lactation on fertility in the absence of contraception and on the effects of contraceptive measures on lactation. They examine data from several countries on the intervals between births and on the return of menstruation and ovulation after childbirth, comparing lactating with nonlactating women. They conclude that lactation is an inefficient contraceptive for the individual, but that in populations sustained lactation is associated with reduced fertility. Possible physiological mechanisms causing lactation amenorrhoea are discussed. Though much of the literature on the effect of contraceptives on lactation is inadequate, there is general agreement that the estrogen component of hormonal preparations has an adverse effect on lactation, but that progestins alone do not. Many questions remain. Is this effect seen in established lactation, or only in the puerperal period? Is it a direct pharmacological effect, or are pill-users the mothers least motivated to maintain breast-feeding? Does a close relationship exist between hormones given and lactation performance? The authors comment on some of the technical deficiencies of previous studies in this field and discuss practical possibilities of, and limitations to, obtaining adequate scientific information in the future. PMID:1084804

Hypoxia-induced carbonic anhydrase IX facilitates lactate flux in human breast cancer cells by non-catalytic function.

PubMed

Jamali, Somayeh; Klier, Michael; Ames, Samantha; Barros, L Felipe; McKenna, Robert; Deitmer, Joachim W; Becker, Holger M

2015-09-04

The most aggressive tumour cells, which often reside in hypoxic environments, rely on glycolysis for energy production. Thereby they release vast amounts of lactate and protons via monocarboxylate transporters (MCTs), which exacerbates extracellular acidification and supports the formation of a hostile environment. We have studied the mechanisms of regulated lactate transport in MCF-7 human breast cancer cells. Under hypoxia, expression of MCT1 and MCT4 remained unchanged, while expression of carbonic anhydrase IX (CAIX) was greatly enhanced. Our results show that CAIX augments MCT1 transport activity by a non-catalytic interaction. Mutation studies in Xenopus oocytes indicate that CAIX, via its intramolecular H(+)-shuttle His200, functions as a "proton-collecting/distributing antenna" to facilitate rapid lactate flux via MCT1. Knockdown of CAIX significantly reduced proliferation of cancer cells, suggesting that rapid efflux of lactate and H(+), as enhanced by CAIX, contributes to cancer cell survival under hypoxic conditions.

Hypoxia-induced carbonic anhydrase IX facilitates lactate flux in human breast cancer cells by non-catalytic function

PubMed Central

Jamali, Somayeh; Klier, Michael; Ames, Samantha; Felipe Barros, L.; McKenna, Robert; Deitmer, Joachim W.; Becker, Holger M.

2015-01-01

The most aggressive tumour cells, which often reside in hypoxic environments, rely on glycolysis for energy production. Thereby they release vast amounts of lactate and protons via monocarboxylate transporters (MCTs), which exacerbates extracellular acidification and supports the formation of a hostile environment. We have studied the mechanisms of regulated lactate transport in MCF-7 human breast cancer cells. Under hypoxia, expression of MCT1 and MCT4 remained unchanged, while expression of carbonic anhydrase IX (CAIX) was greatly enhanced. Our results show that CAIX augments MCT1 transport activity by a non-catalytic interaction. Mutation studies in Xenopus oocytes indicate that CAIX, via its intramolecular H+-shuttle His200, functions as a “proton-collecting/distributing antenna” to facilitate rapid lactate flux via MCT1. Knockdown of CAIX significantly reduced proliferation of cancer cells, suggesting that rapid efflux of lactate and H+, as enhanced by CAIX, contributes to cancer cell survival under hypoxic conditions. PMID:26337752

Association between Several Persistent Organic Pollutants in Serum and Adipokine Levels in Breast Milk among Lactating Women of Korea.

PubMed

Kim, Sunmi; Park, Jeongim; Kim, Hai-Joong; Lee, Jeong Jae; Choi, Gyuyeon; Choi, Sooran; Kim, Sungjoo; Kim, Su Young; Lee, Duk Hee; Moon, Hyo-Bang; Kim, Sungkyoon; Choi, Kyungho

2015-07-07

Exposure to several persistent organic pollutants (POPs) has been linked to alteration of lipid metabolism. Adipokines, such as leptin and adiponectin, are hormones that play roles in lipid metabolism, and have been suggested as markers of health effects that may lead to obesity. To date, only serum adipokines have been associated with POPs exposure. In the present study, for the first time, the associations between leptin and adiponectin in breast milk, and several POPs in serum were investigated among 82 lactating Korean women between 25 and 46 years of age. Breast milk adipokines are important because adipokine intake of infant through breastfeeding may influence the growth of infants. The median concentrations of leptin and adiponectin in skimmed milk of the Korean lactating women were 17.9 ng/L and 16.5 μg/L, respectively. Leptin concentrations in breast milk were negatively associated with ∑hexachlorohexane (HCH), oxychlordane, ∑chlordane, or 2,2',4,4',5,5'-hexachlorobiphenyl (CB 153) levels in maternal serum. Linear relationships between adiponectin and POPs concentrations were not observed, however, nonmonotonic relationship which showed generally positive associations was suggested for p,p'-dichlorodiphenyltrichloroethane (DDT) and ∑chlordane in quartile analysis. Our observations show that POPs at the current level of exposure may be associated with the alteration of lipid metabolism among lactating women. Implication of adipokine transfer to breastfed infants is of concern and deserves further investigation.

PCR-DGGE assessment of the bacterial diversity of breast milk in women with lactational infectious mastitis

PubMed Central

Delgado, Susana; Arroyo, Rebeca; Martín, Rocío; Rodríguez, Juan M

2008-01-01

Background Infectious mastitis is a common condition during lactation and in fact, represents one of the main causes leading to a precocious weaning. The number of studies dealing with lactational mastitis is low and, up to now, the etiological diagnosis is frequently made on the basis of unspecific clinical signs. The aim of this study was to investigate the microbial diversity of breast milk in 20 women with lactational mastitis employing culture-dependent and culture-independent (PCR-DGGE) approaches. Methods Breast milk samples were cultured in different media to investigate the presence of bacteria and/or yeasts, and a total of 149 representative isolates were identified to the species level by 16S rRNA gene PCR sequencing. The microorganisms recovered were compared with those found by PCR-DGGE analysis. To identify the DGGE profiles two reference markers of different microbial species were constructed. Sequence analysis of unknown bands was also performed. Results Staphylococci were the dominant bacterial group and Staphylococcus epidermidis was the dominant species. In a lower number of samples, other bacteria (mainly streptococci and a few gram-negative species) were also identified. Globally, PCR-DGGE results showed a good correlation with those obtained by culture-based methods. However, although DNA bands corresponding to different lactic acid bacteria were detected, such bacteria could not be isolated from the milk samples. Conclusion Staphylococci seem to be the main etiological agents of human lactational mastitis. The combined use of culture and molecular techniques allowed a better characterization of the bacterial diversity in milk from women suffering from infectious mastitis. Our results suggest that this condition could be the result of a disbiotic process where some of the bacterial species usually present in human milk outgrow (staphylococci) while others disappear (lactobacilli or lactococci). PMID:18423017

PCR-DGGE assessment of the bacterial diversity of breast milk in women with lactational infectious mastitis.

PubMed

Delgado, Susana; Arroyo, Rebeca; Martín, Rocío; Rodríguez, Juan M

2008-04-18

Infectious mastitis is a common condition during lactation and in fact, represents one of the main causes leading to a precocious weaning. The number of studies dealing with lactational mastitis is low and, up to now, the etiological diagnosis is frequently made on the basis of unspecific clinical signs. The aim of this study was to investigate the microbial diversity of breast milk in 20 women with lactational mastitis employing culture-dependent and culture-independent (PCR-DGGE) approaches. Breast milk samples were cultured in different media to investigate the presence of bacteria and/or yeasts, and a total of 149 representative isolates were identified to the species level by 16S rRNA gene PCR sequencing. The microorganisms recovered were compared with those found by PCR-DGGE analysis. To identify the DGGE profiles two reference markers of different microbial species were constructed. Sequence analysis of unknown bands was also performed. Staphylococci were the dominant bacterial group and Staphylococcus epidermidis was the dominant species. In a lower number of samples, other bacteria (mainly streptococci and a few gram-negative species) were also identified. Globally, PCR-DGGE results showed a good correlation with those obtained by culture-based methods. However, although DNA bands corresponding to different lactic acid bacteria were detected, such bacteria could not be isolated from the milk samples. Staphylococci seem to be the main etiological agents of human lactational mastitis. The combined use of culture and molecular techniques allowed a better characterization of the bacterial diversity in milk from women suffering from infectious mastitis. Our results suggest that this condition could be the result of a disbiotic process where some of the bacterial species usually present in human milk outgrow (staphylococci) while others disappear (lactobacilli or lactococci).

Lactating Mother and Psychotropic Drugs

PubMed Central

Tripathi, B. M.; Majumder, Pradipta

2010-01-01

Usage of psychotropics during pregnancy and lactation has always been a topic of debate and controversy. The debate stems from the potential adverse effects on the growing fetus or infants due to the transfer of psychotropic drugs through placenta or breast milk of mothers receiving them; and the problem of discontinuing psychotropics in lactating mother considering chances of relapse. However, most of the psychotropics are found to be relatively safe when used cautiously during the lactation phase. This article describes available data on the use of psychotropics in lactating mothers, in particular, in relation to the safety profile of infants. PMID:21327172

Breast cancer statistics and prediction methodology: a systematic review and analysis.

PubMed

Dubey, Ashutosh Kumar; Gupta, Umesh; Jain, Sonal

2015-01-01

Breast cancer is a menacing cancer, primarily affecting women. Continuous research is going on for detecting breast cancer in the early stage as the possibility of cure in early stages is bright. There are two main objectives of this current study, first establish statistics for breast cancer and second to find methodologies which can be helpful in the early stage detection of the breast cancer based on previous studies. The breast cancer statistics for incidence and mortality of the UK, US, India and Egypt were considered for this study. The finding of this study proved that the overall mortality rates of the UK and US have been improved because of awareness, improved medical technology and screening, but in case of India and Egypt the condition is less positive because of lack of awareness. The methodological findings of this study suggest a combined framework based on data mining and evolutionary algorithms. It provides a strong bridge in improving the classification and detection accuracy of breast cancer data.

Relation of Lake Ontario fish consumption, lifetime lactation, and parity to breast milk polychlorobiphenyl and pesticide concentrations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kostyniak, P.J.; Stinson, C.; Hreizerstein, H.B.

1999-02-01

Lactating female members and spouses of male members of the New York State Angler Cohort who agreed to provide breast milk samples were the subjects of this study. Milk samples were analyzed for 77 polychlorinated biphenyls (PCB) congeners, 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (DDE), a metabolite of dichlorodiphenyltrichloroethane (DDT), hexachlorobenzene (HCB), and 1,1a,2,2,3,3a,4,5,5,5a,5b,6-dodecachlorooctahydro-1,3,4-methano-1H-cyclobuta[cd]pentalene (Mirex). The percentage of samples with quantifiable levels, above the limit of detection (LOD), varied among the individual congeners from 10 to 100%. Nine PCB congeners and DDE were found in all of the 100 samples analyzed. Fish eaters had a significantly higher level of several major PCB congeners with congenersmore » 153 and 138 being 1.36 and 1.34 times higher, respectively. PCB and DDE concentrations, expressed on a lipid basis, varied inversely with parity. The total number of months of lifetime lactation varied inversely with the total PCB concentration in breast milk.« less

Analysis of Aflatoxin M1 in Breast Milk and Its Association with Nutritional and Socioeconomic Status of Lactating Mothers in Lebanon.

PubMed

Elaridi, Jomana; Bassil, Maya; Kharma, Joelle Abi; Daou, Farah; Hassan, Hussein F

2017-10-01

Aflatoxin B 1 (AFB 1 ) is the most potent of the dietary aflatoxins, and its major metabolite, aflatoxin M 1 (AFM 1 ), is frequently found in the breast milk of lactating mothers. The aim of this study was to assess the occurrence and factors associated with AFM 1 contamination of breast milk collected from lactating mothers in Lebanon. A total of 111 breast milk samples were collected according to the guidelines set by the World Health Organization. Samples were analyzed with a competitive enzyme-linked immunosorbent assay between December 2015 and November 2016. A survey was used to determine the demographic and anthropometric characteristics of participating lactating mothers. Dietary habits were assessed using a semiquantitative food frequency questionnaire. Mean (±standard deviation) concentration of AFM 1 in the breast milk samples was 4.31 ± 1.8 ng/L, and 93.8% of samples contained AFM 1 at 0.2 to 7.9 ng/L. The mean concentration of AFM 1 was significantly lower (P < 0.05) in fall and winter (4.1 ± 1.9 ng/L) than in spring and summer (5.0 ± 1.7 ng/L). None of the samples exceeded the European Commission regulation limit (25 ng/L) for infant milk replacement formula. AFM 1 contamination was significantly associated (P < 0.05) with the daily consumption of white cheeses but not with the consumption of meat or cereal products. No significant association (P > 0.05) was observed between AFM 1 concentrations in breast milk and anthropometric sociodemographic factors (age and level of education) or the governorate of residence of the nursing mothers. The mean AFM 1 estimated daily intake was found to be 0.69 ng/day/kg of body weight. Although the incidence of AFM 1 contamination was low, our first-of-its-kind study highlights the importance of conducting investigations on mycotoxin contamination in breast milk and of developing protection strategies to tackle the exposure of infants to this potent chemical hazard.

Hyaluronan, CD44, and Emmprin Regulate Lactate Efflux and Membrane Localization of Monocarboxylate Transporters in Human Breast Carcinoma Cells

PubMed Central

Slomiany, Mark G.; Grass, G. Daniel; Robertson, Angela D.; Yang, Xiao Y.; Maria, Bernard L.; Beeson, Craig; Toole, Bryan P.

2013-01-01

Interactions of hyaluronan with CD44 in tumor cells play important cooperative roles in various aspects of malignancy and drug resistance. Emmprin (CD147; basigin)is a cell surface glycoprotein of the immunoglobulin superfamily that is highly up-regulated in malignant cancer cells and stimulates hyaluronan production, as well as several downstream signaling pathways. Emmprin also interacts with various monocarboxylate transporters (MCT). Malignant cancer cells use the glycolytic pathway and require MCTs to efflux lactate that results from glycolysis. Glycolysis and lactate secretion contribute to malignant cell behaviors and drug resistance in tumor cells. In the present study, we find that perturbation of endogenous hyaluronan, using small hyaluronan oligosaccharides, rapidly inhibits lactate efflux from breast carcinoma cells; down-regulation of emmprin, using emmprin small interfering RNA, also results in decreased efflux. In addition, we find that CD44 coimmunoprecipitates with MCT1, MCT4, and emmprin and colocalizes with these proteins at the plasma membrane. Moreover, after treatment of the cells with hyaluronan oligosaccharides, CD44, MCT1, and MCT4 become localized intracellularly whereas emmprin remains at the cell membrane. Together, these data indicate that constitutive interactions among hyaluronan, CD44, and emmprin contribute to regulation of MCT localization and function in the plasma membrane of breast carcinoma cells. PMID:19176383

[Risk of inffective breast-feeding: a nursing diagnosis].

PubMed

Viera, Cláudia Silveira

2004-01-01

This study is aimed at presenting the 'risk of ineffective breast-feeding' nursing diagnosis regarding mothers of premature infants who are hospitalized in a neonatal Intensive Care Unit. The case study outlined the methodology of the study, and the sample is composed of 35 mothers. Such a diagnosis was detected in 100% of the sample and the risk factors are prematureness; insufficient opportunity to breast-feed due to the newborn's hospitalization; lack of knowledge regarding the maintenance of lactation; maternal fear; inconstancy of breast suction due to separation; and artificial feeding of the newborn. It is believed that the identification of the risks of ineffective breast-feeding during the newborn's hospitalization period makes possible a nursing care focused on the prevention of an 'ineffective breast-feeding' diagnosis.

The influence of lactation, occupational exposures and postmenopausal hormone use on the incidence of breast cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, C.P.

A self-administered questionnaire was completely by 1,018 women diagnosed with breast cancer during 1988-1989 identified through the British Columbia Cancer Registry and by 1,025 controls selected at random from the Provincial Voters List. Data were collected on demographic characteristics, lifestyle factors, occupational and reproductive history as well as hormone use. Premenopausal women who ceased lactation within the first month had a relative risk of 3.0, adjusted for age and parity (95% C.I. = 1.6-5.4), compared to women who had breast fed two months or longer. Among women who nursed for at least two months, there was an indication of decreasingmore » risk with increasing duration of nursing. Among post-menopausal women, no relation between lactation history and breast cancer risk was evident. Premenopausal women who reported ever having been a data processing operator (OR = 3.8), hairdresser (OR = 5.5), janitor/housekeeper (OR = 2.1), or having worked in the food processing (OR = 2.7) were found to have an excess risk of breast cancer. Among postmenopausal women, an excess risk was seen for nursing or medical workers (OR = 1.4) whereas a reduced risk was observed among waitresses/bartenders (OR = 0.5), textile workers (OR = 0.5) or defense industry personnel (OR = 0.4). The effect of menopausal hormone use was evaluated among 699 cases and 685 controls who were postmenopausal due to natural causes or to a hysterectomy. There was no overall increase in risk of breast cancer associated with ever use of unopposed estrogen (OR = 1.0, 95% CI = 0.8-1.3). For estrogen use of ten years or longer, the relative risk was 1.6 (95% CI = 1.1-2.5). The risk estimate for current users was somewhat elevated (OR = 1.4, 95% CI = 1.0-2.0). Compared to women who never used hormone preparations, women who had used estrogen plus progestogen had a relative risk of 1.2 (95% CI = 0.6-2.2).« less

Metalloproteomics Approach to Analyze Mercury in Breast Milk and Hair Samples of Lactating Women in Communities of the Amazon Basin, Brazil.

PubMed

Cerbino, M R; Vieira, José Cavalcante Souza; Braga, C P; Oliveira, G; Padilha, I F; Silva, T M; Zara, L F; Silva, N J; Padilha, P M

2018-02-01

Mercury is a potentially toxic element that is present in the environment of the Brazilian Amazon and is responsible for adverse health effects in humans. This study sought to assess possible protein biomarkers of mercury exposure in breast milk samples from lactating women in the Madeira and Negro Rivers in the Brazilian Amazon. The mercury content of hair samples of lactating women was determined, and the proteome of breast milk samples was obtained using two-dimensional electrophoresis after protein precipitation with acetone. Mercury measurements of protein spots obtained via protein fractionation were performed by graphite furnace atomic absorption spectrometry (GFAAS), and it was observed that mercury is linked to proteins with molecular masses in the range of 14-26 kDa. The total mercury concentration was also determined by GFAAS in unprocessed milk, lyophilized milk, and protein pellets, with the purpose of determining the mercury mass balance in relation to the concentration of this element in milk and pellets. Approximately 85 to 97% of mercury present in the lyophilized milk from samples of lactating women of the Madeira River is bound in the protein fraction. From lactating women of the Negro River, approximately 49% of the total mercury is bound in the protein fraction, and a difference of 51% is bound in the lipid fraction.

Lactation and appetite-regulating hormones: increased maternal plasma peptide YY concentrations 3-6 months postpartum.

PubMed

Vila, Greisa; Hopfgartner, Judith; Grimm, Gabriele; Baumgartner-Parzer, Sabina M; Kautzky-Willer, Alexandra; Clodi, Martin; Luger, Anton

2015-10-28

Breast-feeding is associated with maternal hormonal and metabolic changes ensuring adequate milk production. In this study, we investigate the impact of breast-feeding on the profile of changes in maternal appetite-regulating hormones 3-6 months postpartum. Study participants were age- and BMI-matched lactating mothers (n 10), non-lactating mothers (n 9) and women without any history of pregnancy or breast-feeding in the previous 12 months (control group, n 10). During study sessions, young mothers breast-fed or bottle-fed their babies, and maternal blood samples were collected at five time points during 90 min: before, during and after feeding the babies. Outcome parameters were plasma concentrations of ghrelin, peptide YY (PYY), leptin, adiponectin, prolactin, cortisol, insulin, glucose and lipid values. At baseline, circulating PYY concentrations were significantly increased in lactating mothers (100·3 (se 6·7) pg/ml) v. non-lactating mothers (73·6 (se 4·9) pg/ml, P=0·008) and v. the control group (70·2 (se 9) pg/ml, P=0·021). We found no differences in ghrelin, leptin and adiponectin values. Baseline prolactin concentrations were over 4-fold higher in lactating mothers (P<0·001). Lactating women had reduced TAG levels and LDL-cholesterol:HDL-cholesterol ratio, but increased waist circumference, when compared with non-lactating women. Breast-feeding sessions further elevated circulating prolactin (P<0·001), but induced no acute effects on appetite-regulating hormones. In summary, one single breast-feeding session did not acutely modulate circulating appetite-regulating hormones, but increased baseline PYY concentrations are associated with prolonged lactation. PYY might play a role in the coordination of energy balance during lactation, increasing fat mobilisation from maternal depots and ensuring adequate milk production for the demands of the growing infant.

Negative Suction Drain Through a Mini Periareolar Incision for the Treatment of Lactational Breast Abscess Shortens Hospital Stay and Increases Breastfeeding Rates.

PubMed

Wei, Jinli; Zhang, Jiaxin; Fu, Deyuan

2016-06-01

Although breast abscess is a serious uncommon complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments. We reported a novel way of applying negative suction drain through a mini periareolar incision. We retrospectively analyzed and compared the clinical characteristics of 62 patients with lactational breast abscess in our department from August 2012 to April 2015. Thirty-two patients went through traditional incision and drainage (Group A) and 30 patients were placed on negative suction drain through mini periareolar incision (Group B). There is no significant difference between the two groups in terms of age, white blood cell (WBC) count, size of the abscess cavity, and positive rate of Staphylococcus aureus (SA) or methicillin-resistant Staphylococcus aureus (MRSA). Patients in Group B had a shorter hospitalized stay (p = 0.003) and had a higher rate of continuation of breastfeeding (p < 0.005). Applying drain with negative suction pressure through a mini periareolar incision is an effective modality for treating lactational breast abscess and maintaining breastfeeding.

A Correlation Study of DHA Dietary Intake and Plasma, Erythrocyte and Breast Milk DHA Concentrations in Lactating Women from Coastland, Lakeland, and Inland Areas of China

PubMed Central

Liu, Meng-Jiao; Li, Hong-Tian; Yu, Li-Xia; Xu, Gao-Sheng; Ge, Hua; Wang, Lin-Lin; Zhang, Ya-Li; Zhou, Yu-Bo; Li, You; Bai, Man-Xi; Liu, Jian-Meng

2016-01-01

We aimed to assess the correlation between docosahexaenoic acid (DHA) dietary intake and the plasma, erythrocyte and breast milk DHA concentrations in lactating women residing in the coastland, lakeland and inland areas of China. A total of 408 healthy lactating women (42 ± 7 days postpartum) were recruited from four hospitals located in Weihai (coastland), Yueyang (lakeland) and Baotou (inland) city. The categories of food containing DHA, the average amount consumed per time and the frequency of consumption in the past month were assessed by a tailored DHA food frequency questionnaire, the DHA Intake Evaluation Tool (DIET). DHA dietary intake (mg/day) was calculated according to the Chinese Food Composition Table (Version 2009). In addition, fasting venous blood (5 mL) and breast milk (10 mL) were collected from lactating women. DHA concentrations in plasma, erythrocyte and breast milk were measured using capillary gas chromatography, and were reported as absolute concentration (μg/mL) and relative concentration (weight percent of total fatty acids, wt. %). Spearman correlation coefficients were used to assess the correlation between intakes of DHA and its concentrations in biological specimens. The study showed that the breast milk, plasma and erythrocyte DHA concentrations were positively correlated with DHA dietary intake; corresponding correlation coefficients were 0.36, 0.36 and 0.24 for relative concentration and 0.33, 0.32, and 0.18 for absolute concentration (p < 0.05). The median DHA dietary intake varied significantly across areas (p < 0.05), which was highest in the coastland (24.32 mg/day), followed by lakeland (13.69 mg/day), and lowest in the inland (8.84 mg/day). The overall relative and absolute DHA concentrations in breast milk were 0.36% ± 0.23% and 141.49 ± 107.41 μg/mL; the concentrations were significantly lower in inland women than those from coastland and lakeland. We conclude that DHA dietary intake is positively correlated with DHA

A Correlation Study of DHA Dietary Intake and Plasma, Erythrocyte and Breast Milk DHA Concentrations in Lactating Women from Coastland, Lakeland, and Inland Areas of China.

PubMed

Liu, Meng-Jiao; Li, Hong-Tian; Yu, Li-Xia; Xu, Gao-Sheng; Ge, Hua; Wang, Lin-Lin; Zhang, Ya-Li; Zhou, Yu-Bo; Li, You; Bai, Man-Xi; Liu, Jian-Meng

2016-05-20

We aimed to assess the correlation between docosahexaenoic acid (DHA) dietary intake and the plasma, erythrocyte and breast milk DHA concentrations in lactating women residing in the coastland, lakeland and inland areas of China. A total of 408 healthy lactating women (42 ± 7 days postpartum) were recruited from four hospitals located in Weihai (coastland), Yueyang (lakeland) and Baotou (inland) city. The categories of food containing DHA, the average amount consumed per time and the frequency of consumption in the past month were assessed by a tailored DHA food frequency questionnaire, the DHA Intake Evaluation Tool (DIET). DHA dietary intake (mg/day) was calculated according to the Chinese Food Composition Table (Version 2009). In addition, fasting venous blood (5 mL) and breast milk (10 mL) were collected from lactating women. DHA concentrations in plasma, erythrocyte and breast milk were measured using capillary gas chromatography, and were reported as absolute concentration (μg/mL) and relative concentration (weight percent of total fatty acids, wt. %). Spearman correlation coefficients were used to assess the correlation between intakes of DHA and its concentrations in biological specimens. The study showed that the breast milk, plasma and erythrocyte DHA concentrations were positively correlated with DHA dietary intake; corresponding correlation coefficients were 0.36, 0.36 and 0.24 for relative concentration and 0.33, 0.32, and 0.18 for absolute concentration (p < 0.05). The median DHA dietary intake varied significantly across areas (p < 0.05), which was highest in the coastland (24.32 mg/day), followed by lakeland (13.69 mg/day), and lowest in the inland (8.84 mg/day). The overall relative and absolute DHA concentrations in breast milk were 0.36% ± 0.23% and 141.49 ± 107.41 μg/mL; the concentrations were significantly lower in inland women than those from coastland and lakeland. We conclude that DHA dietary intake is positively correlated with DHA

Breast-feeding and benign breast disease.

PubMed

Bernardi, S; Londero, A P; Bertozzi, S; Driul, L; Marchesoni, D; Petri, R

2012-01-01

Benign breast disease (BBD) is very common among women in their fertile age, but its correlation with breast reproductive function remains unclear. Our study aimed to investigate the relation between BBD and breast-feeding. We collected data on 105 women with BBD and 98 controls, focusing on their reproductive history and breast-feeding. We analysed data by R (version 2.12.1) considering p < 0.05 as significant. The results showed that fibroadenoma represented the most frequent BBD (55%), followed by fibrocystic changes (19%), intraductal papilloma (6%) and inflammatory breast disorders (5%). The mean age was 31.5 years (± 6.1), BMI 21.2 kg/m² (± 3.4) and age at menarche 13.0 years (± 1.5). Duration of breast-feeding was not significantly different between controls and BBD types (p = NS). Selecting women with fibroadenoma breast-feeding duration directly correlated with the number of benign lesions (p < 0.05), which remains significant also by multivariate analysis. It was concluded that there seemed to be no difference in breast-feeding among BBDs types, but lactation may influence the number of fibroadenomas. Moreover, prospective studies would better define the correlation between lactation and BBDs.

Effectiveness of lactational amenorrhoea in prevention of pregnancy in Manila, the Philippines: non-comparative prospective trail.

PubMed

Ramos, R; Kennedy, K I; Visness, C M

1996-10-12

To determine the contraceptive efficacy of the lactational amenorrhoea method. Non-comparative prospective trial. Urban Manila, the Philippines. 485 lower income, educated women with extensive experience of breast feeding. Women were offered all available contraceptives for use after birth. Those who chose the lactational amenorrhoea method were taught the method, screened for the study, and followed for 12 months to determine the risk of pregnancy when the method was used. Life table pregnancy rates during correct and incorrect use of the method, censored monthly in the event of sexual abstinence or the use of another contraceptive method. The lactational amenorrhoea method was 99% effective when used correctly (that is, during lactational amenorrhoea and full or nearly full breast feeding for up to six months). At 12 months the effectiveness during amenorrhoea dropped to 97%. The lactational amenorrhoea method provided as much protection from pregnancy as non-breast feeding women experience with non-medicated intrauterine devices and barrier methods. The contraceptive effect of lactation cannot be attributed to lactational or postpartum abstinence.

Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis.

PubMed

Witt, Ann M; Bolman, Maya; Kredit, Sheila; Vanic, Anne

2016-02-01

Many women in developed countries do not meet their breastfeeding goals and wean early because of breast pain. This study aimed to describe clinical response to therapeutic breast massage in lactation (TBML) in the management of engorgement, plugged ducts, and mastitis. Breastfeeding women presenting with engorgement, plugged ducts, or mastitis who received TBML as part of their treatment were enrolled (n = 42). Data collected at the initial visit included demographic, history, and exam data pre-TBML and post-TBML. Email surveys sent 2 days, 2 weeks, and 12 weeks following the initial visit assessed pain and breastfeeding complications. A nested case control of engorged mothers (n = 73) was separately enrolled to compare engorgement severity. Reasons for the visit included engorgement (36%), plugged ducts (67%), and mastitis (29%). Cases, compared to controls, were significantly more likely to have severe engorgement (47% vs 7%, P < .001). Initial mean breast pain level among those receiving TBML was 6.4 out of 10. Following TBML, there was significant improvement in both breast (6.4 vs 2.8, P < .001) and nipple pain (4.6 vs 2.8, P = .013). All women reported immediate improvement in their pain level. At the 12-week survey, 65% found the massage treatment very helpful. The majority of the women with a new episode of mastitis or plugged duct during the study follow-up found the techniques learned during the office visit very helpful for home management of these episodes. In office, TBML is helpful for the reduction of acute breast pain associated with milk stasis. Mothers find TBML helpful both immediately in-office and for home management of future episodes. © The Author(s) 2015.

The Lactate Minimum Test: Concept, Methodological Aspects and Insights for Future Investigations in Human and Animal Models

PubMed Central

Messias, Leonardo H. D.; Gobatto, Claudio A.; Beck, Wladimir R.; Manchado-Gobatto, Fúlvia B.

2017-01-01

In 1993, Uwe Tegtbur proposed a useful physiological protocol named the lactate minimum test (LMT). This test consists of three distinct phases. Firstly, subjects must perform high intensity efforts to induce hyperlactatemia (phase 1). Subsequently, 8 min of recovery are allowed for transposition of lactate from myocytes (for instance) to the bloodstream (phase 2). Right after the recovery, subjects are submitted to an incremental test until exhaustion (phase 3). The blood lactate concentration is expected to fall during the first stages of the incremental test and as the intensity increases in subsequent stages, to rise again forming a “U” shaped blood lactate kinetic. The minimum point of this curve, named the lactate minimum intensity (LMI), provides an estimation of the intensity that represents the balance between the appearance and clearance of arterial blood lactate, known as the maximal lactate steady state intensity (iMLSS). Furthermore, in addition to the iMLSS estimation, studies have also determined anaerobic parameters (e.g., peak, mean, and minimum force/power) during phase 1 and also the maximum oxygen consumption in phase 3; therefore, the LMT is considered a robust physiological protocol. Although, encouraging reports have been published in both human and animal models, there are still some controversies regarding three main factors: (1) the influence of methodological aspects on the LMT parameters; (2) LMT effectiveness for monitoring training effects; and (3) the LMI as a valid iMLSS estimator. Therefore, the aim of this review is to provide a balanced discussion between scientific evidence of the aforementioned issues, and insights for future investigations are suggested. In summary, further analyses is necessary to determine whether these factors are worthy, since the LMT is relevant in several contexts of health sciences. PMID:28642717

Levels of coplanar PCBs in human breast milk at different times of lactation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonzalez, M.J.; Ramos, L.; Hernandez, L.M.

PCBs are a highly lipophilic group of global pollutants, consisting of 209 congeners which exhibit wide differences in their toxic and biological effects. The coplanar PCB (non-, mono- and di-ortho Chlorine substituted) congeners, the most toxic ones, induce similar toxic effects as 2,3,7,8 TCDD. Thus for risk assessment of exposure to PCBs, the analysis of these coplanar congeners is required. The PCB levels in human breast milk are of specific concern because of the potential health damage which may be caused to the nursing baby. The PCB levels in this sample come from previously accumulated quantities in body fat whosemore » principal source is food, and pass directly to the nursing baby who accumulates the PCBs in adipose tissue. The amount of total PCBs and other organochlorine compounds (OCC) in human milk at different time intervals after birth was reported earlier, but data concerning individual and coplanar PCBs are sparse in the literature. The results from some studies showed a gradual decrease of residual levels in milk and milk fat. However, other research has shown differences in this respect. We present our first result concerning the concentration of 14 individual PCBs (13 coplanars) in breast milk from the same mother, during weeks 8 to 12 of lactation. We related the different concentration variations observed among the individual PCBs to their molecular structure and % fat in human breast milk. 17 refs., 1 fig., 2 tabs.« less

Strontium biokinetic model for the lactating woman and transfer to breast milk: application to Techa River studies.

PubMed

Shagina, N B; Tolstykh, E I; Fell, T P; Smith, T J; Harrison, J D; Degteva, M O

2015-09-01

This paper presents a biokinetic model for strontium metabolism in the lactating woman and transfer to breast milk for members of Techa River communities exposed as a result of discharges of liquid radioactive wastes from the Mayak plutonium production facility (Russia) in the early 1950s. This model was based on that developed for the International Commission for Radiological Protection with modifications to account for population specific features of breastfeeding and maternal bone mineral metabolism. The model is based on a biokinetic model for the adult female with allowances made for changes in mineral metabolism during periods of exclusive and partial breast-feeding. The model for females of all ages was developed earlier from extensive data on (90)Sr-body measurements for Techa Riverside residents. Measurements of (90)Sr concentrations in the maternal skeleton and breast milk obtained in the1960s during monitoring of global fallout in the Southern Urals region were used for evaluation of strontium transfer to breast and breast milk. The model was validated with independent data from studies of global fallout in Canada and measurements of (90)Sr body-burden in women living in the Techa River villages who were breastfeeding during maximum (90)Sr-dietary intakes. The model will be used in evaluations of the intake of strontium radioisotopes in breast milk by children born in Techa River villages during the radioactive releases and quantification of (90)Sr retention in the maternal skeleton.

Association of polyunsaturated fatty acids in breast milk with fatty acid desaturase gene polymorphisms among Chinese lactating mothers.

PubMed

Ding, Zhen; Liu, Guo-Liang; Li, Xiang; Chen, Xue-Yan; Wu, Yi-Xia; Cui, Can-Can; Zhang, Xi; Yang, Guang; Xie, Lin

2016-06-01

The fatty acid desaturase (FADS) controls polyunsaturated fatty acid (PUFA) synthesis in human tissues and breast milk. Evaluate the influence of 10 single nucleotide polymorphisms (SNPs) and various haplotypes in the FADS gene cluster (FADS1, FADS2, FADS3) on PUFA concentration in the breast milk of 209 healthy Chinese women. PUFA concentrations were measured in breast milk using gas chromatography and genotyping was performed using the Sequenom Mass Array system. A SNP (rs1535) and 2-locus haplotypes (rs3834458-rs1535, rs1535-rs174575) in the FADS2 gene were associated with concentrations of γ-linoleic acid (GLA) and arachidonic acid (AA) in breast milk. Likewise, in the FADS1 gene, a 2-locus constructed haplotype (rs174547-rs174553) also affected GLA and AA concentration (P<0.05 for all). Minor allele carriers of the SNP and haplotypes described above had lower concentrations of GLA and AA. In the FADS2 gene, the 3-locus haplotype rs3834458-rs1535-rs174575, significantly affected concentrations of GLA but not AA. Pairwise comparison showed that individuals major homozygous for the SNP rs1000778 in the FADS3 gene had lower concentrations of ALA and linoleic acid (LA) in their breast milk. Polymorphisms in the FADS gene cluster influence PUFA concentrations in the breast milk of Chinese Han lactating women. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of DHA supplements during pregnancy on the concentration of PUFA in breast milk of Chinese lactating mothers.

PubMed

Deng, Juan; Li, Xiang; Ding, Zhen; Wu, Yixia; Chen, Xueyan; Xie, Lin

2017-05-24

To determine whether there is an effect of prenatal supplementation with docosahexaenoic acid (DHA) on the concentration of polyunsaturated fatty acids (PUFAs) in the breast milk of Chinese lactating women. A total of 409 participants were recruited at the postpartum care center during their 1-month postpartum care. They were assigned to the supplement group or the control group according to whether or not DHA supplements were taken during pregnancy. Dietary intake was assessed with a food frequency questionnaire (FFQ). Breast milk samples were collected on 1 day between the 22nd and 25th day postpartum and levels of eight kinds of fatty acids in the breast milk were measured by gas chromatography. DHA intake was divided into three levels (<57 mg/day, 57-185 mg/day and >185 mg/day). The concentration of DHA postpartum in the breast milk of the group receiving a DHA supplement >185 mg/day was significantly higher (P=0.003) compared to the control group. DHA intake >185 mg/day resulted in increased DHA concentrations in breast milk. This finding suggests that mothers with inadequate dietary intake of DHA should change their dietary habits to consume a diet rich in DHA or take sufficient DHA supplements to meet the average nutritional needs of infants.

Factors influencing breast feeding.

PubMed Central

McKean, K S; Baum, J D; Sloper, K

1975-01-01

A survey is reported of infant feeding practice at the time of discharge from a single maternity ward. It is shown that a change in the attitude of nursing staff increased the number of mothers breast feeding their infants and eliminated the practice of giving the infants formula feed complements. This change in attitude, however, did nothing to prevent the rapid decline in lactation after leaving hospital, such that 50% of mothers discharged breast feeding were no longer doing so by 2 months. The early introduction of solid feeds was common practice, 50% of mothers discharged breast feeding having introduced mixed feeds within 2 months. Successful lactation was found to be commoner in those mothers who had themselves been breast fed in infancy and in mothers from socioeconomic classes I and II. Successful lactation was not related to parity. The survey also shows the influential role of the health visitor, district nurse, and midwife upon mothers' decisions about infant feeding. PMID:1170810

Optical spectroscopic characteristics of lactate and mitochondrion as new biomarkers in cancer diagnosis: understanding Warburg effect

NASA Astrophysics Data System (ADS)

Liu, C.-H.; Ni, X. H.; Pu, Yang; Yang, Y. L.; Zhou, F.; Zuzolo, R.; Wang, W. B.; Masilamani, V.; Rizwan, A.; Alfano, R. R.

2012-01-01

Cancer cells display high rates of glycolysis even under normoxia and mostly under hypoxia. Warburg proposed this effect of altered metabolism in cells more than 80 years ago. It is considered as a hallmark of cancer. Optical spectroscopy can be used to explore this effect. Pathophysiological studies indicate that mitochondria of cancer cells are enlarged and increased in number. Warburg observed that cancer cells tend to convert most glucose to lactate regardless of the presence of oxygen. Previous observations show increased lactate in breast cancer lines. The focus of this study is to investigate the relative content changes of lactate and mitochondria in human cancerous and normal breast tissue samples using optical spectroscopic techniques. The optical spectra were obtained from 30 cancerous and 25 normal breast tissue samples and five model components (Tryptophan, fat, collagen, lactate and mitochondrion) using fluorescence, Stokes shift and Raman spectroscopy. The basic biochemical component analysis model (BBCA) and a set of algorithm were used to analyze the spectra. Our analyses of fluorescence spectra showed a 14 percent increase in lactate content and 2.5 times increase in mitochondria number in cancerous breast tissue as compared with normal tissue. Our findings indicate that optical spectroscopic techniques may be used to understand Warburg effect. Lactate and mitochondrion content changes in tumors examined using optical spectroscopy may be used as a prognostic molecular marker in clinic applications.

Induction of lactation in the intended mother of a surrogate pregnancy: case report.

PubMed

Biervliet, F P; Maguiness, S D; Hay, D M; Killick, S R; Atkin, S L

2001-03-01

A case of a successful induction of lactation in a commissioning mother of a surrogate pregnancy is reported. Induction of lactation was achieved with oral metoclopramide which was well tolerated. Alternative methods to induce lactation are reviewed. The advantages of breast-feeding and the relative ease with which lactation can be induced after a surrogate pregnancy would suggest that this could be offered to all commissioning mothers.

Postpartum anxiety and breast feeding.

PubMed

Britton, John R

2007-08-01

To evaluate the relationship between postpartum anxiety and lactation experience, knowledge, confidence and performance. State anxiety was measured among breast-feeding women by the State Trait Anxiety Inventory before hospital discharge and at 1 month postpartum. Breast-feeding experience and knowledge were assessed by focused questions and confidence by the Breastfeeding Confidence Scale. Breast-feeding performance measures included breast-feeding immediately after delivery; formula supplementation in the hospital; full, exclusive breast-feeding; and breast-feeding termination at 1 month postpartum. Predischarge anxiety correlated inversely with breast-feeding confidence (r [339] = -0.27, p = 0.000) but not with experience or knowledge. As compared to low-anxiety mothers, those with high anxiety were less likely to breast-feed after delivery (53.0% vs. 65.1%, p = 0.049) and more likely to give their infants formula (43.9% vs. 29.1%, p = 0.022). In logistic regression models adjusting for demographic and social factors, high-anxiety mothers were less likely to practice full, exclusive breast-feeding (AOR = 0.39; 95% CI 0.20, 0.74; p < 0.005) and more likely to have terminated breastfeeding at 1 month (AOR = 4.40; 95% CI 1.70, 11.33; p < 0.005). Postpartum anxiety may be associated with reduced breast-feeding confidence and lactation performance. Awareness of this association may be helpful in identifying women at risk for lactation failure and targeting efforts to promote breast-feeding.

Selenium and breast-feeding.

PubMed

Dorea, Jose G

2002-11-01

The objective of the present review is to discuss Se nutrition during breast-feeding, encompassing environmental and maternal constitutional factors affecting breast-milk-Se metabolism and secretion. A literature search of Medline and Webofscience was used to retrieve and select papers dealing with Se and breast milk. Although Se in natural foods occurs only in organic form, breast milk responds to organic and inorganic Se in supplements. Inorganic Se (selenite, selenate), which is largely used in maternal supplements, is not detectable in breast milk. The mammary-gland regulating mechanism controls the synthesis and secretion of seleno-compounds throughout lactation, with a high total Se level in colostrum that decreases as lactation progresses. Se appears in breast milk as a component of specific seleno-proteins and seleno-amino-acids in milk proteins that are well tolerated by breast-fed infants even in high amounts. Se in breast milk occurs as glutathione peroxidase (4-32 % total Se) > selenocystamine > selenocystine > selenomethionine. The wide range of breast-milk Se concentrations depends on Se consumed in natural foods, which reflects the Se content of the soils where they are grown. Se prophylaxis, either through soil Se fertilization or maternal supplements, is effective in raising breast-milk Se concentration. In spite of wide variation, the median Se concentration from studies worldwide are 26, 18, 15, and 17 microg/l in colostrum (0-5 d), transitional milk (6-21 d), mature milk (1-3 months) and late lactation (>5 months) respectively. Se recommendations for infants are presently not achieved in 30 % of the reported breast-milk Se concentrations; nevertheless Se status is greater in breast-fed than in formula-fed infants.

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

PubMed

Rose, Micah; Rice, Stephen; Craig, Dawn

2018-06-01

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Methodology based on genetic heuristics for in-vivo characterizing the patient-specific biomechanical behavior of the breast tissues.

PubMed

Lago, M A; Rúperez, M J; Martínez-Martínez, F; Martínez-Sanchis, S; Bakic, P R; Monserrat, C

2015-11-30

This paper presents a novel methodology to in-vivo estimate the elastic constants of a constitutive model proposed to characterize the mechanical behavior of the breast tissues. An iterative search algorithm based on genetic heuristics was constructed to in-vivo estimate these parameters using only medical images, thus avoiding invasive measurements of the mechanical response of the breast tissues. For the first time, a combination of overlap and distance coefficients were used for the evaluation of the similarity between a deformed MRI of the breast and a simulation of that deformation. The methodology was validated using breast software phantoms for virtual clinical trials, compressed to mimic MRI-guided biopsies. The biomechanical model chosen to characterize the breast tissues was an anisotropic neo-Hookean hyperelastic model. Results from this analysis showed that the algorithm is able to find the elastic constants of the constitutive equations of the proposed model with a mean relative error of about 10%. Furthermore, the overlap between the reference deformation and the simulated deformation was of around 95% showing the good performance of the proposed methodology. This methodology can be easily extended to characterize the real biomechanical behavior of the breast tissues, which means a great novelty in the field of the simulation of the breast behavior for applications such as surgical planing, surgical guidance or cancer diagnosis. This reveals the impact and relevance of the presented work.

Challenges in the treatment of lactational mastitis for general practitioners.

PubMed

Topić, Zeljka; Amir, Lisa H; Zakarija-Grković, Irena

2015-11-01

To determine how GPs manage breastfeeding women with mastitis and how confident they are in treating women with breast conditions that occur during lactation. A cross-sectional survey conducted among all Croatian GPs. Sixty-four per cent of the total number of respondents (171/268) had seen a patient with lactational mastitis (LM) in the previous 12 months. Among respondents who recommended medication for the treatment of LM, 93% prescribed an antibiotic (122/131). Fifteen per cent of respondents who gave advice on infant feeding advised alternative feeding methods. Approximately half (47%) felt completely confident when treating LM while more than half (57%) felt partially confident when treating other breast conditions that can occur during lactation. The management of LM among Croatian GPs is not in full compliance with current recommendations. FUTURE IMPLICATIONS: There is a need for further training of Croatian GPs in the management of mastitis.

Breast Gangrene

PubMed Central

2011-01-01

Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement. PMID:21854557

Comparison of breast-milk iodine concentration of lactating women in Australia pre and post mandatory iodine fortification.

PubMed

Huynh, Dao; Condo, Dominique; Gibson, Robert; Makrides, Maria; Muhlhausler, Beverly; Zhou, Shao Jia

2017-01-01

To compare the breast-milk iodine concentrations (BMIC) of lactating women before and after the mandatory iodine fortification of bread in Australia in 2009. Cross-sectional study. Breast milk samples were collected from two cohorts of women in South Australia within 7 d of delivery to determine BMIC. The percentage of samples with iodine concentration below 100 µg/l, a level considered adequate for breast-fed infants, was calculated. Sociodemographic information and intake of dietary supplements were obtained from all women. The breast milk samples were collected between 2006 and 2007 in the pre-fortification cohort and between 2012 and 2013 in the post-fortification cohort. The median (interquartile range) BMIC was higher in the post-fortification samples compared with samples collected in the pre-fortification period (187 (130-276) v. 103 (73-156) µg/l; P<0·05). Overall, the percentage of women with BMIC <100 µg/l was lower in the post-fortification cohort than in the pre-fortification cohort (13 v. 49 %; P<0·01). The percentage of women with BMIC <100 µg/l in the post-fortification cohort was lower among women who took iodine supplements in pregnancy (12 v. 29 %; P<0·01). Mandatory iodine fortification of bread has resulted in an increase in the iodine content of breast milk in Australian women. However, iodine supplementation may still be required in some women post-iodine fortification to reach the level of BMIC that is considered adequate to meet the iodine requirement of full-term infants.

Lactate dehydrogenase downregulation mediates the inhibitory effect of diallyl trisulfide on proliferation, metastasis, and invasion in triple-negative breast cancer.

PubMed

Cheng, Shi-Yann; Yang, Yao-Chih; Ting, Kuan-Lun; Wen, Su-Ying; Viswanadha, Vijaya Padma; Huang, Chih-Yang; Kuo, Wei-Wen

2017-04-01

The Warburg effect plays a critical role in tumorigenesis, suggesting that specific agents targeting Warburg effect key proteins may be a promising strategy for cancer therapy. Previous studies have shown that diallyl trisulfide (DATS) inhibits proliferation of breast cancer cells by inducing apoptosis in vitro and in vivo. However, whether the Warburg effect is involved with the apoptosis-promoting action of DATS is unclear. Here, we show that the action of DATS is associated with downregulation of lactate dehydrogenase A (LDHA), an essential protein of the Warburg effect whose upregulation is closely related to tumorigenesis. Interestingly, inhibition of the Warburg effect by DATS in breast cancer cells did not greatly affect normal cells. Furthermore, DATS inhibited growth of breast cancer cells, particularly in MDA-MB-231, a triple-negative breast cancer (TNBC) cell, and reduced proliferation and migration; invasion was reversed by over-expression of LDHA. These data suggest that DATS inhibits breast cancer growth and aggressiveness through a novel pathway targeting the key enzyme of the Warburg effect. Our study shows that LDHA downregulation is involved in the apoptotic effect of DATS on TNBC. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1390-1398, 2017. © 2016 Wiley Periodicals, Inc.

Methodology based on genetic heuristics for in-vivo characterizing the patient-specific biomechanical behavior of the breast tissues

PubMed Central

Lago, M. A.; Rúperez, M. J.; Martínez-Martínez, F.; Martínez-Sanchis, S.; Bakic, P. R.; Monserrat, C.

2015-01-01

This paper presents a novel methodology to in-vivo estimate the elastic constants of a constitutive model proposed to characterize the mechanical behavior of the breast tissues. An iterative search algorithm based on genetic heuristics was constructed to in-vivo estimate these parameters using only medical images, thus avoiding invasive measurements of the mechanical response of the breast tissues. For the first time, a combination of overlap and distance coefficients were used for the evaluation of the similarity between a deformed MRI of the breast and a simulation of that deformation. The methodology was validated using breast software phantoms for virtual clinical trials, compressed to mimic MRI-guided biopsies. The biomechanical model chosen to characterize the breast tissues was an anisotropic neo-Hookean hyperelastic model. Results from this analysis showed that the algorithm is able to find the elastic constants of the constitutive equations of the proposed model with a mean relative error of about 10%. Furthermore, the overlap between the reference deformation and the simulated deformation was of around 95% showing the good performance of the proposed methodology. This methodology can be easily extended to characterize the real biomechanical behavior of the breast tissues, which means a great novelty in the field of the simulation of the breast behavior for applications such as surgical planing, surgical guidance or cancer diagnosis. This reveals the impact and relevance of the presented work. PMID:27103760

Non-Hodgkin's lymphoma of the breast presenting as breast abscess during pregnancy.

PubMed

Sultan, Naheed; Khalid, Mahvesh; Khan, Sarah Rafi; Khan, Fahadullah

2012-10-01

Primary non-Hodgkin's lymphoma of the breast is an uncommon disease. In all patients with breast lump, primary lymphoma of breast should be considered as it is one of the most easily missed pathology. We report a case of a 22 years old lactating mother who presented with the complaint of a painful swelling in the right breast, noticed during the last trimester of her pregnancy, mimicking breast abscess.

Negative-pressure Wound Therapy in Chronic Inflammatory Breast Diseases

PubMed Central

Namdaroğlu, Ozan Barış; Yazıcı, Hilmi; Öztürk, Ahmet Mücteba; Yakan, Savaş; Yıldırım, Mehmet; Uçar, Ahmet Deniz; Erkan, Nazif

2016-01-01

Mastitis is inflammation of breast tissue that may or may not originate from an infection. Two different forms of mastitis have been described, lactational and non-lactational. Lactational mastitis is the most common type and generally conservative therapy that includes milk removal and physical therapy provides symptomatic relief, but antibiotic therapy is also needed. Common types of non-lactational mastitis are periductal mastitis and idiopathic granulomatous mastitis. Treatment includes antibiotics, drainage, and surgery, but usually this is a chronic process and a therapeutic management algorithm for chronic breast inflammation is unclear and has no consensus. Negative-pressure wound therapy is commonly used for various types of wounds but is limited for breast wounds. In this report, we present and discuss two patients with chronic breast inflammation who underwent surgery and were successfully treated using negative-pressure wound therapy to minimize wide tissue defects and cosmetic problems after surgery. Use of negative-pressure wound therapy for breast wounds might be benefical as it is with other wounds but there is scarce information in the literature PMID:28331742

Effect of pumping pressure on onset of lactation after caesarean section: A randomized controlled study.

PubMed

Zhang, Feng; Yang, Yahui; Bai, Ting; Sun, Lele; Sun, Mingzhu; Shi, Xueling; Zhu, Meng; Ge, Meijuan; Xia, Haiou

2018-01-01

Caesarean section is associated with weaker newborn suction pressure. This nonblinded, randomized trial explored the effect of suction pressures generating by a breast pump on mothers' onset of lactation and milk supply after caesarean section. A high pressure group (-150 mmHg), a low pressure group (-100 mmHg), and a control group (none) were generated under computer random assignment with concealed allocation in 2 tertiary hospitals. The breast pumping began within 2 hr after caesarean operation (6 times a day and 30 min per time) until onset of lactation. The primary outcomes were the timing of onset of lactation, milk supply, and mother's satisfaction in lactation, using both intention-to-treat and per-protocol analyses. The secondary endpoints were the pumping-related pain, nipple injury, and maternal fatigue. All 164 women randomized were included in analysis. The breast pumping at -150 mmHg optimally advanced the timing of the onset of lactation and increased daytime milk supply. The pumping also appeared to boost mothers' confidence in lactation. The results in the per-protocol population (n = 148) were consistent with those of intention-to-treat population (n = 164). However, the pumping aggravated maternal nipple pain and fatigue, though there was no statistical significance. The findings suggest that a higher pumping pressure within the range of normal vaginally born infant suction could promote onset of lactation and milk supply among mothers giving birth by caesarean section. The pumping could also enhance mothers' confidence in breastfeeding. © 2017 John Wiley & Sons Ltd.

An infrared image based methodology for breast lesions screening

NASA Astrophysics Data System (ADS)

Morais, K. C. C.; Vargas, J. V. C.; Reisemberger, G. G.; Freitas, F. N. P.; Oliari, S. H.; Brioschi, M. L.; Louveira, M. H.; Spautz, C.; Dias, F. G.; Gasperin, P.; Budel, V. M.; Cordeiro, R. A. G.; Schittini, A. P. P.; Neto, C. D.

2016-05-01

The objective of this paper is to evaluate the potential of utilizing a structured methodology for breast lesions screening, based on infrared imaging temperature measurements of a healthy control group to establish expected normality ranges, and of breast cancer patients, previously diagnosed through biopsies of the affected regions. An analysis of the systematic error of the infrared camera skin temperature measurements was conducted in several different regions of the body, by direct comparison to high precision thermistor temperature measurements, showing that infrared camera temperatures are consistently around 2 °C above the thermistor temperatures. Therefore, a method of conjugated gradients is proposed to eliminate the infrared camera direct temperature measurement imprecision, by calculating the temperature difference between two points to cancel out the error. The method takes into account the human body approximate bilateral symmetry, and compares measured dimensionless temperature difference values (Δ θ bar) between two symmetric regions of the patient's breast, that takes into account the breast region, the surrounding ambient and the individual core temperatures, and doing so, the results interpretation for different individuals become simple and non subjective. The range of normal whole breast average dimensionless temperature differences for 101 healthy individuals was determined, and admitting that the breasts temperatures exhibit a unimodal normal distribution, the healthy normal range for each region was considered to be the dimensionless temperature difference plus/minus twice the standard deviation of the measurements, Δ θ bar ‾ + 2σ Δ θ bar ‾ , in order to represent 95% of the population. Forty-seven patients with previously diagnosed breast cancer through biopsies were examined with the method, which was capable of detecting breast abnormalities in 45 cases (96%). Therefore, the conjugated gradients method was considered effective

A survey on difficulties and desires of breast-feeding women in Wuhan, China.

PubMed

Ouyang, Yan-Qiong; Su, Min; Redding, Sharon R

2016-06-01

exclusive breast feeding in China is relatively low and no research has been conducted to explore the difficulties and desires of Chinese lactating mothers. Currently, Chinese women turn to massage therapists to increase breastmilk volume, implying that many breast-feeding women faced problems but had few support mechanisms.This study aimed to explore the difficulties and desires of Chinese breast-feeding women and to propose strategies for increasing the rate of exclusive breast feeding. three hundred and seventy-five primiparous women were recruited from two randomized cluster communities in Wuhan following ethical approval. Face-to-face semistructured interviews were conducted with 76 of the participants to collect data on their infants' feeding status, duration of exclusive breast feeding, reasons for stopping, difficulties encountered, and sources of support for lactation. the breast feeding initiation rate was 93.6%, but exclusive breast feeding was only 6.2% at six months. The most frequently cited reason for giving up exclusive breast feeding was perceived breastmilk insufficiency. Women cited a desire for professional and individualised instruction from following resources: (1) lactation consultants in hospital and communities; (2) Qualified cuirushi; (3) breast feeding website;(4) Relatives, friends and peers;(5) Telephone hotline. to improve the rate and duration of exclusive breast feeding in China, effective and available resources must be available. Timely,professional and face-to-face lactation counselling such as lactation consultant, qualified cuirushin is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Maternal defense: breast feeding increases aggression by reducing stress.

PubMed

Hahn-Holbrook, Jennifer; Holt-Lunstad, Julianne; Holbrook, Colin; Coyne, Sarah M; Lawson, E Thomas

2011-10-01

Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lactating humans. Breast-feeding mothers inflicted louder and longer punitive sound bursts on unduly aggressive confederates than did formula-feeding mothers or women who had never been pregnant. Maternal aggression in other mammals is thought to be facilitated by the buffering effect of lactation on stress responses. Consistent with the animal literature, our results showed that while lactating women were aggressing, they exhibited lower systolic blood pressure than did formula-feeding or never-pregnant women while they were aggressing. Mediation analyses indicated that reduced arousal during lactation may disinhibit female aggression. Together, our results highlight the contributions of breast feeding to both protecting infants and buffering maternal stress.

Maternal Defense: Breast Feeding Increases Aggression by Reducing Stress

PubMed Central

Hahn-Holbrook, Jennifer; Holt-Lunstad, Julianne; Holbrook, Colin; Coyne, Sarah M.; Lawson, E. Thomas

2012-01-01

Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lactating humans. Breast-feeding mothers inflicted louder and longer punitive sound bursts on unduly aggressive confederates than did formula-feeding mothers or women who had never been pregnant. Maternal aggression in other mammals is thought to be facilitated by the buffering effect of lactation on stress responses. Consistent with the animal literature, our results showed that while lactating women were aggressing, they exhibited lower systolic blood pressure than did formula-feeding or never-pregnant women while they were aggressing. Mediation analyses indicated that reduced arousal during lactation may disinhibit female aggression. Together, our results highlight the contributions of breast feeding to both protecting infants and buffering maternal stress. PMID:21873570

A maternal high n-6 fat diet with fish oil supplementation during pregnancy and lactation in rats decreases breast cancer risk in the female offspring.

PubMed

Su, Hui-Min; Hsieh, Pei-Hsuan; Chen, Hui-Feng

2010-11-01

The timing of dietary fat intake may modify breast cancer risk. In addition, n-3 fatty acids reduce, and n-6 fatty acids increase, the risk of breast cancer and a maternal high n-6 fat diet results in a greater risk of breast cancer in the female offspring. We hypothesized that the timing of n-3 fatty acid-enriched fish oil supplementation would be important for reducing the risk of breast cancer. Female rats were fed to a high n-6 fat diet containing 20% of the sunflower oil by weight during pregnancy and lactation, and the female offspring were exposed to fish oil by oral gavage either during the perinatal period via maternal intake or during puberty or adulthood. Exposure during the perinatal period to a maternal high n-6 fat diet with fish oil supplementation significantly reduced the incidence of carcinogen-induced mammary tumors in the female offspring compared to a maternal high n-6 fat diet with no fish oil supplementation or fish oil supplementation later in life (P=.0228 by Cox proportional hazards model). We found that a maternal high n-6 fat diet during pregnancy is more important in increasing the risk of mammary tumors in the female offspring than a maternal high n-6 fat diet during lactation. This study suggests that fish oil supplementation during the perinatal period decreases the effect of a maternal high n-6 fat diet on subsequent carcinogen-induced mammary tumor risk, whereas fish oil supplementation during puberty or adulthood does not. Copyright © 2010 Elsevier Inc. All rights reserved.

Breast Abscess

PubMed Central

Ajao, Oluwole G.; Ajao, Adebola O.

1979-01-01

Breast abscess is a relatively important disease in the tropics, and yet this condition has received little attention in the literature. Breast abscess encourages artificial feeding, which in many instances may be responsible for gastroenteritis in infants. This occurs when foods are not properly prepared by mothers of low socioeconomic class with inadequate sanitation. Breast abscess occurs primarily in the lactating breast and is most commonly located in the upper half of the breast. The organism most commonly present in the pus is Staphylococcus aureus. When the abscess is localized, it may present with all the clinical features of a breast carcinoma. PMID:522185

Infant acceptance of breast milk after maternal exercise.

PubMed

Wright, Kc S; Quinn, Timothy J; Carey, Gale B

2002-04-01

Previous research reported that breast milk lactic acid (LA) levels increase after lactating women complete a bout of exhaustive exercise, resulting in poor infant acceptance of the postexercise breast milk. This highly publicized finding may not apply to more practical, everyday exercise conditions of lactating women. The purpose of the present study was to reexamine the composition and infant acceptance of postexercise breast milk while controlling maternal diet, exercise intensity, and the method, timing, and assessment of infant feeding. Twenty-four women, 2 to 4 months' postpartum, completed 3 test sessions: a maximal oxygen uptake test, a 30-minute bout of moderate exercise, and a resting control session. One hour before and 1 hour after each session, participants fully expressed their milk, placed it in a bottle familiar to the infant, fed their infant, and rated their infant's acceptance of the milk. Each feeding was videotaped and viewed individually by 3 lactation consultants who rated infant acceptance; consultants were blinded to the test sessions. Milk was analyzed for LA and infant milk consumption was measured. There were no differences in presession versus postsession values for maternal skin temperature, breast milk temperature, and infant milk acceptance as judged by either the mothers or lactation consultants. These results prevailed despite a small but significant increase in breast milk LA premaximal versus postmaximal exercise (0.09 vs 0.21 mM, respectively); there was no difference in milk LA premoderate versus postmoderate exercise, or prerest versus postrest. These data support the hypothesis that moderate or even high-intensity exercise during lactation does not impede infant acceptance of breast milk consumed 1 hour postexercise.

Lactation studies of anticonvulsants: a quality review

PubMed Central

van der Meer, Douwe H; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; ter Horst, Peter G J

2015-01-01

AIM The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. METHODS We reviewed the quality of the available lactation studies for 19 anticonvulsants against the guidelines of the Food and Drug Administration (FDA) and the International Lactation Consultant Association (ILCA). RESULTS Except for one study on lamotrigine and one case report on gabapentin, no study on anticonvulsants had both the absolute infant dose (AID) and milk to plasma ratio (M : P) correctly assessed. Only one study on carbamazepine, phenytoin and vigabatrin was found that correctly assessed the AID. The main cause for this low number is the lack of essential details in published studies, since 25 of 62 studies were case reports, letters or abstracts. Other major shortcomings were the lack of information on sampling methods, the number of samples in a particular dose interval as well as the low number of study participants. CONCLUSION The quality of the current literature on the transfer of anticonvulsants to breast milk is low, except for lamotrigine, which makes it hard to draw conclusions about the safety of the use of anticonvulsants during the lactation period. Therefore, further research is needed. PMID:25291358

Lactation studies of anticonvulsants: a quality review.

PubMed

van der Meer, Douwe H; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; Ter Horst, Peter G J

2015-04-01

The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. We reviewed the quality of the available lactation studies for 19 anticonvulsants against the guidelines of the Food and Drug Administration (FDA) and the International Lactation Consultant Association (ILCA). Except for one study on lamotrigine and one case report on gabapentin, no study on anticonvulsants had both the absolute infant dose (AID) and milk to plasma ratio (M : P) correctly assessed. Only one study on carbamazepine, phenytoin and vigabatrin was found that correctly assessed the AID. The main cause for this low number is the lack of essential details in published studies, since 25 of 62 studies were case reports, letters or abstracts. Other major shortcomings were the lack of information on sampling methods, the number of samples in a particular dose interval as well as the low number of study participants. The quality of the current literature on the transfer of anticonvulsants to breast milk is low, except for lamotrigine, which makes it hard to draw conclusions about the safety of the use of anticonvulsants during the lactation period. Therefore, further research is needed. © 2014 The British Pharmacological Society.

[Food intakes in breast-feeding mothers].

PubMed

Savino, F; Bermond, S; Bonfante, G; Gallo, E; Oggero, R

2001-06-01

The relation between mother's diet and breastmilk composition is still an open issue. Nutritional inadequacies during lactation may affect the well-being of both the mother and the infant. For this reason breast feeding women usually pay attention about their alimentary practices and about their style of life during breast-feeding period. This research was conducted to verify the adequacy of lactating mother's diet in comparison with the Italian recommended daily assumption levels of nutrients (LARN 1996) for this category. We have also compared food intake of not breast feeding mothers with the LARN, and analyzed the differences between these groups of mothers. Forty-eight healthy infants were selected, 23 bottle fed, 25 breast fed. Mothers's diet in the previous 48 hours was investigated using a structured questionnaire. The data collected were processed using software Dietosystem to obtain the daily nutrient intakes. The wetnurses's diet in comparison with the LARN 1996 resulted hypocaloric and hyperproteic, deficient in Calcium, Iron, folic acid and vitamin E. Surprisingly not breast feeding mothers's intake of nutrients is closer to LARN levels than that of breast feeding mothers. Mothers are not informed enough about their alimentation during lactating period. Pediatricians must improve their knowledge about this subject and give the mothers the information they need to achieve the recommended food requirements.

Breastfeeding and Prolactin Levels in Lactating Women With a Family History of Alcoholism

PubMed Central

Mennella, Julie A.; Pepino, Marta Yanina

2010-01-01

OBJECTIVE Many motivated new mothers fail to reach public health goals for breastfeeding, highlighting the need to identify risk factors. Because having a family history of alcoholism is associated with blunted prolactin responses to an alcohol challenge in nonlactating individuals, this study aimed to identify associations in family history of alcoholism, prolactin, and breastfeeding behaviors in lactating women. METHODS This was a 2-day experimental study that used within-subject alcohol or control beverage consumption and between-subject family history of alcoholism factors. The participants were non–alcohol-dependent lactating women; 7 were family history–positive (FHP) for alcohol dependence, and 21 were family history–negative (FHN). Consumption of 0.4 g/kg alcohol or nonalcoholic beverage occurred in separate randomized sessions, followed by use of a breast pump. Basal and suckling-induced prolactin, blood alcohol concentrations, milk yield, self-reported drug effects, neophobia, and breastfeeding patterning were measured. RESULTS Although no group differences in alcohol pharmacokinetics were detected, FHP women exhibited blunted prolactin to breast stimulation after drinking the control and alcohol beverage and felt more of the stimulant-like effects of alcohol than did FHN women. FHP women reported more frequent daily breastfeeding than did FHN women. CONCLUSIONS This is the first evidence that family history of alcoholism is associated with a blunted magnitude, rapidity, and duration of the prolactin response to breast stimulation and an alcohol challenge in lactating women. More frequent breastfeeding by FHP women suggests behavioral compensation for perceived and/or actual poor lactation. Alcohol did not enhance lactational performance, further disputing the lore that alcohol is a galactagogue. PMID:20403941

The effect of extracellular alkalinization on lactate metabolism of breast cancer stem cells: Overview of LDH-A, LDH-B, MCT1 and MCT4 gene expression

NASA Astrophysics Data System (ADS)

Neolaka, G. M. G.; Yustisia, I.; Sadikin, M.; Wanandi, S. I.

2017-08-01

Changes in the metabolic status of cancer cells are presumed to be correlated with the adjustment of these cells to extracellular changes. Cell glycolysis increases the production of intracellular lactate catalyzed by the lactate dehydrogenases, both LDH-A and LDH-B. An increase in intracellular lactate can affect extracellular pH balance through monocarboxylate transporters, particularly MCT1 and MCT4. This study aimed to analyze the effects of extracellular alkalinization on the lactate metabolism of human breast cancer stem cells (BCSCs). In this study, human primary BCSCs (CD24-/CD44+ cells) were treated with 100 mM sodium bicarbonate for 0.5, 24, and 48 h in DMEM F12/HEPES. After incubation, extracellular pH was measured and cells were harvested to extract the total RNA and protein. The expression of LDH-A, LDH-B, MCT1, and MCT4 mRNA genes were analyzed using qRT-PCR method. Our study shows that administration of sodium bicarbonate in the BCSC culture medium could increase extracellular pH. To balance the increase of extracellular pH, BCSCs regulated the expression of LDH-A, LDH-B, MCT1, and MCT4 genes. As the extracellular pH increases, the expression of LDH-A that converts pyruvate to lactate increased along with the increase of MCT 4 and MCT 1 expression, which act as lactate transporters. As the incubation time increases, the pH decreases, leading to the suppression of LDH-A and increase of LDH-B expression that converts lactate into pyruvate. Therefore, we suggest that the extracellular alkalinization by sodium bicarbonate in BCSCs affected the genes that regulate lactate metabolism.

The Secretion of Areolar (Montgomery's) Glands from Lactating Women Elicits Selective, Unconditional Responses in Neonates

PubMed Central

Doucet, Sébastien; Soussignan, Robert; Sagot, Paul; Schaal, Benoist

2009-01-01

Background The communicative meaning of human areolae for newborn infants was examined here in directly exposing 3-day old neonates to the secretion from the areolar glands of Montgomery donated by non related, non familiar lactating women. Methodology/Principal Findings The effect of the areolar stimulus on the infants' behavior and autonomic nervous system was compared to that of seven reference stimuli originating either from human or non human mammalian sources, or from an arbitrarily-chosen artificial odorant. The odor of the native areolar secretion intensified more than all other stimuli the infants' inspiratory activity and appetitive oral responses. These responses appeared to develop independently from direct experience with the breast or milk. Conclusion/Significance Areolar secretions from lactating women are especially salient to human newborns. Volatile compounds carried in these substrates are thus in a position to play a key role in establishing behavioral and physiological processes pertaining to milk transfer and production, and, hence, to survival and to the early engagement of attachment and bonding. PMID:19851461

Albendazole and its metabolites in the breast milk of lactating women following a single oral dose of albendazole

PubMed Central

Abdel-tawab, Ahmed M; Bradley, Mark; Ghazaly, Essam A; Horton, John; El-Setouhy, Maged

2009-01-01

AIMS Albendazole (ABZ) is used in several anthelminthic drug programmws. ABZ side-effects are generally mild, but ABZ-induced pancytopenia may be serious. In filariasis programmes, it may be necessary to administer ABZ to breastfeeding women. Few data are available on safety of ABZ for breastfed infants. In addition, the pharmacokinetics of ABZ and its metabolites in human milk is insufficiently investigated. The aim was to study pharmacokinetics of ABZ and its metabolites [ABZ sulphoxide (ABSX) and ABZ sulphone] in the breast milk lactating women after one single oral dose of ABZ. METHODS Thirty-three lactating women (age 18–40 years) participated in the study. They received a single oral 400-mg dose of ABZ. Five milk samples were taken at 0, 6, 12, 24 and 36 h. One serum sample was taken after 6 h. Samples were analysed using high-performance liquid chromatography and pharmacokinetic analysis was performed. RESULTS ABZ was detectable in milk samples 6 h after the oral dose. The mean concentration of serum ABZ was 63.7 ± 11.9 ng ml−1. The pharmacokinetic parameters for ABSX were calculated as follows: 351.9 ± 32.4 ng ml−1, 6.9 ± 0.5 h, 12.4 ± 2.2 h and 5190.3 ± 482.8 ng*h ml−1 for Cmax, Tmax, t½ and AUC0–36, respectively. The milk-to-serum ratios (range) for ABZ and ABSX were 0.9 (0.2–6.5) and 0.6 (0.1–1.5), respectively. CONCLUSIONS After an oral dose of 400 mg, ABZ and ABSX attain low concentrations in breast milk that are unlikely to be considered harmful for the breastfed infant. PMID:19916998

An obesity-dependent lactation defect in the viable yellow agouti mouse is associated with mammary inflammation

USDA-ARS?s Scientific Manuscript database

Maternal obesity is known to delay lactogenesis in breast-feeding women, as well as negatively impact lactation in other species. Obesity is also understood to be associated with inflammation. Work with the viable yellow agouti (Avy) mouse in our laboratory has documented a lactation defect in obese...

Evaluation of the effect of natural and emotional stress of labor on lactation and breast-feeding.

PubMed

Dimitraki, Marina; Tsikouras, Panagiotis; Manav, Bachar; Gioka, Theodora; Koutlaki, Nikoletta; Zervoudis, Stefanos; Galazios, Georgios

2016-02-01

The amount of stress experienced by both the mother and fetus during labor and delivery varies considerably and is likely to be different in primiparous and multiparous women as well as in those who receive analgesia during labor and those who do not receive. In this study, we explored relations between stress during birth experience and lactogenesis of 100 women, who experienced vaginal delivery in Department of Obstetrics and Gynecology of University Hospital of Alexandroupolis. Stress hormones (cortisol and glucose) were measured in serum (cord and maternal blood) immediately after delivery. Moreover, breast-feeding frequency on day 4, the time when the subjects first felt fullness in the breasts, milk volume on day 4 postpartum and duration of labor were recorded. Also, we recorded maternal exhaustion score during labor and positive and negative affects, posttraumatic stress score and mother-infant bonding rate, with the use of questionnaires. There were significant intercorrelations among the outcome variables. Mothers who experienced pain, exhaustion and negative feelings in a stressful and long labor had delayed onset of lactation. These results indicate that primiparity, long labor, stress to the mother and fetus during labor and delivery, negative affects and high score of posttraumatic stress are risk factors for delayed lactogenesis.

Dietary Iodine Sufficiency and Moderate Insufficiency in the Lactating Mother and Nursing Infant: A Computational Perspective

PubMed Central

Fisher, W.; Wang, Jian; George, Nysia I.; Gearhart, Jeffery M.; McLanahan, Eva D.

2016-01-01

The Institute of Medicine recommends that lactating women ingest 290 μg iodide/d and a nursing infant, less than two years of age, 110 μg/d. The World Health Organization, United Nations Children’s Fund, and International Council for the Control of Iodine Deficiency Disorders recommend population maternal and infant urinary iodide concentrations ≥ 100 μg/L to ensure iodide sufficiency. For breast milk, researchers have proposed an iodide concentration range of 150–180 μg/L indicates iodide sufficiency for the mother and infant, however no national or international guidelines exist for breast milk iodine concentration. For the first time, a lactating woman and nursing infant biologically based model, from delivery to 90 days postpartum, was constructed to predict maternal and infant urinary iodide concentration, breast milk iodide concentration, the amount of iodide transferred in breast milk to the nursing infant each day and maternal and infant serum thyroid hormone kinetics. The maternal and infant models each consisted of three sub-models, iodide, thyroxine (T4), and triiodothyronine (T3). Using our model to simulate a maternal intake of 290 μg iodide/d, the average daily amount of iodide ingested by the nursing infant, after 4 days of life, gradually increased from 50 to 101 μg/day over 90 days postpartum. The predicted average lactating mother and infant urinary iodide concentrations were both in excess of 100 μg/L and the predicted average breast milk iodide concentration, 157 μg/L. The predicted serum thyroid hormones (T4, free T4 (fT4), and T3) in both the nursing infant and lactating mother were indicative of euthyroidism. The model was calibrated using serum thyroid hormone concentrations for lactating women from the United States and was successful in predicting serum T4 and fT4 levels (within a factor of two) for lactating women in other countries. T3 levels were adequately predicted. Infant serum thyroid hormone levels were adequately

Dietary Iodine Sufficiency and Moderate Insufficiency in the Lactating Mother and Nursing Infant: A Computational Perspective.

PubMed

Fisher, W; Wang, Jian; George, Nysia I; Gearhart, Jeffery M; McLanahan, Eva D

2016-01-01

The Institute of Medicine recommends that lactating women ingest 290 μg iodide/d and a nursing infant, less than two years of age, 110 μg/d. The World Health Organization, United Nations Children's Fund, and International Council for the Control of Iodine Deficiency Disorders recommend population maternal and infant urinary iodide concentrations ≥ 100 μg/L to ensure iodide sufficiency. For breast milk, researchers have proposed an iodide concentration range of 150-180 μg/L indicates iodide sufficiency for the mother and infant, however no national or international guidelines exist for breast milk iodine concentration. For the first time, a lactating woman and nursing infant biologically based model, from delivery to 90 days postpartum, was constructed to predict maternal and infant urinary iodide concentration, breast milk iodide concentration, the amount of iodide transferred in breast milk to the nursing infant each day and maternal and infant serum thyroid hormone kinetics. The maternal and infant models each consisted of three sub-models, iodide, thyroxine (T4), and triiodothyronine (T3). Using our model to simulate a maternal intake of 290 μg iodide/d, the average daily amount of iodide ingested by the nursing infant, after 4 days of life, gradually increased from 50 to 101 μg/day over 90 days postpartum. The predicted average lactating mother and infant urinary iodide concentrations were both in excess of 100 μg/L and the predicted average breast milk iodide concentration, 157 μg/L. The predicted serum thyroid hormones (T4, free T4 (fT4), and T3) in both the nursing infant and lactating mother were indicative of euthyroidism. The model was calibrated using serum thyroid hormone concentrations for lactating women from the United States and was successful in predicting serum T4 and fT4 levels (within a factor of two) for lactating women in other countries. T3 levels were adequately predicted. Infant serum thyroid hormone levels were adequately

Zinc, lead, and cadmium levels in serum and milk of lactating women in Ibadan, Nigeria.

PubMed

Edem, Victory Fabian; Akintunde, Kikelomo; Adelaja, Yewande Adeola; Nwozo, Sarah O; Charles-Davies, Mabel

2017-01-01

Zinc (Zn) is known to interact with lead (Pb) and cadmium (Cd) reversing their toxicity and reducing their concentrations. However, lactating women are at high risk of developing Zn deficiency, which may result in Pb and Cd intoxication or increased exposure of breast-fed infants to Pb and Cd from breast milk. The aim of this study was to determine Zn, Pb, and Cd concentrations and examine their relationship in serum and breast milk of lactating women in Ibadan, Nigeria. Ninety-two lactating women were recruited into this study. Anthropometric measurements were assessed by standard methods while serum and breast milk concentrations of Zn, Pb, and Cd were assessed by atomic absorption spectrophotometry. Data analyzed statistically by Student's t test, Pearson's correlation coefficient, and a multiple regression model were significant at p < 0.05. Zn deficiency was observed in 12 (17.1%) of lactating women. Breast milk levels of Zn, Pb, and Cd were significantly higher than their levels in serum, whereas the ratios Zn:Pb and Zn:Cd in milk were significantly less than serum ratios. Significant negative correlation was observed between milk Pb and serum Zn:Pb while milk Cd correlated positively with milk Zn. Significant positive correlations were observed between serum Zn and serum Zn:Pb, serum Zn and serum Zn:Cd, as well as serum Zn:Cd and serum Zn:Pb. Serum Cd and serum Zn were significantly negatively related. Significant negative correlations between serum Pb and serum Zn:Pb as well as milk Zn:Pb. Serum Cd and serum Zn:Pb as well as serum Zn:Cd correlated negatively. Milk Cd and Zn/Cd positively related with milk Pb while milk Zn was a negatively related with milk Pb in a multiple regression model ( R 2 = 0.333; p = 0.023). Breast milk may be contaminated by toxic metals. However, Zn supplementation in deficient mothers may protect maternal and infant health.

IBFAN Africa training initiatives: code implementation and lactation management.

PubMed

Mbuli, A

1994-01-01

As part of an ongoing effort to halt the decline of breast feeding rates in Africa, 35 representatives of 12 different African countries met in Mangochi, Malawi, in February 1994. The Code of Marketing of Breastmilk Substitutes was scrutinized. National codes were drafted based on the "Model Law" of the IBFAN Code Documentation Centre (ICDC), Penang. Mechanisms of implementation, specific to each country, were developed. Strategies for the promotion, protection, and support of breast feeding, which is very important to child survival in Africa, were discussed. The training course was organized by ICDC, in conjunction with IBFAN Africa, and with the support of the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO). Countries in eastern, central, and southern Africa were invited to send participants, who included professors, pediatricians, nutritionists, MCH personnel, nurses, and lawyers. IBFAN Africa has also been conducting lactation management workshops for a number of years in African countries. 26 health personnel (pediatricians, nutritionists, senior nursing personnel, and MCH workers), representing 7 countries in the southern African region, attended a training of trainers lactation management workshop in Swaziland in August, 1993 with the support of their UNICEF country offices. The workshop included lectures, working sessions, discussions, and slide and video presentations. Topics covered included national nutrition statuses, the importance of breast feeding, the anatomy and physiology of breast feeding, breast feeding problems, the International Code of Marketing, counseling skills, and training methods. The field trip to a training course covering primary health care that was run by the Traditional Healers Organization (THO) in Swaziland was of particular interest because of the strong traditional medicine sector in many African countries. IBFAN Africa encourages use of community workers (traditional healers, Rural Health

A physiologically based pharmacokinetic model for lactational transfer of Na-131I

NASA Astrophysics Data System (ADS)

Turner, Anita Loretta

The excretion of radionuclides in human breast milk after administration of radiopharmaceuticals is a concern as a radiation risk to nursing infants. It is not uncommon to administer radiopharmaceuticals to lactating patients due to emergency nuclear medicine investigations such as thyroid complications, kidney failure, and pulmonary embolism. There is a need to quantify the amount of radioactivity translocated into breast milk in cases of ingestion by a breast-fed infant. A physiologically based pharmacokinetic model (PBPK) and a modified International Commission on Radiological Protection (ICRP) model have been developed to predict iodine concentrations in breast milk after ingestion of radioiodine by the mother. In the PBPK model, all compartments are interconnected by blood flow and represent real anatomic tissue regions in the body. All parameters involved are measurable values with physiological or physiochemical meaning such as tissue masses, blood flow rates, partition coefficients and cardiac output. However, some of the parameters such as the partition coefficients and metabolic constants are not available for iodine and had to be inferred from other information. The structure of the PBPK model for the mother consists of the following tissue compartments: gastrointestinal tract, blood, kidney, thyroid, milk, and other tissues. With the exception of the milk compartment, the model for the nursing infant is structured similarly to the mother. The ICRP model describing iodine metabolism in a standard 70-kg man was modified to represent iodine metabolism in a lactating woman and nursing infant. The parameters involved in this model are transfer rates and biological half-lives which are based on experimental observations. The results of the PBPK model and the modified ICRP model describing the lactational transfer of iodine were compared. When administering 1 mCi of Na131I to the lactating mother, the concentration reaches a maximum of 0.1 mCi/liter in 24

Breast pads: their effectiveness and use by lactating women.

PubMed

Griffiths, R J

1993-03-01

The diversity of breast pads available and absence of data on their effectiveness led the Breastfeeding Association of South Africa to design laboratory simulation experiments measuring fluid retention and evaporative properties as indicators of pad surface dryness. Questionnaires distributed at four breastfeeding clinics were used to obtain data on mothers' use of pads and incidence of breast problems. The majority of mothers surveyed used a new disposable breast pad made by Johnson & Johnson. The experimental studies showed that this pad allowed no leaking and kept the breast markedly drier than other disposables. Exclusive use of these pads or cotton towelling pads did not produce a detectable increase in nipple problems. A home-made disposable breast pad using a nappy (diaper) liner encasing toilet paper was most effective at keeping the breast dry and offered good protection against leaking. Since it is economical and easy to use, it is recommended as a good alternative to expensive disposables. Clinging materials, e.g. gauze, cottonwool or paper, and panty liners, maintain excessive surface dampness and are not recommended. If used, two layers of nappy liner on the inner surface may enhance nipple dryness.

Fathers' knowledge about and attitudes towards breast feeding in Manisa, Turkey.

PubMed

Taşpınar, Ayten; Çoban, Ayden; Küçük, Mert; Şirin, Ahsen

2013-06-01

to determine the extent of knowledge fathers of newborns have about breast feeding and lactation and to examine their attitudes regarding breast feeding. a descriptive, cross-sectional study. Manisa Maternity and Children's Hospital. 203 fathers of newborn infants. although a wide majority of the participants (92.1%) expressed a desire to have their infants breastfed, it was found that only 58.6% discussed this with their partners. It was discovered that 88.7% of the fathers were happy to help with the housework so that their wives could breast feed while 57.6% stated that breast feeding would be psychologically beneficial to both the mother and the baby. Approximately half of the study subjects (48.8%) expressed an interest in attending an educational programme on breast feeding for fathers. The study also showed that the fathers' level of education, the type of family they were a part of and previously received education on lactation and breast feeding had an effect on their knowledge and attitudes toward breast feeding (p<0.05). it was seen that fathers were eager to have their infants breastfed but unable to adequately share such thoughts with their wives. It was also observed that their knowledge about breast feeding and lactation was limited, leading to the conclusion that fathers may benefit from a supportive educational programme on breast feeding. Copyright © 2012 Elsevier Ltd. All rights reserved.

Developing a workplace breast feeding support model for employed lactating mothers.

PubMed

Yimyam, Susanha; Hanpa, Wasana

2014-06-01

Resuming work is often considered an obstacle for continued breast feeding. The objectives of this participatory action research study were to develop a breast feeding support model in the workplace and to compare breast feeding rates before and after implementation of the breast feeding support campaign. Twenty-four women participated before the implementation of the breast feeding support campaign, whereas 31 women participated after the campaign. Data were collected by interviewing employed women about their breast feeding practices within six months post partum. Additional data were collected through interviews with the workplace administrator and head of work sections as well as observation of the breast feeding support campaigns. Qualitative data were analysed using thematic analysis, whereas quantitative data were analysed using descriptive statistics and χ(2) test. The workplace breast feeding support model was developed based on the concept of Mother-Friendly Workplace Initiatives by the World Alliance for Breastfeeding Action (WABA) and the Thai government׳s promotion of a workplace breast feeding corner. Within this model, a committee for breast feeding support was created for working with the research team to develop breast feeding activities and media for breast feeding education and breast feeding support campaigns in the workplace. Breast feeding rates at six months after implementation of the breast feeding support campaign were significantly higher than rates before, both for exclusive breast feeding and any breast feeding at levels .004 and .033, respectively. These results suggest that breast feeding should be encouraged in every workplace depending on context. Individual advice and help for employed mothers should be provided from pregnancy through weaning in the postpartum period. Copyright © 2014 Elsevier Ltd. All rights reserved.

In-Silico Genomic Approaches To Understanding Lactation, Mammary Development, And Breast Cancer

USDA-ARS?s Scientific Manuscript database

Lactation-related traits are influenced by genetics. From a quantitative standpoint, these traits have been well studied in dairy species, but there has also been work on the genetics of lactation in humans and mice. In addition, there is evidence to support the notion that other mammary gland trait...

Towards an in-plane methodology to track breast lesions using mammograms and patient-specific finite-element simulations

NASA Astrophysics Data System (ADS)

Lapuebla-Ferri, Andrés; Cegoñino-Banzo, José; Jiménez-Mocholí, Antonio-José; Pérez del Palomar, Amaya

2017-11-01

In breast cancer screening or diagnosis, it is usual to combine different images in order to locate a lesion as accurately as possible. These images are generated using a single or several imaging techniques. As x-ray-based mammography is widely used, a breast lesion is located in the same plane of the image (mammogram), but tracking it across mammograms corresponding to different views is a challenging task for medical physicians. Accordingly, simulation tools and methodologies that use patient-specific numerical models can facilitate the task of fusing information from different images. Additionally, these tools need to be as straightforward as possible to facilitate their translation to the clinical area. This paper presents a patient-specific, finite-element-based and semi-automated simulation methodology to track breast lesions across mammograms. A realistic three-dimensional computer model of a patient’s breast was generated from magnetic resonance imaging to simulate mammographic compressions in cranio-caudal (CC, head-to-toe) and medio-lateral oblique (MLO, shoulder-to-opposite hip) directions. For each compression being simulated, a virtual mammogram was obtained and posteriorly superimposed to the corresponding real mammogram, by sharing the nipple as a common feature. Two-dimensional rigid-body transformations were applied, and the error distance measured between the centroids of the tumors previously located on each image was 3.84 mm and 2.41 mm for CC and MLO compression, respectively. Considering that the scope of this work is to conceive a methodology translatable to clinical practice, the results indicate that it could be helpful in supporting the tracking of breast lesions.

Breast-feeding and family planning: a review of the relationships between breast-feeding and family planning.

PubMed

Brown, R E

1982-01-01

A number of interrelated factors must be considered when breast-feeding is introduced as a concern for family planning programs: the number of pregnancies and births experienced, age at each pregnancy and birth, duration of the intervals between conceptions, lactation including duration and type, health and nutritional services available to meet the demands of pregnancy, delivery, and postpartum care. The dietary intake of the mother and her health and disease status have an effect on the duration of breast-feeding, and lactation has an effect on her ovulation and birth spacing. Those at particularly high risk include adolescent girls, older grand-multipara women, and families living in poverty. An historical relationship between the reduction in infant and childhood mortality and the falling off of births can be documented. The straightforward benefits on nutritional status of breast-fed infants, the conjunction with the antibody protection afforded by breast milk, served to reduce infant mortality and indirectly served to reduce birth rates. In addition, the prolongation of postpartum anovulatory cycles in breast-feeding women, coupled with sexual mores that postpone sexual relations while a women is breast-feeding in certain groups, will serve to prolong the interbirth intervals. Populations where breast-feeding is customary have been shown to have fewer births than populations where the women do not breast-fed and where infants are artificially fed.

The study of breast milk IGF-1, leptin, ghrelin and adiponectin levels as possible reasons of high weight gain in breast-fed infants.

PubMed

Kon, Igor Ya; Shilina, Natalia M; Gmoshinskaya, Maria V; Ivanushkina, Tatiana A

2014-01-01

Excessive consumption of protein that leads to increased blood levels of insulin-like growth factor-1 (IGF-1) is an important risk factor for high growth velocity and obesity in formula-fed infants. However, it is not clear whether these factors can explain the high growth velocity in breast-fed infants. To study the possible links between the growth velocity in breast-fed infants and the levels of protein, IGF-1 and other hormones, which regulate energy homeostasis, in mothers' breast milk. We studied 103 mother-infant pairs. Their daily breast milk intake and level of IGF-1, leptin, ghrelin, adiponectin, protein and fat in breast milk were measured at 1, 2 and 3 months of lactation. The infant group was divided into three subgroups of low, normal and high weight gain tertiles. The breast milk consumed by the infants with high weight gain contained higher levels of IGF-1 than that consumed by those with low weight gain at all periods studied (p = 0.032 at 3 months of lactation), and ghrelin levels were higher at 1 and 2 months and leptin levels at 2 and 3 months of lactation (p < 0.05). A positive correlation was observed between the breast milk IGF-1 level and infant weight gain (r = 0.294, p = 0.043). Total daily breast milk, fat and hormone intake was also higher in the high weight gain group compared to the low weight gain group. One of the reasons for the high growth velocity in breast-fed infants may be the enhanced levels of the studied hormones in breast milk.

Breast-feeding intentions among low-income pregnant and lactating women.

PubMed

Hill, Gina Jarman; Arnett, Dennis B; Mauk, Eileen

2008-01-01

Provide a better understanding of the process used by low-income pregnant/postpartum women when deciding whether to breast-feed or not. Pregnant/postpartum women admitted to an obstetrics floor completed a survey to determine breast-feeding intention (n=88). Subjects were primarily Hispanic and African American women. Beliefs and referent other were related positively to attitude and subjective norm, respectively. Subjective norm was related positively to intention to breast-feed. Breast-feeding knowledge was low. Others' opinions clearly influence feeding intentions among this population of low-income women. Inclusion of these significant others, family, and friends within the breast-feeding education process is warranted.

Nonnutritive Sweeteners in Breast Milk.

PubMed

Sylvetsky, Allison C; Gardner, Alexandra L; Bauman, Viviana; Blau, Jenny E; Garraffo, H Martin; Walter, Peter J; Rother, Kristina I

2015-01-01

Nonnutritive sweeteners (NNS), including saccharin, sucralose, aspartame, and acesulfame-potassium, are commonly consumed in the general population, and all except for saccharin are considered safe for use during pregnancy and lactation. Sucralose (Splenda) currently holds the majority of the NNS market share and is often combined with acesulfame-potassium in a wide variety of foods and beverages. To date, saccharin is the only NNS reported to be found in human breast milk after maternal consumption, while there is no apparent information on the other NNS. Breast milk samples were collected from 20 lactating volunteers, irrespective of their habitual NNS intake. Saccharin, sucralose, and acesulfame-potassium were present in 65% of participants' milk samples, whereas aspartame was not detected. These data indicate that NNS are frequently ingested by nursing infants, and thus prospective clinical studies are necessary to determine whether early NNS exposure via breast milk may have clinical implications.

NONNUTRITIVE SWEETENERS IN BREAST MILK

PubMed Central

Sylvetsky, Allison C.; Gardner, Alexandra L.; Bauman, Viviana; Blau, Jenny E.; Garraffo, H. Martin; Walter, Peter J.; Rother, Kristina I.

2017-01-01

Nonnutritive sweeteners (NNS), including saccharin, sucralose, aspartame, and acesulfame-potassium, are commonly consumed in the general population, and all except for saccharin are considered safe for use during pregnancy and lactation. Sucralose (Splenda) currently holds the majority of the NNS market share and is often combined with acesulfame-potassium in a wide variety of foods and beverages. To date, saccharin is the only NNS reported to be found in human breast milk after maternal consumption, while there is no apparent information on the other NNS. Breast milk samples were collected from 20 lactating volunteers, irrespective of their habitual NNS intake. Saccharin, sucralose, and acesulfame-potassium were present in 65% of participants’ milk samples, whereas aspartame was not detected. These data indicate that NNS are frequently ingested by nursing infants, and thus prospective clinical studies are necessary to determine whether early NNS exposure via breast milk may have clinical implications. PMID:26267522

Lactation, nutrition and fertility and the secretion of prolactin and gonadotrophins in Mopan Mayan women.

PubMed

Fink, A E; Fink, G; Wilson, H; Bennie, J; Carroll, S; Dick, H

1992-01-01

The effect of lactation on menstrual cycles, ovulation and conception was studied in a group of non-contracepting Amerindian Mopan Mayan women. Anthropological observations of relevant events were made over a 21-month period. Blood samples were assayed to determine the plasma concentrations of prolactin, luteinising hormone, follicle stimulating hormone, human chorionic gonadotrophin, placental lactogen, oestrogen, progesterone and cortisol. The data show that: frequent and prolonged breast-feeding was associated with a marked increase in plasma prolactin concentrations to levels similar to those in lactating Gaing but higher than those in lactating Scottish women; ovulatory menstrual cycles and pregnancy occurred during frequent lactation; in lactating menstruating women there was an inverse correlation between fat weight and months post-partum. These data suggest that other factors as well as suckling account for the effects of lactation on fecundity.

Epidemiology of breast-feeding in Italy.

PubMed

Giovannini, M; Banderali, G; Agostoni, C; Riva, E

2001-01-01

To evaluate the prevalence of breast-feeding in Italy and to describe the social and environmental factors associated with its practice, 1601 mothers were systematically recruited as representative of deliveries across all regions of Italy during November 1995. They were interviewed in March, June, and September of 1996. Interviews were conducted by telephone using a standardized questionnaire designed for computer scanning. The results indicated that 85% of mothers breast-fed their infants. The rates of breast-feeding at 3, 6, and 9 months were, respectively, 51%, 32%, and 19%. Among the 830 lactating mothers at 3 months, 72% practiced breast-feeding "on demand." Pediatricians, midwives, and gynecologists were the main sources of information about breast-feeding, but 43% of the mothers did not receive any information. Media (radio, TV) were mentioned as sources of information by only 2% of the mothers. Maternal factors significantly associated with breast-feeding and its duration were: a) having been breast-fed as infants, b) being nonsmokers, and c) being given information about lactation at the time of discharge from their hospital ward. Maternal characteristics (age, weight, and height), parental socioeconomic indicators (profession and education), and neonatal care (rooming-in practice) were not significantly associated with breast-feeding. Our results show that in Italy a fairly high percentage of mothers start breast-feeding and that both maternal factors (history and habits) and good information may support its duration.

Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History.

PubMed

Oza-Frank, Reena; Moreland, Jennifer J; McNamara, Kelly; Geraghty, Sheela R; Keim, Sarah A

2016-11-01

Detailed data on lactation practices by gestational diabetes mellitus (GDM) history are lacking, precluding potential explanations and targets for interventions to improve lactation intensity and duration and, ultimately, long-term maternal and child health. This study aimed to examine breastfeeding practices through 12 months postpartum by GDM history. Women who delivered a singleton, liveborn infant at The Ohio State University Wexner Medical Center (Columbus, OH), in 2011 completed a postal questionnaire to assess lactation and infant feeding practices and difficulties. Bivariate and multivariate associations between GDM history and lactation and infant feeding practices were examined. The sample included 432 women (62% response rate), including 7.9% who had GDM during the index pregnancy. Women with GDM initiated breastfeeding (at-the-breast or pumping) as often as women without any diabetes but were more likely to report introduction of formula within the first 2 days of life (79.4% vs 53.8%, P < .01; adjusted odds ratio: 3.48; 95% confidence interval, 1.47-8.26). Women with GDM initiated pumping 4 days earlier than women without diabetes ( P < .05), which was confirmed in adjusted analyses. There was no difference in the proportion of women reporting breastfeeding difficulty (odds ratio: 2.08; 95% confidence interval, 0.78-5.52). However, there was a trend toward women with GDM reporting more formula feeding and less at-the-breast feeding as strategies to address difficulty compared with women without diabetes. Additional research is needed to understand why women with GDM engage in different early lactation and infant feeding practices, and how best to promote and sustain breastfeeding among these women.

Methodological considerations in estrogen assays of breast fluid and breast tissue.

PubMed

Chatterton, Robert T; Muzzio, Miguel; Heinz, Richard; Gann, Peter H; Khan, Seema A

2015-07-01

Estradiol (E2) in nipple aspirate fluid (NAF), ductal lavage fluid (DLF), and random fine needle aspirates (rFNA) are compared. Quantification was by immunoassay or tandem MS. The percent of women yielding NAF varied between 24% and 48% and for DLF was 86.3%. Variation between ducts within a breast was not less than variation between breasts within women but variation between breasts and within women over time was significantly less than variation between women. Serum E2 was highly significantly different among phases of the menstrual cycle but NAF E2 was not different. The correlation between serum and breast fluid E2 concentrations in premenopausal women had coefficients of determination of less than 15%. The correlation between serum and NAF in studies of postmenopausal women varied greatly and may depend on patient selection. The difference between NAF E2 between pre- and postmenopausal women was only 22%; for rFNA it was non-significantly 44% lower in a similar group of postmenopausal women. Progesterone was 96% and 98% lower in postmenopausal NAF and rFNA samples, respectively. Measurements of E2 in breast fluid or breast tissue appears to provide similar estimates of E2 exposure. E2 levels in breast fluid do not reflect the rapid changes that occur in serum and, thus, serum availability of E2 is only one factor determining its levels in the breast. The similarity of levels between breasts and between ducts suggests that estimates of estrogen exposure does not require multiple samples, however, unavailability of fluid may require rFNA in some cases. Copyright © 2014 Elsevier Inc. All rights reserved.

Reproductive history and breast cancer risk.

PubMed

Kobayashi, Shunzo; Sugiura, Hiroshi; Ando, Yoshiaki; Shiraki, Norio; Yanagi, Takeshi; Yamashita, Hiroko; Toyama, Tatsuya

2012-10-01

The fact that reproductive factors have significant influence on the risk of breast cancer is well known. Early age of first full-term birth is highly protective against late-onset breast cancers, but each pregnancy, including the first one, increases the risk of early-onset breast cancer. Estradiol and progesterone induce receptor activator of NF-kappa B ligand (RANKL) in estrogen receptor (ER)- and progesterone receptor (PgR)-positive luminal cells. RANKL then acts in a paracrine fashion on the membranous RANK of ER/PgR-negative epithelial stem cells of the breast. This reaction cascade is triggered by chorionic gonadotropin during the first trimester of pregnancy and results in the morphological and functional development of breast tissue. On the other hand, the administration of non-steroidal anti-inflammatory drugs in the early steps of weaning protects against tumor growth through reduction of the acute inflammatory reaction of post lactation remodeling of breast tissue. This is experimental evidence that may explain the short-term tumor-promoting effect of pregnancy. The protective effect of prolonged breast feeding may also be explained, at least in a part, by a reduced inflammatory reaction due to gradual weaning. Delay of first birth together with low parity and short duration of breast feeding are increasing social trends in developed countries. Therefore, breast cancer risk as a result of reproductive factors will not decrease in these countries in the foreseeable future. In this review, the significance of reproductive history with regard to the risk of breast cancers will be discussed, focusing on the age of first full-term birth and post lactation involution of the breast.

TP53-inducible Glycolysis and Apoptosis Regulator (TIGAR) Metabolically Reprograms Carcinoma and Stromal Cells in Breast Cancer*

PubMed Central

Ko, Ying-Hui; Domingo-Vidal, Marina; Roche, Megan; Lin, Zhao; Whitaker-Menezes, Diana; Seifert, Erin; Capparelli, Claudia; Tuluc, Madalina; Birbe, Ruth C.; Tassone, Patrick; Curry, Joseph M.; Navarro-Sabaté, Àurea; Manzano, Anna; Bartrons, Ramon; Caro, Jaime; Martinez-Outschoorn, Ubaldo

2016-01-01

A subgroup of breast cancers has several metabolic compartments. The mechanisms by which metabolic compartmentalization develop in tumors are poorly characterized. TP53 inducible glycolysis and apoptosis regulator (TIGAR) is a bisphosphatase that reduces glycolysis and is highly expressed in carcinoma cells in the majority of human breast cancers. Hence we set out to determine the effects of TIGAR expression on breast carcinoma and fibroblast glycolytic phenotype and tumor growth. The overexpression of this bisphosphatase in carcinoma cells induces expression of enzymes and transporters involved in the catabolism of lactate and glutamine. Carcinoma cells overexpressing TIGAR have higher oxygen consumption rates and ATP levels when exposed to glutamine, lactate, or the combination of glutamine and lactate. Coculture of TIGAR overexpressing carcinoma cells and fibroblasts compared with control cocultures induce more pronounced glycolytic differences between carcinoma and fibroblast cells. Carcinoma cells overexpressing TIGAR have reduced glucose uptake and lactate production. Conversely, fibroblasts in coculture with TIGAR overexpressing carcinoma cells induce HIF (hypoxia-inducible factor) activation with increased glucose uptake, increased 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 (PFKFB3), and lactate dehydrogenase-A expression. We also studied the effect of this enzyme on tumor growth. TIGAR overexpression in carcinoma cells increases tumor growth in vivo with increased proliferation rates. However, a catalytically inactive variant of TIGAR did not induce tumor growth. Therefore, TIGAR expression in breast carcinoma cells promotes metabolic compartmentalization and tumor growth with a mitochondrial metabolic phenotype with lactate and glutamine catabolism. Targeting TIGAR warrants consideration as a potential therapy for breast cancer. PMID:27803158

The potential for oxytocin (OT) to prevent breast cancer: a hypothesis.

PubMed

Murrell, T G

1995-08-01

This hypothesis proposes that carcinogens in the breast are generated by the action of superoxide free radicals released when acinal gland distension, under the influence of unopposed prolactin, causes microvessel ischaemia. Inadequate nipple care in the at-risk years leads to ductal obstruction preventing the elimination of carcinogens from the breast. The regular production of oxytocin (OT) from nipple stimulation would cause contraction of the myoepithelial cells, relieving acinal gland distension and aiding the active elimination of carcinogenic fluid from the breast. Mechanical breast pump stimulation causes an increase in plasma OT levels in the luteal but not in the follicular phase of the menstrual cycle. OT production upon nipple stimulation in the luteal phase of premenopausal, non-lactating women may be protective against the high rates of mitotic breast cell division noted at this time via the potential to block the effect of oestrogen. The epidemiology of breast cancer suggests that lengthy lactation time is beneficial. Sexual activity in nulliparous women also protects and OT levels have been shown to rise with orgasm in women and in men. OT systems in the brain are intricately linked to oestrogen and progesterone levels, and it is possible that these hormones may modify the OT secretory response both centrally and through an effect on the sensitivity of the breast. OT production with nipple care and in sex and lactation, and the reduction in cycling ovarian hormones that occurs with pregnancy, may all be important preventative factors in the development of breast cancer both pre- and post-menopausally.

The Availability of Information on Induced Lactation in Malaysia.

PubMed

Rahim, Norsyamlina Che Abdul; Sulaiman, Zaharah; Ismail, Tengku Alina Tengku

2017-08-01

Induced lactation is a method of stimulating the production of breast milk in women who have not gone through the process of pregnancy. Recent advances in technology have given such women the opportunity to breastfeed adopted children. Previous studies conducted in Western countries have explored the breastfeeding of adopted children, as well as the experiences, successes and challenges of this process. However, research on procedures for breastfeeding adopted children is lacking in Malaysia. The authors have therefore reviewed literature related to induced lactation in Malaysia to fill this gap. Of the 30 related articles identified, 19 described the breastfeeding practices and experiences of adoptive mothers in Malaysia. Out of 19 articles, there were four journal articles, five circulars and regulations, two books, two post-graduate theses, four blogs posts and forum discussions, and two online newspaper articles. Medical information relating to induced lactation procedures was also reviewed, showing that there was a lack of scientific studies focusing on induced lactation practices among adoptive mothers. Information on religious, specifically Islamic, perspectives on breastfeeding and child adoption laws was gathered from websites, social networks, blogs, magazines and online news sources. In consideration of recent advancements in medical technology and the dire need among Malaysians, it is crucial that evidence-based, accurate and reliable information on induced lactation is made available to professionals and other individuals in this country.

The Availability of Information on Induced Lactation in Malaysia

PubMed Central

Rahim, Norsyamlina Che Abdul; Sulaiman, Zaharah; Ismail, Tengku Alina Tengku

2017-01-01

Induced lactation is a method of stimulating the production of breast milk in women who have not gone through the process of pregnancy. Recent advances in technology have given such women the opportunity to breastfeed adopted children. Previous studies conducted in Western countries have explored the breastfeeding of adopted children, as well as the experiences, successes and challenges of this process. However, research on procedures for breastfeeding adopted children is lacking in Malaysia. The authors have therefore reviewed literature related to induced lactation in Malaysia to fill this gap. Of the 30 related articles identified, 19 described the breastfeeding practices and experiences of adoptive mothers in Malaysia. Out of 19 articles, there were four journal articles, five circulars and regulations, two books, two post-graduate theses, four blogs posts and forum discussions, and two online newspaper articles. Medical information relating to induced lactation procedures was also reviewed, showing that there was a lack of scientific studies focusing on induced lactation practices among adoptive mothers. Information on religious, specifically Islamic, perspectives on breastfeeding and child adoption laws was gathered from websites, social networks, blogs, magazines and online news sources. In consideration of recent advancements in medical technology and the dire need among Malaysians, it is crucial that evidence-based, accurate and reliable information on induced lactation is made available to professionals and other individuals in this country. PMID:28951685

Pharmacokinetics of Metoprolol During Pregnancy and Lactation

PubMed Central

Ryu, Rachel J.; Eyal, Sara; Easterling, Thomas R.; Caritis, Steve N.; Venkataraman, Raman; Hankins, Gary; Rytting, Erik; Thummel, Kenneth; Kelly, Edward J.; Risler, Linda; Phillips, Brian; Honaker, Matthew T.; Shen, Danny D.; Hebert, Mary F.

2017-01-01

The objective of this study was to evaluate the steady-state pharmacokinetics of metoprolol during pregnancy and lactation. Serial plasma, urine, and breast milk concentrations of metoprolol and its metabolite, α-hydroxymetoprolol, were measured over 1 dosing interval in women treated with metoprolol (25–750 mg/day) during early pregnancy (n = 4), mid-pregnancy (n = 14), and late pregnancy (n = 15), as well as postpartum (n = 9) with (n = 4) and without (n = 5) lactation. Subjects were genotyped for CYP2D6 loss-of-function allelic variants. Using paired analysis, mean metoprolol apparent oral clearance was significantly higher in mid-pregnancy (361 ± 223 L/h, n = 5, P < .05) and late pregnancy (568 ± 273 L/h, n = 8, P < .05) compared with ≥3 months postpartum (200 ± 131 and 192 ± 98 L/h, respectively). When the comparison was limited to extensive metabolizers (EMs), metoprolol apparent oral clearance was significantly higher during both mid- and late pregnancy (P < .05). Relative infant exposure to metoprolol through breast milk was <1.0% of maternal weight-adjusted dose (n = 3). Because of the large, pregnancy-induced changes in metoprolol pharmacokinetics, if inadequate clinical responses are encountered, clinicians who prescribe metoprolol during pregnancy should be prepared to make aggressive changes in dosage (dose and frequency) or consider using an alternate beta-blocker. PMID:26461463

Perchlorate exposure in lactating women in an urban community in New Jersey.

PubMed

Borjan, Marija; Marcella, Stephen; Blount, Benjamin; Greenberg, Michael; Zhang, Junfeng Jim; Murphy, Eileen; Valentin-Blasini, Liza; Robson, Mark

2011-01-01

Perchlorate is most widely known as a solid oxidant for missile and rocket propulsion systems although it is also present as a trace contaminant in some fertilizers. It has been detected in drinking water, fruits, and vegetables throughout New Jersey and most of the United States. At sufficiently high doses, perchlorate interferes with the uptake of iodine into the thyroid and may interfere with the development of the skeletal system and the central nervous system of infants. Therefore, it is important to quantify perchlorate in breast milk to understand potential perchlorate exposure in infants. In this study we measured perchlorate in breast milk, urine, and drinking water collected from 106 lactating mothers from Central New Jersey. Each subject was asked to provide three sets of samples over a 3-month period. The average±SD perchlorate level in drinking water, breast milk, and urine was 0.168±0.132 ng/mL (n=253), 6.80±8.76 ng/mL (n=276), and 3.19±3.64 ng/mL (3.51±6.79 μg/g creatinine) (n=273), respectively. Urinary perchlorate levels were lower than reference range values for women of reproductive age (5.16±11.33 μg/g creatinine, p=0.03), likely because of perchlorate secretion in breast milk. Drinking water perchlorate levels were ≤1.05 ng/mL and were not positively correlated with either breast milk or urine perchlorate levels. These findings together suggest that drinking water was not the most important perchlorate exposure source for these women. Creatinine-adjusted urine perchlorate levels were strongly correlated with breast milk perchlorate levels (r=0.626, p=<0.0005). Breast milk perchlorate levels in this study are consistent with widespread perchlorate exposure in lactating women and thus infants. This suggests that breast milk may be a source of exposure to perchlorate in infants. Copyright © 2010 Elsevier B.V. All rights reserved.

Maternal intestinal HIF-2α is necessary for sensing iron demands of lactation in mice

PubMed Central

Ramakrishnan, Sadeesh K.; Anderson, Erik R.; Martin, Angelical; Centofanti, Brook; Shah, Yatrik M.

2015-01-01

The mechanisms that are essential for the maintenance of nutrient status in breast milk are unclear. Our data demonstrate that the intestine via hypoxia-inducible factor (HIF)-2α is an essential regulatory mechanism for maintaining the quality of breast milk. During lactation, intestinal HIF-2α is highly increased, leading to an adaptive induction of apical and basolateral iron transport genes. Disruption of intestinal HIF-2α (but not HIF-1α) or the downstream target gene divalent metal transporter (DMT)-1 in lactating mothers did not alter systemic iron homeostasis in the mothers, but led to anemia, decreased growth, and truncal alopecia in pups which was restored following weaning. Moreover, pups born from mothers with a disruption of intestinal HIF-2α led to long-term cognitive defects. Cross-fostering experiments and micronutrient profiling of breast milk demonstrated that the defects observed were due to decreased maternal iron delivery via milk. Increasing intestinal iron absorption by activation of HIF-2α or parenteral administration of iron-dextran in HIF-2α knockout mothers ameliorated anemia and restored neonatal development and adult cognitive functions. The present work details the importance of breast milk iron in neonatal development and uncovers an unexpected molecular mechanism for the regulation of nutritional status of breast milk through intestinal HIF-2α. PMID:26124130

Bioactivity-Guided Identification and Cell Signaling Technology to Delineate the Lactate Dehydrogenase A Inhibition Effects of Spatholobus suberectus on Breast Cancer

PubMed Central

Wang, Zhiyu; Wang, Dongmei; Han, Shouwei; Wang, Neng; Mo, Feizhi; Loo, Tjing Yung; Shen, Jiangang; Huang, Hui; Chen, Jianping

2013-01-01

Aerobic glycolysis is an important feature of cancer cells. In recent years, lactate dehydrogenase A (LDH-A) is emerging as a novel therapeutic target for cancer treatment. Seeking LDH-A inhibitors from natural resources has been paid much attention for drug discovery. Spatholobus suberectus (SS) is a common herbal medicine used in China for treating blood-stasis related diseases such as cancer. This study aims to explore the potential medicinal application of SS for LDH-A inhibition on breast cancer and to determine its bioactive compounds. We found that SS manifested apoptosis-inducing, cell cycle arresting and anti-LDH-A activities in both estrogen-dependent human MCF-7 cells and estrogen-independent MDA-MB-231 cell. Oral herbal extracts (1 g/kg/d) administration attenuated tumor growth and LDH-A expression in both breast cancer xenografts. Bioactivity-guided fractionation finally identified epigallocatechin as a key compound in SS inhibiting LDH-A activity. Further studies revealed that LDH-A plays a critical role in mediating the apoptosis-induction effects of epigallocatechin. The inhibited LDH-A activities by epigallocatechin is attributed to disassociation of Hsp90 from HIF-1α and subsequent accelerated HIF-1α proteasome degradation. In vivo study also demonstrated that epigallocatechin could significantly inhibit breast cancer growth, HIF-1α/LDH-A expression and trigger apoptosis without bringing toxic effects. The preclinical study thus suggests that the potential medicinal application of SS for inhibiting cancer LDH-A activity and the possibility to consider epigallocatechin as a lead compound to develop LDH-A inhibitors. Future studies of SS for chemoprevention or chemosensitization against breast cancer are thus warranted. PMID:23457597

Lutein concentration in human milk during early lactation and its relationship with dietary lutein intake.

PubMed

Cena, Hellas; Castellazzi, Anna Maria; Pietri, Amedeo; Roggi, Carla; Turconi, Giovanna

2009-10-01

The present study aimed to estimate the lutein concentration in human milk during early lactation and its relationship with dietary lutein intake measured through the administration of a short FFQ. A cross-sectional study in which an FFQ was administered twice: on day 3 (T0) and day 30 (T1) postpartum; meanwhile two breast milk samples were collected. Maternal plasma samples were obtained at T0. The comparison of dietary lutein intakes and likewise lutein concentrations in breast milk at T0 and T1 were analysed with Student's t test. Pearson's correlation coefficient was used to determine the association between dietary lutein intake and lutein concentration in milk and plasma, respectively, as well as the correlation between breast milk and plasma lutein concentrations at T0. Pavia, northern Italy. Twenty-one pregnant women, age range 24-42 years, were recruited during their last trimester on a voluntary basis. Both breast milk and plasma lutein concentrations were significantly correlated with dietary lutein intake (r = 0.86, P = 0.0001 and r = 0.94, P = 0.0001, respectively). There was a clear significant correlation between milk and plasma lutein concentrations (r = 0.87, P = 0.0001). Mature milk lutein concentration, although significantly reduced at T1 (P < 0.01), maintained a fairly high correlation with dietary lutein intake (r = 0.82, P = 0.0001). Even though milk lutein concentration decreased during early lactation, it remained significantly correlated with daily lutein intake. Therefore, while awaiting further research, dietary recommendations advising intake of fresh fruit and vegetables rich in lutein, throughout the whole duration of pregnancy and lactation, are extremely useful.

[Bone histomorphometry of lactating and no lactating hyperthyroid rats].

PubMed

Serakides, Rogéria; Ocarino, Natália de Melo; Magalhães, Fernanda do Carmo; Souza, Cíntia de Almeida; Leite, Eveline Dias; Freitas, Edmilson Santos de

2008-06-01

The objective of this study was to verify if hyperthyroidism potentiates the osteopenia lactational. 24 adult female rats were distributed in four groups: euthyroid no lactating (control), euthyroid lactating, hyperthyroid no lactating and hyperthyroid lactating. 20 days after gestation, all the animals were necropsied. The thoracic and lumbar vertebrae, the femur and tibia were decalcified and processed for histomorphometric analysis. The euthyroid lactating group presented intense osteopenia in the studied bones. In the hyperthyroid no lactating group, there was not any change in trabecular bone percentage in none of the analyzed bone. In the hyperthyroid lactating group, there was osteopenia in the tibia and femur, similar to the one in the euthyroid lactating group. But the trabecular bone percentage in all the vertebral bodies was significantly larger in comparison with the euthyroid lactating group. It was concluded that the hyperthyroidism does not potentiate the osteopenia lactational in female rats, but it minimizes the vertebral osteopenia once it stimulates the osteoblastic activity.

Breast feeding in technically developing regions (with especial reference to West Bengal).

PubMed

Jelliffe, D B

1956-04-01

A study of infant feeding trends was undertaken in India--among urban and rural, upper and lower socioeconomic class women. Breast feeding was found to have been successful at 1 month and at 6 months among 155 lower income Bengali village women. 99% of lower income urban women were successfully breast feeding at 1 month and 95% were continuing at 6 months. These rates are remarkably high given the fact that these women suffered from malnutrition and illness. Among low income lactating women, there was a drop from the birth weight during the 2nd and 3rd days, with weight gain beginning after the 3rd day. This compares with results in Western countries. However, the weight loss was less pronounced among the Bengali neonates and the subsequent weight regain more rapid, due probably to the mothers' complete acceptance of breast feeding, ease at establishing lactation, and abundance of milk secreted. Among the lower socioeconomic groups, there were relatively few lactation complications, e.g., cracked nipples or breast abscess. Contrastingly, the 78 upper socioeconomic women surveyed showed less successful breast feeding results, with 46% not continuing at 6 months, 13% of women citing nipple damage, and 1 with a breast abscess during the puerperium. Some experts have theorized that the development of mammary complications derives from a failure of the let-down reflex. Maternal attitude is seen as the most important factor in successful breast feeding.

The 3 M's of breast-feeding the preterm infant.

PubMed

Hurst, Nancy M

2007-01-01

Mother's own milk is considered best for preterm infants. Given the often protracted period between birth and breast-feeding for most preterm newborns, a number of challenges exist for mothers and neonatal intensive care unit nurses in establishing lactation, providing mother's own milk, and achieving breast-feeding. This article conceptualizes breast-feeding the preterm infant in the context of the neonatal intensive care unit as a 3-phase process, the 3 M's of breast-feeding: medication, mother's milk feedings, and the mechanics of breast-feeding.

The work patterns of lactating women in Madura.

PubMed

Launer, L J

1993-08-01

Little is known about the work patterns of mildly malnourished lactating women: are they modified to accommodate the demands of lactation? What factors influence their pattern of work during this period of nutritional stress? These questions were addressed using quantitative and qualitative data collected from 36 randomly selected women living in a poor community in Madura, Indonesia. Work patterns of the lactating women and their family members were documented for the first 12 months post-partum. Changes in work activity were analysed within four time periods corresponding to Madurese views on development during infancy: the vulnerable neonatal (birth-40 days), early (6-12 wk) and mid (13-31 wk) stages and the independent late (32-54 wk) stage. Quantitative data suggest that women did adjust work patterns to accommodate the demands of lactation and that these adjustments went beyond the neonatal stage. Mothers curtailed their participation in high- and low-energy income-generating activities, modified their conditions of work to promote maternal-infant proximity and conserved energy while performing specific activities. These patterns were most common through the mid infancy stage. Data are presented that describe how cultural values supporting maternal-infant proximity, intra- and inter-familial work exchanges, season and resources played a role in the type of accommodations mothers were able to make to breast-feed. These data suggest that even in relatively poor environments alterations in work patterns that may be favourable to lactation are possible, particularly when cultural concepts of infancy support such a trade-off.

Effectiveness of Workplace Lactation Interventions on Breastfeeding Outcomes in the United States: An Updated Systematic Review.

PubMed

Kim, Julia H; Shin, Jong C; Donovan, Sharon M

2018-06-01

Background Returning to work is one of the main barriers to breastfeeding duration among working mothers in the United States. However, the impact of workplace lactation programs is unclear. Research Aim The aim of this study was to evaluate the effectiveness of workplace lactation programs in the United States on breastfeeding practices. Methods A systematic search was conducted of seven databases through September 2017. Articles ( N = 10) meeting the inclusion criteria of describing a workplace lactation intervention and evaluation in the United States and measuring initiation, exclusivity, or duration using an experimental or observational study design were critically evaluated. Two reviewers conducted quality assessments and reviewed the full-text articles during the analysis. Results Common services provided were breast pumps, social support, lactation rooms, and breastfeeding classes. Breastfeeding initiation was very high, ranging from 87% to 98%. Several factors were significantly associated with duration of exclusive breastfeeding: (a) receiving a breast pump for one year (8.3 versus 4.7 months), (b) return-to-work consultations (40% versus 17% at 6 months), and (c) telephone support (42% versus 15% at 6 months). Each additional service (except prenatal education) dose-dependently increased exclusively breastfeeding at 6 months. Sociodemographic information including older maternal age, working part-time, longer maternity leave, and white ethnicity were associated with longer breastfeeding duration. Conclusion Workplace lactation interventions increased breastfeeding initiation, duration, and exclusive breastfeeding, with greater changes observed with more available services. More evidence is needed on the impact of workplace support in low-income populations, and the cost-effectiveness of these programs in reducing health care costs.

The After Breast Cancer Pooling Project: rationale, methodology, and breast cancer survivor characteristics.

PubMed

Nechuta, Sarah J; Caan, Bette J; Chen, Wendy Y; Flatt, Shirley W; Lu, Wei; Patterson, Ruth E; Poole, Elizabeth M; Kwan, Marilyn L; Chen, Zhi; Weltzien, Erin; Pierce, John P; Shu, Xiao Ou

2011-09-01

The After Breast Cancer Pooling Project was established to examine the role of physical activity, adiposity, dietary factors, supplement use, and quality of life (QOL) in breast cancer prognosis. This paper presents pooled and harmonized data on post-diagnosis lifestyle factors, clinical prognostic factors, and breast cancer outcomes from four prospective cohorts of breast cancer survivors (three US-based and one from Shanghai, China) for 18,314 invasive breast cancer cases diagnosed between 1976 and 2006. Most participants were diagnosed with stage I-II breast cancer (84.7%). About 60% of breast tumors were estrogen receptor (ER)+/progesterone receptor (PR)+; 21% were ER-/PR-. Among 8,118 participants with information on HER-2 tumor status, 74.8% were HER-2- and 18.5% were HER-2+. At 1-2 years post-diagnosis (on average), 17.9% of participants were obese (BMI ≥ 30 kg/m2), 32.6% were overweight (BMI 25-29 kg/m2), and 59.9% met the 2008 Physical Activity Guidelines for Americans (≥ 2.5 h per week of moderate activity). During follow-up (mean = 8.4 years), 3,736 deaths (2,614 from breast cancer) and 3,564 recurrences have been documented. After accounting for differences in year of diagnosis and timing of post-diagnosis enrollment, five-year overall survival estimates were similar across cohorts. This pooling project of 18,000 breast cancer survivors enables the evaluation of associations of post-diagnosis lifestyle factors, QOL, and breast cancer outcomes with an adequate sample size for investigation of heterogeneity by hormone receptor status and other clinical predictors. The project sets the stage for international collaborations for the investigation of modifiable predictors for breast cancer outcomes.

Knowledge about Iodine in Pregnant and Lactating Women in the Oslo Area, Norway.

PubMed

Garnweidner-Holme, Lisa; Aakre, Inger; Lilleengen, Anne Marie; Brantsæter, Anne Lise; Henjum, Sigrun

2017-05-13

Lack of knowledge about iodine may be a risk factor for iodine deficiency in pregnant and lactating women. The aim of this study was to assess knowledge about iodine and predictors of iodine knowledge scores among pregnant and lactating women. The study also examined whether iodine knowledge scores were associated with iodine status. A cross-sectional study was performed on 804 pregnant women and 175 lactating women from 18 to 44 years of age in 2016 in the Oslo area, Norway. Knowledge about iodine was collected through a self-administered, paper-based questionnaire. Iodine concentrations in urine and breast milk were measured using an inductively coupled plasma mass spectrometer (ICPMS). 74% of the pregnant women and 55% of the lactating women achieved none to low iodine knowledge scores. Higher educated pregnant women and those who had received information about iodine had significantly higher knowledge scores. In lactating women, increased age was associated with higher knowledge scores. Knowledge scores were not associated with participants' iodine status. This study revealed a lack of knowledge about the importance of iodine in pregnant and lactating women, as well as about the most important dietary sources. Public education initiatives are required to increase the awareness about iodine in these population groups.

Combined hormonal versus nonhormonal versus progestin-only contraception in lactation.

PubMed

Lopez, Laureen M; Grey, Thomas W; Stuebe, Alison M; Chen, Mario; Truitt, Sarah T; Gallo, Maria F

2015-03-20

Postpartum contraception improves the health of mothers and children by lengthening birth intervals. For lactating women, contraception choices are limited by concerns about hormonal effects on milk quality and quantity and passage of hormones to the infant. Ideally, the contraceptive chosen should not interfere with lactation or infant growth. Timing of contraception initiation is also important. Immediately postpartum, most women have contact with a health professional, but many do not return for follow-up contraceptive counseling. However, immediate initiation of hormonal methods may disrupt the onset of milk production. To determine the effects of hormonal contraceptives on lactation and infant growth We searched for eligible trials until 2 March 2015. Sources included the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, POPLINE, Web of Science, LILACS, ClinicalTrials.gov, and ICTRP. We also examined review articles and contacted investigators. We sought randomized controlled trials in any language that compared hormonal contraception versus another form of hormonal contraception, nonhormonal contraception, or placebo during lactation. Hormonal contraception includes combined or progestin-only oral contraceptives, injectable contraceptives, implants, and intrauterine devices.Trials had to have one of our primary outcomes: breast milk quantity or biochemical composition; lactation initiation, maintenance, or duration; infant growth; or timing of contraception initiation and effect on lactation. Secondary outcomes included contraceptive efficacy while breastfeeding and birth interval. For continuous variables, we calculated the mean difference (MD) with 95% confidence interval (CI). For dichotomous outcomes, we computed the Mantel-Haenszel odds ratio (OR) with 95% CI. Due to differing interventions and outcome measures, we did not aggregate the data in a meta-analysis. In 2014, we added seven trials for a new total of 11. Five reports were

Monitoring In-Vivo the Mammary Gland Microstructure during Morphogenesis from Lactation to Post-Weaning Using Diffusion Tensor MRI.

PubMed

Nissan, Noam; Furman-Haran, Edna; Shapiro-Feinberg, Myra; Grobgeld, Dov; Degani, Hadassa

2017-09-01

Lactation and the return to the pre-conception state during post-weaning are regulated by hormonal induced processes that modify the microstructure of the mammary gland, leading to changes in the features of the ductal / glandular tissue, the stroma and the fat tissue. These changes create a challenge in the radiological workup of breast disorder during lactation and early post-weaning. Here we present non-invasive MRI protocols designed to record in vivo high spatial resolution, T 2 -weighted images and diffusion tensor images of the entire mammary gland. Advanced imaging processing tools enabled tracking the changes in the anatomical and microstructural features of the mammary gland from the time of lactation to post-weaning. Specifically, by using diffusion tensor imaging (DTI) it was possible to quantitatively distinguish between the ductal / glandular tissue distention during lactation and the post-weaning involution. The application of the T 2 -weighted imaging and DTI is completely safe, non-invasive and uses intrinsic contrast based on differences in transverse relaxation rates and water diffusion rates in various directions, respectively. This study provides a basis for further in-vivo monitoring of changes during the mammary developmental stages, as well as identifying changes due to malignant transformation in patients with pregnancy associated breast cancer (PABC).

Differential expression of cancer associated proteins in breast milk based on age at first full term pregnancy.

PubMed

Qin, Wenyi; Zhang, Ke; Kliethermes, Beth; Ruhlen, Rachel L; Browne, Eva P; Arcaro, Kathleen F; Sauter, Edward R

2012-03-21

First full term pregnancy (FFTP) completed at a young age has been linked to low long term breast cancer risk, whereas late FFTP pregnancy age confers high long term risk, compared to nulliparity. Our hypothesis was that proteins linked to breast cancer would be differentially expressed in human milk collected at three time points during lactation based on age at FFTP. We analyzed breast milk from 72 lactating women. Samples were collected within 10 days of the onset of lactation (baseline-BL), two months after lactation started and during breast weaning (W). We measured 16 proteins (11 kallikreins (KLKs), basic fibroblast growth factor, YKL-40, neutrophil gelatinase-associated lipocalin and transforming growth factor (TGF) β-1 and -2) associated with breast cancer, most known to be secreted into milk. During lactation there was a significant change in the expression of 14 proteins in women < 26 years old and 9 proteins in women > = 26 at FFTP. The most significant (p < .001) changes from BL to W in women divided by FFTP age (< 26 vs. > = 26) were in KLK3,6, 8, and TGFβ2 in women < 26; and KLK6, 8, and TGFβ2 in women > = 26. There was a significant increase (p = .022) in KLK8 expression from BL to W depending on FFTP age. Examination of DNA methylation in the promoter region of KLK6 revealed high levels of methylation that did not explain the observed changes in protein levels. On the other hand, KLK6 and TGFβ1 expression were significantly associated (r2 = .43, p = .0050). The expression profile of milk proteins linked to breast cancer is influenced by age at FFTP. These proteins may play a role in future cancer risk.

Breast-feeding pattern and onset of menstruation among Yoruba mothers of South-west Nigeria.

PubMed

Kuti, Oluwafemi; Adeyemi, Adebayo B; Owolabi, Alexander T

2007-12-01

To determine the breast-feeding practices and duration of lactational amenorrhoea among women within the first year of delivery in a Nigerian population. Cross-sectional study carried out between January 2005 and April 2006, among mothers within one year of delivery, who were attending the Infant Welfare Clinic at Wesley Guild Hospital, Ilesa, Nigeria. Using a semi-structured questionnaire, mothers were interviewed to obtain information regarding their socio-demographic characteristics, parity, breast-feeding habits, use of contraception and onset of menstruation after delivery. Information obtained was analysed using the Statistical Package for Social Sciences (SPSS) software version 11. All 268 (100%) mothers interviewed breast-fed their babies, 261 (97.4%) of which for at least 6 months. Most (71.6%) suckled exclusively for 6 months and more; only 10 (3.7%) never carried out exclusive breast-feeding. Age, parity and educational level did not affect the duration of exclusive breast-feeding. Lactational amenorrhoea lasted 3 months or more in 229 (85.5%) of the mothers. Of the 174 who exclusively breast-fed for 6 months, 109 (62.6%) remained amenorrhoeic during that time and, hence, met the criteria for use of LAM contraception. Exclusive breast-feeding among nursing mothers is highly prevalent among Yoruba mothers of South-west Nigeria. Since lactational amenorrhoea lasts 6 months in about two-thirds of the women nursing for that period of time, there is a great potential for the application of LAM for contraception.

Sodium diacetate and sodium lactate affect microbiology and sensory and objective characteristics of a restructured turkey breast product formulated with a fibrin cold-set binding system.

PubMed

Mohammed Shafit, H; Williams, S K

2010-03-01

Research was conducted to manufacture and evaluate a restructured turkey breast product using the Fibrimex cold-set binding system, sodium diacetate (NaD), and sodium lactate (NaL) and to ascertain effects of the treatments on proximate composition, pH, psychrotrophic organisms, water activity, onset of rancidity (TBA), thaw loss, cooking yields, and objective color, and sensory characteristics. Whole turkey breasts were cut into 5-cm-thick strips; treated with either water only (control), 1.5% NaL, 2.0% NaL, 0.1% NaD, 1.5% NaL + 0.1% NaD, or 2.0% NaL + 0.1% NaD; blended with Fibrimex ingredients; stuffed into casings; and stored at -30 degrees C for 0, 1, 2, and 3 mo. After each storage period, frozen chubs were tempered at 4 degrees C, sliced into 1-cm-thick steaks, packaged in retail trays, stored at 0 degrees C to simulate retail storage, and analyzed after 0, 2, 4, 6, 8, and 10 d. Sodium diacetate used alone or in combination with NaL reduced (P < 0.05) growth of psychrotrophic organisms and had no adverse effects on water activity, pH, cooking yield, fat, moisture, protein, objective color, onset of rancidity, and sensory characteristics (juiciness, turkey flavor intensity, and tenderness). Panelists reported slight off-flavor in all steaks treated with NaL. Treating steaks with NaL alone or in combination with NaD resulted in increased (P < 0.05) ash content. Sodium lactate also functioned to minimize thaw loss in the frozen restructured turkey product.

Breast milk donation after neonatal death in Australia: a report.

PubMed

Carroll, Katherine E; Lenne, Brydan S; McEgan, Kerri; Opie, Gillian; Amir, Lisa H; Bredemeyer, Sandra; Hartmann, Ben; Jones, Rachel; Koorts, Pieter; McConachy, Helen; Mumford, Patricia; Polverino, Jan

2014-01-01

Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia hosted Australia's first National Stakeholder Meeting (NSM) on the topic of milk donation after neonatal death. The NSM drew together representatives from Australian HMBs, neonatal intensive care units (NICUs) currently using donor human milk, and Australia's chief NICU parent support organization. The NSM was video-recorded and transcribed, and analyzed thematically by researchers. This article reports the seven dominant themes discussed by stakeholders during the NSM: the spectrum of women's lactation and donation experiences after infant death; the roles of the HMB and NICU in meeting the needs of the bereaved donor; how bereaved mothers' lactation autonomy may interface with a HMB's donation guidelines; how milk donation may be discussed with bereaved mothers; the variation between four categories of milk donation after neonatal death; the impact of limited resources and few HMBs on providing donation programs for bereaved mothers in Australia. This article provides evidence from researchers and practitioners that can assist HMB staff in refining their bank's policy on milk donation after infant death, and provides national policy makers with key considerations to support lactation, human milk banking, and bereavement services nation-wide.

Minerals and Trace Elements in Human Breast Milk Are Associated with Guatemalan Infant Anthropometric Outcomes within the First 6 Months.

PubMed

Li, Chen; Solomons, Noel W; Scott, Marilyn E; Koski, Kristine G

2016-10-01

Breast milk is the recommended source of nutrients for infant growth, but its adequacy to meet infants' mineral and trace element needs is unknown. We used breast-milk mineral and trace element concentrations of Guatemalan mothers at 3 lactation stages to estimate total daily intakes and to determine whether intakes were associated with early infant growth. In this cross-sectional study, breast-milk samples were collected from Mam-Mayan mothers during transitional (5-17 d, n = 56), early (18-46 d, n = 75), and established (4-6 mo, n = 103) lactation; z scores for weight (WAZ), length (LAZ), and head circumference (HCAZ) were measured. Concentrations of 11 minerals (calcium, potassium, magnesium, sodium, copper, iron, manganese, rubidium, selenium, strontium, and zinc) were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). WHO equations were used to calculate the estimated energy requirement, which was divided by the energy density of breast milk to estimate daily milk volume, and this number was multiplied by breast-milk mineral concentrations to estimate intakes. Principal component analyses identified clusters of minerals; principal components (PCs) were used in regression analyses for anthropometric outcomes. Estimated breast-milk intakes during established lactation were insufficient to compensate for the lower milk sodium, copper, manganese, and zinc concentrations in male infants and the lower sodium, iron and manganese concentrations in female infants. Estimated intakes of calcium, magnesium, potassium, sodium, and selenium were below the Institute of Medicine Adequate Intake for both sexes at all 3 stages of lactation. In early lactation, multiple linear regressions showed that PC1 (calcium, magnesium, potassium, rubidium, and strontium intakes) was positively associated with WAZ, LAZ, and HCAZ. In established lactation, the same PC with sodium added was positively associated with all 3 anthropometric outcomes; a second PC (PC2: zinc

Quinoline 3-sulfonamides inhibit lactate dehydrogenase A and reverse aerobic glycolysis in cancer cells

PubMed Central

2013-01-01

Background Most normal cells in the presence of oxygen utilize glucose for mitochondrial oxidative phosphorylation. In contrast, many cancer cells rapidly convert glucose to lactate in the cytosol, a process termed aerobic glycolysis. This glycolytic phenotype is enabled by lactate dehydrogenase (LDH), which catalyzes the inter-conversion of pyruvate and lactate. The purpose of this study was to identify and characterize potent and selective inhibitors of LDHA. Methods High throughput screening and lead optimization were used to generate inhibitors of LDHA enzymatic activity. Effects of these inhibitors on metabolism were evaluated using cell-based lactate production, oxygen consumption, and 13C NMR spectroscopy assays. Changes in comprehensive metabolic profile, cell proliferation, and apoptosis were assessed upon compound treatment. Results 3-((3-carbamoyl-7-(3,5-dimethylisoxazol-4-yl)-6-methoxyquinolin-4-yl) amino) benzoic acid was identified as an NADH-competitive LDHA inhibitor. Lead optimization yielded molecules with LDHA inhibitory potencies as low as 2 nM and 10 to 80-fold selectivity over LDHB. Molecules in this family rapidly and profoundly inhibited lactate production rates in multiple cancer cell lines including hepatocellular and breast carcinomas. Consistent with selective inhibition of LDHA, the most sensitive breast cancer cell lines to lactate inhibition in hypoxic conditions were cells with low expression of LDHB. Our inhibitors increased rates of oxygen consumption in hepatocellular carcinoma cells at doses up to 3 microM, while higher concentrations directly inhibited mitochondrial function. Analysis of more than 500 metabolites upon LDHA inhibition in Snu398 cells revealed that intracellular concentrations of glycolysis and citric acid cycle intermediates were increased, consistent with enhanced Krebs cycle activity and blockage of cytosolic glycolysis. Treatment with these compounds also potentiated PKM2 activity and promoted apoptosis in Snu

The effect of medications on the lactating mother and her infant.

PubMed

Bowes, W A

1980-12-01

Most drugs have been found to be excreted in human breast milk. Usually when the drug is taken in therapeutic amounts for short periods of time by the mother, the levels of the drug in breast milk are sufficiently low to be of little hazard to the infant. However, is a breast-feeding infant should become ill or fail to thrive and the morbidity cannot be explained, one of the following should be done: 1. Discontinue the drug. 2. Discontinue breast feeding. Frequently this can be accomplished on a temporary basis with the mother pumping her breasts to maintain lactation while the response of the infant is monitored. 3. Collect maternal plasma, breast milk, and infant plasma samples for drug assay. In situations in which this can be accomplished, it may be possible to incriminate (or exonerate) a drug or one of its metabolites as the source of the morbidity on the basis of the amounts of drug found in the milk or the infant's plasma. As tedious and impractical as this approach may seem, it would eventually lead to the accumulation of a reasonable amount of data from which could be drawn sensible conclusions about the effect of drugs on the breast-fed infant.

Breastfeeding and the prevention of breast cancer: a retrospective review of clinical histories.

PubMed

González-Jiménez, Emilio; García, Pedro A; Aguilar, María José; Padilla, Carlos A; Álvarez, Judit

2014-09-01

To evaluate at what age parous and nonparous women were diagnosed with breast cancer. Factors taken into account for parous women were whether they had breastfed their children, and if so, the length of the lactation period. Other factors considered for both groups were obesity, family histories of cancer, smoking habits and alcohol consumption. Breast cancer is the most common form of cancer in younger women in Western countries. Its growing incidence as well as the increasingly early age of diagnosis led us to carefully analyse its possible causes and the preventive measures to be taken. This is a particularly important goal in epidemiological research. A retrospective study of the clinical histories of patients diagnosed with breast cancer at the San Cecilio University Hospital in Granada (Spain). In this study, we analysed 504 medical records of female patients, 19-91 years of age, who had been diagnosed and treated for breast cancer from 2004-2009 at the San Cecilio University Hospital in Granada (Spain). Relevant data (age of diagnosis, period of lactation, family history of cancer, obesity, alcohol consumption and smoking habits) were collected from the clinical histories of each patient and analysed. A conditional inference tree was used to relate the age of diagnosis to smoking habits and the length of the lactation period. The conditional inference tree identified significant differences between the age of the patients at breast cancer diagnosis, smoking habits (p < 0·001) and lactation period if the subjects had breastfed their children for more than six months (p = 0·006), regardless of whether they had a family history of cancer. Our study concluded that breastfeeding for over six months not only provides children with numerous health benefits, but also protects mothers from breast cancer when the mothers are nonsmokers. Nurses play a crucial role in encouraging new mothers to breastfeed their children, and this helps to prevent breast cancer. �

Which Breast Pump for Which Mother: An Evidenced-Based Approach to Individualizing Breast Pump Technology

PubMed Central

Meier, Paula P.; Patel, Aloka L.; Hoban, Rebecca; Engstrom, Janet L.

2015-01-01

The majority of new mothers in the United States use breast pumps in the first four months post-birth in order to achieve their personal human milk feeding goals. Although these mothers seek guidance from health care professionals with respect to the type and use of breast pumps, there are few evidence-based guidelines to guide this professional advice. This paper reviews the evidence to facilitate professional individualization of breast pump recommendations using three categories of literature: the infant as the gold standard to which the pump is compared; the degree of maternal breast pump dependency (e.g., the extent to which the breast pump replaces the infant for milk removal and mammary gland stimulation); and the stage of lactation for which the pump replaces the infant. This review can also serve to inform public and private payers with respect to individualizing breast pump type to mother-dyad characteristics. PMID:26914013

Predictors of Primary Breast Abscesses and Recurrence

PubMed Central

Bharat, Ankit; Gao, Feng; Aft, Rebecca L.; Gillanders, William E.; Eberlein, Timothy J.

2014-01-01

Background We investigated the patients and microbiological risk factors that predispose to the development of primary breast abscesses and subsequent recurrence. Methods Patients with a primary breast abscess requiring surgical therapy between January 1, 2000 and December 31, 2006 were reviewed. Recurrent breast abscess was defined by the need for repeated drainage within 6 months. Patient characteristics were compared to the general population and between groups. Results A total of 89 patients with a primary breast abscess were identified; 12 (14%) were lactational and 77 (86%) were nonlactational. None of the lactational abscesses recurred, whereas 43 (57%) of the nonlactational abscesses did so (P < 0.01). Compared to the general population, patients with a primary breast abscess were predominantly African American (64% vs. 12%), had higher rates of obesity (body mass index > 30: 43% vs. 22%), and were tobacco smokers (45% vs, 23%) (P < 0.01 for all). The only factor significantly associated with recurrence in the multivariate logistic regression analysis was tobacco smoking (P = 0.003). Compared to patients who did not have a recurrence, patients with recurrent breast abscesses had a higher incidence of mixed bacteria (20.5% vs. 8.9%), anaerobes (4.5% vs. 0%), and Proteus (9.1% vs. 4.4%) but lower incidence of Staphylococcus (4.6% vs. 24.4%) (P < 0.05 for each). Conclusions Risk factors for developing a primary breast abscess include African American race, obesity, and tobacco smoking. Patients with recurrent breast abscesses are more likely to be smokers and have mixed bacterial and anaerobic infections. Broader antibiotic coverage should be considered for the higher risk groups. PMID:19669231

Stimulation of lactate receptor (HCAR1) affects cellular DNA repair capacity.

PubMed

Wagner, Waldemar; Kania, Katarzyna D; Ciszewski, Wojciech M

2017-04-01

Numerous G-protein coupled receptors have been reported to enhance cancer cell survival and resistance to clinically used chemotherapeutics. Recently, hydroxycarboxylic acid receptor 1 (HCAR1) was shown to drive lactate-dependent enhancement of cell survival and metastasis in pancreatic and breast cancers. Furthermore, our previous study confirmed the involvement of HCAR1 in lactate-related enhancement of DNA repair in cervical cancer cells. In the present study, we examined the possible mechanisms of HCAR1-mediated enhancement of DNA repair capacity. We observed that the HCAR1 agonist dihydroxybenzoic acid (DHBA) up-regulated BRCA1 (breast cancer type 1 susceptibility protein) and NBS1 (Nijmegen breakage syndrome 1) expression in HeLa cells. Moreover, HCAR1 silencing decreased mRNA and protein levels of BRCA1 by 30% and 20%, respectively. Immunocytochemical analyses of BRCA1, nibrin and DNA-PKcs indicated an increased accumulation of these proteins in cell nuclei after DHBA stimulation. Subsequently, these changes in the DNA repair protein levels translated into an enhanced DNA repair rate after doxorubicin treatment, as shown by γ-H2AX and comet assay experiments. In contrast, the down-regulation of HCAR1 decreased the efficiency of DNA repair. Finally, we observed the abrogation of DHBA-driven BRCA1 protein up-regulation and enhanced DNA repair following the preincubation of cells with the PKC inhibitor Gö6983. Taken together, our data indicate that lactate receptor/HCAR1 expression in cervical carcinoma cells may contribute to the modulation of cellular DNA repair mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

Pharmacokinetics of metoprolol during pregnancy and lactation.

PubMed

Ryu, Rachel J; Eyal, Sara; Easterling, Thomas R; Caritis, Steve N; Venkataraman, Raman; Hankins, Gary; Rytting, Erik; Thummel, Kenneth; Kelly, Edward J; Risler, Linda; Phillips, Brian; Honaker, Matthew T; Shen, Danny D; Hebert, Mary F

2016-05-01

The objective of this study was to evaluate the steady-state pharmacokinetics of metoprolol during pregnancy and lactation. Serial plasma, urine, and breast milk concentrations of metoprolol and its metabolite, α-hydroxymetoprolol, were measured over 1 dosing interval in women treated with metoprolol (25-750 mg/day) during early pregnancy (n = 4), mid-pregnancy (n = 14), and late pregnancy (n = 15), as well as postpartum (n = 9) with (n = 4) and without (n = 5) lactation. Subjects were genotyped for CYP2D6 loss-of-function allelic variants. Using paired analysis, mean metoprolol apparent oral clearance was significantly higher in mid-pregnancy (361 ± 223 L/h, n = 5, P < .05) and late pregnancy (568 ± 273 L/h, n = 8, P < .05) compared with ≥3 months postpartum (200 ± 131 and 192 ± 98 L/h, respectively). When the comparison was limited to extensive metabolizers (EMs), metoprolol apparent oral clearance was significantly higher during both mid- and late pregnancy (P < .05). Relative infant exposure to metoprolol through breast milk was <1.0% of maternal weight-adjusted dose (n = 3). Because of the large, pregnancy-induced changes in metoprolol pharmacokinetics, if inadequate clinical responses are encountered, clinicians who prescribe metoprolol during pregnancy should be prepared to make aggressive changes in dosage (dose and frequency) or consider using an alternate beta-blocker. © 2015, The American College of Clinical Pharmacology.

Breast milk is conditionally perfect.

PubMed

Erick, Miriam

2018-02-01

conception and fetal development. While alternative forms of infant nutrition carry standard product labels of nutrient adequacy, this information does not apply universally to all breast milk. Infant formulas are fortified with various amounts of vitamins, minerals, supplemental protein concentrates, nucleic factors, omega 3 fatty acids and any important new nutritional finding. Infant formulas are manufactured to be consistent in composition and are monitored closely for quality. Not true for human breast milk. Any nutrient deficiency existing in pregnancy will ultimately be carried forward via lactation. It is a biological impossibility for a lactating woman to transfer nutrients via breast milk she does not have! Copyright © 2017 Elsevier Ltd. All rights reserved.

Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

PubMed

Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

2013-12-31

While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

Exogenous lactate supply affects lactate kinetics of rainbow trout, not swimming performance

PubMed Central

Omlin, Teye; Langevin, Karolanne

2014-01-01

Intense swimming causes circulatory lactate accumulation in rainbow trout because lactate disposal (Rd) is not stimulated as strongly as lactate appearance (Ra). This mismatch suggests that maximal Rd is limited by tissue capacity to metabolize lactate. This study uses exogenous lactate to investigate what constrains maximal Rd and minimal Ra. Our goals were to determine how exogenous lactate affects: 1) Ra and Rd of lactate under baseline conditions or during graded swimming, and 2) exercise performance (critical swimming speed, Ucrit) and energetics (cost of transport, COT). Results show that exogenous lactate allows swimming trout to boost maximal Rd lactate by 40% and reach impressive rates of 56 μmol·kg−1·min−1. This shows that the metabolic capacity of tissues for lactate disposal is not responsible for setting the highest Rd normally observed after intense swimming. Baseline endogenous Ra (resting in normoxic water) is not significantly reduced by exogenous lactate supply. Therefore, trout have an obligatory need to produce lactate, either as a fuel for oxidative tissues and/or from organs relying on glycolysis. Exogenous lactate does not affect Ucrit or COT, probably because it acts as a substitute for glucose and lipids rather than extra fuel. We conclude that the observed 40% increase in Rd lactate is made possible by accelerating lactate entry into oxidative tissues via monocarboxylate transporters (MCTs). This observation together with the weak expression of MCTs and the phenomenon of white muscle lactate retention show that lactate metabolism of rainbow trout is significantly constrained by transmembrane transport. PMID:25121611

Bilateral breast abscess: a rare complication of enteric fever.

PubMed

Singh, S; Pandya, Y; Rathod, J; Trivedi, S

2009-01-01

Breast abscess is usually caused by Staphylococcus aureus in pregnant or lactating females. Salmonella spp. is occasionally associated with abscess formation in various organs, but breast abscess is a very rare complication. In enteric fever dissemination to multiple organ systems following bacteraemia can lead to localized abscess. We report a case of bilateral breast abscess due to Salmonella Typhi in an unmarried 35-year-old female without any predisposing conditions. She presented with fever and painful swelling of both the breasts. S. typhi was isolated from both breasts. Such rare cause must be suspected in females without any evident predisposing factors for effective management.

Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success.

PubMed

Elagili, Faisal; Abdullah, Norlia; Fong, Liew; Pei, Tan

2007-01-01

To assess ultrasonographically (US) guided needle aspiration of breast abscesses as an alternative to surgical incision and drainage. In our prospective study, 30 patients with 31 breast abscesses (one patient had bilateral breast abscess) underwent percutaneous breast abscess drainage under US guidance with local anaesthesia and oral antibiotics between 1 January 2004 and 31 March 2005. These patients consisted of 16 (53.3%) non-lactating and 14 (46.7%) lactating women, with ages ranging from 18 to 68 years (median, 28 years). The racial distribution comprised 26 (86.7%) Malays, three (10%) Chinese and one (3.3%) Indian. All patients had the chief complaint of breast swelling and 25 (83.3%) had breast pain. Clinically, 28 (93.3%) were found to have a palpable mass. Nine (30%) lesions were in the upper outer quadrant of the left breast. US diameters ranged from 1 to 15 cm (median, 4 cm). The pus volumes varied from 1 to 200 mL (median, 14 mL). Fifteen (50%) patients required only a single aspiration, 10 required multiple aspirations and five required incision and drainage. Those patients in whom needle aspiration failed had multiloculated lesions irrespective of abscess volume and size. Needle aspiration with ultrasound guidance is an effective treatment for breast abscess irrespective of abscess volume and size.

Breast milk breaks new boundaries.

PubMed

Hilton, Sioned

2012-01-01

It is widely understood that breast milk is best for babies, but groundbreaking research continues to be conducted by the world's leading researchers to ensure we have the most recent knowledge to help breastfeeding mothers and give health professionals up to date guidance. This article provides a report from the recent International Breastfeeding and Lactation Symposium, hosted by Medela, touching on some of the key findings that were presented. This year's symposium revealed some exciting news for the breastfeeding world and here our reporter gives us a snap shot of the three most significant updates: further understanding of stem cells in breast milk, findings that have unlocked the power of human milk and insights into medication and breast milk.

Lactate shuttles in nature.

PubMed

Brooks, G A

2002-04-01

Once thought to be the consequence of oxygen lack in contracting skeletal muscle, the glycolytic product lactate is formed and utilized continuously under fully aerobic conditions. "Cell-cell" and "intracellular lactate shuttle" concepts describe the roles of lactate in the delivery of oxidative and gluconeogenic substrates, as well as in cell signalling. Examples of cell-cell shuttles include lactate exchanges between white-glycolytic and red-oxidative fibres within a working muscle bed, between working skeletal muscle and heart, and between tissues of net lactate release and gluconeogenesis. Lactate exchange between astrocytes and neurons that is linked to glutamatergic signalling in the brain is an example of a lactate shuttle supporting cell-cell signalling. Lactate uptake by mitochondria and pyruvate-lactate exchange in peroxisomes are examples of intracellular lactate shuttles. Lactate exchange between sites of production and removal is facilitated by monocarboxylate transport proteins, of which there are several isoforms, and, probably, also by scaffolding proteins. The mitochondrial lactate-pyruvate transporter appears to work in conjunction with mitochondrial lactate dehydrogenase, which permits lactate to be oxidized within actively respiring cells. Hence mitochondria function to establish the concentration and proton gradients necessary for cells with high mitochondrial densities (e.g. cardiocytes) to take up and oxidize lactate. Arteriovenous difference measurements on working cardiac and skeletal muscle beds as well as NMR spectral analyses of these tissues show that lactate is formed and oxidized within the cells of formation in vivo. Glycolysis and lactate oxidation within cells permits high flux rates and the maintenance of redox balance in the cytosol and mitochondria. Other examples of intracellular lactate shuttles include lactate uptake and oxidation in sperm mitochondria and the facilitation of beta-oxidation in peroxisomes by pyruvate-lactate

Prognostic significance of blood lactate and lactate clearance in trauma patients.

PubMed

Régnier, Marie-Alix; Raux, Mathieu; Le Manach, Yannick; Asencio, Yves; Gaillard, Johann; Devilliers, Catherine; Langeron, Olivier; Riou, Bruno

2012-12-01

Lactate has been shown to be a prognostic biomarker in trauma. Although lactate clearance has already been proposed as an intermediate endpoint in randomized trials, its precise role in trauma patients remains to be determined. Blood lactate levels and lactate clearance (LC) were calculated at admission and 2 and 4 h later in trauma patients. The association of initial blood lactate level and lactate clearance with mortality was tested using receiver-operating characteristics curve, logistic regression using triage scores, Trauma Related Injury Severity Score as a reference standard, and reclassification method. The authors evaluated 586 trauma patients (mean age 38±16 yr, 84% blunt and 16% penetrating, mortality 13%). Blood lactate levels at admission were elevated in 327 (56%) patients. The lactate clearance should be calculated within the first 2 h after admission as LC0-2 h was correlated with LC0-4 h (R=0.55, P<0.001) but not with LC2-4 h (R=0.04, not significant). The lactate clearance provides additional predictive information to initial blood lactate levels and triage scores and the reference score. This additional information may be summarized using a categorical approach (i.e., less than or equal to -20 %/h) in contrast to initial blood lactate. The results were comparable in patients with high (5 mM/l or more) initial blood lactate. Early (0-2 h) lactate clearance is an important and independent prognostic variable that should probably be incorporated in future decision schemes for the resuscitation of trauma patients.

Prednisone Pharmacokinetics During Pregnancy and Lactation.

PubMed

Ryu, Rachel J; Easterling, Thomas R; Caritis, Steve N; Venkataramanan, Raman; Umans, Jason G; Ahmed, Mahmoud S; Clark, Shannon; Kantrowitz-Gordon, Ira; Hays, Karen; Bennett, Brooke; Honaker, Matthew T; Thummel, Kenneth E; Shen, Danny D; Hebert, Mary F

2018-05-07

To evaluate the steady-state pharmacokinetics of prednisone and its metabolite prednisolone in pregnant and lactating female subjects, 19 subjects received prednisone (4-40 mg/day orally) in early (n = 3), mid (n = 9), and late (n = 13) pregnancy as well as postpartum with (n = 2) and without (n = 5) lactation. Serial blood and urine samples were collected over 1 dosing interval. Prednisone and its metabolite, prednisolone, steady-state noncompartmental pharmacokinetic parameters were estimated. During pregnancy, prednisone apparent oral clearance increased with dose (35.1 ± 11.4 L/h with 5 mg, 52.6 ± 5.2 L/h with 10 mg, and 64.3 ± 6.9 L/h with 20 mg, P = .001). Similarly, unbound prednisone apparent oral clearance increased with dose. In addition, prednisolone renal clearance increased with dose (0.3 ± 0.3 L/h with 5 mg, 0.5 ± 0.4 L/h with 10 mg, and 1.3 ± 1.1 L/h with 20 mg, P = .002). Higher prednisone (r = 0.57, P ≤ .05) and prednisolone (r = 0.75, P ≤ .05) concentrations led to a higher percentage of unbound drug. Breast-milk/plasma area under the concentration-time curve ratios were 0.5-0.6 for prednisone and 0.02-0.03 for prednisolone. Relative infant doses were 0.35% to 0.53% and 0.09% to 0.18%, for prednisone and prednisolone, respectively. Prednisone and prednisolone exhibit dose- and concentration-dependent pharmacokinetics during pregnancy, and infant exposure to these agents via breast milk is minimal. © 2018, The American College of Clinical Pharmacology.

Inhibition of lactation.

PubMed

Llewellyn-Jones, D

1975-01-01

The mechanism and hormonal regulation of lactation is explained and illustrated with a schematic representation. Circulating estrogen above a critical amount seems to be the inhibitory factor controlling lactation during pregnancy. Once delivery occurs, the level of estrogen falls, that of prolactin rises, and lactation begins. Nonsuckling can be used to inhibit lactation. Estrogens can also be used to inhibit lactation more quickly and with less pain. The reported association between estrogens and puerperal thromboembolism cannot be considered conclusive due to defects in the reporting studies. There is no reason not to use estrogens in lactation inhibition except for women over 35 who experienced a surgical delivery. Alternative therapy is available for these women. The recently-developed drug, brom-ergocryptine, may replace other methods of lactation inhibition.

Antioxidant capacity of fresh and stored breast milk: is -80°C optimal temperature for freeze storage?

PubMed

Sari, Fatma Nur; Akdag, Arzu; Dizdar, Evrim Alyamac; Uras, Nurdan; Erdeve, Omer; Erel, Ozcan; Dilmen, Ugur

2012-06-01

To determine total antioxidant capacity and total oxidation status in fresh and freeze stored (at -80°C) breast milk during the stages of lactation. Samples of colostrum, transitional and mature milk were collected from 44 healthy women at 3, 8 and 30 days after birth. The total milk volume collected (6 ml) was divided in two aliquot parts: 3 ml for the fresh analysis which was done immediately after the extraction and 3 ml for storage under freezing conditions at -80°C for two months. The antioxidant status and oxidative stress of the fresh and stored breast milk were assessed via determination of total antioxidant capacity and total oxidation status. Antioxidant capacity of transitional and mature milk decreased (p = 0.0001, p = 0.028, respectively); however, antioxidant capacity of colostrum did not change by storage at -80°C (p > 0.05). Total antioxidant capacity of fresh and stored breast milk significantly decreased during the stages of lactation (p < 0.0001, p = 0.028, respectively). Total oxidation status showed no significant difference in fresh and stored breast milk during the stages of lactation (p > 0.05). Freeze storage of breast milk at -80°C for two months seems not to be the optimal condition to preserve the antioxidant capacity of breast milk.

Choline deficiency impairs intestinal lipid metabolism in the lactating rat.

PubMed

da Silva, Robin P; Kelly, Karen B; Lewis, Erin D; Leonard, Kelly-Ann; Goruk, Sue; Curtis, Jonathan M; Vine, Donna F; Proctor, Spencer D; Field, Catherine J; Jacobs, René L

2015-10-01

Choline is a precursor to phosphatidylcholine (PC), a structural molecule in cellular membranes that is crucial for cell growth and function. PC is also required for the secretion of lipoprotein particles from liver and intestine. Choline requirements are increased during lactation when maternal choline is supplied to the offspring through breast milk. To investigate the effect of dietary choline on intestinal lipid metabolism during lactation, choline-supplemented (CS), phosphatidylcholine-supplemented (PCS) or choline-deficient (CD) diets were fed to dams during the suckling period. CD dams had lower plasma triacylglycerol, cholesterol and apoB in the fasted state and following a fat-challenge (P < .05). There was a higher content of neutral lipids and lower content of PC in the intestine of CD dams, compared with CS and PCS fed animals (P < .05). In addition, there was lower (P < .05) villus height in CD dams, which indicated a reduced absorptive surface area in the intestine. Choline is critical for the absorption of fat in lactating rats and choline deficiency alters intestinal morphology and impairs chylomicron secretion by limiting the supply of PC. Copyright © 2015 Elsevier Inc. All rights reserved.

Mothers' experience of fathers' support for breast-feeding.

PubMed

Nickerson, Lauren E; Sykes, Abby C; Fung, Teresa T

2012-09-01

To examine mothers' experience of support received from fathers for breast-feeding. We conducted in-depth in-person interviews with women with recent breast-feeding experience. Interview transcripts were analysed by qualitative content analysis. Interviews were designed to explore the mothers' perception of role of fathers in breast-feeding, education on breast-feeding that fathers received and their perception of the fathers' view on breast-feeding. Urban and suburban community. Nineteen women from a metropolitan area in the north-eastern USA. Ten themes emerged, these involved practical and emotional support provided by fathers, especially during times of unexpected breast-feeding challenges. In addition, mothers perceived fathers may benefit from more peer and professional support, lactation consultant service and breast-feeding education. Mothers appreciated the support from fathers for breast-feeding continuation, including encouragement and understanding. These results may be useful for health-care practitioners to promote breast-feeding continuation by supporting fathers in their role in the breast-feeding process.

Brain lactate kinetics: Modeling evidence for neuronal lactate uptake upon activation.

PubMed

Aubert, Agnès; Costalat, Robert; Magistretti, Pierre J; Pellerin, Luc

2005-11-08

A critical issue in brain energy metabolism is whether lactate produced within the brain by astrocytes is taken up and metabolized by neurons upon activation. Although there is ample evidence that neurons can efficiently use lactate as an energy substrate, at least in vitro, few experimental data exist to indicate that it is indeed the case in vivo. To address this question, we used a modeling approach to determine which mechanisms are necessary to explain typical brain lactate kinetics observed upon activation. On the basis of a previously validated model that takes into account the compartmentalization of energy metabolism, we developed a mathematical model of brain lactate kinetics, which was applied to published data describing the changes in extracellular lactate levels upon activation. Results show that the initial dip in the extracellular lactate concentration observed at the onset of stimulation can only be satisfactorily explained by a rapid uptake within an intraparenchymal cellular compartment. In contrast, neither blood flow increase, nor extracellular pH variation can be major causes of the lactate initial dip, whereas tissue lactate diffusion only tends to reduce its amplitude. The kinetic properties of monocarboxylate transporter isoforms strongly suggest that neurons represent the most likely compartment for activation-induced lactate uptake and that neuronal lactate utilization occurring early after activation onset is responsible for the initial dip in brain lactate levels observed in both animals and humans.

Life history theory and breast cancer risk: methodological and theoretical challenges: Response to "Is estrogen receptor negative breast cancer risk associated with a fast life history strategy?".

PubMed

Aktipis, Athena

2016-01-01

In a meta-analysis published by myself and co-authors, we report differences in the life history risk factors for estrogen receptor negative (ER-) and estrogen receptor positive (ER+) breast cancers. Our meta-analysis did not find the association of ER- breast cancer risk with fast life history characteristics that Hidaka and Boddy suggest in their response to our article. There are a number of possible explanations for the differences between their conclusions and the conclusions we drew from our meta-analysis, including limitations of our meta-analysis and methodological challenges in measuring and categorizing estrogen receptor status. These challenges, along with the association of ER+ breast cancer with slow life history characteristics, may make it challenging to find a clear signal of ER- breast cancer with fast life history characteristics, even if that relationship does exist. The contradictory results regarding breast cancer risk and life history characteristics illustrate a more general challenge in evolutionary medicine: often different sub-theories in evolutionary biology make contradictory predictions about disease risk. In this case, life history models predict that breast cancer risk should increase with faster life history characteristics, while the evolutionary mismatch hypothesis predicts that breast cancer risk should increase with delayed reproduction. Whether life history tradeoffs contribute to ER- breast cancer is still an open question, but current models and several lines of evidence suggest that it is a possibility. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

Methodology of phase II clinical trials in metastatic elderly breast cancer: a literature review.

PubMed

Cabarrou, B; Mourey, L; Dalenc, F; Balardy, L; Kanoun, D; Roché, H; Boher, J M; Rougé-Bugat, M E; Filleron, Thomas

2017-08-01

As the incidence of invasive breast cancer will increase with age, the number of elderly patients with a diagnosis metastatic breast cancer will also rise. But the use of cytotoxic drugs in elderly metastatic breast cancer patients is not systematic and is dreaded by medical oncologists. The need for prospective oncologic data from this population seems increasingly obvious. The main objective of this review is to investigate design and characteristics of phase II trials that assess activity and feasibility of chemotherapies in elderly advanced/metastatic breast cancer patients. An electronic search in PUBMED allowed us to retrieve articles published in English language on phase II trials in elderly metastatic breast cancer between January 2002 and May 2016. Sixteen publications were finally included in this review. The primary endpoint was a simple, a composite, and a co-primary endpoints in 11, three, and two studies, respectively. Efficacy was the primary objective in 15 studies: simple (n = 10), composite (n = 3), co-primary endpoints (n = 2). Composite or co-primary endpoints combined efficacy and toxicity. Thirteen studies used multistage designs. Only five studies evaluated the feasibility, i.e., to jointly assess efficacy and tolerance to treatment (toxicity, quality of life, etc) as primary endpoint. Development of elderly specific phase III clinical trials might be challenging, it therefore seems essential to conduct phase II clinical trials evaluating jointly efficacy and toxicity in a well-defined geriatric population. Use of multistage designs that take into account heterogeneity would allow to identify a subpopulation at interim analysis and to reduce the number of patients exposed to an inefficient or a toxic treatment regimen. It is crucial to evaluate new therapies (targeted therapies, immunotherapies) using adequate methodologies (Study design, endpoint).

Breast feeding: is it vital?

PubMed

Alnasir, F A

1990-12-01

Human milk is the natural food of infants. It is a naturally balanced diet which meets the needs of the newborn. No artificial food can compare with human milk's natural, nutritional, and anti-infective properties. Various agencies have therefore strongly advocated every infant's right to be breast fed. For example, the International Confederation of Midwives at their 1984 meeting recommended that breast feeding be undertaken for at least 6 months especially in areas of the world where the incidence of infant mortality, morbidity, and malnutrition is high. The majority of women should be able to breast feed even if malnourished, and providing food for a lactating woman is less expensive than providing artificial formula for her baby. In some Western countries, breasts are seen more as sex symbols than sources of nourishment for infants. Women in developing countries should instead retain their tradition of breast feeding in the best interest of both their children and society.

Brain lactate kinetics: Modeling evidence for neuronal lactate uptake upon activation

PubMed Central

Aubert, Agnès; Costalat, Robert; Magistretti, Pierre J.; Pellerin, Luc

2005-01-01

A critical issue in brain energy metabolism is whether lactate produced within the brain by astrocytes is taken up and metabolized by neurons upon activation. Although there is ample evidence that neurons can efficiently use lactate as an energy substrate, at least in vitro, few experimental data exist to indicate that it is indeed the case in vivo. To address this question, we used a modeling approach to determine which mechanisms are necessary to explain typical brain lactate kinetics observed upon activation. On the basis of a previously validated model that takes into account the compartmentalization of energy metabolism, we developed a mathematical model of brain lactate kinetics, which was applied to published data describing the changes in extracellular lactate levels upon activation. Results show that the initial dip in the extracellular lactate concentration observed at the onset of stimulation can only be satisfactorily explained by a rapid uptake within an intraparenchymal cellular compartment. In contrast, neither blood flow increase, nor extracellular pH variation can be major causes of the lactate initial dip, whereas tissue lactate diffusion only tends to reduce its amplitude. The kinetic properties of monocarboxylate transporter isoforms strongly suggest that neurons represent the most likely compartment for activation-induced lactate uptake and that neuronal lactate utilization occurring early after activation onset is responsible for the initial dip in brain lactate levels observed in both animals and humans. PMID:16260743

Lactation stage-dependent expression of transporters in rat whole mammary gland and primary mammary epithelial organoids.

PubMed

Gilchrist, Samuel E; Alcorn, Jane

2010-04-01

Since solute carrier (SLC) and ATP-binding cassette (ABC) transporters play pivotal roles in the transport of both nutrients and drugs into breast milk, drug-nutrient transport interactions at the lactating mammary gland are possible. Our purpose was to characterize lactation stage-dependent changes in transporter expression in rat mammary gland and isolated mammary epithelial organoids (MEO) to provide additional insight for the safe use of maternal medications during breastfeeding. We used quantitative reverse transcription-polymerase chain reaction to assess the temporal expression patterns of SLC and ABC transporters in rat mammary gland and isolated MEO at different stages of lactation. In whole mammary gland five distinct patterns of expression emerged relative to late gestation: (i) decreasing throughout lactation (Mdr1a, Mdr1b, Mrp1, Octn2, Ent2, Ent3, Ncbt2, Mtx1); (ii) prominent increase in early lactation, which may remain elevated or decline with advancing lactation (Octn1, Cnt2, Cnt3, Ent1, Pept1, Pept2); (iii) constant but decreasing later in lactation (Octn3, Dmt1); (iv) increasing until mid-to-late lactation (Oct1, Cnt1); and (v) prominent increase late in lactation (Ncbt1). In isolated MEO (an enriched source of mammary epithelial cells) major differences in expression patterns were noted for Octn3, Ncbt1, and Mtx1, but otherwise were reasonably similar with the whole mammary gland. In conclusion our study augments existing data on transporter expression in the lactating mammary gland. These data should facilitate investigations into lactation-stage dependent changes in drug or nutrient milk-to-serum concentration ratios, the potential for drug- or disease-transporter interactions, and mechanistic studies of transporter function in the lactating mammary gland.

Comparison of effects of breast-feeding practices on birth-spacing in three societies: nomadic Turkana, Gainj, and Quechua.

PubMed

Gray, S J

1994-01-01

Variation in the duration and pattern of breast-feeding contributes significantly to inter-population differences in fertility. In this paper, measures of suckling frequency and intensity are used to compare the effects of breast-feeding practices on the duration of lactational amenorrhoea, and on the length of the birth interval in three prospective studies undertaken during the 1980s, among Quechua Indians of Peru, Turkana nomads of Kenya, and Gainj of Papua New Guinea. In all three societies, lactation is prolonged well into the second year postpartum, and frequent, on-demand breast-feeding is the norm. However, the duration of lactational amenorrhoea and the length of birth intervals vary considerably. Breast-feeding patterns among Gainj and Turkana are similar, but Turkana women resume menses some 3 months earlier than do the Gainj. The average birth interval among the Gainj exceeds that of nomadic Turkana by over 15 months. Suckling activity decreases significantly with increasing age of nurslings among both Gainj and Quechua, but not among Turkana. Earlier resumption of menses among Turkana women may be linked to the unpredictable demands of the pastoral system, which increase day-to-day variation in the number of periods of on-demand breast-feeding, although not in suckling patterns. This effect is independent of the age of infants. The short birth intervals of Turkana women, relative to those of the Gainj, may be related to early supplementation of Turkana nurslings with butterfat and animals' milk, which reduces energetic demands on lactating women at risk of negative energy balance.

Does Circadian Variation of Mothers Affect Macronutrients of Breast Milk?

PubMed

Çetinkaya, Aslihan Köse; Dizdar, Evrim Alyamaç; Yarcı, Erbu; Sari, Fatma Nur; Oguz, Serife Suna; Uras, Nurdan; Canpolat, Fuat Emre

2017-06-01

Objective  To determine the within-day variation of fat, protein, and carbohydrate content of breast milk. Methods  The study was conducted at Zekai Tahir Burak Maternity Teaching Hospital between April 2013 and January 2014. We obtained milk samples from lactating mothers of hospitalized infants through hand expression after breast-feeding or pumping three times a day. A mid-infrared human milk analyzer was used for measuring the macronutrient contents of breast milk samples. Results  Lactating mothers of 52 infants (30 preterm, 22 term) were recruited to the study. No significant difference was found in protein, fat, and carbohydrate content of milk samples throughout the day. We compared within-day variation of macronutrients of transitional and mature milk, milk samples from the mothers of preterm and term infants, and samples collected by either hand expression or pumping. We did not find a significant difference between the groups. Conclusion  Absence of circadian variations in lipid, carbohydrate, and protein content of breast milk in our study may be related to ethnic differences, maternal nutritional status, different milk content measurement technique, and population characteristics. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diffusion-tensor MR imaging of the breast: hormonal regulation.

PubMed

Nissan, Noam; Furman-Haran, Edna; Shapiro-Feinberg, Myra; Grobgeld, Dov; Degani, Hadassa

2014-06-01

To investigate the parameters obtained with magnetic resonance (MR) diffusion-tensor imaging (DTI) of the breast throughout the menstrual cycle phases, during lactation, and after menopause, with and without hormone replacement therapy (HRT). All protocols were approved by the internal review board, and signed informed consent was obtained from all participants. Forty-five healthy volunteers underwent imaging by using T2-weighted and DTI MR sequences at 3 T. Premenopausal volunteers (n = 16) underwent imaging weekly, four times during one menstrual cycle. Postmenopausal volunteers (n = 19) and lactating volunteers (n = 10) underwent imaging once. The principal diffusion coefficients (λ1, λ2, and λ3), apparent diffusion coefficient (ADC), fractional anisotropy (FA), and maximal anisotropy (λ1-λ3) were calculated pixel by pixel for the fibroglandular tissue in the entire breast. In all premenopausal volunteers, the DTI parameters exhibited high repeatability, remaining almost equal along the menstrual cycle, with a low mean within-subject coefficient of variance of λ1, λ2, λ3, and ADC (1%-2% for all) and FA (5%), as well as a high intraclass correlation of 0.92-0.98. The diffusion coefficients were significantly lower (a) in the group without HRT use as compared with the group with HRT use (P < .01) and premenopausal volunteers (P < .01) and (b) in the lactating volunteers as compared with the premenopausal volunteers (P < .005). No significant differences in DTI parameters were found between premenopausal volunteers free of oral contraceptives and those who used oral contraceptives (P = .28-0.82) and between premenopausal volunteers and postmenopausal volunteers who used HRT (P = .31-0.93). DTI parameters are not sensitive to menstrual cycle changes, while menopause, long-term HRT, and presence of milk in lactating women affected the DTI parameters. Therefore, the timing for performing breast DTI is not restricted throughout the menstrual cycle, whereas the

The influence of medroxyprogesterone on the duration of breast-feeding in mothers in an urban community.

PubMed

Hannon, P R; Duggan, A K; Serwint, J R; Vogelhut, J W; Witter, F; DeAngelis, C

1997-05-01

To assess the effect of medroxyprogesterone acetate on lactation when it is given immediately post partum. Prospective cohort study with follow-up through 16 weeks post partum. Urban teaching hospital in Baltimore, Md. Consecutive sample (N = 95) of mothers who were delivered of healthy, term newborns, had home telephones, received either medroxyprogesterone or nonhormonal contraception at discharge, and were currently breast-feeding their newborns. Lactation (duration and frequency) and timing of first introduction of formula were measured by weekly telephone interviews. Maternal characteristics included the mean +/- SD maternal age (24 +/- 5 years), race (90% African American), history of pregnancy (63% multiparous), marital status or relationship (50% married or living with partner), and medical assistance (81% of the recipients received aid). Women who were receiving medroxyprogesterone (n = 43) were older (P < .05) and were more likely to be married (P < .05) compared with those who were receiving nonhormonal contraception (n = 52). No other factors that were likely to influence lactation were significantly different. Groups did not differ in the baseline-planned duration of lactation. Follow-up data were obtained on 90 women (96%). The groups were comparable in the duration of lactation (medroxyprogesterone: 98%, 74%, 55%, 47%, and 42% were breast-feeding at least once per day at 1, 4, 8, 12, and 16 weeks, respectively [median, 10.14 weeks], vs nonhormonal contraception: 86%, 70%, 47%, 36%, and 30%, respectively [median, 6.57 weeks] [P = .19]). The percentage of subjects who were exclusively breast-feeding at these times and the timing of formula introduction also did not differ by group. Medroxyprogesterone, when given to mothers in an urban community immediately after delivery, has no detrimental effect on the duration of lactation, frequency of lactation, and timing of introduction of formula within the first 16 weeks post partum.

Breast feeding--a study of 8750 Malaysian infants.

PubMed

Pathmanathan, I

1978-12-01

Infant feeding patterns in Malaysia were assessed using data obtained by interviewing 5160 women who gave birth to 8755 babies in 3 urban areas and 6 rural areas from 1970-1974. The study was undertaken in an effort to determine appropriate strategies for promoting breast-feeding. 64.2% of the 8755 were breast-fed. Considerable variation in breast-feeding patterns was observed when the data was analyzed in reference to ethnic affiliation, residence, family income, and mother's educational level. While 88.9% of the Malay infants were breast-fed, only 69.7% of the Indian infants and 42.3% of the Chinese infants were breast-fed. 47.0% of the infants in urban areas were breast-fed compared to 77.5% in the rural areas. Women in higher income and educational groupings were less likely to breast-feed their children than women in lower income and educational groupings. In the urban areas, approximately 1/2 of the Malay women, 1/2 of the Indian women, and 2/3 of the Chinese women discontinued breast-feeding before their children were 3 months old. Chinese women who delivered in private hospitals were less likely to breast-feed their infants than those who delivered in government hospitals. Among rural Malay women, those who delivered in hospitals were less likely to breast-feed than those who delivered at home. The findings suggested that 1) hospital personnel, especially those who work in private hospitals, should take a more active role in promoting lactation; 2) health personnel and mothers need to be more adequately informed about the advantages of breast-feeding; 3) women in higher income and educational groups should be encouraged to breast-feed since they serve as role models for women in the lower income and educational groups; and 4) additional studies should be undertaken in order to identify those cultural attitudes which inhibit lactation among Chinese women. Tables showed 1) the number and % distribution of breast-feeding and 2) the % of infants breast-fed by

Concentrations of estrogen and progesterone in breast milk and their relationship with the mother's diet.

PubMed

Lu, Mengqing; Xiao, Hailong; Li, Kelei; Jiang, Jiajing; Wu, Kejian; Li, Duo

2017-09-20

The aim of the present study was to determine the concentrations of estradiol (E2), estriol (E3) and progesterone in breast milk over different lactation periods, and to assess their relationship with the mother's diet. Ninety-six breast milk samples as well as 24-hour dietary records from 32 lactating mothers were collected on day 1 (colostrum), day 14 (transitional milk) and day 42 (mature milk) after delivery in Hangzhou, China. The concentrations of E2, E3 and progesterone differed significantly through different periods of lactation (p < 0.001). The content of E2 in colostrum, transitional milk and mature milk was 1.60 ± 0.96 μg L -1 , 0.83 ± 0.36 μg L -1 and 1.26 ± 0.48 μg L -1 , respectively. The concentrations of E3 were 2.09 ± 1.66 μg L -1 , 2.23 ± 1.74 μg L -1 and 4.64 ± 2.15 μg L -1 , respectively. The concentrations of progesterone were 6.10 ± 8.30 μg L -1 , 4.25 ± 4.76 μg L -1 and 1.70 ± 2.42 μg L -1 , respectively. The concentration of progesterone in breast milk was significantly negatively correlated with the intake of protein (p = 0.015), fat (p = 0.008), vegetables (p = 0.012), and meat and eggs (p = 0.036), while the concentration of E3 was significantly positively correlated with the intake of soy products (p = 0.025). This information indicates that the concentrations of E2, E3 and progesterone in breast milk varied over the lactating period. Dietary intake will to some extent affect the contents of E3 and progesterone in breast milk.

Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy

PubMed Central

Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

2013-01-01

While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast—it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray—these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001 PMID:24381245

Going beyond a First Reader: A Machine Learning Methodology for Optimizing Cost and Performance in Breast Ultrasound Diagnosis.

PubMed

Venkatesh, Santosh S; Levenback, Benjamin J; Sultan, Laith R; Bouzghar, Ghizlane; Sehgal, Chandra M

2015-12-01

The goal of this study was to devise a machine learning methodology as a viable low-cost alternative to a second reader to help augment physicians' interpretations of breast ultrasound images in differentiating benign and malignant masses. Two independent feature sets consisting of visual features based on a radiologist's interpretation of images and computer-extracted features when used as first and second readers and combined by adaptive boosting (AdaBoost) and a pruning classifier resulted in a very high level of diagnostic performance (area under the receiver operating characteristic curve = 0.98) at a cost of pruning a fraction (20%) of the cases for further evaluation by independent methods. AdaBoost also improved the diagnostic performance of the individual human observers and increased the agreement between their analyses. Pairing AdaBoost with selective pruning is a principled methodology for achieving high diagnostic performance without the added cost of an additional reader for differentiating solid breast masses by ultrasound. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Immunology of breast milk.

PubMed

Palmeira, Patricia; Carneiro-Sampaio, Magda

2016-09-01

In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Colostrum is the most potent natural immune booster known to science. Breastfeeding protects infants against infections mainly via secretory IgA (SIgA) antibodies, but also via other various bioactive factors. It is striking that the defense factors of human milk function without causing inflammation; some components are even anti-inflammatory. Protection against infections has been well evidenced during lactation against, e.g., acute and prolonged diarrhea, respiratory tract infections, including otitis media, urinary tract infection, neonatal septicemia, and necrotizing enterocolitis. The milk's immunity content changes over time. In the early stages of lactation, IgA, anti-inflammatory factors and, more likely, immunologically active cells provide additional support for the immature immune system of the neonate. After this period, breast milk continues to adapt extraordinarily to the infant's ontogeny and needs regarding immune protection and nutrition. The need to encourage breastfeeding is therefore justifiable, at least during the first 6 months of life, when the infant's secretory IgA production is insignificant.

Characteristics of cold-induced dark, firm, dry broiler chicken breast meat.

PubMed

Dadgar, S; Lee, E S; Crowe, T G; Classen, H L; Shand, P J

2012-01-01

1. A study was designed to characterise dark, firm, dry (DFD) breast meat resulting from cold exposure of broilers and compare its properties with normal breast meat from cold-stressed and control birds. 2. A total of 140 broilers were selected from 5- and 6-week-old birds exposed to cold temperatures ranging from -18 to -4°C, or a control temperature of +20°C for 3 h in an environmental chamber. Half of these birds were slaughtered immediately following the cold exposure and the other half were given 2 h of lairage. 3. Breast meat samples were categorised based on ultimate pH (pH(u)) and colour L* (lightness) values into normal (5·7 ≤ pH(u)≤ 6·1; 46 ≤ L* ≤ 53) breast meat from control (control-normal) or cold-stressed (cold-normal) birds, and DFD (pH(u) > 6·1; L* < 46) breast meat, which only occurred in cold-stressed birds (cold-DFD). 4. Residual glycogen was not different between cold-DFD and control-normal breast meat. Lactate concentration was lower in cold-DFD compared with control-normal breast meat. Lactate concentration almost tripled for all the samples by 30 h post-mortem, which resulted in a drop in pH of normal meat, but did not have any effect on pH of DFD breast meat. Glycolytic potential at both 5 min and 30 h post-mortem was lower in DFD breast meat compared with the normal breast meat from both cold-stressed and control birds. 5. Cold-DFD breast meat was significantly darker, with higher pH(u), lower cook loss, higher water-binding capacity and processing cook yield than cold-normal and control-normal breast meat, which were not different from each other.

Effects of high and low blood lactate concentrations on sweat lactate response.

PubMed

Green, J M; Bishop, P A; Muir, I H; McLester, J R; Heath, H E

2000-11-01

Sweat lactate results from eccrine gland metabolism, however, the possible clearance of blood lactate through sweat has not been resolved. On separate days in an environmental chamber (32 +/- 1 C) 12 subjects completed a constant load (CON) (30 min at 40% VO2 max) and an interval cycling trial (INT) (15 one-min intervals at 80% VO2 max, each separated by one min rest) each designed to elicit different blood lactate responses. Each 30 min cycling trial was preceded by 15 min warm-up (30 watts) and followed by 15 min passive rest. Sweat and blood were analyzed for lactate concentration at 15, 25, 35, 45, and 60 min during CON and INT. Total body water loss was used to calculate sweat rate (ml/hr). Blood lactate was significantly greater (p < or = 0.05) at 25, 35, 45, and 60 min during INT compared to CON (approximately 5 mmol/L vs 1.5 mmol/L). Sweat lactate was not significantly different (p>0.05) between trials at any time (approximately 10 mmol/L). Sweat rates (approximately 600ml/hr) and estimated total lactate secretion were not significantly different (CON vs. INT) (p > 0.05). Elevated blood lactate was not associated with changes in sweat lactate concentration. Sweat lactate seems to originate in eccrine glands independent of blood lactate.

Is Breast Best? Examining the effects of alcohol and cannabis use during lactation.

PubMed

Brown, R A; Dakkak, H; Seabrook, J A

2018-05-23

Maternal drug use during lactation may have adverse effects on the health of their children. Two common drugs used during this period are alcohol and cannabis. A literature search was conducted using PubMed, CINAHL, Nursing and Allied Health, and Google Scholar with the following search terms: marijuana, cannabis, THC, alcohol, ethanol, breastfeeding, lactation, and breastmilk. The search strategy was restricted to papers since the year 2000, and limited to English language journals. Reference lists were also used to capture any articles that were missed from the database searches. In total, 19 articles were found related to alcohol and breastfeeding (n = 17 original research papers; n = 2 systematic reviews), and 4 articles were specific to cannabis (n = 2 original papers; n = 2 systematic reviews). The most common outcomes associated with alcohol consumption and breastfeeding included changes in sleep patterns, reduced milk production and flow, lower milk intake, and impaired immune function. Maternal outcomes related to cannabis consumption included panic attacks, delayed response time, increased heart rate, reduced short-term memory, dizziness, and impaired motor performance; infant outcomes associated with maternal cannabis use and breastfeeding were reduced muscular tonus, poor sucking, and growth delay and restriction. Mothers should be advised to refrain from substance use during the lactation period for the health and safety of their children.

Cellular calcium dynamics in lactation and breast cancer: From physiology to pathology

USDA-ARS?s Scientific Manuscript database

Breast cancer is the second leading cause of cancer mortality in women, estimated at nearly 40,000 deaths and more than 230,000 new cases diagnosed in the U.S. this year alone. One of the defining characteristics of breast cancer is the radiographic presence of microcalcifications. These palpable mi...

The effect of lactation length on greenhouse gas emissions from the national dairy herd.

PubMed

Wall, E; Coffey, M P; Pollott, G E

2012-11-01

Many governments have signed up to greenhouse gas emission (GHGE) reduction programmes under their national climate change obligations. Recently, it has been suggested that the use of extended lactations in dairy herds could result in reduced GHGE. Dairy GHGE were modelled on a national basis and the model was used to compare emissions from lactations of three different lengths (305, 370 and 440 days), and a current 'base' scenario on the basis of maintaining current milk production levels. In addition to comparing GHGE from the average 'National Herd' under these scenarios, results were used to investigate how accounting for lactations of different lengths might alter the estimation of emissions calculated from the National Inventory methodology currently recommended by Intergovernmental Panel on Climate Change. Data for the three lactation length scenarios were derived from nationally recorded dairy performance information and used in the GHGE model. Long lactations required fewer milking cows and replacements to maintain current milk yield levels than short ones, but GHGEs were found to rise from 1214 t of CO2 equivalent (CE)/farm per year for lactations of 305 days to 1371 t CE/farm per year for 440-day lactations. This apparent anomaly can be explained by the less efficient milk production (kg milk produced per kg cow weight) found in later lactation, a more pronounced effect in longer lactations. The sensitivity of the model to changes in replacement rate, persistency and level of milk yield was investigated. Changes in the replacement rate from 25% to 20% and in persistency by −10% to +20% resulted in very small changes in GHGE. Differences in GHGE due to the level of milk yield were much more dramatic with animals in the top 10% for yield, producing about 25% less GHGE/year than the average animal. National Inventory results were investigated using a more realistic spread of lactation lengths than recommended for such calculations using emissions

Does dietary iodine regulate oxidative stress and adiponectin levels in human breast milk?

PubMed

Gutiérrez-Repiso, Carolina; Velasco, Inés; Garcia-Escobar, Eva; Garcia-Serrano, Sara; Rodríguez-Pacheco, Francisca; Linares, Francisca; Ruiz de Adana, Maria Soledad; Rubio-Martin, Elehazara; Garrido-Sanchez, Lourdes; Cobos-Bravo, Juan Francisco; Priego-Puga, Tatiana; Rojo-Martinez, Gemma; Soriguer, Federico; García-Fuentes, Eduardo

2014-02-10

Little is known about the association between iodine and human milk composition. In this study, we investigated the association between iodine and different markers of oxidative stress and obesity-related hormones in human breast milk. This work is composed of two cross-sectional studies (in lactating women and in the general population), one prospective and one in vitro. In the cross-sectional study in lactating women, the breast milk iodine correlated negatively with superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) activities, and with adiponectin levels. An in vitro culture of human adipocytes with 1 μM potassium iodide (KI, dose similar to the human breast milk iodine concentration) produced a significant decrease in adiponectin, GSH-Px, SOD1, and SOD2 mRNA expression. However, after 2 months of treatment with KI in the prospective study, a positive correlation was found between 24-h urinary iodine and serum adiponectin. Our observations lead to the hypothesis that iodine may be a factor directly involved in the regulation of oxidative stress and adiponectin levels in human breast milk.

Impact of anxiety in the puerperium on breast-feeding outcomes: role of parity.

PubMed

Zanardo, Vincenzo; Gasparetto, Sara; Giustardi, Arturo; Suppiej, Agnese; Trevisanuto, Daniele; Pascoli, Irene; Freato, Federica

2009-11-01

: Studies in animals indicate that stress and anxiety can depress lactation, but there is much less information available concerning humans. We aimed to determine whether maternal anxiety in puerperium, potentially exacerbated by the primiparity inexperience, has a negative impact on breast-feeding outcomes. : The state-trait anxiety inventory Y form (Spielberger, 1983) was administered to a total of 204 mothers, 101 primiparae, and 103 pluriparae on the third to fourth day postpartum. : We found that primiparae had state anxiety (T) scores significantly higher than pluriparae (44.57 +/- 5.85 vs 43.28 +/- 7.10, P = 0.03). Increased state anxiety levels impaired breast-feeding success. In addition, in the logistic regression analysis model used to assess factors predictive of breast-feeding longer than 3 months, maternal state anxiety was the most significant risk factor (odds ratio 0.99; 0.88-0.98, P < 0.01). : In the puerperium, anxiety, potentially exacerbated by primiparae inexperience, is associated with impaired lactation. Alleviating maternal anxiety could be beneficial for stimulating breast-feeding in more vulnerable women.

Prolonged breast-feeding and mortality up to two years post-partum among HIV-positive women in Zambia

PubMed Central

Kuhn, Louise; Kasonde, Prisca; Sinkala, Moses; Kankasa, Chipepo; Semrau, Katherine; Vwalika, Cheswa; Tsai, Wei-Yann; Aldrovandi, Grace M.; Thea, Donald M.

2005-01-01

Background A previously reported association between prolonged lactation and maternal mortality has generated concern that breast-feeding may be detrimental for HIV-positive women. Methods As part of a trial conducted in Lusaka, Zambia, 653 HIV-positive women were randomly assigned either to a counseling program that encouraged abrupt cessation of breast-feeding at 4 months (group A) or to a program that encouraged prolonged breast-feeding for the duration of the woman’s own informed choice (group B). We examined whether mortality up to 2 years post-partum increased with breast-feeding for a longer duration. Results There was no difference in mortality 12 months after delivery between 326 HIV-positive women randomly assigned to short breast-feeding [group A: 4.93%; 95% confidence interval (CI), 2.42–7.46] versus 327 women assigned to long breast-feeding (group B: 4.89%; 95% CI, 2.38–7.40). Analysis based on actual practice, rather than random assignment, also demonstrated no increased mortality due to breast-feeding. Conclusions Although HIV-related mortality was high in this cohort of untreated HIV-positive women, prolonged lactation was not associated with increased mortality. PMID:16184038

A physiological role of breast milk leptin in body weight control in developing infants.

PubMed

Miralles, Olga; Sánchez, Juana; Palou, Andreu; Picó, Catalina

2006-08-01

Leptin, a hormone that regulates food intake and energy metabolism, is present in breast milk. The aim of this study was to determine whether milk leptin concentration is correlated with maternal circulating leptin and BMI and with body weight gain of infants. A group of 28 non-obese women (BMI between 16.3 and 27.3 kg/m(2)) who breast-fed their infants for at least 6 months and their infants were studied. Venous blood and milk samples were obtained from mothers at 1, 3, 6, and 9 months of lactation, and leptin concentration was determined. Infant body weight and height were followed until 2 years of age. During the whole lactation period, milk leptin concentration correlated positively with maternal plasma leptin concentration and with maternal BMI. In addition, milk leptin concentration at 1 month of lactation was negatively correlated with infant BMI at 18 and 24 months of age. A better negative correlation was also found between log milk leptin concentration at 1 and at 3 months of lactation and infant BMI from 12 to 24 months of age. We concluded that, in a group of non-obese mothers, infant body weight during the first 2 years may be influenced by milk leptin concentration during the first stages of lactation. Thus, moderate milk-borne maternal leptin appears to provide moderate protection to infants from an excess of weight gain. These results seem to point out that milk leptin is an important factor that could explain, at least partially, the major risk of obesity of formula-fed infants with respect to breast-fed infants.

[Methicillin-resistant Staphylococcus aureus (MRSA) isolation in breast abscesses in a Public Maternity].

PubMed

Boccaccio, Cristina; Verdaguer Babic, Virginia; Botto, Liliana; Cervetto, María M; Cetani, Silvia; Paladino, Silvina; Conti, Roxana; Lanzillota, Antonio; Herrera, Rosa; Amarante, Dora

2014-01-01

Mastitis and breast abscess in lactating women are risk factors for early breastfeeding cessation. This pathology is included in the group of skin and soft tissue infections. A descriptive study was performed with an advanced outlook. As of January 2007 through December 2011 a total of 137 breast abscesses were treated in our institution. We analyzed incidence, parity, postpartum days, risk factors, microbiological isolation and the adequacy of initial antibiotic treatment. In that period we observed a steady and significant increase in breast abscesses. Incidence from 0.19 to 0.84% in lactating women 2007 vs. 2011 p = 0.0001 IC 95% (-0.009; 0.003), 70.6% of them primiparous and a mean interval from delivery to breast abscess of 41.9 ± 35.8 days. The most frequent risk factors were sore nipples and breast engorgement. Staphylococcus aureus was isolated in 82.3 to 95.0%. Methicillin resistance was higher than 60%. These strains were susceptible to erythromycin, clindamycin, gentamicin, rifampicin, ciprofloxacin and trimethoprim-sulfamethoxazol. All the cases were surgically drained; the initial empirical treatment was inadequate in 60% of them, 90% of patients could maintain breast feeding after the procedure. these data emphasize the need to prevent risk factors associated to breast abscesses: sore nipples and breast engorgement. In order to determine the adequate antibiotic treatment, bacteriological studies are required at every collection because SAMR prevalence varies according to diverse populations and geographic location.

Non-puerperal induced lactation: an infant feeding option in paediatric HIV/AIDS in tropical Africa.

PubMed

Ogunlesi, Tinuade A; Adekanmbi, Folasade A; Fetuga, Bolanle M; Ogundeyi, Mojisola M

2008-09-01

A major problem in the management of infants exposed to HIV is the issue of feeding, which stems from the need to avoid transmission of the virus via breast milk. Other important issues in the nutrition of infants exposed to the virus include severe maternal illness, which makes suckling extremely difficult, and feeding orphans. Wet nursing is one of the recommended steps in addressing the feeding problems of such infants but for reasons of sociocultural disapproval, it appears not to be popular in traditional African settings. Non-puerperal induced lactation or re-lactation of a close relation, usually a grandmother, which hitherto has been used to rehabilitate severely malnourished motherless infants, may be equally useful. The procedure of re-lactation and the limitations of the method are highlighted. Also, the need to employ information, education and communication in improving the sociocultural acceptability of this veritable infant feeding method in tropical Africa is discussed.

Breast Shape Analysis With Curvature Estimates and Principal Component Analysis for Cosmetic and Reconstructive Breast Surgery.

PubMed

Catanuto, Giuseppe; Taher, Wafa; Rocco, Nicola; Catalano, Francesca; Allegra, Dario; Milotta, Filippo Luigi Maria; Stanco, Filippo; Gallo, Giovanni; Nava, Maurizio Bruno

2018-03-20

Breast shape is defined utilizing mainly qualitative assessment (full, flat, ptotic) or estimates, such as volume or distances between reference points, that cannot describe it reliably. We will quantitatively describe breast shape with two parameters derived from a statistical methodology denominated principal component analysis (PCA). We created a heterogeneous dataset of breast shapes acquired with a commercial infrared 3-dimensional scanner on which PCA was performed. We plotted on a Cartesian plane the two highest values of PCA for each breast (principal components 1 and 2). Testing of the methodology on a preoperative and postoperative surgical case and test-retest was performed by two operators. The first two principal components derived from PCA are able to characterize the shape of the breast included in the dataset. The test-retest demonstrated that different operators are able to obtain very similar values of PCA. The system is also able to identify major changes in the preoperative and postoperative stages of a two-stage reconstruction. Even minor changes were correctly detected by the system. This methodology can reliably describe the shape of a breast. An expert operator and a newly trained operator can reach similar results in a test/re-testing validation. Once developed and after further validation, this methodology could be employed as a good tool for outcome evaluation, auditing, and benchmarking.

[The effect of breast massage at different time in the early period after cesarean section].

PubMed

Chu, J Y; Zhang, L; Zhang, Y J; Yang, M J; Li, X W; Sun, L L

2017-11-06

Objective: To evaluate the effect of breast massage at different time in the early period on maternal lactation after cesarean section. Methods: 80 women delivered by cesarean section were randomly selected from maternity ward of a hospital in Shandong province during Jan. 2013 to Jan. 2015; which were divided into four groups, with 20 patients in each. Three groups received 3 times of breast massage every 24 hoursbeginning from 2, 12 and 24 h after cesarean section, respectively. The control group didn't receive any breast massage. The starting time and status of lactation were observed and recorded after cesarean section. 5 ml venous blood sample was drawn from each patient respectively at 2 h before cesarean, 6, 12, 24, 48 and 72 h after cesarean to test the level of serum prolactin. The lactation status of each group was compared. Results: The P (50) ( P (25)- P (75)) of starting time of lactation of the three massage groups and control group were 3 (2-6) h, 4 (2-8) h, 4 (3-12) h and 4 (2-12) h, respectively, whose differences showed no statistical significance ( H =3.32, P= 0.345).The number of delivered women with adequate lactation 24 hours after cesarean was 10 in the group who received massage beginning from 2 h after cesarean; while the number was only 2 in the control group. The number of delivered women with adequate lactation 48 hours after cesarean was 18 in the group who received massage beginning from 2 h after cesarean; while the number was 8 in the control group. The differences showed statistical significances ( P values were 0.021 and 0.008, respectively). The serum prolactin level in the group of delivered women who received massage from 2 h after cesarean was separately (195.9±78.5), (176.0±96.5), (216.4±110.0), (190.0±56.8) and (184.8±69.6) μg/L at 2, 12, 24, 48 and 72 h after cesarean, which were significantly higher than those in the control group (which were (128.8±40.6), (127.3±66.8), (162.2±58.8), (145.1±64.7) and (141.7±49

Excretion of trazodone in breast milk.

PubMed Central

Verbeeck, R K; Ross, S G; McKenna, E A

1986-01-01

The excretion of breast milk was studied in six lactating women following the oral administration of a single trazodone tablet (50 mg). The milk/plasma ratio of trazodone based on area under the plasma and milk curves was small: 0.142 +/- 0.045 (mean +/- s.d.). Assuming that the babies would drink 500 ml 12 h-1, they would be exposed to less than 0.005 mg kg-1 as compared to 0.77 mg kg-1 for the mothers. It is concluded that exposure of babies to trazodone via breast milk is very small. PMID:3768252

Methodology to predict a maximum follow-up period for breast cancer patients without significantly reducing the chance of detecting a local recurrence

NASA Astrophysics Data System (ADS)

Mould, Richard F.; Asselain, Bernard; DeRycke, Yann

2004-03-01

For breast cancer where the prognosis of early stage disease is very good and even when local recurrences do occur they can present several years after treatment, the hospital resources required for annual follow-up examinations of what can be several hundreds of patients are financially significant. If, therefore, there is some method to estimate a maximum length of follow-up Tmax necessary, then cost savings of physicians' time as well as outpatient workload reductions can be achieved. In modern oncology where expenses continue to increase exponentially due to staff salaries and the expense of chemotherapy drugs and of new treatment and imaging technology, the economic situation can no longer be ignored. The methodology of parametric modelling, based on the lognormal distribution is described, showing that useful estimates for Tmax can be made, by making a trade-off between Tmax and the fraction of patients who will experience a delay in detection of their local recurrence. This trade-off depends on the chosen tail of the lognormal. The methodology is described for stage T1 and T2 breast cancer and it is found that Tmax = 4 years which is a significant reduction on the usual maximum of 10 years of follow-up which is employed by many hospitals for breast cancer patients. The methodology is equally applicable for cancers at other sites where the prognosis is good and some local recurrences may not occur until several years post-treatment.

Excretion of moxidectin into breast milk and pharmacokinetics in healthy lactating women.

PubMed

Korth-Bradley, Joan M; Parks, Virginia; Chalon, Stephan; Gourley, Ian; Matschke, Kyle; Gossart, Sophie; Bryson, Philip; Fleckenstein, Lawrence

2011-11-01

Moxidectin, registered worldwide as a veterinary antiparasitic agent, is currently under development for humans for the treatment of onchocerciasis in collaboration with the World Health Organization. The objective of this study was to assess the pharmacokinetics of moxidectin in healthy lactating women, including the excretion into breast milk. Twelve women, ages 23 to 38 years, weighing 54 to 79 kg, all more than 5 months postpartum, were enrolled, following their plan to wean their infants and provision of informed consent. A single 8-mg, open-label dose was administered orally after consumption of a standard breakfast. Complete milk collection was done for approximately 28 days, and plasma samples were collected for 90 days. Moxidectin concentrations were measured by high-performance liquid chromatography (HPLC) with fluorescence detection, with a validated range of 0.08 to 120 ng/ml. Noncompartmental pharmacokinetic methods were used to find the following results: peak concentration in plasma (C(max)), 87 ± 25 ng/ml; time to C(max) (t(max)), 4.18 ± 1.59 h; terminal-phase elimination half-life (t(1/2)), 832 ± 321 h; total area under the concentration-time curve (AUC), 4,046 ± 1,796 ng · h/ml; apparent oral dose clearance (CL/F), 2.35 ± 1.07 l/h; ratio of CL/F to the terminal-phase disposition rate constant, λ(z) (Vλ(z)/F), 2,526 ± 772 liters; percentage of maternal dose excreted in milk, 0.701 ± 0.299%; absolute amount excreted in milk, 0.056 ± 0.024 mg; relative infant dose, 8.73 ± 3.17% of maternal dose assuming complete absorption; clearance in milk (CL(milk)), 0.016 ± 0.009 liter/h. Nine of 12 subjects reported adverse events, all of which were considered treatment emergent but not drug related and were mostly reported during the long outpatient period 8 to 90 days after dose administration. The most frequently reported adverse events were headache and nausea (n = 4), oropharyngeal pain (n = 2), rhinitis, viral pharyngitis, and viral upper

Lactate shuttling and lactate use as fuel after traumatic brain injury: metabolic considerations

PubMed Central

Dienel, Gerald A

2014-01-01

Lactate is proposed to be generated by astrocytes during glutamatergic neurotransmission and shuttled to neurons as ‘preferred' oxidative fuel. However, a large body of evidence demonstrates that metabolic changes during activation of living brain disprove essential components of the astrocyte–neuron lactate shuttle model. For example, some glutamate is oxidized to generate ATP after its uptake into astrocytes and neuronal glucose phosphorylation rises during activation and provides pyruvate for oxidation. Extension of the notion that lactate is a preferential fuel into the traumatic brain injury (TBI) field has important clinical implications, and the concept must, therefore, be carefully evaluated before implementation into patient care. Microdialysis studies in TBI patients demonstrate that lactate and pyruvate levels and lactate/pyruvate ratios, along with other data, have important diagnostic value to distinguish between ischemia and mitochondrial dysfunction. Results show that lactate release from human brain to blood predominates over its uptake after TBI, and strong evidence for lactate metabolism is lacking; mitochondrial dysfunction may inhibit lactate oxidation. Claims that exogenous lactate infusion is energetically beneficial for TBI patients are not based on metabolic assays and data are incorrectly interpreted. PMID:25204393

Suboptimal Iodine Concentration in Breastmilk and Inadequate Iodine Intake among Lactating Women in Norway.

PubMed

Henjum, Sigrun; Lilleengen, Anne Marie; Aakre, Inger; Dudareva, Anna; Gjengedal, Elin Lovise Folven; Meltzer, Helle Margrete; Brantsæter, Anne Lise

2017-06-22

Breastfed infants depend on sufficient maternal iodine intake for optimal growth and neurological development. Despite this, few studies have assessed iodine concentrations in human milk and there is currently no published data on iodine status among lactating women in Norway. The aim of this study was to assess iodine concentrations in breast milk (BMIC) in lactating women and estimate iodine intake. Five Mother and Child Health Centres in Oslo were randomly selected during 2016, and 175 lactating women between 2nd and 28th weeks postpartum participated. Each of the women provided four breastmilk samples which were pooled and analysed for iodine concentrations. Participants also provided information on iodine intake from food and supplements covering the last 24 h and the habitual iodine intake (food frequency questionnaire). The median (p25, p75 percentiles) BMIC was 68 (45, 98) µg/L and 76% had BMIC <100 µg/L. Only 19% had taken an iodine-containing supplement during the last 24 h. The median 24 h iodine intake from food (p25, p75) was 121 (82, 162) µg/day and the total intake (food and supplements) was 134 (95, 222) µg/day. The majority of lactating women had suboptimal BMIC and inadequate intake of iodine from food and supplements.

Suboptimal Iodine Concentration in Breastmilk and Inadequate Iodine Intake among Lactating Women in Norway

PubMed Central

Henjum, Sigrun; Lilleengen, Anne Marie; Aakre, Inger; Dudareva, Anna; Gjengedal, Elin Lovise Folven; Meltzer, Helle Margrete; Brantsæter, Anne Lise

2017-01-01

Breastfed infants depend on sufficient maternal iodine intake for optimal growth and neurological development. Despite this, few studies have assessed iodine concentrations in human milk and there is currently no published data on iodine status among lactating women in Norway. The aim of this study was to assess iodine concentrations in breast milk (BMIC) in lactating women and estimate iodine intake. Five Mother and Child Health Centres in Oslo were randomly selected during 2016, and 175 lactating women between 2nd and 28th weeks postpartum participated. Each of the women provided four breastmilk samples which were pooled and analysed for iodine concentrations. Participants also provided information on iodine intake from food and supplements covering the last 24 h and the habitual iodine intake (food frequency questionnaire). The median (p25, p75 percentiles) BMIC was 68 (45, 98) µg/L and 76% had BMIC <100 µg/L. Only 19% had taken an iodine-containing supplement during the last 24 h. The median 24 h iodine intake from food (p25, p75) was 121 (82, 162) µg/day and the total intake (food and supplements) was 134 (95, 222) µg/day. The majority of lactating women had suboptimal BMIC and inadequate intake of iodine from food and supplements. PMID:28640217

Elevated levels of short carbon-chain PFCAs in breast milk among Korean women: Current status and potential challenges.

PubMed

Kang, Habyeong; Choi, Kyungho; Lee, Haeng-Shin; Kim, Do-Hee; Park, Na-Youn; Kim, Sunmi; Kho, Younglim

2016-07-01

Breast milks can be contaminated with perfluoroalkyl substances (PFASs). Exposure to PFASs during early stages of life may lead to adverse health effects among breastfed infants. To date, perfluorootanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have been most frequently measured PFASs in breast milks worldwide. Information on shorter carbon-chain PFASs in breast milk is scarce. In this study, breast milks were sampled from 264 Korean lactating women, and measured for seventeen PFASs, including ten perfluoroalkyl carboxylates (PFCAs), four perfluoroalkyl sulfonates, and three perfluoroalkyl sulfonamides. PFOA and PFOS were detected in 98.5% of the breast milk samples, with median concentrations of 0.072 and 0.050ng/mL, respectively. Perfluoropentanoic acid (PFPeA), perfluorohexanoic acid (PFHxA), and perfluoroheptanoic acid (PFHpA) were detected in higher frequencies, ranging between 67.4% and 81.8%. The concentrations of short carbon-chain PFCAs in breast milk such as PFPeA and PFHxA were the highest ever reported to date, and were comparable to that of PFOS. Concentrations of shorter chain PFCA in breast milk tended to be higher among the women with longer lactation period, while those of PFOA showed the opposite trend, suggesting a possibility that breastfeeding might be an important route of excretion for PFOA among lactating women. Fish consumption and the use of consumer products, e.g., skin care products, cosmetics and non-stick coated cooking utensils, were identified as significant predictors of PFAS concentrations in breast milk. Health risks associated with PFOA and PFOS exposure through breastfeeding were estimated negligible, however, risks of the short carbon-chain PFCAs could not be assessed because of lack of relevant toxicological information. Further efforts for source identification and exposure management measures for shorter chain PFCAs are necessary. Copyright © 2016 Elsevier Inc. All rights reserved.

[A Listeria breast abscess in a man].

PubMed

Marsaudon, E; Berthy, J; Mamoune, S; Deniel, A; Ksiyer, S; Tiuca, D

2018-03-01

Listeriosis is a food-borne illness leading to bacteriemia or central nervous system infection especially in pregnant women or high-risk patients. It is rarely a localized infection. Breast contamination has rarely been reported in lactating women. We report a breast abscess in man. A 80 year old man, hypertensive and arrhythmic, was explored for weakness and dehydration. Type 2 diabetes and chronic lymphocytic leukemia were diagnosed. Clinical examination disclosed a breast abcess related to L monocytogenes infection. Histopathological study also revealed a breast subcutaneous infiltration by chronic lymphocytic leukemia. Listeriosis sometimes uncover an unknown immunosuppression, especially in the elderly. Breast is a non-sterile tissue containing a stable microbiome partly from digestive origin. It can thereby be contaminated by Listeria. The specific cutaneous infiltrate of chronic lymphocytic leukemia can create the conditions for a local infection. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Implementation of an education package on breast engorgement aimed at lactation consultants and midwives to prevent conflicting information for postnatal mothers.

PubMed

Anderson, Loretta; Kynoch, Kathryn

2017-03-01

The aim of this evidence-based practice project was to improve local practice in the treatment of breast engorgement in postnatal mothers and to ensure the treatment of engorgement in postnatal mothers is performed according to the best available evidence. This evidence-based practice project took place in a 28-bed postnatal ward in a large metropolitan tertiary hospital. Twenty midwives and 20 in-patients were recruited for the project. The project utilized an audit and feedback design. Midwives were asked a series of questions to test their knowledge on engorgement, and mothers were asked questions relating to the breastfeeding and engorgement care they received. The project was conducted in three phases: preparation for quality audit, implementation of best practice and postimplementation audit. Comparison of Audit 1 (preimplementation) and Audit 2 (postimplementation) results shows significant improvements in all eight audit criteria. An increase of 80% was achieved for the criteria 'midwives received formal education on engorgement' on completion of the project. A 20% increase in 'consistency of education regarding latch' was reported by the mothers, and there was a 30% increase in 'information given to mothers on prevention and signs of engorgement'. Sixty-five percent of midwives were able to correctly identify and manage engorgement, a significant improvement from 5% at baseline. This evidence-based practice project successfully identified and utilized best practice in the management of breast engorgement care in mothers in our clinical setting. With effective breast engorgement interventions in place, mothers could continue to successfully breastfeed their babies. The major challenges identified during the conduct of the project included: time constraints on the midwives to attend education sessions and to educate mothers on prevention. At the completion of this project, a closer relationship was forged between the lactation consultant team and the

Medications in pregnancy and lactation: part 1. Teratology.

PubMed

Buhimschi, Catalin S; Weiner, Carl P

2009-01-01

One of the least-developed areas of clinical pharmacology and drug research is the use of medication during pregnancy and lactation. This article is the first in a two-part series designed to familiarize physicians with many aspects of the drugs they commonly prescribe for pregnant and breast-feeding women. Almost every pregnant woman is exposed to some type of medication during pregnancy. Although the majority of pregnant and breast-feeding women consume clinically indicated or over-the-counter drug preparation regularly, only few medications have specifically been tested for safety and efficacy during pregnancy. There is scant information on the effect of common pregnancy complications on drug clearance and efficacy. Often, the safety of a drug for mothers, their fetuses, and nursing infants cannot be determined until it has been widely used. Absent this crucial information, many women are either refused medically important agents or experience potentially harmful delays in receiving drug treatment. Conversely, many drugs deemed "safe" are prescribed despite evidence of possible teratogenicity. Novel research and diagnostic applications evolving from the opportunities presented by the advances in genomics and proteomics are now beginning to affect clinical diagnosis, vaccine development, drug discovery, and unique therapies in a modern diagnostic-therapeutic framework-part of the new scientific field of theranostics. This review critically explores a number of recently raised issues in regard to the use of several classes of medications during gestation and seeks to provide a general and concise resource on drugs commonly used during pregnancy and lactation. It also seeks to make clinicians more aware of the controversies surrounding some drugs in an effort to encourage safer prescribing practices through consultation with a maternal-fetal medicine specialist and through references and Web sites that list up-to-date information.

Oral Administration to Nursing Women of Lactobacillus fermentum CECT5716 Prevents Lactational Mastitis Development: A Randomized Controlled Trial

PubMed Central

Hurtado, José A.; Maldonado-Lobón, Jose A.; Díaz-Ropero, M. Paz; Flores-Rojas, Katherine; Uberos, José; Leante, José L.; Affumicato, Laura; Couce, María Luz; Garrido, José M.; Olivares, Mónica

2017-01-01

Abstract Objective: The objective of this study is to evaluate the preventive effect of oral administration of Lactobacillus fermentum CECT5716 on mastitis incidence in lactating women. Methods: A randomized double-blinded controlled trial that included 625 women was conducted. Women who received preventive dose of antibiotic in the context of delivery were recruited 1–6 days after childbirth and randomly assigned to a group. Probiotic group received 1 capsule/day containing L. fermentum 3 × 109 CFU, control group received 1 placebo capsule/day containing maltodextrin. The intervention period was 16 weeks. The primary outcome of the study was the incidence of clinical mastitis defined as at least two out of the three breast symptoms (pain, redness, and lump) and at least one of fever or flu-like symptoms (shivering, hot sweats, or aches). Results: Two hundred ninety-one women completed 16 weeks of treatment. Sixteen women in the probiotic group developed mastitis versus 30 women in the control group (odds ratio = 0.531; p = 0.058). Incidence rate of mastitis in the probiotic group was significantly lower than that in the control group (IR = 0.130 in the probiotic group versus IR = 0.263 in the control group; p = 0.021). Therefore, the oral administration of L. fermentum CECT5716 during lactation decreased by 51% the incidence rate of clinical mastitis. Staphylococcus spp. load at the end of intervention was significantly lower in breast milk of women in the probiotic group than in breast milk of women in the control group (p = 0.025). Conclusion: Consumption of the probiotic strain L. fermentum CECT5716 might be used during breastfeeding as an efficient strategy to prevent development of lactational mastitis in women. Trial registration: NCT02203877.

Does Dietary Iodine Regulate Oxidative Stress and Adiponectin Levels in Human Breast Milk?

PubMed Central

Gutiérrez-Repiso, Carolina; Velasco, Inés; Garcia-Escobar, Eva; Garcia-Serrano, Sara; Rodríguez-Pacheco, Francisca; Linares, Francisca; Ruiz de Adana, Maria Soledad; Rubio-Martin, Elehazara; Garrido-Sanchez, Lourdes; Cobos-Bravo, Juan Francisco; Priego-Puga, Tatiana; Rojo-Martinez, Gemma; Soriguer, Federico

2014-01-01

Abstract Little is known about the association between iodine and human milk composition. In this study, we investigated the association between iodine and different markers of oxidative stress and obesity-related hormones in human breast milk. This work is composed of two cross-sectional studies (in lactating women and in the general population), one prospective and one in vitro. In the cross-sectional study in lactating women, the breast milk iodine correlated negatively with superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) activities, and with adiponectin levels. An in vitro culture of human adipocytes with 1 μM potassium iodide (KI, dose similar to the human breast milk iodine concentration) produced a significant decrease in adiponectin, GSH-Px, SOD1, and SOD2 mRNA expression. However, after 2 months of treatment with KI in the prospective study, a positive correlation was found between 24-h urinary iodine and serum adiponectin. Our observations lead to the hypothesis that iodine may be a factor directly involved in the regulation of oxidative stress and adiponectin levels in human breast milk. Antioxid. Redox Signal. 20, 847–853. PMID:24001137

Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants.

PubMed

Weissman, Alicia M; Levy, Barcey T; Hartz, Arthur J; Bentler, Suzanne; Donohue, Micca; Ellingrod, Vicki L; Wisner, Katherine L

2004-06-01

The available data on antidepressant levels in nursing infants were analyzed in order to calculate average infant drug levels and determine what factors influence plasma drug levels in breast-feeding infants of mothers treated with antidepressants. Electronic searches of MEDLINE, PreMEDLINE, Current Contents, Biological Abstracts, and PsycINFO from 1966 through July 2002 followed by bibliographic searches identified 67 relevant studies (two unpublished). By consensus the authors identified 57 studies of maternal plasma, breast milk, and/or infant plasma antidepressant levels from nursing mother-infant pairs, measured by liquid chromatography. Infants with recent prenatal exposure and symptomatic infants included in case reports were analyzed separately. Infant plasma levels were standardized against the average maternal level for each drug. The average infant-maternal plasma ratio was calculated for each drug, and correlations of infant plasma level to maternal dose, maternal plasma level, and breast milk level were calculated. Nortriptyline, paroxetine, and sertraline usually produce undetectable infant levels. Of drugs currently used, fluoxetine produces the highest proportion (22%) of infant levels that are elevated above 10% of the average maternal level. Based on smaller numbers, the data on citalopram indicate that it produces elevated levels in 17% of infants. The milk-to-plasma ratios for 11 antidepressants had a statistically significant negative association with the percentage of the drug bound to protein. Nortriptyline, paroxetine, and sertraline may be preferred choices in breast-feeding women. Minimizing the maternal dose may be helpful with citalopram. Current data do not support monitoring breast milk levels in individual patients. Future researchers should report maternal, breast milk, and infant antidepressant levels along with other appropriate variables.

Comparison of the fatty acid profile of Spanish infant formulas and Galician women breast milk.

PubMed

Barreiro, Rocío; Regal, Patricia; López-Racamonde, Olga; Cepeda, Alberto; Fente, Cristina A

2018-02-01

The importance of dietary lipids during childhood is evident, as they are necessary for correct growth and development of the newborn. When breastfeeding is not possible, infant formulas are designed to mimic human milk as much as possible to fulfill infant's requirements. However, the composition of these dairy products is relatively constant, while human milk is not a uniform bio-fluid and changes according to the requirements of the baby. In this study, breast milk samples were donated by 24 Spanish mothers in different lactation stages and different infant formulas were purchased in supermarkets and pharmacies. Gas chromatography coupled to flame ionization detection was used for the fatty acid determination. Compared to breast milk, first-stage formulas are apparently very similar in composition; however, no major differences were observed in the fatty acid profiles between formulas of different lactation stages. The Galician women breast milk has a fatty acid profile rich in oleic acid, linoleic acid, arachidonic acid, and docosahexaenoic acid. When comparing human milk with formulas, it becomes evident that the manufacturers tend to enrich the formulas with essential fatty acids (especially with α-linolenic acid), but arachidonic and docosahexaenoic acid levels are lower than in breast milk. Additionally, the obtained results demonstrated that after 1 year of lactation, human milk is still a good source of energy, essential fatty acids, and long-chain polyunsaturated fatty acids for the baby.

Epstein-Barr virus, human papillomavirus and mouse mammary tumour virus as multiple viruses in breast cancer.

PubMed

Glenn, Wendy K; Heng, Benjamin; Delprado, Warick; Iacopetta, Barry; Whitaker, Noel J; Lawson, James S

2012-01-01

The purpose of this investigation is to determine if Epstein Barr virus (EBV), high risk human papillomavirus (HPV), and mouse mammary tumour viruses (MMTV) co-exist in some breast cancers. All the specimens were from women residing in Australia. For investigations based on standard PCR, we used fresh frozen DNA extracts from 50 unselected invasive breast cancers. For normal breast specimens, we used DNA extracts from epithelial cells from milk donated by 40 lactating women. For investigations based on in situ PCR we used 27 unselected archival formalin fixed breast cancer specimens and 18 unselected archival formalin fixed normal breast specimens from women who had breast reduction surgery. Thirteen of these fixed breast cancer specimens were ductal carcinoma in situ (dcis) and 14 were predominantly invasive ductal carcinomas (idc). EBV sequences were identified in 68%, high risk HPV sequences in 50%, and MMTV sequences in 78% of DNA extracted from 50 invasive breast cancer specimens. These same viruses were identified in selected normal and breast cancer specimens by in situ PCR. Sequences from more than one viral type were identified in 72% of the same breast cancer specimens. Normal controls showed these viruses were also present in epithelial cells in human milk - EBV (35%), HPV, 20%) and MMTV (32%) of 40 milk samples from normal lactating women, with multiple viruses being identified in 13% of the same milk samples. We conclude that (i) EBV, HPV and MMTV gene sequences are present and co-exist in many human breast cancers, (ii) the presence of these viruses in breast cancer is associated with young age of diagnosis and possibly an increased grade of breast cancer.

Infants’ Exposure to Aflatoxin M1 from Mother’s Breast Milk in Iran

PubMed Central

Ghiasian, SA; Maghsood, AH

2012-01-01

Background The occurrence of aflatoxin M1 (AFM1) in milk, especially breast milk, is a valuable biomarker for exposure determination to aflatoxin B1 (AFB1). In the present study, the risk of exposure to AFM1 in infants fed breast milk was investigated. Methods: An enzyme-linked immunosorbent assay (ELISA) was used for the analysis of AFM1 in breast milk samples from 132 lactating mothers referred to four urban Mothers and Babies Care Unit of Hamadan, western Iran. Results: AFM1 was detected in eight samples (6.06%) at mean concentration of 9.45 ng/L. The minimum and maximum of concentration was 7.1 to 10.8 ng/L, respectively. Although the concentration of AFM1 in none of the samples was higher than the maximum tolerance limit accepted by USA and European Union (25 ng/kg) however, 25% had a level of AFM1 above the allowable level of Australia and Switzerland legal limit (10 ng/L). Conclusions: Lactating mothers and infants in western parts of Iran could be at risk for AFB1 and AFM1 exposure, respectively. Considering all this information, the investigation of AFM1 in lactating mothers as a biomarker for post-natal exposure of infants to this carcinogen deserves further studies in various seasons and different parts of Iran. PMID:23113156

[Nursing contributions to the development of the Brazilian Telehealth Lactation Support Program].

PubMed

Prado, Cláudia; Silva, Isília Aparecida; Soares, Alda Valéria Neves; Aragaki, Ilva Marico Mizumoto; Shimoda, Gilcéria Tochika; Zaniboni, Vanessa Forte; Padula, Camila Brolezzi; Muller, Fabiana Swain; Salve, Jeanine Maria; Daré, Sergio Junior; Wen, Chao Lung; Peres, Heloísa Helena Ciqueto; Leite, Maria Madalena Januário

2013-08-01

The National Telehealth Program was founded by the Ministry of Health, in partnership with the Ministry of Education (Ministério da Educação - MEC) and the Ministry of Science and Technology (Ministério da Ciência e Tecnologia - MCT), to support the development of family healthcare teams throughout the country. The São Paulo Telehealth Center has developed the Telehealth Lactation Support program, which provides primary healthcare professionals with information on diverse aspects of breastfeeding. This paper reports the development of the Lactation Support program and the nursing contributions. Project methodology included the formation of a multidisciplinary group of pediatricians, nurses, speech and language therapists, nutritionists, and dentists. Multimedia teaching resources were prepared for inclusion in the Cybertutor platform. Telehealth Lactation Support is an innovative and promising addition to continuing education for healthcare professionals and provides a framework for the development of other programs.

Regulation of monocarboxylate transporter MCT1 expression by p53 mediates inward and outward lactate fluxes in tumors.

PubMed

Boidot, Romain; Végran, Frédérique; Meulle, Aline; Le Breton, Aude; Dessy, Chantal; Sonveaux, Pierre; Lizard-Nacol, Sarab; Feron, Olivier

2012-02-15

The monocarboxylate transporter (MCT) family member MCT1 can transport lactate into and out of tumor cells. Whereas most oxidative cancer cells import lactate through MCT1 to fuel mitochondrial respiration, the role of MCT1 in glycolysis-derived lactate efflux remains less clear. In this study, we identified a direct link between p53 function and MCT1 expression. Under hypoxic conditions, p53 loss promoted MCT1 expression and lactate export produced by elevated glycolytic flux, both in vitro and in vivo. p53 interacted directly with the MCT1 gene promoter and altered MCT1 mRNA stabilization. In hypoxic p53(-/-) tumor cells, NF-κB further supported expression of MCT1 to elevate its levels. Following glucose deprivation, upregulated MCT1 in p53(-/-) cells promoted lactate import and favored cell proliferation by fuelling mitochondrial respiration. We also found that MCT1 expression was increased in human breast tumors harboring p53 mutations and coincident features of hypoxia, with higher MCT1 levels associated with poorer clinical outcomes. Together, our findings identify MCT1 as a target for p53 repression and they suggest that MCT1 elevation in p53-deficient tumors allows them to adapt to metabolic needs by facilitating lactate export or import depending on the glucose availability.

Iodine supplementation during pregnancy and lactation. Position statement of the working group on disorders related to iodine deficiency and thyroid dysfunction of the Spanish Society of Endocrinology and Nutrition.

PubMed

Donnay, Sergio; Arena, Jose; Lucas, Anna; Velasco, Inés; Ares, Susana

2014-01-01

Severe and mild iodine deficiency during pregnancy and lactation affects thyroid function of the mother and neonate as well as the infant's neuropsychological development. Studies performed in Spain confirm that most women are iodine deficient during pregnancy and lactation. Pregnant and breast feeding women and women planning to become pregnant should take iodine supplements. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

Lifestyle factors and breast cancer: a case-control study in Kuala Lumpur, Malaysia.

PubMed

Kamarudin, Rozanim; Shah, Shamsul Azhar; Hidayah, Noor

2006-01-01

Breast cancer is the most common female cancer and the commonest cause of death due to cancer for women in Malaysia. This study was performed to identify the relationship with lifestyle factors. A case-control study was conducted among females with breast cancer who came for treatment to the Breast Clinic Hospital Kuala Lumpur in July until September 2004. A total of 203 female patients were recruited as cases along with 203 patients who attended the Outpatient Clinic, Hospital Kuala Lumpur during the study period as the controls. The study showed women who did not exercise regularly to have four times higher risk (adjusted odds ratio is 3.49, 95% CI is 1.84 to 6.62) compared to those who exercised regularly. Women with a high fat diet were also at elevated risk (adjusted odds ratio 3.84, 95% CI is 1.20 to 12.34) compared to those consuming a low fat diet. Women without breast cancer generally had a longer duration of lifetime lactation with a median of thirty-three months compared to women with breast cancer (twenty months, p<0.05). Women who did not take oral contraceptive pills but had breast-fed their child have a 56.0% lower risk (crude odds ratio 0.44, CI is 0.22 to 0.87) compared to women who did not take oral contraceptive pill and also did not breast-feed their child. If they had breast fed for thirteen months and above, they faced a 61.0% lower risk (crude odds ratio 0.39, 95% CI is 0.17 to 0.87). There was a significant inverse trend for lifetime lactation and breast cancer risk. In conclusion certain life styles of women are associated with a higher risk of breast cancer development. Therefore, the promotion of a healthy life style should be emphasized.

Have the organisms that cause breast abscess changed with time?--Implications for appropriate antibiotic usage in primary and secondary care.

PubMed

Dabbas, Natalie; Chand, Manish; Pallett, Ann; Royle, Gavin T; Sainsbury, Richard

2010-01-01

Many patients with breast abscess are managed in primary care. Knowledge of current trends in the bacteriology is valuable in informing antibiotic choices. This study reviews bacterial cultures of a large series of breast abscesses to determine whether there has been a change in the causative organisms during the era of increasing methicillin-resistant Staphylococcus aureus (MRSA). Analysis was undertaken of all breast abscesses treated in a single unit over 2003 - 2006, including abscess type, bacterial culture, antibiotic sensitivity and resistance patterns. One hundred and ninety cultures were obtained (32.8% lactational abscess, 67.2% nonlactational). 83% yielded organisms. Staphylococcus aureus was the commonest organism isolated (51.3%). Of these, 8.6% were MRSA. Other common organisms included mixed anaerobes (13.7%), and anaerobic cocci (6.3%). Lactational abscesses were significantly more likely to be caused by S. aureus (p < 0.05). Methicillin-resistant Staphylococcus aureus rates were not statistically different between lactational and nonlactational abscess groups. Appropriate antibiotic choices are of great importance in the community management of breast abscess. Ideally, microbial cultures should be obtained to institute targeted therapy but we recommend the continued use of flucloxacillin with or without metronidazole (or amoxicillin-clavulanate as a single preparation) as initial empirical therapy.

Functional properties of bicarbonates and lactic acid on chicken breast retail display properties and cooked meat quality.

PubMed

Lee, Nakia; Sharma, Vijendra; Brown, Nettie; Mohan, Anand

2015-02-01

Whole chicken breast was injected with potassium bicarbonate (PB), sodium bicarbonate (SB), and potassium lactate (K-lactate) and salt, alone or in combination at different concentration levels. The objectives were to 1) investigate the effects of different concentration of PB, SB, and PL on instrumental color, water-holding capacity (WHC), objective tenderness, expressible moisture, and moisture content and 2) evaluate whether sodium-containing ingredients can be replaced with potassium as a potential strategy to reduce total sodium content in the finished product. Results showed that chicken breast tissue marinated with SB and PB had greater moisture retention, display characteristics, and cooked product qualities than chicken breast tissue injected with water and the nonmarinated control. The L* values (lightness) did not change over the period of retail display and were not different compared to the control (P>0.05). The chicken breast enhanced with SB, PB, and K-lactate retained better retail display color than the controls (marinated with water and nonmarinated). Increasing the potassium bicarbonate concentration from 0.5 to 1.5% significantly improved the water-holding capacity (82.17 to 92.61%; P<0.05) and led to better cook yield (83.84 to 91.96%). Shear force values were lower at the 0.5% level for both SB and PB compared to the control. PB performed better on retail display and cooked meat quality than SB. This study suggests that chicken breast tissue can be marinated with KB as a healthier alternative to phosphate or SB. © 2015 Poultry Science Association Inc.

Lactate is a mediator of metabolic cooperation between stromal carcinoma associated fibroblasts and glycolytic tumor cells in the tumor microenvironment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rattigan, Yanique I.; Patel, Brijesh B.; Department of Pharmacology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901

2012-02-15

Human mesenchymal stem cells (hMSCs) are bone marrow-derived stromal cells, which play a role in tumor progression. We have shown earlier that breast cancer cells secrete higher levels of interleukin-6 (IL-6) under hypoxia, leading to the recruitment of hMSCs towards hypoxic tumor cells. We found that (i) MDA-MB-231 cells secrete significantly higher levels of lactate (3-fold more) under hypoxia (1% O{sub 2}) than under 20% O{sub 2} and (ii) lactate recruits hMSCs towards tumor cells by activating signaling pathways to enhance migration. The mRNA and protein expression of functional MCT1 in hMSCs is increased in response to lactate exposure. Thus,more » we hypothesized that hMSCs and stromal carcinoma associated fibroblasts (CAFs) in the tumor microenvironment have the capacity to take up lactate expelled from tumor cells and use it as a source of energy. Our {sup 13}C NMR spectroscopic measurements indicate that {sup 13}C-lactate is converted to {sup 13}C-alpha ketoglutarate in hMSCs and CAFs supporting this hypothesis. To our knowledge this is the first in vitro model system demonstrating that hMSCs and CAFs can utilize lactate produced by tumor cells.« less

Expression of the hypoxia-inducible monocarboxylate transporter MCT4 is increased in triple negative breast cancer and correlates independently with clinical outcome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doyen, J.; Trastour, C.; Ettore, F.

2014-08-15

Highlights: • Glycolytic markers are highly expressed in triple negative breast cancers. • Lactate/H{sup +} symporter MCT4 demonstrated the strongest deleterious impact on survival. • MCT4 should serve as a new prognostic factor in node-negative breast cancers. - Abstract: Background: {sup 18}Fluor-deoxy-glucose PET-scanning of glycolytic metabolism is being used for staging in many tumors however its impact on prognosis has never been studied in breast cancer. Methods: Glycolytic and hypoxic markers: glucose transporter (GLUT1), carbonic anhydrase IX (CAIX), monocarboxylate transporter 1 and 4 (MCT1, 4), MCT accessory protein basigin and lactate-dehydrogenase A (LDH-A) were assessed by immunohistochemistry in two cohortsmore » of breast cancer comprising 643 node-negative and 127 triple negative breast cancers (TNBC) respectively. Results: In the 643 node-negative breast tumor cohort with a median follow-up of 124 months, TNBC were the most glycolytic (≈70%), followed by Her-2 (≈50%) and RH-positive cancers (≈30%). Tumoral MCT4 staining (without stromal staining) was a strong independent prognostic factor for metastasis-free survival (HR = 0.47, P = 0.02) and overall-survival (HR = 0.38, P = 0.002). These results were confirmed in the independent cohort of 127 cancer patients. Conclusion: Glycolytic markers are expressed in all breast tumors with highest expression occurring in TNBC. MCT4, the hypoxia-inducible lactate/H{sup +} symporter demonstrated the strongest deleterious impact on survival. We propose that MCT4 serves as a new prognostic factor in node-negative breast cancer and can perhaps act soon as a theranostic factor considering the current pharmacological development of MCT4 inhibitors.« less

Factors affecting breast-feeding initiation in Greece: What is important?

PubMed

Tavoulari, Evangelia-Filothei; Benetou, Vassiliki; Vlastarakos, Petros V; Andriopoulou, Eirini; Kreatsas, George; Linos, Athena

2015-02-01

to investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece. cross-sectional study. Tertiary University Hospital, maternity ward. 428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth. 71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89-0.98) and caesarean section (OR=0.54, 95% CI=0.35-0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39-3.78), information about breast feeding (OR=2.38, 95% CI=1.41-4.01) and rooming-in (OR=1.62 95% CI=1.03-2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90-15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53-18.89), and rooming-in (OR=6.93 95% CI=2.01-23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03-0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02-62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation. maternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast

Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors.

PubMed

Neil, Sarah E; Klika, Riggs J; Garland, S Jayne; McKenzie, Donald C; Campbell, Kristin L

2013-03-01

Fatigue is one of the most commonly reported side effects during treatment for breast cancer and can persist following treatment completion. Cancer-related fatigue after treatment is multifactorial in nature, and one hypothesized mechanism is cardiorespiratory and neuromuscular deconditioning. The purpose of this study was to compare cardiorespiratory and neuromuscular function in breast cancer survivors who had completed treatment and met the specified criteria for cancer-related fatigue and a control group of breast cancer survivors without fatigue. Participants in the fatigue (n = 16) and control group (n = 11) performed a maximal exercise test on a cycle ergometer for determination of peak power, power at lactate threshold, and VO(2) peak. Neuromuscular fatigue was induced with a sustained submaximal contraction of the right quadriceps. Central fatigue (failure of voluntary activation) was evaluated using twitch interpolation, and peripheral fatigue was measured with an electrically evoked twitch. Power at lactate threshold was lower in the fatigue group (p = 0.05). There were no differences between groups for power at lactate threshold as percentage of peak power (p = 0.10) or absolute or relative VO(2) peak (p = 0.08 and 0.33, respectively). When adjusted for age, the fatigue group had a lower power at lactate threshold (p = 0.02) and absolute VO(2) peak (p = 0.03). There were no differences between groups in change in any neuromuscular parameters after the muscle-fatiguing protocol. Findings support the hypothesis that cardiorespiratory deconditioning may play a role in the development and persistence of cancer-related fatigue following treatment. Future research into the use of exercise training to reduce cardiorespiratory deconditioning as a treatment for cancer-related fatigue is warranted to confirm these preliminary findings.

Liesegang-Like Rings in Lactational Changes in the Breast

PubMed Central

Islam, Mohd T.; Ou, Joyce J.; Hansen, Katrine; Simon, Rochelle A.; Quddus, M. Ruhul

2012-01-01

Liesagang-like rings (LR) are periodic structures with equally spaced radial striations formed by a process that involves diffusion, nucleation, flocculation or precipitation, and supersaturation. Being more common in vitro, on rare occasions also reported in vivo in association with inflammatory or cystic lesions and confused with parasites or calcification on needle aspirates. The current paper documents that LRs may be seen in noncystic and noninflammatory changes of the breast. PMID:23094171

Treatments for breast abscesses in breastfeeding women.

PubMed

Irusen, Hayley; Rohwer, Anke C; Steyn, D Wilhelm; Young, Taryn

2015-08-17

The benefits of breastfeeding are well known, and the World Health Organization recommends exclusive breastfeeding for the first six months of life and continuing breastfeeding to age two. However, many women stop breastfeeding due to lactational breast abscesses. A breast abscess is a localised accumulation of infected fluid in breast tissue. Abscesses are commonly treated with antibiotics, incision and drainage (I&D) or ultrasound-guided needle aspiration, but there is no consensus on the optimal treatment. To assess the effects of different treatments for the management of breast abscesses in breastfeeding women. We searched the Cochrane Pregnancy and Childbirth Group's Trial Register (27 February 2015). In addition we searched African Journals Online (27 February 2015), Google Scholar (27 February 2015), ProQuest Dissertations and Theses Databases (27 February 2015) and the WHO International Clinical Trials Registry Platform (ICTRP) search portal (27 February 2015). We also checked reference lists of retrieved studies and contacted experts in the field as well as relevant pharmaceutical companies. Randomised controlled trials (RCTs) investigating any intervention for treating lactational breast abscesses compared with any other intervention. Studies published in abstract form, quasi-RCTs and cluster-RCTs were not eligible for inclusion. Two review authors independently assessed studies for inclusion, assessed risk of bias and extracted data. Data were checked for accuracy. We included six studies. Overall, trials had an unclear risk of bias for most domains due to poor reporting. Two studies did not stratify data for lactational and non-lactational breast abscesses, and these studies do not contribute to the results. This review is based on data from four studies involving 325 women. Needle aspiration (with and without ultrasound guidance) versus incision and drainage (I&D) Mean time (days) to complete resolution of breast abscess (three studies) - there was

Dinosaur lactation?

PubMed

Else, Paul L

2013-02-01

Lactation is a process associated with mammals, yet a number of birds feed their newly hatched young on secretions analogous to the milk of mammals. These secretions are produced from various sections (crop organ, oesophageal lining and proventriculus) of the upper digestive tract and possess similar levels of fat and protein, as well as added carotenoids, antibodies and, in the case of pigeons and doves, epidermal growth factor. Parental care in avian species has been proposed to originate from dinosaurs. This study examines the possibility that some dinosaurs used secretory feeding to increase the rate of growth of their young, estimated to be similar to that of present day birds and mammals. Dinosaur 'lactation' could also have facilitated immune responses as well as extending parental protection as a result of feeding newly hatched young in nest environments. While the arguments for dinosaur lactation are somewhat generic, a case study for lactation in herbivorous site-nesting dinosaurs is presented. It is proposes that secretory feeding could have been used to bridge the gap between hatching and establishment of the normal diet in some dinosaurs.

Prolactin cycling and the management of breast-feeding failure.

PubMed

Weichert, C E

1980-01-01

Various studies (Tyson et.al.; Frantz; Aono et.al.) show that cycling of prolactin is critical to the establishment of successful lactation in the first 60 to 80 days postpartum, and that a 2-hour nursing interval is associated with a statistically significant earlier onset of milk production (Salarija et.al.). However, in the patient with a lactational insufficiency, efforts to increase the frequency of nursing more often than every 2 hours may be counterproductive, as experimental evidence shows that prolactin exerts a negative feedback upon itself, and the patient with a breastfeeding problems may experience increased episodes of anxiety and fatigue. The patient with breast milk insufficiency can be managed by ensuring that a sucking stimulus of 30 minutes (15 minutes bilaterally) be present and repeated every 2-3 hours to provide adequate stimulation for prolactin release. Maternal anxiety about milk supply can be relieved by using the Lact-Aid nursing supplementer, a device which provides an additional source of milk to the infant at the breast. Nursing should be carried out in a sheltered situation to provide an uninterrupted sucking stimulus devoid of distraction. The mother should be directed to focus on pleasant associations while nursing to keep her from worrying about whether she will have enough milk. Symptoms of lactational insufficiency can be corrected with proper hormonal regulation. Evaluation of a breastfeeding disorder depends upon a careful physical examination of the breast, preferably to be done prior to and during infant nursing. Observation of infant nursing has not been a standard part of physical examination, although it is critical to making a diagnosis of the problem. The principles of breastfeeding management are illustrated in 3 cases in this chapter. In cases where there is no response to treatment, additional evaluation of the patient's developmental (e.g., adolescent attitude towards the breast) attitude and sexual function history

Bicarbonate versus lactate solutions for acute peritoneal dialysis.

PubMed

Bai, Zheng Gang; Yang, KeHu; Tian, Jin Hui; Ma, Bin; Liu, Yali; Jiang, Lei; Tan, Jiying; Liu, Tian Xi; Chi, Iris

2014-07-04

The high mortality rate among critically ill patients with acute kidney injury (AKI) remains an unsolved problem in intensive care medicine, despite the use of renal replacement therapy (RRT). Increasing evidence from clinical studies in adults and children suggests that the new peritoneal dialysis (PD) fluids may allow for better long-term preservation of peritoneal morphology and function. Formation of glucose degradation products (GDPs) can be reduced and even avoided with the use of newer "biocompatible" solutions. However, it is still unclear if there are any differences in using conventional (lactate) solutions compared with low GDP (bicarbonate) solutions for acute PD. To look at the benefits and harms of bicarbonate versus lactate solutions in acute PD. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (from 1966), EMBASE (from 1980), Latin American and Caribbean Health Sciences Literature Database LILACS (from 1982), and reference lists of articles.Date of last search: 6 May 2014. Randomised controlled trials (RCTs) comparing bicarbonate to lactate solution for acute PD. Two authors independently assess the methodological quality of studies. One author abstracted data onto a standard form, and a second author checked data extraction. We used the random-effects model and expressed the results as relative risk (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes with 95% confidence intervals (CI). We included one study (20 patients) in this review. In shock patients, bicarbonate did not differ from lactate with respect to mortality (RR 0.50, 95% CI 0.06 to 3.91); however there were significant differences in blood lactate (MD -1.60 mmol/L, 95% CI -2.04 to -1.16), serum bicarbonate (MD 5.00 mmol/L, 95% CI 3.26 to 6.74) and blood pH (MD 0.12, 95% CI 0.06 to 0.18). In non-shock patients there was a significance difference in blood lactate (MD -0.60 mmol/L, 95% CI -0.85 to -0.35) but not in serum

Epstein-Barr Virus, Human Papillomavirus and Mouse Mammary Tumour Virus as Multiple Viruses in Breast Cancer

PubMed Central

Glenn, Wendy K.; Heng, Benjamin; Delprado, Warick; Iacopetta, Barry; Whitaker, Noel J.; Lawson, James S.

2012-01-01

Background The purpose of this investigation is to determine if Epstein Barr virus (EBV), high risk human papillomavirus (HPV), and mouse mammary tumour viruses (MMTV) co-exist in some breast cancers. Materials and Methods All the specimens were from women residing in Australia. For investigations based on standard PCR, we used fresh frozen DNA extracts from 50 unselected invasive breast cancers. For normal breast specimens, we used DNA extracts from epithelial cells from milk donated by 40 lactating women. For investigations based on in situ PCR we used 27 unselected archival formalin fixed breast cancer specimens and 18 unselected archival formalin fixed normal breast specimens from women who had breast reduction surgery. Thirteen of these fixed breast cancer specimens were ductal carcinoma in situ (dcis) and 14 were predominantly invasive ductal carcinomas (idc). Results EBV sequences were identified in 68%, high risk HPV sequences in 50%, and MMTV sequences in 78% of DNA extracted from 50 invasive breast cancer specimens. These same viruses were identified in selected normal and breast cancer specimens by in situ PCR. Sequences from more than one viral type were identified in 72% of the same breast cancer specimens. Normal controls showed these viruses were also present in epithelial cells in human milk – EBV (35%), HPV, 20%) and MMTV (32%) of 40 milk samples from normal lactating women, with multiple viruses being identified in 13% of the same milk samples. Conclusions We conclude that (i) EBV, HPV and MMTV gene sequences are present and co-exist in many human breast cancers, (ii) the presence of these viruses in breast cancer is associated with young age of diagnosis and possibly an increased grade of breast cancer. PMID:23183846

A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding

PubMed Central

Bazzano, Alessandra N.; Hofer, Rebecca; Thibeau, Shelley; Gillispie, Veronica; Jacobs, Marni; Theall, Katherine P.

2016-01-01

Background: Therapeutic approaches to addressing insufficient lactation are available but remain poorly understood. Current trends in maternal health, such as increasing rates of obesity, delayed age at childbearing, and high rates of cesarean section, may be associated with physiological challenges for lactation that cannot be managed by counseling alone. Women who have not had success with counseling alone, including adoptive mothers seeking to induce lactation, may use galactagogues (pharmaceutical and herbal compounds used to increase lactation). We present a review of selected studies of galactagogues and data indicating popular demand for such products. Methods: A systematic search was conducted for published studies on the use of galactagogues for breast-feeding. The following databases were searched: MEDLINE (PubMed), EBSCO (Academic Search Complete), and EMBASE. The search was conducted between July 15, 2015, and August 18, 2015; only English language articles were included, and we imposed no restrictions on publication date. Two authors independently reviewed the studies and extracted data. Results: Blinded, placebo-controlled clinical trials of 2 pharmaceutical galactagogues (domperidone and metoclopramide) and 5 popular herbal galactagogues (shatavari, fenugreek, silymarin, garlic, and malunggay) were identified. All of the studies identified for domperidone showed a significant difference in milk production between the treatment and placebo groups. Of the 6 trials of metoclopramide, only 1 study showed a significant difference in milk production compared to placebo. Results of the clinical trials on herbal galactagogues were mixed. Our review of the evidence for the efficacy of popular pharmaceutical and herbal galactagogues revealed a dearth of high-quality clinical trials and mixed results. Conclusion: Health providers face the challenge of prescribing or recommending galactagogues without the benefit of robust evidence. Given the suboptimal rates of

A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding.

PubMed

Bazzano, Alessandra N; Hofer, Rebecca; Thibeau, Shelley; Gillispie, Veronica; Jacobs, Marni; Theall, Katherine P

2016-01-01

Therapeutic approaches to addressing insufficient lactation are available but remain poorly understood. Current trends in maternal health, such as increasing rates of obesity, delayed age at childbearing, and high rates of cesarean section, may be associated with physiological challenges for lactation that cannot be managed by counseling alone. Women who have not had success with counseling alone, including adoptive mothers seeking to induce lactation, may use galactagogues (pharmaceutical and herbal compounds used to increase lactation). We present a review of selected studies of galactagogues and data indicating popular demand for such products. A systematic search was conducted for published studies on the use of galactagogues for breast-feeding. The following databases were searched: MEDLINE (PubMed), EBSCO (Academic Search Complete), and EMBASE. The search was conducted between July 15, 2015, and August 18, 2015; only English language articles were included, and we imposed no restrictions on publication date. Two authors independently reviewed the studies and extracted data. Blinded, placebo-controlled clinical trials of 2 pharmaceutical galactagogues (domperidone and metoclopramide) and 5 popular herbal galactagogues (shatavari, fenugreek, silymarin, garlic, and malunggay) were identified. All of the studies identified for domperidone showed a significant difference in milk production between the treatment and placebo groups. Of the 6 trials of metoclopramide, only 1 study showed a significant difference in milk production compared to placebo. Results of the clinical trials on herbal galactagogues were mixed. Our review of the evidence for the efficacy of popular pharmaceutical and herbal galactagogues revealed a dearth of high-quality clinical trials and mixed results. Health providers face the challenge of prescribing or recommending galactagogues without the benefit of robust evidence. Given the suboptimal rates of exclusive breast-feeding worldwide and

[Breast feeding in Spain. Current situation].

PubMed

Morán Rey, J

1992-01-01

Throughout the ages, breast-feeding as a biological need has been the most used method on infant feeding during the first year of life. Because of its nutritional and protective characteristics, it is still the best system of feeding in spite of the present advances in the composition of formulated milks. In order to know the present situation of natural feeding in Spain we have performed a study in which the fieldwork consisted of the participation of 1,061 mothers and 152 pediatricians. The most important results are detailed in the present work. At birth, 73.5% of the mothers began to nurse their babies, a 19.2% used formula, and 7.3% used the feeding methods. The decision related to the type of feeding was taken by the mother in the majority of the cases (92.6%) with a surprisingly low incidence of prenatal advice (1.8%). Of the mothers, 90.7% clearly had positive opinions about breast-feeding. Negative opinions included concerns about their jobs or social obligations (18.5%). The most normal reason for not nursing was related to hypogalactia (61.2%). At 90 days of age, 22.8% of the breast-feed babies were still being suckled, whereas only 28.0% those receiving mixed nutrition were being nursed at 30 days of age. Supplementation of breastmilk is established early since at one month of age 32.1% of the infants were receiving mixed nutrition after beginning with only breast-feeding. The decision to give up the natural lactation corresponded equally to the mother (45.2%) and the pediatrician (54.2%) with the general motive being hypogalactia (74.2%). After giving up natural lactation, 8.4% of the mothers introduced the beikost.

Early lactation production, health, and welfare characteristics of cows selected for extended lactation.

PubMed

Lehmann, J O; Mogensen, L; Kristensen, T

2017-02-01

Some cows are able to achieve relatively high milk yields during extended lactations beyond 305 d in milk, and farmers may be able to use this potential by selecting the most suitable cows for an extended lactation. However, the decision to postpone insemination has to rely on information available in early lactation. The main objectives of this study were, therefore, to assess the association between the information available in early lactation and the relative milk production of cows on extended lactation, and to investigate if this information can be used to differentiate time of first insemination between cows. Data came from 4 Danish private herds practicing extended lactation in which some cows are selected to have a delayed time of planned first insemination. Average herd size varied from 93 to 157 cows, and milk yield varied from 7,842 to 12,315 kg of energy-corrected milk (ECM) per cow per year across herds. The analysis was based on 422 completed extended lactations (427 ± 87 d), and each lactation was assigned to 1 of 3 (low, medium, and high) milk performance groups (MPG) within parity group within herd based on a standardized lactation yield. For cows in the high MPG, peak ECM yield, and ECM yield at dry off were significantly greater, the relative reduction in milk yield between 60 and 305 d in milk was significantly smaller, and a smaller proportion had a body condition score (scale: 1-5) at dry off of 3.5 or greater compared with cows in low MPG. Previous lactation days in milk at peak ECM yield and ECM yield at dry off were higher, the relative reduction in milk yield between 60 and 305 d in milk was smaller, and the number of inseminations per conception was higher for multiparous cows in high MPG compared with low. Current lactation ECM yield at second and third milk recording were greater for cows in high MPG compared with low. A principal component analysis indicated that variables related to fertility, diseases, and milk yield explained most

A grounded theory study of Swedish women's experiences of inflammatory symptoms of the breast during breast feeding.

PubMed

Kvist, Linda J; Larsson, Bodil Wilde; Hall-Lord, Marie Louise

2006-06-01

to gain an understanding of the experiences of women who have had an episode of inflammatory symptoms of the breast during lactation. a grounded theory approach, inspired by Glaser and Strauss, was used in an interview study. the study was carried out at a midwife-led breast-feeding clinic in Sweden. the strategic sample consisted of 14 mothers, all of whom had had an episode of breast inflammation between 10 and 22 weeks before the interview. Nine were primiparous. Ages ranged between 24 and 38 years. the analysis resulted in the emergence of one core category and five conceptual categories. The core category was 'the will to breast feed', and the five conceptual categories were 'perspectives on breast feeding', 'personal strategies', 'enduring and adjustment', 'support' and 'causal frameworks'. The core category was reflected in all the other categories and was dependent on them. an episode of breast inflammation is a possible threat to the maintenance of breast feeding, but the will to breast feed may make it possible for mothers to withstand physical and emotional difficulties caused by the illness. Breast-feeding mothers may have chosen a goal for the length of time they wish to breast feed, and the attainment of this goal is prestige-filled. Midwives, throughout the chain of care, could improve the amount and type of information given about the demands and possible complications of breast feeding. The availability of immediate clinical expertise for these mothers is an important factor, and health-care planners should be aware of this.

Correlation between lead levels in drinking water and mothers' breast milk: Dakahlia, Egypt.

PubMed

Mandour, Raafat A; Ghanem, Abdel-Aziz; El-Azab, Somaia M

2013-04-01

This study was performed on fifty-two drinking tap water samples (surface and groundwater) collected from different districts of Dakahlia Governorate and fifty-two breast milk samples from lactating mothers hosted in Dakahlia Governorate hospitals. All these samples were subjected to lead analysis. Lead level in drinking groundwater showed higher levels than in drinking surface water. Also, an elevation of lead levels in breast milk of mothers drinking groundwater was noticed when compared with that of mothers drinking surface water. The comparison between mean lead levels in drinking water and mothers' breast milk samples showed positive relationship. Lead concentrations in breast milk of the studied samples were elevated by exposure to smoking. We conclude that prolonged contact with lead plumbing can increase the lead content in tap water with subsequent increase in lead burden in infant fed formula and infant blood. Also, we recommend that chemical analyses must be carried out periodically for the surface and groundwater to ensure the water suitability for drinking purposes. Passive exposure to smoking during lactation should be avoided. Capsule: Prolonged contact with lead plumbing can increase the lead content in tap water with subsequent increase in lead burden in infant fed formula and infant blood.

Approaches to supporting lactation and breastfeeding for very preterm infants in the NICU: a qualitative study in three European regions

PubMed Central

Bonet, Mercedes; Forcella, Emanuela; Blondel, Béatrice; Draper, Elizabeth S; Agostino, Rocco; Cuttini, Marina; Zeitlin, Jennifer

2015-01-01

Objectives To explore differences in approaches to supporting lactation and breastfeeding for very preterm infants in neonatal intensive care units (NICU) in 3 European regions. Design Qualitative cross-sectional study carried out by means of face-to-face semistructured interviews. Verbatim transcripts were coded using a theoretical framework derived from the literature and supplemented by data-driven concepts and codes. Setting 4 purposively selected NICUs in each of 3 European regions in 2010 (Ile-de-France in France, Lazio in Italy, and the former Trent region in the UK). Participants NICU staff members (n=22). Results Policies and practices for managing mother's own milk for very preterm babies differed between regions, and were much more complex in Ile-de-France than in the Trent or Lazio regions. Staff approaches to mothers to initiate lactation differed by region, with an emphasis on the nutritional and immunological value of human milk in the Trent region and on the ‘normalising’ effect of breastfeeding on the mother-child relationship in Lazio. French and English staff expressed conflicting opinions about the use of bottles, which was routine in Italy. Italian informants stressed the importance of early maternal milk expression and feeding, but also mentioned discharging infants home before feeding at the breast was established. In Ile-de-France and Trent, successful feeding from the breast was achieved before discharge, although this was seen as a factor that could prolong hospitalisation and discourage continued breastfeeding for some women. Conclusions Targeted health promotion policies in the NICU are necessary to increase the number of infants receiving their mother's milk and to support mothers with transfer of the infant to the breast. Integrating knowledge about the different approaches to lactation and breastfeeding in European NICUs could improve the relevance of recommendations in multiple cultural settings. PMID:26129632

Breast tuberculosis: Diagnosis, management and treatment

PubMed Central

Marinopoulos, Spyridon; Lourantou, Dionysia; Gatzionis, Thomas; Dimitrakakis, Constantine; Papaspyrou, Irini; Antsaklis, Aris

2012-01-01

INTRODUCTION Mammary (breast) tuberculosis is a rare manifestation of extra-pulmonary localization of the disease which accounts for less than 0.1% of breast conditions in developed countries, but reaches 3–4% in regions where the disease presents with high incidence (India, Africa). It appears mostly in women of reproductive age, multiparous, lactating. It has been scarcely reported to infect male patients, mainly before puberty, as well as women of older age. The most common presentation is that of a tumor in the middle or upper-outer quadrant of the breast, with multifocal involvement being rarely documented. The differential diagnosis includes breast cancer and abscess formation. PRESENTATION OF CASE We report a case of breast tuberculosis that was treated in the Breast Unit of our hospital. Differential diagnosis, imaging methods, operative diagnostic approach and surgical treatment, histological verification of the disease and further therapeutic management are described. DISCUSSION High risk population is identified, primary and secondary disease is described and clinical presentations are analyzed. Evaluation of diagnostic workup and limitations are reported. CONCLUSION In accordance with the present worldwide revival of the disease, mainly because of massive numbers of migrating population, this subject is reviewed, reminding us of a rather uncommon clinical entity. PMID:22918083

Breast-feeding during maternal use of azathioprine.

PubMed

Moretti, Myla E; Verjee, Zul; Ito, Shinya; Koren, Gideon

2006-12-01

To report the clinical outcome of infants whose mothers were taking azathioprine while nursing and to quantify the transfer of 6-mercaptopurine (6-MP), its active metabolite, into breast milk. We report on a series of 4 patients treated with azathioprine while lactating. Breast milk samples were analyzed for 6-MP in 2 of the mothers. Several milk samples per patient were analyzed; levels of 6-MP were undetectable by high performance liquid chromatography (limit of detection 5 ng/mL). Therefore, the absolute relative infant dose would have been less than 0.09% of the maternal weight-adjusted dose. No adverse effects were encountered in any of the 4 infants. A large number of women of reproductive age are treated with azathioprine for a range of chronic conditions that require immunosuppression, such as systemic lupus erythematosus or solid organ transplants. Similar to other antimetabolites, the drug has generally been contraindicated for use during breast-feeding because of the theoretical concern for toxicity in the nursing infant. The available literature in this area is sparse and dated. The data presented here confirm published reports of minimal 6-MP excretion into milk, suggesting that significant systemic adverse effects in the infant are unlikely. Maternal azathioprine use during lactation does not appear to pose a significant immediate clinical risk to the suckling infant. Continued monitoring and long-term assessment of these infants are warranted.

Leukocyte Populations in Human Preterm and Term Breast Milk Identified by Multicolour Flow Cytometry

PubMed Central

Trend, Stephanie; de Jong, Emma; Lloyd, Megan L.; Kok, Chooi Heen; Richmond, Peter; Doherty, Dorota A.; Simmer, Karen; Kakulas, Foteini; Strunk, Tobias; Currie, Andrew

2015-01-01

Background Extremely preterm infants are highly susceptible to bacterial infections but breast milk provides some protection. It is unknown if leukocyte numbers and subsets in milk differ between term and preterm breast milk. This study serially characterised leukocyte populations in breast milk of mothers of preterm and term infants using multicolour flow cytometry methods for extended differential leukocyte counts in blood. Methods Sixty mothers of extremely preterm (<28 weeks gestational age), very preterm (28–31 wk), and moderately preterm (32–36 wk), as well as term (37–41 wk) infants were recruited. Colostrum (d2–5), transitional (d8–12) and mature milk (d26–30) samples were collected, cells isolated, and leukocyte subsets analysed using flow cytometry. Results The major CD45+ leukocyte populations circulating in blood were also detectable in breast milk but at different frequencies. Progression of lactation was associated with decreasing CD45+ leukocyte concentration, as well as increases in the relative frequencies of neutrophils and immature granulocytes, and decreases in the relative frequencies of eosinophils, myeloid and B cell precursors, and CD16- monocytes. No differences were observed between preterm and term breast milk in leukocyte concentration, though minor differences between preterm groups in some leukocyte frequencies were observed. Conclusions Flow cytometry is a useful tool to identify and quantify leukocyte subsets in breast milk. The stage of lactation is associated with major changes in milk leukocyte composition in this population. Fresh preterm breast milk is not deficient in leukocytes, but shorter gestation may be associated with minor differences in leukocyte subset frequencies in preterm compared to term breast milk. PMID:26288195

Effect of vitamin supplements on HIV shedding in breast milk.

PubMed

Villamor, Eduardo; Koulinska, Irene N; Aboud, Said; Murrin, Clare; Bosch, Ronald J; Manji, Karim P; Fawzi, Wafaie W

2010-10-01

Supplementation in lactating HIV-1-infected women with preformed vitamin A and β-carotene (VA/BC) increases the risk of mother-to-child transmission of HIV through breastfeeding. Identifying a biological mechanism to explain this unexpected finding would lend support to a causal effect. The aim of the study was to evaluate the effect of VA/BC or multivitamin (B complex, vitamin C, and vitamin E) supplementation of HIV-infected women on HIV shedding in breast milk during the first 2 y postpartum. We quantified viral (cell-free) and proviral (cell-associated) HIV loads in breast-milk samples collected ≤15 d after delivery and every 3 mo thereafter from 594 Tanzanian HIV-1-infected women who participated in a randomized trial. Women received 1 of the following 4 daily oral regimens in a 2 × 2 factorial fashion during pregnancy and throughout the first 2 y postpartum: multivitamin, VA/BC, multivitamin including VA/BC, or placebo. The proportion of breast-milk samples with detectable viral load was significantly higher in women who received VA/BC (51.3%) than in women who were not assigned to VA/BC (44.8%; P = 0.02). The effect was apparent ≥6 mo postpartum (relative risk: 1.34; 95% CI: 1.04, 1.73). No associations with proviral load were observed. The multivitamin had no effects. In observational analyses, β-carotene but not retinol breast-milk concentrations were significantly associated with an increased viral load in milk. VA/BC supplementation in lactating women increases the HIV load in breast milk. This finding contributes to explaining the adverse effect of VA/BC on mother-to-child transmission. β-Carotene appears to have an effect on breast-milk viral load, independent of preformed vitamin A. This trial was registered at clinicaltrials.gov as NCT00197756.

Butyrate activates the monocarboxylate transporter MCT4 expression in breast cancer cells and enhances the antitumor activity of 3-bromopyruvate.

PubMed

Queirós, Odília; Preto, Ana; Pacheco, António; Pinheiro, Céline; Azevedo-Silva, João; Moreira, Roxana; Pedro, Madalena; Ko, Young H; Pedersen, Peter L; Baltazar, Fátima; Casal, Margarida

2012-02-01

Most malignant tumors exhibit the Warburg effect, which consists in increased glycolysis rates with production of lactate, even in the presence of oxygen. Monocarboxylate transporters (MCTs), maintain these glycolytic rates, by mediating the influx and/or efflux of lactate and are overexpressed in several cancer cell types. The lactate and pyruvate analogue 3-bromopyruvate (3-BP) is an inhibitor of the energy metabolism, which has been proposed as a specific antitumor agent. In the present study, we aimed at determining the effect of 3-BP in breast cancer cells and evaluated the putative role of MCTs on this effect. Our results showed that the three breast cancer cell lines used presented different sensitivities to 3-BP: ZR-75-1 ER (+)>MCF-7 ER (+)>SK-BR-3 ER (-). We also demonstrated that 3-BP reduced lactate production, induced cell morphological alterations and increased apoptosis. The effect of 3-BP appears to be cytotoxic rather than cytostatic, as a continued decrease in cell viability was observed after removal of 3-BP. We showed that pre-incubation with butyrate enhanced significantly 3-BP cytotoxicity, especially in the most resistant breast cancer cell line, SK-BR-3. We observed that butyrate treatment induced localization of MCT1 in the plasma membrane as well as overexpression of MCT4 and its chaperone CD147. Our results thus indicate that butyrate pre-treatment potentiates the effect of 3-BP, most probably by increasing the rates of 3-BP transport through MCT1/4. This study supports the potential use of butyrate as adjuvant of 3-BP in the treatment of breast cancer resistant cells, namely ER (-).

Riboflavin uptake transporter Slc52a2 (RFVT2) is upregulated in the mouse mammary gland during lactation.

PubMed

Wu, Alex Man Lai; Dedina, Liana; Dalvi, Pooja; Yang, Mingdong; Leon-Cheon, John; Earl, Brian; Harper, Patricia A; Ito, Shinya

2016-04-01

While it is well recognized that riboflavin accumulates in breast milk as an essential vitamin for neonates, transport mechanisms for its milk excretion are not well characterized. The multidrug efflux transporter ABCG2 in the apical membrane of milk-producing mammary epithelial cells (MECs) is involved with riboflavin excretion. However, it is not clear whether MECs possess other riboflavin transport systems, which may facilitate its basolateral uptake into MECs. We report here that transcripts encoding the second (SLC52A2) and third (SLC52A3) member of the recently discovered family of SLC52A riboflavin uptake transporters are expressed in milk fat globules from human breast milk. Furthermore, Slc52a2 and Slc52a3 mRNA are upregulated in the mouse mammary gland during lactation. Importantly, the induction ofSlc52a2, which was the major Slc52a riboflavin transporter in the lactating mammary gland, was also observed at the protein level. Subcellular localization studies showed that green fluorescent protein-tagged mouse SLC52A2 mainly localized to the cell membrane, with no preferential distribution to the apical or basolateral membrane in polarized kidney MDCK cells. These results strongly implicate a potential role for SLC52A2 in riboflavin uptake by milk-producing MECs, a critical step in the transfer of riboflavin into breast milk. Copyright © 2016 the American Physiological Society.

A Review of Worksite Lactation Accommodations.

PubMed

Hilliard, Elizabeth Dianne

2017-01-01

The purpose of this review was to examine workplace lactation accommodations, and their association with breastfeeding duration, and identify strategies occupational health professionals can use to promote lactation improvements. This study included literature published from 1985 through 2015 and listed in PubMed and CINAHL. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 11 articles were identified for review. Presence of a corporate lactation program, on-site child care, and return to work/telephone lactation consultation were consistently associated with breastfeeding at 6 months. Other breastfeeding accommodations (i.e., lactation spaces, lactation breaks, worksite lactation policies, and supervisor/coworker support) were not consistently associated with breastfeeding duration. Occupational health professionals can play key roles in improving the effectiveness of lactation accommodations. Assuring adequate implementation of accommodations, increasing communication and marketing of accommodations, and promoting supervisor and coworker support are areas that occupational health professionals should explore for improving lactation duration.

Applying Lean-Six-Sigma Methodology in radiotherapy: Lessons learned by the breast daily repositioning case.

PubMed

Mancosu, Pietro; Nicolini, Giorgia; Goretti, Giulia; De Rose, Fiorenza; Franceschini, Davide; Ferrari, Chiara; Reggiori, Giacomo; Tomatis, Stefano; Scorsetti, Marta

2018-05-01

Lean Six Sigma Methodology (LSSM) was introduced in industry to provide near-perfect services to large processes, by reducing improbable occurrence. LSSM has been applied to redesign the 2D-2D breast repositioning process (Lean) by the retrospective analysis of the database (Six Sigma). Breast patients with daily 2D-2D matching before RT were considered. The five DMAIC (define, measure, analyze, improve, and control) LSSM steps were applied. The process was retrospectively measured over 30 months (7/2014-12/2016) by querying the RT Record&Verify database. Two Lean instruments (Poka-Yoke and Visual Management) were considered for advancing the process. The new procedure was checked over 6 months (1-6/2017). 14,931 consecutive shifts from 1342 patients were analyzed. Only 0.8% of patients presented median shifts >1 cm. The major observed discrepancy was the monthly percentage of fractions with almost zero shifts (AZS = 13.2% ± 6.1%). Ishikawa fishbone diagram helped in defining the main discrepancy con-causes. Procedure harmonization involving a multidisciplinary team to increase confidence in matching procedure was defined. AZS was reduced to 4.8% ± 0.6%. Furthermore, distribution symmetry improvement (Skewness moved from 1.4 to 1.1) and outlier reduction, verified by Kurtosis diminution, demonstrated a better "normalization" of the procedure after the LSSM application. LSSM was implemented in a RT department, allowing to redesign the breast repositioning matching procedure. Copyright © 2018 Elsevier B.V. All rights reserved.

Pre-germinated brown rice could enhance maternal mental health and immunity during lactation.

PubMed

Sakamoto, Shigeko; Hayashi, Takashi; Hayashi, Keiko; Murai, Fumie; Hori, Miyo; Kimoto, Koichi; Murakami, Kazuo

2007-10-01

Rice is a dietary staple worldwide, especially pre-germinated brown rice has recently been widely served in Japan because of its abundant nutrition. Relationship between lactation and pre-germinated brown rice has attracted interest in terms of mental health and immunity. To demonstrate that Japanese foods are beneficial for psychosomatic health, the effects of pre-germinated brown rice on the mental status and immunological features during lactation were investigated. Forty-one breast-feeding mothers were recruited, and randomly divided into two groups. One group took pre-germinated brown rice and the other white rice (control) as their staple diet for 2 weeks. The Profile of Mood States (POMS) and salivary amylase activity as psychological indices and secretory IgA (s-IgA) and lactoferrin (LTF) in breast milk as immunological indices were determined before and after dietary intervention, and changes were investigated. In the psychological assessment, the scores of depression, anger-hostility, and fatigue were decreased on POMS analysis in the pre-germinated brown rice diet group, resulting in a significant decrease in total mood disturbance (TMD). The salivary amylase activity measurement suggested that resistance to stress was increased in the pre-germinated brown rice diet group. On the immunological assessment, the s-IgA level was significantly increased in the pre-germinated brown rice diet group. We have shown that pre-germinated brown rice may have beneficial effects on psychosomatic health.

Novel insights into human lactation as a driver of infant formula development.

PubMed

Lönnerdal, Bo

2010-01-01

Progress in research on human lactation and breast milk has advanced our knowledge about the significance of breast milk for the recipient infant and the effects of various components on long-term outcomes. Recent findings have expanded our knowledge in this area. Several growth factors and cytokines are present in breast milk and their capacity to persist in the infant gut and exert their activities is likely to affect maturation of immune function, possibly affecting the development of oral tolerance. A proper balance of polyunsaturated fatty acids (n-3/n-6 ratio) may also be of significance for allergy prevention in children, emphasizing the need for the mother to achieve a balance of these fatty acids in her diet. The recent findings that specific strains of bacteria are present in breast milk and act as probiotics in the early colonization of the infant gut and that human milk oligosaccharides are specific substrates for these probiotic strains may not only affect the defense against pathogens, but also affect energy utilization and development of obesity. Previously neglected milk fat globule membranes contain several components involved in protection against infection and may be an additional arm in the multifaceted shield that breastfed infants have developed against bacterial and viral antagonists. All these findings have implications for development of improved infant formulae. Copyright © 2010 S. Karger AG, Basel.

Breast, milk and microbes: a complex relationship that does not end with lactation.

PubMed

Urbaniak, Camilla; Burton, Jeremy P; Reid, Gregor

2012-07-01

Until relatively recently, the extent of microbiota presence in the human breast was under-appreciated. A high-throughput sequencing study and culture-based studies have demonstrated the extensive presence of microbes in human milk, with their origin believed to be from the skin, oral cavity and via gut translocation. Since formula milk substitutes do not contain these bacteria, what benefits are denied to these infants? The addition of probiotic bacteria to some infant formula is meant to provide some benefits, but these only contain one species and the dose is relatively high compared with breast milk. Many questions of importance to women's health arise from these findings. When, how and what types of microbes colonize the breast at different stages of a woman's life, including postlactation, and what effect do they have on the host in the short and long term? This article discusses some aspects of these questions.

Human milk IgA concentrations during the first year of lactation

PubMed Central

Weaver, L.; Arthur, H.; Bunn, J.; Thomas, J.

1998-01-01

AIMS—To measure the concentrations of total IgA in the milk secreted by both breasts, throughout the first year of lactation, in a cohort of Gambian mothers of infants at high risk of infection.
SUBJECTS AND METHODS—Sixty five women and their infants were studied monthly from the 4th to 52nd postpartum week. Samples of milk were obtained from each breast by manual expression immediately before the infant was suckled. Milk intakes were measured by test weighing the infants before and after feeds over 12 hour periods; IgA concentrations were determined by enzyme linked immunosorbent assay.
RESULTS—A total of 1590 milk samples was measured. The median (interquartile range) concentration of IgA for all samples was 0.708(0.422-1.105) g/l; that in milk obtained from the left breast was 0.785 (0.458-1.247) g/l, and that in milk obtained from the right breast was 0.645 (0.388-1.011) g/l (p < 0.0001). There was no significant change in milk or IgA intakes with advancing infant age, but there was a close concordance of IgA concentrations between the two breasts, with "tracking" of the output of the left and right breasts. There was a significant (p < 0.01) negative correlation between maternal age and parity, and weight of milk ingested by infants. During the dry season (December to May) the median (interquartile range) IgA concentration was significantly higher at 0.853 (0.571-1.254) g/l than during the rainy season (June to November), when it was 0.518 (0.311-0.909) g/l (p < 0.0001).
CONCLUSIONS—Sustained IgA secretion is likely to protect suckling infants from microbial infection.

 PMID:9613353

Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in human milk: effects on growth, morbidity, and duration of lactation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rogan, W.J.; Gladen, B.C.; McKinney, J.D.

1987-10-01

The authors followed 858 children from birth to one year of age to determine whether the presence of polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in breast milk affected their growth or health. Neither chemical showed an adverse effect on weight or frequency of physician visits for various illnesses, although differences were seen between breast-fed and bottle-fed children, with bottle-fed children being heavier and having more frequent gastroenteritis and otitis media. Children of mothers with higher levels of DDE were breast-fed for markedly shorter times, but adjustments for possible confounders and biases did not change the findings. In absence ofmore » any apparent effect on the health of the children, they speculate that DDE may be interfering with the mother's ability to lactate, possibly because of its estrogenic properties.« less

Note of the methodological flaws in the paper entitled "GSTT1 and GSTM1 polymorphisms predict treatment outcome for breast cancer: a systematic review and meta-analysis".

PubMed

Qiu, Mali; Wu, Xu; Qu, Xiaobing

2016-09-01

With great interest, we read the paper "GSTT1 and GSTM1 polymorphisms predict treatment outcome for breast cancer: a systematic review and meta-analysis" (by Hu XY et al.), which has reached important conclusions that GSTM1 null and GSTT1/GSTM1 double null polymorphisms might be significantly associated with an increased tumor response in breast cancer. The result is encouraging. Nevertheless, several methodological flaws in this meta-analysis are worth noticing.

Differences in the ribosomes prepared from lactating and non-lactating bovine mammary gland

PubMed Central

Herrington, M. D.; Hawtrey, A. O.

1971-01-01

1. Ribosomes prepared from bovine lactating mammary gland are able to synthesize protein, whereas similar preparations from non-lactating glands are not. Washing the ribosome suspensions through a medium containing 0.5m-ammonium chloride enhanced their ability to incorporate phenylalanine into polyphenylalanine. 2. Ribosomes isolated from non-lactating bovine mammary gland, in contrast with those from rat liver and lactating mammary gland, contained significant amounts of extraneous nucleases. These enzymes could be removed by washing with a medium A buffer containing 0.5m-ammonium chloride. 3. Only those ribosomes from functionally active tissues were able to bind polyuridylic acid and phenylalanyl-tRNA. PMID:5165653

A Lactate Kinetics Method for Assessing the Maximal Lactate Steady State Workload

PubMed Central

Hering, Gernot O.; Hennig, Ewald M.; Riehle, Hartmut J.; Stepan, Jens

2018-01-01

During a continuously increasing exercise workload (WL) a point will be reached at which arterial lactate accumulates rapidly. This so-called lactate threshold (LT) is associated with the maximal lactate steady state workload (MLSSW), the highest WL, at which arterial lactate concentration [LA] does not change. However, the physiological range in which the LT and the MLSSW occur has not been demonstrated directly. We used minor WL variations in the MLSSW range to assess arterial lactate kinetics in 278 treadmill and 148 bicycle ergometer exercise tests. At a certain workload, minimal further increment of running speed (0.1–0.15 m/s) or cycling power (7–10 W) caused a steep elevation of [LA] (0.9 ± 0.43 mM, maximum increase 2.4 mM), indicating LT achievement. This sharp [LA] increase was more pronounced when higher WL increments were used (0.1 vs. 0.30 m/s, P = 0.02; 0.15 vs. 0.30 m/s, P < 0.001; 7 vs. 15 W, P = 0.002; 10 vs. 15 W, P = 0.001). A subsequent workload reduction (0.1 m/s/7 W) stopped the [LA] increase indicating MLSSW realization. LT based determination of running speed (MLSSW) was highly reproducible on a day-to-day basis (r = 0.996, P < 0.001), valid in a 10 km constant velocity setting (r = 0.981, P < 0.001) and a half marathon race (r = 0.969, P < 0.001). These results demonstrate a fine-tuned regulation of exercise-related lactate metabolism, which can be reliably captured by assessing lactate kinetics at the MLSSW. PMID:29651253

Temporal and Lateral Dynamics of HIV Shedding and Elevated Sodium in Breast Milk Among HIV-Positive Mothers During the First 4 Months of Breast-Feeding

PubMed Central

Semrau, Katherine; Ghosh, Mrinal; Kankasa, Chipepo; Sinkala, Moses; Kasonde, Prisca; Mwiya, Mwiya; Thea, Donald M.; Kuhn, Louise; Aldrovandi, Grace M.

2009-01-01

Objective To better understand the dynamics of breast milk HIV shedding and its relation to postnatal HIV transmission, we investigated the temporal and lateral relations of breast milk viral shedding and sodium concentrations in HIV-positive women. Design This was a longitudinal cohort study in Lusaka, Zambia. Method We examined patterns of HIV shedding in breast milk over the first 4 months of breast-feeding and their correlations with postnatal HIV transmission among 138 breast-feeding mothers. Sodium concentration in breast milk was also examined in the same samples and in breast milk from 23 HIV-negative controls. Results Higher breast milk viral load at 1 week, 1 month, and 4 months and consistent viral shedding in breast milk were significantly associated with increased risk of HIV transmission. Elevated breast milk sodium concentration ($13 mmol/L) at 4 months was associated with HIV transmission, low maternal CD4 cell count, and high maternal plasma viral load. Elevated sodium concentration at 1 week postpartum was common and was not associated with any of these parameters. Conclusions Consistent viral shedding and high breast milk viral load are strong predictors of mother-to-child HIV transmission. Although sodium concentrations later in breast-feeding correlate with breast milk viral load, increased breast milk sodium is normal in early lactation and does not predict HIV transmission. PMID:18398972

Temporal and lateral dynamics of HIV shedding and elevated sodium in breast milk among HIV-positive mothers during the first 4 months of breast-feeding.

PubMed

Semrau, Katherine; Ghosh, Mrinal; Kankasa, Chipepo; Sinkala, Moses; Kasonde, Prisca; Mwiya, Mwiya; Thea, Donald M; Kuhn, Louise; Aldrovandi, Grace M

2008-03-01

To better understand the dynamics of breast milk HIV shedding and its relation to postnatal HIV transmission, we investigated the temporal and lateral relations of breast milk viral shedding and sodium concentrations in HIV-positive women. This was a longitudinal cohort study in Lusaka, Zambia. We examined patterns of HIV shedding in breast milk over the first 4 months of breast-feeding and their correlations with postnatal HIV transmission among 138 breast-feeding mothers. Sodium concentration in breast milk was also examined in the same samples and in breast milk from 23 HIV-negative controls. Higher breast milk viral load at 1 week, 1 month, and 4 months and consistent viral shedding in breast milk were significantly associated with increased risk of HIV transmission. Elevated breast milk sodium concentration (> or =13 mmol/L) at 4 months was associated with HIV transmission, low maternal CD4 cell count, and high maternal plasma viral load. Elevated sodium concentration at 1 week postpartum was common and was not associated with any of these parameters. Consistent viral shedding and high breast milk viral load are strong predictors of mother-to-child HIV transmission. Although sodium concentrations later in breast-feeding correlate with breast milk viral load, increased breast milk sodium is normal in early lactation and does not predict HIV transmission.

Behavior of Listeria monocytogenes at 7 degrees C in commercial turkey breast, with or without antimicrobials, after simulated contamination for manufacturing, retail and consumer settings.

PubMed

Lianou, Alexandra; Geornaras, Ifigenia; Kendall, Patricia A; Scanga, John A; Sofos, John N

2007-08-01

Uncured turkey breast, commercially available with or without a mixture of potassium lactate and sodium diacetate, was sliced, inoculated with a 10-strain composite of Listeria monocytogenes, vacuum-packaged, and stored at 4 degrees C, to simulate contamination after a lethal processing step at the plant. At 5, 15, 25 and 50 days of storage, packages were opened, slices were tested, and bags with remaining slices were reclosed with rubber bands; this simulated home use of plant-sliced and -packaged product. At the same above time intervals, portions of original product (stored at 4 degrees C in original processing bags) were sliced and inoculated as above, and packaged in delicatessen bags, simulating contamination during slicing/handling at retail or home. Both sets of bags were stored aerobically at 7 degrees C for 12 days to simulate home storage. L. monocytogenes populations were lower (P<0.05) during storage in turkey breast containing a combination of lactate and diacetate compared to product without antimicrobials under both contamination scenarios. Due to prolific growth of the pathogen under the plant-contamination scenario in product without lactate-diacetate during vacuum-packaged storage (4 degrees C), populations at 3 days of aerobic storage (7 degrees C) of such product ranged from 4.6 to 7.4 log cfu/cm(2). Under the retail/home-contamination scenario, mean growth rates (log cfu/cm(2)/day) of the organism during aerobic storage ranged from 0.14 to 0.16, and from 0.25 to 0.51, in product with and without lactate-diacetate, respectively; growth rates in turkey breast without antimicrobials decreased (P<0.05) with age of the product. Overall, product without antimicrobials inoculated to simulate plant-contamination and product with lactate-diacetate inoculated to simulate retail/home-contamination were associated with the highest and lowest pathogen levels during aerobic storage at 7 degrees C, respectively. However, 5- and 15-day-old turkey breast

Influence of lactation and pregnancy + lactation on mechanical properties and mineral content of the rat femur.

PubMed

Peng, T C; Kusy, R P; Garner, S C; Hirsch, P F; De Blanco, M C

1987-06-01

The quality of bone was assessed from femurs of rats both during lactation and after pregnancy + lactation. Mechanical properties of stiffness, strength, toughness, and ductility were measured, along with standard measurements of dry weight, ash weight, and total bone mineral. No changes occurred during the first week of lactation. During the second and third weeks of lactation all bone parameters except ductility decreased significantly. These data are consistent with bone losing mineral in order to supplement the dietary calcium intake necessary for milk production. In other experiments, femurs were collected from nulliparous rats and from rats that had previously undergone 1-3 pregnancy + lactations. The largest changes in bone mineral and mechanical properties occurred after a single pregnancy + lactation period, although significant further decreases in stiffness and strength occurred after the second pregnancy + lactation. No additional losses occurred following the third pregnancy + lactation. Even 5 months after only one pregnancy + lactation period, the bone quality was still impaired as all bone properties were lower than in nulliparous controls. Because the changes, especially stiffness and strength, were relatively larger than the changes in dry and ash weights of bone, measurements of these mechanical properties provide a more sensitive method to evaluate the quality of bone.

Elevated lactate during psychogenic hyperventilation.

PubMed

ter Avest, E; Patist, F M; Ter Maaten, J C; Nijsten, M W N

2011-04-01

Elevated arterial lactate levels are closely related to morbidity and mortality in various patient categories. In the present retrospective study, the relation between arterial lactate, partial pressure of carbon dioxide (Pco(2)) and pH was systematically investigated in patients who visited the emergency department (ED) with psychogenic hyperventilation. Over a 5-month period, all the patients who visited the ED of a university hospital with presumed psychogenic hyperventilation were evaluated. Psychogenic hyperventilation was presumed to be present when an increased respiratory rate (>20 min) was documented at or before the ED visit and when somatic causes explaining the hyperventilation were absent. Arterial blood gas and lactate levels (reference values 0.5-1.5 mmol/l) were immediately measured by a point-of-care analyser that was managed and calibrated by the central laboratory. During the study period, 46 patients were diagnosed as having psychogenic hyperventilation. The median (range) Pco(2) for this group was 4.3 (2.0-5.5) kPa, the pH was 7.47 (7.40-7.68) and the lactate level was 1.2 (0.5-4.4) mmol/l. 14 participants (30%) had a lactate level above the reference value of 1.5 mmol/l. Pco(2) was the most important predictor of lactate in multivariate analysis. None of the participants underwent any medical treatment other than observation at the ED or had been hospitalised after their ED visit. In patients with psychogenic hyperventilation, lactate levels are frequently elevated. Whereas high lactates are usually associated with acidosis and an increased risk of poor outcome, in patients with psychogenic hyperventilation, high lactates are associated with hypocapnia and alkalosis. In this context, elevated arterial lactate levels should not be regarded as an adverse sign.

Expressed breast milk as 'connection' and its influence on the construction of 'motherhood' for mothers of preterm infants: a qualitative study

PubMed Central

Sweet, Linda

2008-01-01

Background Breast milk is considered the optimal nutrition for all newborn infants. While there is high initiation of lactation among mothers of preterm infants in Australia, there is a rapid decline of continued lactation. Furthermore, there is an inverse relationship between infant gestation and duration of lactation. To better understand the breastfeeding experience of parents of very low birth weight (VLBW) preterm infants an interpretive phenomenological study was conducted. Methods This longitudinal study was conducted using an interpretive phenomenological approach. Data were collected from 17 parents through 45 individual interviews with both mothers and fathers, from birth to 12 months of age. This data was then transcribed verbatim and analysed using thematic analysis. Results The analysis identified six primary themes: the intention to breastfeed naturally; breast milk as connection; the maternal role of breast milk producer; breast milk as the object of attention; breastfeeding and parenting the hospitalised baby and the demise of breastfeeding. This paper reports on the theme of 'breast milk as connection'. Providing expressed breast milk offered one way the mothers could be physiologically and emotionally connected to their preterm infant while they were in the constant care of hospital staff. Indeed, breast milk was considered the only way the new mother could connect her body (or part there of) to her preterm baby in hospital. This sense of connection however, comes at a cost. On the one hand, the breast milk offers a feeling of connection to the baby, but, on the other, this connection comes only after disconnection of the mother and baby and – through breast expression – mother and her milk. This ability of breast milk to connect mother and baby makes the expressed breast milk highly valued, and places unexpected pressure on the mother to produce milk as integral to her sense of motherhood. Conclusion The findings of this study have

Perioperative ketorolac in high risk breast cancer patients. Rationale, feasibility and methodology of a prospective randomized placebo-controlled trial.

PubMed

Forget, Patrice; Berlière, Martine; van Maanen, Aline; Duhoux, Francois P; Machiels, Jean-Pascal; Coulie, Pierre G; Bouche, Gauthier; De Kock, Marc

2013-10-01

Ketorolac, a NSAID routinely used during surgery proposed to have anticancer effects, is a promising way to improve postoperative oncological outcome. This effect may be particularly prominent in patients with elevated preoperative inflammatory scores, like the neutrophil:lymphocyte ratio. In this paper, we describe the rationale, the preliminary analyses in our patients, the feasibility and the methodology of a prospective randomized trial called "Ketorolac in Breast Cancer trial" (KBCt) (NCT01806259). Copyright © 2013 Elsevier Ltd. All rights reserved.

Effect of vitamin supplements on HIV shedding in breast milk123

PubMed Central

Koulinska, Irene N; Aboud, Said; Murrin, Clare; Bosch, Ronald J; Manji, Karim P; Fawzi, Wafaie W

2010-01-01

Background: Supplementation in lactating HIV-1–infected women with preformed vitamin A and β-carotene (VA/BC) increases the risk of mother-to-child transmission of HIV through breastfeeding. Identifying a biological mechanism to explain this unexpected finding would lend support to a causal effect. Objective: The aim of the study was to evaluate the effect of VA/BC or multivitamin (B complex, vitamin C, and vitamin E) supplementation of HIV-infected women on HIV shedding in breast milk during the first 2 y postpartum. Design: We quantified viral (cell-free) and proviral (cell-associated) HIV loads in breast-milk samples collected ≤15 d after delivery and every 3 mo thereafter from 594 Tanzanian HIV-1–infected women who participated in a randomized trial. Women received 1 of the following 4 daily oral regimens in a 2 × 2 factorial fashion during pregnancy and throughout the first 2 y postpartum: multivitamin, VA/BC, multivitamin including VA/BC, or placebo. Results: The proportion of breast-milk samples with detectable viral load was significantly higher in women who received VA/BC (51.3%) than in women who were not assigned to VA/BC (44.8%; P = 0.02). The effect was apparent ≥6 mo postpartum (relative risk: 1.34; 95% CI: 1.04, 1.73). No associations with proviral load were observed. The multivitamin had no effects. In observational analyses, β-carotene but not retinol breast-milk concentrations were significantly associated with an increased viral load in milk. Conclusions: VA/BC supplementation in lactating women increases the HIV load in breast milk. This finding contributes to explaining the adverse effect of VA/BC on mother-to-child transmission. β-Carotene appears to have an effect on breast-milk viral load, independent of preformed vitamin A. This trial was registered at clinicaltrials.gov as NCT00197756. PMID:20739426

Lactate: link between glycolytic and oxidative metabolism.

PubMed

Brooks, George A

2007-01-01

Once thought to be the consequence of oxygen lack in contracting skeletal muscle, the glycolytic product lactate is formed and utilised continuously under fully aerobic conditions. 'Cell-cell' and 'intracellular lactate shuttle' concepts describe the roles of lactate in delivery of oxidative and gluconeogenic substrates as well as in cell signalling. Examples of cell-cell shuttles include lactate exchanges (i) between white-glycolytic and red-oxidative fibres within a working muscle bed; (ii) between working skeletal muscle and heart; and (iii) between tissues of net lactate release and gluconeogenesis. Lactate shuttles exist in diverse tissues including in the brain, where a shuttle between astrocytes and neurons is linked to glutamatergic signalling. Because lactate, the product of glycogenolysis and glycolysis, is disposed of by oxidative metabolism, lactate shuttling unites the two major processes of cellular energy transduction. Lactate disposal is mainly through oxidation, especially during exercise when oxidation accounts for 70-75% of removal and gluconeogenesis the remainder. Lactate flux occurs down proton and concentration gradients that are established by the mitochondrial lactate oxidation complex. Marathon running is a power activity requiring high glycolytic and oxidative fluxes; such activities require lactate shuttling. Knowledge of the lactate shuttle is yet to be imparted to the sport.

Regulation of gene expression in human mammary epithelium: effect of breast pumping

USDA-ARS?s Scientific Manuscript database

Little is known of the molecular regulation of human milk production because of limitations in obtaining mammary tissue from lactating women. Our objectives were to evaluate whether RNA isolated from breast milk fat globules (MFGs) could be an alternative to mammary biopsies and to determine whether...

Limited infant exposure to benznidazole through breast milk during maternal treatment for Chagas disease.

PubMed

García-Bournissen, Facundo; Moroni, Samanta; Marson, Maria Elena; Moscatelli, Guillermo; Mastrantonio, Guido; Bisio, Margarita; Cornou, Laura; Ballering, Griselda; Altcheh, Jaime

2015-01-01

Benznidazole (BNZ) is safe and effective for the treatment of paediatric Chagas disease. Treatment of adults is also effective in many cases, but discouraged in breastfeeding women because no information on BNZ transfer into breast milk is available. We aimed to evaluate the degree of BNZ transfer into breast milk in lactating women with Chagas disease. Prospective cohort study of lactating women with Chagas disease treated with BNZ administered for 30 days. Patients and their breastfed infants were evaluated at admission, the 7th and 30th day of treatment (and monthly thereafter, for 6 months). BNZ was measured in plasma and milk by high performance liquid chromatography. The protocol was registered in ClinicalTrials.gov (#NCT01547533). 12 lactating women with chronic Chagas disease were enrolled (median age 28.5 years, range 20-34). Median BNZ dose was 5.65 mg/kg/day twice daily. Five mothers had adverse drug events (45%), but no adverse drug reactions or any untoward outcomes were observed in the breastfed infants. Median milk BNZ concentration was 3.8 mg/L (range 0.3-5.9) and 6.26 mg/L (range 0.3-12.6) in plasma. Median BNZ milk to plasma ratio was 0.52 (range 0.3-2.79). Median relative BNZ dose received by the infant (assuming a daily breast milk intake of 150 mL/kg/day) was 12.3% of the maternal dose per kg (range 5.5%-17%). The limited transference of BNZ into breast milk and the reassuring normal clinical evaluation of the breastfed babies suggest that maternal BNZ treatment for Chagas disease during breast feeding is unlikely to present a risk for the breastfed infant. ClinicalTrials.gov NCT01547533. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Antidepressants, anxiolytics, and hypnotics in pregnancy and lactation

PubMed Central

Ram, Daya; Gandotra, S.

2015-01-01

Aims: Untreated perinatal depression and anxiety disorders are known to have significant negative impact on both maternal and fetal health. Dilemmas still remain regarding the use and safety of psychotropics in pregnant and lactating women suffering from perinatal depression and anxiety disorders. The aim of the current paper was to review the existing evidence base on the exposure and consequences of antidepressants, anxiolytics, and hypnotics in women during pregnancy and lactation and to make recommendations for clinical decision making in management of these cases. Materials and Methods: We undertook a bibliographic search of Medline/PubMed (1972 through 2014), Science Direct (1972 through 2014), Archives of Indian Journal of Psychiatry databases was done. References of retrieved articles, reference books, and dedicated websites were also checked. Results and Conclusions: The existing evidence base is extensive in studying multiple outcomes of the antidepressant or anxiolytic exposure in neonates, and some of the findings appear conflicting. Selective serotonin reuptake inhibitors are the most researched antidepressants in pregnancy and lactation. The available literature is criticized mostly on the lack of rigorous well designed controlled studies as well as lacunae in the methodologies, interpretation of statistical information, knowledge transfer, and translation of information. Research in this area in the Indian context is strikingly scarce. Appropriate risk-benefit analysis of untreated mental illness versus medication exposure, tailor-made to each patient's past response and preference within in the context of the available evidence should guide clinical decision making. PMID:26330654

Diminution in energy expenditure during lactation.

PubMed Central

Illingworth, P J; Jung, R T; Howie, P W; Leslie, P; Isles, T E

1986-01-01

Energy expenditure at rest and in response to a meal and to an infusion of noradrenaline was measured in 12 lactating women and compared with that in seven bottle feeding women and seven non-pregnant, non-lactating controls. The energy response of the lactating women was remeasured after lactation stopped. During lactation the resting metabolic rate was unaltered but there was a reduced response to infusion of noradrenaline and to a meal, which increased to normal control values after lactation stopped. Such reductions in expenditure were not found in women who had been bottle feeding and were tested at a similar six to eight weeks post partum. These findings suggest that metabolic efficiency is enhanced in lactating women, who may not need to increase energy intake to the extent suggested by current recommended dietary allowances. PMID:3081114

Zoledronate prevents lactation induced bone loss and results in additional post-lactation bone mass in mice.

PubMed

Wendelboe, Mette Høegh; Thomsen, Jesper Skovhus; Henriksen, Kim; Vegger, Jens Bay; Brüel, Annemarie

2016-06-01

In rodents, lactation is associated with a considerable and very rapid bone loss, which almost completely recovers after weaning. The aim of the present study was to investigate whether the bisphosphonate Zoledronate (Zln) can inhibit lactation induced bone loss, and if Zln interferes with recovery of bone mass after lactation has ceased. Seventy-six 10-weeks-old NMRI mice were divided into the following groups: Baseline, Pregnant, Lactation, Lactation+Zln, Recovery, Recovery+Zln, and Virgin Control (age-matched). The lactation period was 12days, then the pups were removed, and thereafter recovery took place for 28days. Zln, 100μg/kg, was given s.c. on the day of delivery, and again 4 and 8days later. Mechanical testing, μCT, and dynamic histomorphometry were performed. At L4, lactation resulted in a substantial loss of bone strength (-55% vs. Pregnant, p<0.01), BV/TV (-40% vs. Pregnant, p<0.01), and trabecular thickness (Tb.Th) (-29% vs. Pregnant, p<0.001). Treatment with Zln completely prevented lactation induced loss of bone strength, BV/TV, and Tb.Th at L4. Full recovery of micro-architectural and mechanical properties was found 28days after weaning in vehicle-treated mice. Interestingly, the recovery group treated with Zln during the lactation period had higher BV/TV (+45%, p<0.01) and Tb.Th (+16%, p<0.05) compared with virgin controls. Similar results were found at the proximal tibia and femur. This indicates that Zln did not interfere with the bone formation taking place after weaning. On this background, we conclude that post-lactation bone formation is not dependent on a preceding lactation induced bone loss. Copyright © 2016 Elsevier Inc. All rights reserved.

Human breast milk: A review on its composition and bioactivity.

PubMed

Andreas, Nicholas J; Kampmann, Beate; Mehring Le-Doare, Kirsty

2015-11-01

Breast milk is the perfect nutrition for infants, a result of millions of years of evolution, finely attuning it to the requirements of the infant. Breast milk contains many complex proteins, lipids and carbohydrates, the concentrations of which alter dramatically over a single feed, as well as over lactation, to reflect the infant's needs. In addition to providing a source of nutrition for infants, breast milk contains a myriad of biologically active components. These molecules possess diverse roles, both guiding the development of the infants immune system and intestinal microbiota. Orchestrating the development of the microbiota are the human milk oligosaccharides, the synthesis of which are determined by the maternal genotype. In this review, we discuss the composition of breast milk and the factors that affect it during the course of breast feeding. Understanding the components of breast milk and their functions will allow for the improvement of clinical practices, infant feeding and our understanding of immune responses to infection and vaccination in infants. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center.

PubMed

Giess, Catherine S; Golshan, Mehra; Flaherty, Karen; Birdwell, Robyn L

2014-01-01

Our purpose was to review needle aspiration of breast abscesses and identify factors associated with treatment by aspiration alone versus aspiration with surgical incision and drainage (I/D). This Institutional Review Board-approved, retrospective review of the breast ultrasound database from 2008 to 2010 identified 40 patients (41 abscesses) who underwent aspiration, with or without I/D. Demographics, imaging, number of aspirations, and microbiology were reviewed. Twenty-two abscesses underwent aspiration only, 16 > 3 cm, 6 ≤ 3 cm (mean 4.3 cm, range 0.9-10 cm). Known risk factors included lactational (11), 3 weeks post partum (1), pregnancy (1), recent biopsy/lumpectomy (5). Nineteen abscesses underwent aspiration and I/D, 15 > 3 cm, 4 ≤ 3 cm (mean 4.1 cm, range 2.2-7.5 cm). Known risk factors included lactational (4), recurrent subareolar abscess (4), diabetes (3), hydradenitis suppuritiva (1), nipple piercing (2), smoking (1), pregnancy (1), HIV (1), and lumpectomy (1). Identified reasons for I/D included lack of improvement/recurrence (12), fistula (3), and one electively after clinical improvement of a recurrent subareolar abscess. Abscesses associated with pregnancy and lactation or breast biopsy are effectively managed with aspiration, even when large. Recurrence, chronicity, or fistula may require surgical intervention. © 2014 Wiley Periodicals, Inc.

Concentration of aluminium in breast cyst fluids collected from women affected by gross cystic breast disease.

PubMed

Mannello, Ferdinando; Tonti, Gaetana A; Darbre, Philippa D

2009-01-01

Gross cystic breast disease (GCBD) is the most common benign breast disorder, but the molecular basis of cyst formation remains to be identified. If the use of aluminium-based antiperspirant salts is involved in the etiology of gross breast cyst formation, it might be expected that aluminium would be at elevated levels in human breast cyst fluid (BCF). Aluminium was measured by ICP-MS in 48 samples of BCF, 30 samples of human blood serum and 45 samples of human breast milk at different stages of lactation (colostrum, intermediate, mature). The median level of aluminium in apocrine type I BCF (n = 27, 150 microg l(-1)) was significantly higher than in transudative type II BCF (n = 21, 32 microg l(-1); P < 0.0001). By comparison, aluminium measurements gave a median concentration of 6 microg l(-1) in human serum and 25 microg l(-1) in human breast milk, with no difference between colostrum, intermediate and mature milk. Levels of aluminium were significantly higher in both types of BCF than in human serum (P < 0.0001). However when compared with human breast milk, aluminium levels were only significantly higher in apocrine type I BCF (P < 0.0001) and not in transudative type II BCF (P = 0.152). It remains to be identified why such high levels of aluminium were found in the apocrine type I BCF and from where the aluminium originated. However, if aluminium-based antiperspirants are found to be the source and to play any causal role in development of breast cysts, then it might become possible to prevent this common breast disorder. Copyright (c) 2008 John Wiley & Sons, Ltd.

Breast cancer screening in developing countries

PubMed Central

da Costa Vieira, René Aloísio; Biller, Gabriele; Uemura, Gilberto; Ruiz, Carlos Alberto; Curado, Maria Paula

2017-01-01

Developing countries have limited healthcare resources and use different strategies to diagnose breast cancer. Most of the population depends on the public healthcare system, which affects the diagnosis of the tumor. Thus, the indicators observed in developed countries cannot be directly compared with those observed in developing countries because the healthcare infrastructures in developing countries are deficient. The aim of this study was to evaluate breast cancer screening strategies and indicators in developing countries. A systematic review and the Population, Intervention, Comparison, Outcomes, Timing, and Setting methodology were performed to identify possible indicators of presentation at diagnosis and the methodologies used in developing countries. We searched PubMed for the terms “Breast Cancer” or “Breast Cancer Screening” and “Developing Country” or “Developing Countries”. In all, 1,149 articles were identified. Of these articles, 45 full articles were selected, which allowed us to identify indicators related to epidemiology, diagnostic intervention (diagnostic strategy, diagnostic infrastructure, percentage of women undergoing mammography), quality of intervention (presentation of symptoms at diagnosis, time to diagnosis, early stage disease), comparisons (trend curves, subpopulations at risk) and survival among different countries. The identification of these indicators will improve the reporting of methodologies used in developing countries and will allow us to evaluate improvements in public health related to breast cancer. PMID:28492725

Community pharmacists’ services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study

PubMed Central

Albassam, Abdullah

2018-01-01

Objectives This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists’ recommendations for treatment of pregnancy-related and breast feeding-related ailments. Design Cross-sectional questionnaire-based survey. Setting Community pharmacies in Kuwait. Participants 207 pharmacies were randomly selected from the Ministry of Health database. One registered pharmacist was approached from each pharmacy. One hundred and ninety-two (92.8%) pharmacists agreed to participate and completed a self-administered questionnaire. Outcomes The proportions of pharmacists offering particular advice for health conditions in pregnancy and lactation, pharmacists’ recommendations for common and specific ailments during pregnancy and breast feeding, and pharmacists’ views about self-care in pregnancy and breast feeding. Results The top services provided to pregnant and lactating women were recommending vitamins and food supplements (89.8%) and contraception advice (83.4%), respectively. More than half of participants indicated that they would recommend medications for headache, constipation, cough, runny nose, sore throat, nausea/vomiting, indigestion, sore or cracked nipple and insufficient milk. Diarrhoea, haemorrhoids, insomnia, varicose vein, swelling of the feet and legs, vaginal itching, back pain, fever, mastitis and engorgement were frequently referred to the physician. Recommendations on medication use were occasionally inappropriate in terms of unneeded drug therapy, off-label use and safety. In relation to offering advice and solving medication and health problems of pregnant and lactating women, more than half of pharmacists indicated that they have sufficient knowledge (61.5%; 50.5%) and confidence (58.3%; 53.1%), respectively. Most of the respondents (88.5%) agreed that a continuing education programme on this topic would be of

Breast-Feeding and Diabetes: Long-Term Impact on Mothers and Their Infants

PubMed Central

Gunderson, Erica P.

2010-01-01

In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive breast-feeding. Breast-feeding has been shown to slow infant growth up to 2 years of age. By contrast, the scientific evidence is inconclusive about whether breast-feeding protects against the onset of overweight and subsequent development of type 2 diabetes among offspring whose mothers had diabetes during pregnancy. Moreover, evidence is insufficient to determine if lactation protects against development of type 2 diabetes later in life in women with a diabetes history during pregnancy. Given the paucity of the evidence and equivocal findings about the long-term effects of breast-feeding on future health of women with diabetes during pregnancy and their infants, further research is recommended. PMID:18631440

Breast-feeding and diabetes: long-term impact on mothers and their infants.

PubMed

Gunderson, Erica P

2008-08-01

In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive breast-feeding. Breast-feeding has been shown to slow infant growth up to 2 years of age. By contrast, the scientific evidence is inconclusive about whether breast-feeding protects against the onset of overweight and subsequent development of type 2 diabetes among offspring whose mothers had diabetes during pregnancy. Moreover, evidence is insufficient to determine if lactation protects against development of type 2 diabetes later in life in women with a diabetes history during pregnancy. Given the paucity of the evidence and equivocal findings about the long-term effects of breast-feeding on future health of women with diabetes during pregnancy and their infants, further research is recommended.

Effects of mother's dietary exposure to acesulfame-K in Pregnancy or lactation on the adult offspring's sweet preference.

PubMed

Zhang, Gen-Hua; Chen, Meng-Ling; Liu, Si-Si; Zhan, Yue-Hua; Quan, Ying; Qin, Yu-Mei; Deng, Shao-Ping

2011-11-01

This study investigates whether mother's exposure to the artificial sweetener acesulfame-K (AK) during pregnancy or lactation affected her adult offspring's sweet preference. It was found that mother's dietary exposure to AK in pregnancy or lactation decreased the preference thresholds for AK and sucrose solutions in the adult offspring, whereas the preference pattern and the most preferred concentration for AK or sucrose solution were unchanged. Furthermore, the preference scores in the exposure groups were increased significantly when compared with the control group at a range of concentrations for AK or sucrose solution. The existence of AK and its dynamic changes within 24 h in amniotic fluid during pregnancy or in mother's milk during lactation after a single oral infusion of AK solution were revealed by the methods of reversed-phase high-performance liquid chromatography and mass spectrometry. Our data suggest that AK can be ingested by the prenatal or postnatal mice through their mother's amniotic fluid or breast milk, producing a long-dated function on the adult's sweet preference.

Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial.

PubMed

Su, Lin-Lin; Chong, Yap-Seng; Chan, Yiong-Huak; Chan, Yah-Shih; Fok, Doris; Tun, Kay-Thwe; Ng, Faith S P; Rauff, Mary

2007-09-22

To investigate whether antenatal breast feeding education alone or postnatal lactation support alone improves rates of exclusive breast feeding compared with routine hospital care. Randomised controlled trial. A tertiary hospital in Singapore. 450 women with uncomplicated pregnancies. Primary outcomes were rates of exclusive breast feeding at discharge from hospital and two weeks, six weeks, three months, and six months after delivery. Secondary outcomes were rates of any breast feeding. Compared with women who received routine care, women in the postnatal support group were more likely to breastfeed exclusively at two weeks (relative risk 1.82, 95% confidence interval 1.14 to 2.90), six weeks (1.85, 1.11 to 3.09), three months (1.87, 1.03 to 3.41), and six months (2.12, 1.03 to 4.37) postnatally. Women receiving antenatal education were more likely to breast feed exclusively at six weeks (1.73, 1.04 to 2.90), three months (1.92, 1.07 to 3.48), and six months (2.16, 1.05 to 4.43) postnatally. The numbers needed to treat to achieve one woman exclusively breast feeding at six months were 11 (6 to 80) for postnatal support and 10 (6 to 60) for antenatal education. Women who received postnatal support were more likely to exclusively or predominantly breast feed two weeks after delivery compared with women who received antenatal education (1.53, 1.01 to 2.31). The rate of any breastfeeding six weeks after delivery was also higher in the postnatal support group compared with women who received routine care (1.16, 1.02 to 1.31). Antenatal breast feeding education and postnatal lactation support, as single interventions based in hospital both significantly improve rates of exclusive breast feeding up to six months after delivery. Postnatal support was marginally more effective than antenatal education. Clinical Trials NCT00270920 [ClinicalTrials.gov].

21 CFR 184.1311 - Ferrous lactate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... prepared by reacting calcium lactate or sodium lactate with ferrous sulfate, direct reaction of lactic acid with iron filings, reaction of ferrous chloride with sodium lactate, or reaction of ferrous sulfate...

Mammary-Specific Ablation of the Calcium-Sensing Receptor During Lactation Alters Maternal Calcium Metabolism, Milk Calcium Transport, and Neonatal Calcium Accrual

PubMed Central

Mamillapalli, Ramanaiah; VanHouten, Joshua; Dann, Pamela; Bikle, Daniel; Chang, Wenhan; Brown, Edward

2013-01-01

To meet the demands for milk calcium, the lactating mother adjusts systemic calcium and bone metabolism by increasing dietary calcium intake, increasing bone resorption, and reducing renal calcium excretion. As part of this adaptation, the lactating mammary gland secretes PTHrP into the maternal circulation to increase bone turnover and mobilize skeletal calcium stores. Previous data have suggested that, during lactation, the breast relies on the calcium-sensing receptor (CaSR) to coordinate PTHrP secretion and milk calcium transport with calcium availability. To test this idea genetically, we bred BLG-Cre mice with CaSR-floxed mice to ablate the CaSR specifically from mammary epithelial cells only at the onset of lactation (CaSR-cKO mice). Loss of the CaSR in the lactating mammary gland did not disrupt alveolar differentiation or milk production. However, it did increase the secretion of PTHrP into milk and decreased the transport of calcium from the circulation into milk. CaSR-cKO mice did not show accelerated bone resorption, but they did have a decrease in bone formation. Loss of the mammary gland CaSR resulted in hypercalcemia, decreased PTH secretion, and increased renal calcium excretion in lactating mothers. Finally, loss of the mammary gland CaSR resulted in decreased calcium accrual by suckling neonates, likely due to the combination of increased milk PTHrP and decreased milk calcium. These results demonstrate that the mammary gland CaSR coordinates maternal bone and calcium metabolism, calcium transport into milk, and neonatal calcium accrual during lactation. PMID:23782944

21 CFR 184.1311 - Ferrous lactate.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... It is prepared by reacting calcium lactate or sodium lactate with ferrous sulfate, direct reaction of lactic acid with iron filings, reaction of ferrous chloride with sodium lactate, or reaction of ferrous...

Fumonisin B1 contamination in breast milk and its exposure in infants under 6 months of age in Rombo, Northern Tanzania.

PubMed

Magoha, Happy; De Meulenaer, Bruno; Kimanya, Martin; Hipolite, Danstan; Lachat, Carl; Kolsteren, Patrick

2014-12-01

The carry-over of fumonisin B1 from contaminated feed into dairy milk also suggests its carry-over from contaminated food into breast milk. This study assessed fumonisin B1 contamination in breast milk and associated exposures of infants under 6 months of age. Breast milk samples were collected from 131 lactating mothers and the weight of their infants was measured during the first month of lactation. Fumonisin B1 was extracted using methanol:acetone, cleaned up with Strong Anion Exchange columns and quantified by HPLC. Fumonisin B1 exposure in each child was estimated using deterministic approach. Out of the 131 samples, 58 (44.3%) contained fumonisin B1 at levels ranging from 6.57 to 471.05 ng/ml. Of the contaminated samples, 10.3% had fumonisin B1 levels above the EU limit of 200 ppb for fumonisins in infants' food. Exposure in the infants ranged from 0.78 to 64.93 µg/kg body weight (bw) per day (median, 3 µg/kg bw/day) and exceeded the provisional maximum tolerable limit of 2 µg/kg bw/day in 29% of the infants. In conclusion, breast milk from mothers in Northern Tanzania is contaminated with fumonisins at levels that lead to unacceptable exposures in infants. Strategies to prevent lactating mothers from fumonisin exposure are urgently needed to minimise fumonisin exposure in infants. Copyright © 2014 Elsevier Ltd. All rights reserved.

Balancing exercise and food intake with lactation to promote post-partum weight loss.

PubMed

Lovelady, Cheryl

2011-05-01

Excess weight gain during pregnancy and post-partum weight retention are risk factors for obesity. While many studies report average weight retained from pregnancy is only 0·5-3·0 kg; between 14 and 20% of women are 5 kg heavier at 6-18 months post-partum than they were before pregnancy. Among normal-weight women, lactation usually promotes weight loss to a moderate extent, but not among those with BMI≥35 kg/m2. While exercise and energy restriction may promote weight loss during lactation, their effect on milk volume and composition and, consequently, infant growth must be considered. The effect of exercise on lactation performance has been investigated. Moderate aerobic exercise of 45 min/d, 5 d/week improved cardiovascular fitness, plasma lipids and insulin response; however, it did not promote post-partum weight loss. Breast milk volume and composition were not affected. The effect of exercise with energy restriction in overweight women on the growth of their infants has also been studied. At 1 month post-partum, women restricted their energy intake by 2092 kJ/d and exercised 45 min/d, 4 d/week for 10 weeks. Women in the diet and exercise group lost more weight than the control group (4·8 (sd 1·7) kg v. 0·8 (sd 2·3) kg); however, there were no differences in infant growth. Based on the current evidence, it is recommended that once lactation is established, overweight women may restrict their energy intake by 2092 kJ/d and exercise aerobically 4 d/week to promote a weight loss of 0·5 kg/week.

[THE ROLE OF MOTHER'S MILK AND BREAST FEEDING. MEDICAL PROBLEMS DURING THE LACTATION PERIOD LACTOBACILUS FERMENTUM--A NEW APPROACH TOWARDS THE PREVENTION AND THE TREATMENT OF ACUTE AND SUBACUTE MASTITIS].

PubMed

Popova, B; Mitev, D; Nikolov, A

2016-01-01

Breast feeding provides a lot of short and long-term benefits for the mother and the baby. It prevents the baby of gastrointestinal, urinary and respiratory infections, atopical conditions and assures long-term protection of cardiovascular and metabolic diseases. The breast feeding decreases the risk for the mother of ovary and breast carcinoma and creates a positive emotional bond between the mother and the baby Mother's milk is a species specific; its content is relatively stable regardless of mother's age race, way and place of living. Mother's milk is not sterile. There is a 10 year international trial held in Spanish and Finnish universities. It has identified and count all microorganisms in mother's milk (more than 700) and proved that their content and quantity varies according the age of the baby. Mother's milk is a source of lactobacillus for baby's intestines and most of them have probiotic potential. Lactobacillus fermentum Lc40 (hereditum) is isolated from mother's milk. It has a good viability in gastrointestinal system, high level of adhesion to intestinal epithelium cells, produces glutation--strong antioxidant, good antibacterial activity to entero-pathogens and potential of increasing the immunologic response. Clinical trials reveal that Lactobacillus fermentum plays important role to microflora balance of mother's milk in mastitis during lactation. Many trials estimating the efficiency of lactobacillus fermentum in prevention and treatment of acute and subacute mastitis have been carried out. The results of them open a new door in front of us in the treatment of these conditions--treatment with probiotics instead of antibiotics.

Methylglyoxal treatment in lactating mothers leads to type 2 diabetes phenotype in male rat offspring at adulthood.

PubMed

Francisco, Flávio Andrade; Barella, Luiz Felipe; Silveira, Sandra da Silva; Saavedra, Lucas Paulo Jacinto; Prates, Kelly Valério; Alves, Vander Silva; Franco, Claudinéia Conationi da Silva; Miranda, Rosiane Aparecida; Ribeiro, Tatiane Aparecida; Tófolo, Laize Peron; Malta, Ananda; Vieira, Elaine; Palma-Rigo, Kesia; Pavanello, Audrei; Martins, Isabela Peixoto; Moreira, Veridiana Mota; de Oliveira, Júlio Cezar; Mathias, Paulo Cezar de Freitas; Gomes, Rodrigo Mello

2018-03-01

Environmental and nutritional disorders during perinatal period cause metabolic dysfunction in the progeny and impair human health. Advanced glycation end products (AGEs) are primarily produced during metabolism of excess blood glucose, which is observed in diabetes. Methylglyoxal (MG) is a precursor for the generation of endogenous AGEs, which disturbs the metabolism. This work aimed to investigate whether the maternal MG treatment during lactation programs the progeny to metabolic dysfunction later in life. Female Wistar rats were divided into two groups: control group (C) treated with saline and MG group treated with MG (60 mg/kg/day) by gavage throughout the lactation period. Both mothers and offspring were fed a standard chow. At weaning, breast milk composition was analyzed and mothers euthanized for blood and tissue sample collections. At 90 days of age, offspring were submitted to glucose tolerance test (ivGTT) and euthanized for blood and tissue samples collection. MG mothers showed increase in glucose and fructosamine levels; however, they showed low insulin levels and failure in β-cell function (p < 0.05). MG mothers also showed dyslipidemia (p < 0.05). Moreover, breast milk had elevated levels of glucose, triglycerides, cholesterol and fructosamine and low insulin (p < 0.05). Interestingly, MG offspring had increased body weight and adipose tissue at adulthood, and they also showed glucose intolerance and failure in β-cell function (p < 0.05). Besides, MG offspring showed dyslipidemia (p < 0.05) increasing cardiovascular diseases risk. Maternal MG treatment negatively affects the male rat offspring, leading to type 2 diabetes and dyslipidemia in later life, possibly by changes in breast milk composition.

Spectrum of the Breast Lesions With Increased 18F-FDG Uptake on PET/CT

PubMed Central

Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Changjing

2016-01-01

Abstract Interpretation of 18F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging. PMID:26975010

Immediate systemic allergic reaction in an infant to fish allergen ingested through breast milk

PubMed Central

Arima, Takayasu; Campos-Alberto, Eduardo; Funakoshi, Hiraku; Inoue, Yuzaburo; Tomiita, Minako; Kohno, Yoichi

2016-01-01

This is a rare case report of systemic allergic reaction to fish allergen ingested through breast milk. Mother ate raw fish more than 3 times a week. Her consumption of fish was associated with urticaria and wheeze in an infant via breast-feeding. Fish-specific IgE antibodies were detected by skin prick test but not by in vitro IgE test. This case demonstrates that fish protein ingested by mother can cause an immediate systemic allergic reaction in offspring through breast-feeding. Although fish intake is generally recommended for prevention of allergy, one should be aware that frequent intake of fish by a lactating mother may sensitize the baby and induce an allergic reaction through breast-feeding. PMID:27803887

Cumulative lactate and hospital mortality in ICU patients

PubMed Central

2013-01-01

Background Both hyperlactatemia and persistence of hyperlactatemia have been associated with bad outcome. We compared lactate and lactate-derived variables in outcome prediction. Methods Retrospective observational study. Case records from 2,251 consecutive intensive care unit (ICU) patients admitted between 2001 and 2007 were analyzed. Baseline characteristics, all lactate measurements, and in-hospital mortality were recorded. The time integral of arterial blood lactate levels above the upper normal threshold of 2.2 mmol/L (lactate-time-integral), maximum lactate (max-lactate), and time-to-first-normalization were calculated. Survivors and nonsurvivors were compared and receiver operating characteristic (ROC) analysis were applied. Results A total of 20,755 lactate measurements were analyzed. Data are srpehown as median [interquartile range]. In nonsurvivors (n = 405) lactate-time-integral (192 [0–1881] min·mmol/L) and time-to-first normalization (44.0 [0–427] min) were higher than in hospital survivors (n = 1846; 0 [0–134] min·mmol/L and 0 [0–75] min, respectively; all p < 0.001). Normalization of lactate <6 hours after ICU admission revealed better survival compared with normalization of lactate >6 hours (mortality 16.6% vs. 24.4%; p < 0.001). AUC of ROC curves to predict in-hospital mortality was the largest for max-lactate, whereas it was not different among all other lactate derived variables (all p > 0.05). The area under the ROC curves for admission lactate and lactate-time-integral was not different (p = 0.36). Conclusions Hyperlactatemia is associated with in-hospital mortality in a heterogeneous ICU population. In our patients, lactate peak values predicted in-hospital mortality equally well as lactate-time-integral of arterial blood lactate levels above the upper normal threshold. PMID:23446002

Reliability of the Lactate Scout point-of-care instrument for the determination of blood L-lactate concentration in sheep.

PubMed

Kaynar, Ozgur; Karapinar, Tolga; Hayirli, Armagan; Baydar, Ersoy

2015-12-01

Data on accuracy and precision of the Lactate Scout point-of-care (POC) analyzer in ovine medicine are lacking. The purpose of the study was to assess the reliability of the Lactate Scout in sheep. Fifty-seven sheep at varying ages with various diseases were included. Blood lactate concentration in samples collected from the jugular vein was measured immediately on the Lactate Scout. Plasma L-lactate concentration was measured by the Cobas autoanalyzer as the reference method. Data were subjected to Student's t-test, Passing-Bablok regression, and Bland-Altman plot analyses for comparison and assessment of accuracy, precision, and reliability. Plasma l-lactate concentration was consistently lower than blood L-lactate concentration (3.06 ± 0.24 vs 3.3 ± 0.3 mmol/L, P < .0001). There was a positive correlation between plasma and blood L-lactate concentrations (r = .98, P < .0001). The Lactate Scout had 99% accuracy and 98% precision with the reference method. Blood (Y) and plasma (X) L-lactate concentrations were fitted to Y = 0.28 + 1.00 · X, with a residual standard deviation of 0.31 and a negligible deviation from the identity line (P = .93). The bias was fitted to Y = 0.10 + 0.05 · X, with Sy.x of 0.44 (P < .07). The Lactate Scout has high accuracy and precision, with a negligible bias. It is a reliable POC analyzer to assess L-lactate concentration in ovine medicine. © 2015 American Society for Veterinary Clinical Pathology.

Microarray analysis of human milk cells: persistent high expression of osteopontin during the lactation period

PubMed Central

NAGATOMO, T; OHGA, S; TAKADA, H; NOMURA, A; HIKINO, S; IMURA, M; OHSHIMA, K; HARA, T

2004-01-01

To continue the search for immunological roles of breast milk, cDNA microarray analysis on cytokines and growth factors was performed for human milk cells. Among the 240 cytokine-related genes, osteopontin (OPN) gene ranked top of the expression. Real-time PCR revealed that the OPN mRNA levels in colostrum cells were approximately 100 times higher than those in PHA-stimulated peripheral blood mononuclear cells (PBMNCs), and 10 000 times higher than those in PB CD14+ cells. The median levels of OPN mRNA in early milk or mature milk cells were more than three times higher than those in colostrum cells. Western blot analysis of human milk showed appreciable expression of full-length and short form proteins of OPN. The concentrations of full-length OPN in early milk or mature milk whey continued to be higher than those in colostrum whey and plasma as assessed by ELISA. The early milk (3–7 days postpartum) contained the highest concentrations of OPN protein, while the late mature milk cells (1 years postpartum) had the highest expression of OPN mRNA of all the lactating periods. The results of immunohistochemical and immunocytochemical staining indicated that OPN-producing epithelial cells and macrophages are found in actively lactating mammary glands. These results suggest that the persistently and extraordinarily high expression of OPN in human milk cells plays a potential role in the immunological development of breast-fed infants. PMID:15373904

Attitudes and education of pediatric house staff concerning breast-feeding.

PubMed

Freed, G L; Jones, T M; Fraley, J K

1992-05-01

Pediatricians are expected to offer information and advice on breast-feeding to expectant and lactating mothers, but the educational experience for pediatric residents may not adequately prepare them for this responsibility. To examine knowledge and confidence regarding breast-feeding gained by pediatric house staff during their residency, a survey was administered to pediatric residents in a large, hospital-based training program. Of 108 program residents, 87 (81%) participated. Forty-one percent of the respondents were postgraduate level I (PL-I), 29% were PL-II, and 30% were PL-III. There was no evidence that PL-III residents were more competent or comfortable with routine breast-feeding counseling or intervention than their PL-I counterparts. Residents who had breast-fed, those with spouses who had breast-fed, and those with children of their own had the greatest knowledge and confidence base in several areas, such as their ability to teach breast-feeding techniques and to treat cracked nipples. They were also more familiar with different types of breastpumps. There were no significant differences among those who were or were not breast-fed as a child nor among men versus women. Residency programs must provide comprehensive education on breast-feeding to prepare future pediatricians to meet the needs of patients and their parents.

Health service support of breast feeding--are we practising what we preach?

PubMed Central

Beeken, S.; Waterston, T.

1992-01-01

OBJECTIVE--To ascertain the attitudes of health professionals and breast feeding mothers to breast feeding and their views on current practice. DESIGN--Questionnaire to all midwives and health visitors and to breast feeding mothers in Newcastle upon Tyne. SETTING--Maternity units and community in Newcastle upon Tyne. SUBJECTS--127 hospital midwives, 23 community midwives, 63 health visitors, and 50 first time breast feeding mothers. RESULTS--Optimum practice guidelines were not followed. 30 (60%) mothers said they were separated from their babies on the first night after birth. 82 (42%) professionals said that breast fed babies were frequently given water to drink. 28 (56%) babies in the mothers survey had received food or water other than breast milk; 19 of these had been given water. Professionals expressed mainly positive attitudes towards breast feeding in general but less positive attitudes to specific issues such as the beneficial effects on child health and the value of voluntary organisations in breast feeding promotion and management. CONCLUSIONS--Although many health workers are in favour of breast feeding there is conflict among the professions working most closely with breast feeding mothers. Good breast feeding support requires closer attention to monitoring hospital practices and continued training on good lactation management. Images p286-a p287-a PMID:1392861

Inflammatory mediators in mastitis and lactation insufficiency.

PubMed

Ingman, Wendy V; Glynn, Danielle J; Hutchinson, Mark R

2014-07-01

Mastitis is a common inflammatory disease during lactation that causes reduced milk supply. A growing body of evidence challenges the central role of pathogenic bacteria in mastitis, with disease severity associated with markers of inflammation rather than infection. Inflammation in the mammary gland may be triggered by microbe-associated molecular patterns (MAMPs) as well as danger-associated molecular patterns (DAMPs) binding to pattern recognition receptors such as the toll-like receptors (TLRs) on the surface of mammary epithelial cells and local immune cell populations. Activation of the TLR4 signalling pathway and downstream nuclear factor kappa B (NFkB) is critical to mediating local mammary gland inflammation and systemic immune responses in mouse models of mastitis. However, activation of NFkB also induces epithelial cell apoptosis and reduced milk protein synthesis, suggesting that inflammatory mediators activated during mastitis promote partial involution. Perturbed milk flow, maternal stress and genetic predisposition are significant risk factors for mastitis, and could lead to a heightened TLR4-mediated inflammatory response, resulting in increased susceptibility and severity of mastitis disease in the context of low MAMP abundance. Therefore, heightened host inflammatory signalling may act in concert with pathogenic or commensal bacterial species to cause both the inflammation associated with mastitis and lactation insufficiency. Here, we present an alternate paradigm to the widely held notion that breast inflammation is driven principally by infectious bacterial pathogens, and suggest there may be other therapeutic strategies, apart from the currently utilised antimicrobial agents, that could be employed to prevent and treat mastitis in women.

Foundation and methodologies in computer-aided diagnosis systems for breast cancer detection.

PubMed

Jalalian, Afsaneh; Mashohor, Syamsiah; Mahmud, Rozi; Karasfi, Babak; Saripan, M Iqbal B; Ramli, Abdul Rahman B

2017-01-01

Breast cancer is the most prevalent cancer that affects women all over the world. Early detection and treatment of breast cancer could decline the mortality rate. Some issues such as technical reasons, which related to imaging quality and human error, increase misdiagnosis of breast cancer by radiologists. Computer-aided detection systems (CADs) are developed to overcome these restrictions and have been studied in many imaging modalities for breast cancer detection in recent years. The CAD systems improve radiologists' performance in finding and discriminating between the normal and abnormal tissues. These procedures are performed only as a double reader but the absolute decisions are still made by the radiologist. In this study, the recent CAD systems for breast cancer detection on different modalities such as mammography, ultrasound, MRI, and biopsy histopathological images are introduced. The foundation of CAD systems generally consist of four stages: Pre-processing, Segmentation, Feature extraction, and Classification. The approaches which applied to design different stages of CAD system are summarised. Advantages and disadvantages of different segmentation, feature extraction and classification techniques are listed. In addition, the impact of imbalanced datasets in classification outcomes and appropriate methods to solve these issues are discussed. As well as, performance evaluation metrics for various stages of breast cancer detection CAD systems are reviewed.

Foundation and methodologies in computer-aided diagnosis systems for breast cancer detection

PubMed Central

Jalalian, Afsaneh; Mashohor, Syamsiah; Mahmud, Rozi; Karasfi, Babak; Saripan, M. Iqbal B.; Ramli, Abdul Rahman B.

2017-01-01

Breast cancer is the most prevalent cancer that affects women all over the world. Early detection and treatment of breast cancer could decline the mortality rate. Some issues such as technical reasons, which related to imaging quality and human error, increase misdiagnosis of breast cancer by radiologists. Computer-aided detection systems (CADs) are developed to overcome these restrictions and have been studied in many imaging modalities for breast cancer detection in recent years. The CAD systems improve radiologists' performance in finding and discriminating between the normal and abnormal tissues. These procedures are performed only as a double reader but the absolute decisions are still made by the radiologist. In this study, the recent CAD systems for breast cancer detection on different modalities such as mammography, ultrasound, MRI, and biopsy histopathological images are introduced. The foundation of CAD systems generally consist of four stages: Pre-processing, Segmentation, Feature extraction, and Classification. The approaches which applied to design different stages of CAD system are summarised. Advantages and disadvantages of different segmentation, feature extraction and classification techniques are listed. In addition, the impact of imbalanced datasets in classification outcomes and appropriate methods to solve these issues are discussed. As well as, performance evaluation metrics for various stages of breast cancer detection CAD systems are reviewed. PMID:28435432

Detectable Tenofovir Levels in Breast-Feeding Infants of Mothers Exposed to Topical Tenofovir.

PubMed

Noguchi, Lisa M; Montgomery, Elizabeth T; Biggio, Joseph R; Hendrix, Craig W; Bogen, Debra L; Hillier, Sharon L; Dai, James Y; Piper, Jeanna M; Marzinke, Mark A; Dezzutti, Charlene S; Isaacs, S Karen; Schwartz, Jill L; Watts, D Heather; Beigi, Richard H

2016-09-01

Lactation studies are necessary evaluations of medications for reproductive-age women. We evaluated pharmacokinetics (PK), pharmacodynamics, safety, and adherence profiles associated with 7 days of 1% tenofovir (TFV) vaginal gel use during lactation. Tenofovir levels (maternal/infant serum, milk) and anti-HIV activity (milk), adverse events (AEs), and adherence were measured for 17 HIV-1-seronegative breast-feeding mother-infant pairs. Tenofovir use was well-tolerated and detected at low levels in maternal serum, milk, and infant serum but demonstrated no anti-HIV activity in milk. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

A study of the microbiology of breast abscess in a teaching hospital in Kuwait.

PubMed

Al Benwan, Khalifa; Al Mulla, Ahmed; Rotimi, Vincent O

2011-01-01

To determine the microbiological profile of breast abscess and assess the antibiotic susceptibility of the causative agents. Data obtained from cases of breast abscess over a period of 3.5 years, June 2006 to December 2009, were retrospectively analyzed. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques. The antibiotic susceptibility test was carried out using the methods recommended by the Clinical and Laboratory Standards Institute. One specimen per patient was analyzed. Of the 114 patients, 107 (93.8%) non-lactating and 7 (6.1%) lactating women were diagnosed with breast abscess during this period. Of the 114 specimens, 83 (73%) yielded bacterial growth. Of these, 115 pathogens were isolated with an average of 1.4 pathogens per abscess. Eighteen (22%) of the 83 specimens yielded mixed bacterial growth. There were more Gram-positive pathogens (60, 52%) than anaerobes (32, 28%) and Gram-negative pathogens (22, 19%). The predominant organisms were methicillin-susceptible Staphylococcus aureus (37, 32%), methicillin-resistant S. aureus (MRSA; 11, 10%), Bacteroides spp. (16, 14%), anaerobic streptococci (14, 12%) and Pseudomonas aeruginosa (9, 8%). Of the 48 S. aureus, MRSA accounted for 11 (23%). All MRSA isolates were susceptible to trimethoprim-sulfamethoxazole and vancomycin. S. aureus was the most common pathogenic organism isolated in breast abscesses at Al-Amiri Hospital, Kuwait, of which 23% were MRSA. Nearly a third of the cases were caused by anaerobes, particularly B. fragilis. The data present a basis for the formation of empirical antimicrobial therapeutic policy in the management of breast abscess. Copyright © 2011 S. Karger AG, Basel.

Leptin regulates energy metabolism in MCF-7 breast cancer cells.

PubMed

Blanquer-Rosselló, Mª Del Mar; Oliver, Jordi; Sastre-Serra, Jorge; Valle, Adamo; Roca, Pilar

2016-03-01

Obesity is known to be a poorer prognosis factor for breast cancer in postmenopausal women. Among the diverse endocrine factors associated to obesity, leptin has received special attention since it promotes breast cancer cell growth and invasiveness, processes which force cells to adapt their metabolism to satisfy the increased demands of energy and biosynthetic intermediates. Taking this into account, our aim was to explore the effects of leptin in the metabolism of MCF-7 breast cancer cells. Polarographic analysis revealed that leptin increased oxygen consumption rate and cellular ATP levels were more dependent on mitochondrial oxidative metabolism in leptin-treated cells compared to the more glycolytic control cells. Experiments with selective inhibitors of glycolysis (2-DG), fatty acid oxidation (etomoxir) or aminoacid deprivation showed that ATP levels were more reliant on fatty acid oxidation. In agreement, levels of key proteins involved in lipid catabolism (FAT/CD36, CPT1, PPARα) and phosphorylation of the energy sensor AMPK were increased by leptin. Regarding glucose, cellular uptake was not affected by leptin, but lactate release was deeply repressed. Analysis of pyruvate dehydrogenase (PDH), lactate dehydrogenase (LDH) and pyruvate carboxylase (PC) together with the pentose-phosphate pathway enzyme glucose-6 phosphate dehydrogenase (G6PDH) revealed that leptin favors the use of glucose for biosynthesis. These results point towards a role of leptin in metabolic reprogramming, consisting of an enhanced use of glucose for biosynthesis and lipids for energy production. This metabolic adaptations induced by leptin may provide benefits for MCF-7 growth and give support to the reverse Warburg effect described in breast cancer. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Role of Avocados in Maternal Diets during the Periconceptional Period, Pregnancy, and Lactation.

PubMed

Comerford, Kevin B; Ayoob, Keith T; Murray, Robert D; Atkinson, Stephanie A

2016-05-21

Maternal nutrition plays a crucial role in influencing fertility, fetal development, birth outcomes, and breast milk composition. During the critical window of time from conception through the initiation of complementary feeding, the nutrition of the mother is the nutrition of the offspring-and a mother's dietary choices can affect both the early health status and lifelong disease risk of the offspring. Most health expert recommendations and government-sponsored dietary guidelines agree that a healthy diet for children and adults (including those who are pregnant and/or lactating) should include an abundance of nutrient-rich foods such as fruits and vegetables. These foods should contain a variety of essential nutrients as well as other compounds that are associated with lower disease risk such as fiber and bioactives. However, the number and amounts of nutrients varies considerably among fruits and vegetables, and not all fruit and vegetable options are considered "nutrient-rich". Avocados are unique among fruits and vegetables in that, by weight, they contain much higher amounts of the key nutrients folate and potassium, which are normally under-consumed in maternal diets. Avocados also contain higher amounts of several non-essential compounds, such as fiber, monounsaturated fats, and lipid-soluble antioxidants, which have all been linked to improvements in maternal health, birth outcomes and/or breast milk quality. The objective of this report is to review the evidence that avocados may be a unique nutrition source for pregnant and lactating women and, thus, should be considered for inclusion in future dietary recommendations for expecting and new mothers.

The Role of Avocados in Maternal Diets during the Periconceptional Period, Pregnancy, and Lactation

PubMed Central

Comerford, Kevin B.; Ayoob, Keith T.; Murray, Robert D.; Atkinson, Stephanie A.

2016-01-01

Maternal nutrition plays a crucial role in influencing fertility, fetal development, birth outcomes, and breast milk composition. During the critical window of time from conception through the initiation of complementary feeding, the nutrition of the mother is the nutrition of the offspring—and a mother’s dietary choices can affect both the early health status and lifelong disease risk of the offspring. Most health expert recommendations and government-sponsored dietary guidelines agree that a healthy diet for children and adults (including those who are pregnant and/or lactating) should include an abundance of nutrient-rich foods such as fruits and vegetables. These foods should contain a variety of essential nutrients as well as other compounds that are associated with lower disease risk such as fiber and bioactives. However, the number and amounts of nutrients varies considerably among fruits and vegetables, and not all fruit and vegetable options are considered “nutrient-rich”. Avocados are unique among fruits and vegetables in that, by weight, they contain much higher amounts of the key nutrients folate and potassium, which are normally under-consumed in maternal diets. Avocados also contain higher amounts of several non-essential compounds, such as fiber, monounsaturated fats, and lipid-soluble antioxidants, which have all been linked to improvements in maternal health, birth outcomes and/or breast milk quality. The objective of this report is to review the evidence that avocados may be a unique nutrition source for pregnant and lactating women and, thus, should be considered for inclusion in future dietary recommendations for expecting and new mothers. PMID:27213449

Effects of point massage of liver and stomach channel combined with pith and trotter soup on postpartum lactation start time.

PubMed

Luo, Qiong; Hu, Yin; Zhang, Hui

2017-10-01

Delay in lactation initiation causes maternal anxiety and subsequent adverse impact on maternal exclusive breast feeding. It is important to explore a safe and convenient way to promote lactation initiation. The feasibility of point massage of liver and stomach channel combined with pith and trotter soup on prevention of delayed lactation initiation was investigated in the present study. 320 women were enrolled and randomly divided into four groups, control group (80 women), point massage group (80 women), pith and trotter soup group (80 women), and massage + soup group (80 women) to compare the lactation initiation time. We found that women in point massage group, pith and trotter soup group and massage + soup group had earlier initiation of lactation compared with control group. Women in massage + soup group had the earliest initiation time of lactation. There were significant differences between massage + soup group and pith and trotter soup group. But, there were no significant differences between massage + soup group and massage group. We conclude that point massage of the liver and stomach channel is easy to operate and has the preventive effect on delayed lactation initiation. Impact statement What is already known on this subject: Initiation of lactation is a critical period in postpartum milk secretion. Delays in lactation initiation lead to maternal anxiety and have an adverse impact on maternal exclusive breastfeeding. Sucking frequently by babies and mammary massage might be effective but insufficient for delayed lactation initiation. What the results of this study add: We found in the present study that lactation initiation is significantly earlier in women receiving routine nursing combined with point massage of liver and stomach channel, or pith trotters soup, or massage of liver and stomach channel with pith and trotters soup than in a control group receiving routine nursing. These three methods are all effective, while the most

Differentials in colostrum feeding among lactating women of block RS Pura of J and K: A lesson for nursing practice.

PubMed

Raina, Sunil Kumar; Mengi, Vijay; Singh, Gurdeep

2012-07-01

Breast feeding is universally and traditionally practicised in India. Experts advocate breast feeding as the best method of feeding young infants. To assess the role of various factors in determining colostrum feeding in block R. S. Pura of district Jammu. A stratified two-stage design with villages as the primary sampling unit and lactating mothers as secondary sampling unit. Villages were divided into different clusters on the basis of population and sampling units were selected by a simple random technique. Breastfeeding is almost universal in R. S. Pura. Differentials in discarding the first milk were not found to be important among various socioeconomic groups and the phenomenon appeared more general than specific.

Overexpression of miR-206 suppresses glycolysis, proliferation and migration in breast cancer cells via PFKFB3 targeting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ge, Xin; Lyu, Pengwei; Cao, Zhang

miRNAs, sorting as non-coding RNAs, are differentially expressed in breast tumor and act as tumor promoters or suppressors. miR-206 could suppress the progression of breast cancer, the mechanism of which remains unclear. The study here was aimed to investigate the effect of miR-206 on human breast cancers. We found that miR-206 was down-regulated while one of its predicted targets, 6-Phosphofructo-2-kinase (PFKFB3) was up-regulated in human breast carcinomas. 17β-estradiol dose-dependently decreased miR-206 expression as well as enhanced PFKFB3 mRNA and protein expression in estrogen receptor α (ERα) positive breast cancer cells. Furthermore, we identified that miR-206 directly interacted with 3′-untranslated regionmore » (UTR) of PFKFB3 mRNA. miR-206 modulated PFKFB3 expression in MCF-7, T47D and SUM159 cells, which was influenced by 17β-estradiol depending on ERα expression. In addition, miR-206 overexpression impeded fructose-2,6-bisphosphate (F2,6BP) production, diminished lactate generation and reduced cell proliferation and migration in breast cancer cells. In conclusion, our study demonstrated that miR-206 regulated PFKFB3 expression in breast cancer cells, thereby stunting glycolysis, cell proliferation and migration. - Highlights: • miR-206 was down-regulated and PFKFB3 was up-regulated in human breast carcinomas. • 17β-estradiol regulated miR-206 and PFKFB3 expression in ERα+ cancer cells. • miR-206directly interacted with 3′-UTR of PFKFB3 mRNA. • miR-206 fructose-2,6-bisphosphate (F2,6BP) impeded production and lactate generation. • miR-206 reduced cell proliferation and migration in breast cancer cells.« less

Potential of Breastmilk Analysis to Inform Early Events in Breast Carcinogenesis: Rationale and Considerations

PubMed Central

Murphy, Jeanne; Sherman, Mark E.; Browne, Eva P.; Caballero, Ana I.; Punska, Elizabeth C.; Pfeiffer, Ruth M.; Yang, Hannah P.; Lee, Maxwell; Yang, Howard; Gierach, Gretchen L.; Arcaro, Kathleen F.

2016-01-01

This review summarizes methods related to the study of human breastmilk in etiologic and biomarkers research. Despite the importance of reproductive factors in breast carcinogenesis, factors that act early in life are difficult to study because young women rarely require breast imaging or biopsy, and analysis of critical circulating factors (e.g. hormones) is often complicated by the requirement to accurately account for menstrual cycle date. Accordingly, novel approaches are needed to understand how events such as pregnancy, breastfeeding, weaning, and post-weaning breast remodeling influence breast cancer risk. Analysis of breastmilk offers opportunities to understand mechanisms related to carcinogenesis in the breast, and to identify risk markers that may inform efforts to identify high-risk women early in the carcinogenic process. In addition, analysis of breastmilk could have value in early detection or diagnosis of breast cancer. In this article we describe the potential for using breastmilk to characterize the microenvironment of the lactating breast with the goal of advancing research on risk assessment, prevention, and detection of breast cancer. PMID:27107568

Keeping abreast of the mammary epithelial hierarchy and breast tumorigenesis.

PubMed

Visvader, Jane E

2009-11-15

The epithelium of the mammary gland exists in a highly dynamic state, undergoing dramatic morphogenetic changes during puberty, pregnancy, lactation, and regression. The recent identification of stem and progenitor populations in mouse and human mammary tissue has provided evidence that the mammary epithelium is organized in a hierarchical manner. Characterization of these normal epithelial subtypes is an important step toward understanding which cells are predisposed to oncogenesis. This review summarizes progress in the field toward defining constituent cells and key molecular regulators of the mammary epithelial hierarchy. Potential relationships between normal epithelial populations and breast tumor subtypes are discussed, with implications for understanding the cellular etiology underpinning breast tumor heterogeneity.

Are arterial, muscle and working limb lactate exchange data obtained on men at altitude consistent with the hypothesis of an intracellular lactate shuttle?

PubMed

Brooks, G A

1999-01-01

The "Lactate Shuttle" Hypothesis posits that lactate removal requires exchange among producing and consuming cells. The "Intra-cellular Lactate Shuttle" hypothesis posits that lactate exchange occurs among compartments within cells, and that mitochondria are the major sites of cellular lactate disposal. Thus, cells with high mitochondrial densities (cardiocytes, myocytes, hepatocytes) are those which participate in lactate clearance. The model of an Intracellular Lactate Shuttle recognizes that the Keq for LDH is 3.6 x 10(4) M-1; thus, glycolysis results in cytosolic lactate production regardless of the intracellular PO2. The model also requires presence of a mitochondrial monocarboxylate transporter (MCT) that allows uptake of lactate as well as pyruvate, and intra-mitochondrial LDH whose function is linked to the ETC, and which permits lactate-->pyruvate conversion and oxidation. Recently, we have shown that liver, heart and muscle mitochondria readily oxidize lactate and contain LDH and MCT1. Accordingly, we have concluded that lactate is the predominant monocarboxylate oxidized by mitochondria in vivo. The model of an "Intra-cellular Lactate Shuttle" is consistent with many of the observations on men at sea level and altitude. The observations include: oxidation is the primary fate of lactate disposal during rest and exercise; lactate production and oxidation occur simultaneously within resting and working muscle; increasing [lactate]a increases muscle lactate extraction, and that by increasing SaO2 acclimatization reduces blood [lactate].

When Parents Ask ... about Preterm Birth, Breastfeeding Success, Breast Cancer, or Waterbirth.

PubMed

Moore, Mary Lou

2003-01-01

IN THIS COLUMN, THE AUTHOR REVIEWS RESEARCH ON FOUR SEPARATE TOPICS: the prevention of preterm birth, the effect of epidurals on breastfeeding success, the possible protective effect of lactation on breast cancer, and laboring in water. In two separate studies-a multisite study in the United States and a second study from Brazil-natural progesterone was shown to significantly reduce the incidence of preterm birth in women at high risk. A third study conducted in the United Kingdom examined the effect of clindamycin on preventing infection that can lead to preterm birth. A group of studies related to lactation found that early breastfeeding was more successful in women who did not have epidural anesthesia. In a Korean study, the lifetime duration of breastfeeding was associated with a significant reduction in breast cancer. Concerning waterbirth, Swiss researchers found that, when a woman labored in water, she regulated both water temperature and bathing duration to ensure that her body temperature and that of the fetus remained within a normal physiological range.

Application of Extra Virgin Olive Oil to Prevent Nipple Cracking in Lactating Women.

PubMed

Cordero, María José Aguilar; Villar, Norma Mur; Barrilao, Rafael Guisado; Cortés, Manuel Eduardo Cortés; López, Antonio Manuel Sánchez

2015-12-01

It is well established that extra virgin olive oil (EVOO), applied to the skin, has healing and anti-inflammatory properties. To evaluate the effectiveness of EVOO in the prevention of nipple cracking in lactating women. Experimental, prospective, randomized study of 300 lactating women, admitted to the postpartum unit of the city's general hospital (Cienfuegos, Cuba). The study was carried out in 2012. Eligible patients were randomized into two groups of 150 women. In Group 1, EVOO was applied on the nipple after feeding, and in Group 2, drops of breast milk were applied to the nipple after feeding. Clinical evaluations were made during the first week of treatment and after the first month. All women who initiated breastfeeding were considered eligible to be included in this study; breastfeeding was characterized as the moment of mother-child interaction with suction on the nipple. Efficacy was evaluated quantitatively, as the absence of cracks in the nipple during the first 2 weeks of lactation using as the proportion of women with or without nipple cracks, and if present, whether they were moderate or slight. The quantitative efficacy was 97.3% and no adverse effects occurred in mothers and newborns during the administration of EVOO. EVOO helps prevent nipple cracking in lactating women. It has been shown to have protective effects when breastfeeding presents technical difficulties. This conclusion is borne out by the frequency distribution results obtained, which reflect a significantly higher proportion of nipple cracking in the population that was not treated with EVOO. Use EVOO to prevent nipple cracking during breastfeeding by administering 3 drops on each nipple after each feeding. Decreased nipple cracking will reduce pain and enhance breastfeedinging by administering 3 drops on each nipple after each feeding, improving the health of mothers and infants. © 2015 Sigma Theta Tau International.

21 CFR 582.1207 - Calcium lactate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Calcium lactate. 582.1207 Section 582.1207 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1207 Calcium lactate. (a) Product. Calcium lactate. (b) Conditions of use. This substance is...

21 CFR 582.1207 - Calcium lactate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Calcium lactate. 582.1207 Section 582.1207 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1207 Calcium lactate. (a) Product. Calcium lactate. (b) Conditions of use. This substance is...

Long chain fatty acids and related pro-inflammatory, specialized pro-resolving lipid mediators and their intermediates in preterm human milk during the first month of lactation.

PubMed

Robinson, D T; Palac, H L; Baillif, V; Van Goethem, E; Dubourdeau, M; Van Horn, L; Martin, C R

2017-06-01

This study aimed to measure longitudinal quantities of the long chain fatty acids, their biologically active terminal metabolites and related intermediates (also called oxylipins) in preterm human milk expressed during the first month of lactation. In a prospective cohort, breast milk was collected throughout the first month of lactation in 30 women who delivered preterm infants. Eighteen bioactive lipids and their intermediates were quantified via solid phase extraction and LC-MS/MS. Analysis by GC-FID quantified the fatty acid precursors. Arachidonic acid (ARA) and docosahexaenoic acid (DHA) milk concentrations significantly declined throughout the first month. Oxylipin concentrations did not change during lactation. Positive associations existed between ARA and thromboxane B2, eicosapentaenoic acid and 18-hydroxyeicosapentaenoic acid, and between DHA and PDX and 14- and 17-hydroxydocosahexaenoic acids. DHA concentrations were 1.5 times higher and 14-HDHA was 1.7 times higher in milk from women taking DHA supplements. This investigation showed conditionally essential fatty acids, ARA and DHA, decreased in preterm milk, suggesting a need to supplement their intake for the breast milk-fed preterm infant. Positive associations between parent fatty acids, bioactive lipids and intermediates, as well as sensitivity of milk to maternal fatty acid intake, support consideration of a comprehensive approach to providing fatty acids for preterm infants through both maternal and infant supplementation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.

PubMed

Durif-Bruckert, C; Roux, P; Morelle, M; Mignotte, H; Faure, C; Moumjid-Ferdjaoui, N

2015-07-01

The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. © 2014 John Wiley & Sons Ltd.

A quality improvement project to improve the rate of early breast milk expression in mothers of preterm infants.

PubMed

Murphy, Lindsey; Warner, Diane D; Parks, Jessica; Whitt, Jenny; Peter-Wohl, Sigal

2014-11-01

Providing breast milk is challenging for non-nursing mothers of premature infants. Early breast milk expression results in successful and longer lactation in mothers of very low birth weight (VLBW) infants. This quality improvement initiative sought to increase the rate of early milk expression in mothers of VLBW infants and increase the proportion of infants receiving maternal breast milk (MBM) at 28 days of age and at discharge. Phase 1 (n = 45) occurred between April 1, 2012, and August 31, 2012. Phase 2 (n = 58) occurred between September 1, 2012, and February 28, 2013. Pre-phase 2 actions included increased lactation consultant workforce, early lactation consultation, tracking of MBM supply, and physician education. Inborn infants < 1500 grams were eligible. Primary outcomes were the time of first maternal milk expression (TFME) and infant feeding type at 28 days of age and at discharge. The median TFME decreased from 9 (25th, 75th percentile; 6, 16) hours to 6 (5, 11) hours after implementation (P = .06). The proportion of infants receiving exclusive MBM at 28 days and at discharge was 64% and 74%, respectively (P = .40), and the proportion of infants receiving exclusive MBM at discharge increased from 37% to 59% (P = .046). In conclusion, a multidisciplinary initiative aimed at improving the rate of early milk expression was associated with more VLBW infants receiving exclusive MBM at discharge. © The Author(s) 2014.

Bisphenol S Alters the Lactating Mammary Gland and Nursing Behaviors in Mice Exposed During Pregnancy and Lactation.

PubMed

LaPlante, Charlotte D; Catanese, Mary C; Bansal, Ruby; Vandenberg, Laura N

2017-10-01

High doses of estrogenic pharmaceuticals were once prescribed to women to halt lactation. Yet, the effects of low-level xenoestrogens on lactation remain poorly studied. We investigated the effects of bisphenol S (BPS), an estrogen receptor (ER) agonist, on the lactating mammary gland; the arcuate nucleus, a region of the hypothalamus important for neuroendocrine control of lactational behaviors; and nursing behavior in CD-1 mice. Female mice were exposed to vehicle, 2 or 200 µg BPS/kg/d from pregnancy day 9 until lactational day (LD) 20, and tissues were collected on LD21. Tissues were also collected from a second group at LD2. BPS exposure significantly reduced the fraction of the mammary gland comprised of lobules, the milk-producing units, on LD21, but not LD2. BPS also altered expression of Esr1 and ERα in the mammary gland at LD21, consistent with early involution. In the arcuate nucleus, no changes were observed in expression of signal transducer and activator of transcription 5, a marker of prolactin signaling, or ERα, suggesting that BPS may act directly on the mammary gland. However, observations of nursing behavior collected during the lactational period revealed stage-specific effects on both pup and maternal nursing behaviors; BPS-treated dams spent significantly more time nursing later in the lactational period, and BPS-treated pups were less likely to initiate nursing. Pup growth and development were also stunted. These data indicate that low doses of BPS can alter lactational behaviors and the maternal mammary gland. Together, they support the hypothesis that pregnancy and lactation are sensitive to low-dose xenoestrogen exposures. Copyright © 2017 Endocrine Society.

Lactation and changes in maternal metabolic risk factors.

PubMed

Gunderson, Erica P; Lewis, Cora E; Wei, Gina S; Whitmer, Rachel A; Quesenberry, Charles P; Sidney, Steve

2007-03-01

To examine the relationship between duration of lactation and changes in maternal metabolic risk factors. This 3-year prospective study examined changes in metabolic risk factors among lactating women from preconception to postweaning and among nonlactating women from preconception to postdelivery, in comparison with nongravid women. Of 1,051 (490 black, 561 white) women who attended two consecutive study visits in years 7 (1992-1993) and 10 (1995-1996), 942 were nongravid and 109 had one interim birth. Of parous women, 48 (45%) did not lactate, and 61 (55%) lactated and weaned before year 10. The lactated and weaned women were subdivided by duration of lactation into less than 3 months and 3 months or more. Multiple linear regression models estimated mean 3-year changes in metabolic risk factors adjusted for age, race, parity, education, and behavioral covariates. Both parous women who did not lactate and parous women who lactated and weaned gained more weight (+5.6, +4.4 kg) and waist girth (+5.3, +4.9 cm) than nongravid women over the 3-year interval; P<.001. Low-density lipoprotein cholesterol (+6.7 mg/dL, P<.05) and fasting insulin (+2.6 microunits, P=.06) increased more for parous women who did not lactate than for nongravid and parous women who lactated and weaned. High-density lipoprotein cholesterol decrements for both parous women who did not lactate and parous women who lactated and weaned were 4.0 mg/dL greater than for nongravid women (P<.001). Among parous, lactated and weaned women, lactation for 3 months or longer was associated with a smaller decrement in high-density lipoprotein cholesterol (-1.3 mg/dL versus -7.3 mg/dL for less than 3 months; P<.01). Lactation may attenuate unfavorable metabolic risk factor changes that occur with pregnancy, with effects apparent after weaning. As a modifiable behavior, lactation may affect women's future risk of cardiovascular and metabolic diseases. II.

Hemodynamic changes in the breast and frontal cortex of mothers during breastfeeding.

PubMed

Tanimoto, Kimie; Kusaka, Takashi; Nishida, Tomoko; Ogawa, Kayo; Kato, Ikuko; Ijichi, Sonoko; Mikami, Junko; Sobue, Ikuko; Isobe, Kenichi; Itoh, Susumu

2011-10-01

The objective of this study was to confirm physiological reactions in the breast and brain in mothers during breastfeeding and collect basic objective data, aiming at effective support for breastfeeding. Ten healthy women who were exclusively breastfeeding their babies participated in this study. Changes in the concentration of oxygenated Hb (oxyHb) and deoxygenated Hb in the breasts and frontal cortex of these women during breastfeeding lactation were measured using double-channel near-infrared spectroscopy (NIRS). Changes were measured in three conditions: (1) in both breasts; (2) the ipsilateral breast and frontal cortex; and (3) the contralateral breast and frontal cortex. OxyHb and total Hb (totalHb) levels in the bilateral breasts decreased significantly after the onset of breastfeeding in comparison with prebreastfeeding levels. These two values repeatedly increased and decreased thereafter. In the frontal cortex, regardless of which breast was involved, oxyHb and totalHb levels increased significantly in comparison with prebreastfeeding levels. Similar hemodynamic changes occurred simultaneously in the bilateral breasts during breastfeeding regardless of the feeding or nonfeeding side. Hemodynamic changes were also noted in the frontal cortex, but the reactions in the breast and prefrontal cortex were different and not synchronous, confirming that the physiological circulatory dynamics during breastfeeding vary among organs.

Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions.

PubMed

Field, Scott S

2016-02-01

Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal. © The Author(s) 2015.

Relationship between season, lactation number and incidence of clinical mastitis in different stages of lactation in a Holstein dairy farm.

PubMed

Moosavi, Maede; Mirzaei, Abdolah; Ghavami, Mohsen; Tamadon, Amin

2014-01-01

The aim of the present study was to compare the occurrence and duration of clinical mastitis in different seasons, stages of lactation period and parities in a Holstein dairy farm in Iran. A retrospective epidemiological survey from April 2005 to March 2008 was conducted on 884 clinical mastitis cases of 7437 lactations. Data of each case including calendar-date of mastitis onset, days in milk (DIM) of mastitis onset (early: 0-74 DIM; middle: 75-150 DIM, and late ≥ 150 DIM), duration of mastitis, and parity (1, 2, and ≥ 3) were recorded. Based on date of mastitis onset, cases were classified into stages of lactation. Moreover, beginning of mastitis was seasonally categorized. Duration of clinical mastitis after treatment in early lactation was less than late lactation in the first-parity cows (p = 0.005). In early lactation period, the first-parity cows suffered clinical mastitis in days earlier than two other parity groups (p < 0.001). Moreover, in late lactation period, the first-parity cows had clinical mastitis in days later than cows in the third and more parities (p = 0.002). Occurrence of clinical mastitis in summer increased in late lactation period but in winter increased in early lactation period (p = 0.001). In addition, occurrence time of clinical mastitis in summer were in days later than in spring (p = 0.02) and winter (p = 0.03) in early lactation period. In conclusion, occurrence of mastitis in winter and spring during early lactation and in summer during late lactation period were more prevalent especially in lower parities.

Relationship between season, lactation number and incidence of clinical mastitis in different stages of lactation in a Holstein dairy farm

PubMed Central

Moosavi, Maede; Mirzaei, Abdolah; Ghavami, Mohsen; Tamadon, Amin

2014-01-01

The aim of the present study was to compare the occurrence and duration of clinical mastitis in different seasons, stages of lactation period and parities in a Holstein dairy farm in Iran. A retrospective epidemiological survey from April 2005 to March 2008 was conducted on 884 clinical mastitis cases of 7437 lactations. Data of each case including calendar-date of mastitis onset, days in milk (DIM) of mastitis onset (early: 0-74 DIM; middle: 75-150 DIM, and late ≥ 150 DIM), duration of mastitis, and parity (1, 2, and ≥ 3) were recorded. Based on date of mastitis onset, cases were classified into stages of lactation. Moreover, beginning of mastitis was seasonally categorized. Duration of clinical mastitis after treatment in early lactation was less than late lactation in the first-parity cows (p = 0.005). In early lactation period, the first-parity cows suffered clinical mastitis in days earlier than two other parity groups (p < 0.001). Moreover, in late lactation period, the first-parity cows had clinical mastitis in days later than cows in the third and more parities (p = 0.002). Occurrence of clinical mastitis in summer increased in late lactation period but in winter increased in early lactation period (p = 0.001). In addition, occurrence time of clinical mastitis in summer were in days later than in spring (p = 0.02) and winter (p = 0.03) in early lactation period. In conclusion, occurrence of mastitis in winter and spring during early lactation and in summer during late lactation period were more prevalent especially in lower parities. PMID:25568687

A versatile breast reduction technique: Conical plicated central U shaped (COPCUs) mammaplasty

PubMed Central

Copcu, Eray

2009-01-01

Background There have been numerous studies on reduction mammaplasty and its modifications in the literature. The multitude of modifications of reduction mammaplasty indicates that the ideal technique has yet to be found. There are four reasons for seeking the ideal technique. One reason is to preserve functional features of the breast: breastfeeding and arousal. Other reasons are to achieve the real geometric and aesthetic shape of the breast with the least scar and are to minimize complications of prior surgical techniques without causing an additional complication. Last reason is the limitation of the techniques described before. To these aims, we developed a new versatile reduction mammaplasty technique, which we called conical plicated central U shaped (COPCUs) mammaplasty. Methods We performed central plication to achieve a juvenile look in the superior pole of the breast and to prevent postoperative pseudoptosis and used central U shaped flap to achieve maximum NAC safety and to preserve lactation and nipple sensation. The central U flap was 6 cm in width and the superior conical plication was performed with 2/0 PDS. Preoperative and postoperative standard measures of the breast including the superior pole fullness were compared. Results Forty six patients were operated with the above mentioned technique. All of the patients were satisfied with functional and aesthetic results and none of them had major complications. There were no changes in the nipple innervation. Six patients becoming pregnant after surgery did not experience any problems with lactation. None of the patients required scar revision. Conclusion Our technique is a versatile, safe, reliable technique which creates the least scar, avoids previously described disadvantages, provides maximum preservation of functions, can be employed in all breasts regardless of their sizes. PMID:19575809

Community pharmacists' services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study.

PubMed

Albassam, Abdullah; Awad, Abdelmoneim

2018-01-05

This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists' recommendations for treatment of pregnancy-related and breast feeding-related ailments. Cross-sectional questionnaire-based survey. Community pharmacies in Kuwait. 207 pharmacies were randomly selected from the Ministry of Health database. One registered pharmacist was approached from each pharmacy. One hundred and ninety-two (92.8%) pharmacists agreed to participate and completed a self-administered questionnaire. The proportions of pharmacists offering particular advice for health conditions in pregnancy and lactation, pharmacists' recommendations for common and specific ailments during pregnancy and breast feeding, and pharmacists' views about self-care in pregnancy and breast feeding. The top services provided to pregnant and lactating women were recommending vitamins and food supplements (89.8%) and contraception advice (83.4%), respectively. More than half of participants indicated that they would recommend medications for headache, constipation, cough, runny nose, sore throat, nausea/vomiting, indigestion, sore or cracked nipple and insufficient milk. Diarrhoea, haemorrhoids, insomnia, varicose vein, swelling of the feet and legs, vaginal itching, back pain, fever, mastitis and engorgement were frequently referred to the physician. Recommendations on medication use were occasionally inappropriate in terms of unneeded drug therapy, off-label use and safety. In relation to offering advice and solving medication and health problems of pregnant and lactating women, more than half of pharmacists indicated that they have sufficient knowledge (61.5%; 50.5%) and confidence (58.3%; 53.1%), respectively. Most of the respondents (88.5%) agreed that a continuing education programme on this topic would be of value for their practice. The present findings show that

Higher Accuracy of the Lactate Minimum Test Compared to Established Threshold Concepts to Determine Maximal Lactate Steady State in Running.

PubMed

Wahl, Patrick; Zwingmann, Lukas; Manunzio, Christian; Wolf, Jacob; Bloch, Wilhelm

2018-05-18

This study evaluated the accuracy of the lactate minimum test, in comparison to a graded-exercise test and established threshold concepts (OBLA and mDmax) to determine running speed at maximal lactate steady state. Eighteen subjects performed a lactate minimum test, a graded-exercise test (2.4 m·s -1 start,+0.4 m·s -1 every 5 min) and 2 or more constant-speed tests of 30 min to determine running speed at maximal lactate steady state. The lactate minimum test consisted of an initial lactate priming segment, followed by a short recovery phase. Afterwards, the initial load of the subsequent incremental segment was individually determined and was increased by 0.1 m·s -1 every 120 s. Lactate minimum was determined by the lowest measured value (LM abs ) and by a third-order polynomial (LM pol ). The mean difference to maximal lactate steady state was+0.01±0.14 m·s -1 (LM abs ), 0.04±0.15 m·s -1 (LM pol ), -0.06±0.31 m·s 1 (OBLA) and -0.08±0.21 m·s 1 (mDmax). The intraclass correlation coefficient (ICC) between running velocity at maximal lactate steady state and LM abs was highest (ICC=0.964), followed by LM pol (ICC=0.956), mDmax (ICC=0.916) and OBLA (ICC=0.885). Due to the higher accuracy of the lactate minimum test to determine maximal lactate steady state compared to OBLA and mDmax, we suggest the lactate minimum test as a valid and meaningful concept to estimate running velocity at maximal lactate steady state in a single session for moderately up to well-trained athletes. © Georg Thieme Verlag KG Stuttgart · New York.

Partial reconstruction of in vitro gluconeogenesis arising from mitochondrial l-lactate uptake/metabolism and oxaloacetate export via novel L-lactate translocators.

PubMed

De Bari, Lidia; Atlante, Anna; Valenti, Daniela; Passarella, Salvatore

2004-05-15

In the light of the occurrence of L-lactate dehydrogenase inside the mitochondrial matrix, we looked at whether isolated rat liver mitochondria can take up and metabolize L-lactate, and provide oxaloacetate outside mitochondria, thus contributing to a partial reconstruction of gluconeogenesis in vitro. We found that: (1) L-lactate (10 mM), added to mitochondria in the presence of a cocktail of glycolysis/gluconeogenesis enzymes and cofactors, can lead to synthesis of glyceraldehyde-3-phosphate at a rate of about 7 nmol/min per mg mitochondrial protein. (2) Three novel translocators exist to mediate L-lactate traffic across the inner mitochondrial membrane. An L-lactate/H+ symporter was identified by measuring fluorimetrically the rate of endogenous pyridine nucleotide reduction. Consistently, L-lactate oxidation was found to occur with P/O ratio=3 (where P/O ratio is the ratio of mol of ATP synthesized to mol of oxygen atoms reduced to water during oxidative phosphorylation) and with generation of membrane potential. Proton uptake, which occurred as a result of addition of L-lactate to RLM together with electron flow inhibitors, and mitochondrial swelling in ammonium L-lactate solutions were also monitored. L-Lactate/oxaloacetate and L-lactate/pyruvate anti-porters were identified by monitoring photometrically the appearance of L-lactate counter-anions outside mitochondria. These L-lactate translocators, which are distinct from the monocarboxylate carrier, were found to differ from each other in V(max) values and in inhibition and pH profiles, and proved to regulate mitochondrial L-lactate metabolism in vitro. The role of lactate/mitochondria interactions in gluconeogenesis is discussed.

Delayed onset of weanling diarrhoea associated with high breast milk intake.

PubMed

Watkinson, M

1981-01-01

In a West African community where breast feeding was practised universally for 18 to 24 months infants with the higher breast milk intakes were given supplementary foods later than others. Although 66% of infants had diarrhoea before the introduction of these foods, it was generally mild and only 12% suffered diarrhoea-induced weight loss in this pre-weaning period. By the end of infancy, all children had had diarrhoea and 89% had suffered weight loss in one or more attacks. As the bulk of diarrhoeal morbidity occurred after weaning had started, children with the higher breast milk intakes tended to be older before losing weight with diarrhoea. By one year, children with a higher than average breast milk intake and with no diarrhoea-induced weight loss in the first half of infancy weighed an average of 1 kg more than those with low breast milk intakes and early weight loss with diarrhoea. Interventions which improve or maintain maternal lactation performance should not only increase the nutrient intake of an infant, but also delay the almost inevitable weight loss of weanling diarrhoea.

Choline intake and genetic polymorphisms influence choline metabolite concentrations in human breast milk and plasma123

PubMed Central

Fischer, Leslie M; da Costa, Kerry Ann; Galanko, Joseph; Sha, Wei; Stephenson, Brigitte; Vick, Julie; Zeisel, Steven H

2010-01-01

Background: Choline is essential for infant nutrition, and breast milk is a rich source of this nutrient. Common single nucleotide polymorphisms (SNPs) change dietary requirements for choline intake. Objective: The aim of this study was to determine whether total choline intake and/or SNPs influence concentrations of choline and its metabolites in human breast milk and plasma. Design: We gave a total of 103 pregnant women supplemental choline or a placebo from 18 wk gestation to 45 d postpartum and genotyped the women for 370 common SNPs. At 45 d postpartum, we measured choline metabolite concentrations in breast milk and plasma and assessed the dietary intake of choline by using a 3-d food record. Results: On average, lactating women in our study ate two-thirds of the recommended intake for choline (Adequate Intake = 550 mg choline/d). Dietary choline intake (no supplement) correlated with breast-milk phosphatidylcholine and plasma choline concentrations. A supplement further increased breast-milk choline, betaine, and phosphocholine concentrations and increased plasma choline and betaine concentrations. We identified 5 SNPs in MTHFR that altered the slope of the intake–metabolite concentration relations, and we identified 2 SNPs in PEMT that shifted these curves upward. Individuals who shared sets of common SNPs were outliers in plots of intake–metabolite concentration curves; we suggest that these SNPs should be further investigated to determine how they alter choline metabolism. Conclusion: Total intake of choline and genotype can influence the concentrations of choline and its metabolites in the breast milk and blood of lactating women and thereby affect the amount of choline available to the developing infant. This study was registered at clinicaltrials.gov as NCT00678925. PMID:20534746

Genotoxicity profiles in exfoliated human mammary cells recovered from lactating mothers in Istanbul; relationship with demographic and dietary factors.

PubMed

Yilmaz, Bayram; Sandal, Suleyman; Ayvaci, Habibe; Tug, Niyazi; Vitrinel, Ayca

2012-12-12

We have investigated the presence of DNA damage in human mammary epithelial cells collected from healthy lactating mothers (age, 20-35 years) who were resident in the Istanbul area. Breast milk (10ml) was collected from 30 women between one and two weeks post-partum. Demographic information (parity, breast cancer, occupation, duration of residency in Istanbul, consumption of fish, beef and poultry) was also obtained. Milk samples were diluted 1:1 with RPMI 1640 medium and centrifuged to collect cells. The cells were re-suspended and cell viability was determined by use of 0.4% trypan blue. DNA damage was assessed by use of the comet assay (alkaline single-cell gel electrophoresis). Fifty cells per slide and two slides per sample were scored to evaluate DNA damage. The cells were visually classified into four categories on the basis of extent of migration: undamaged (UD), lightly damaged (LD), moderately damaged (MD) and highly damaged (HD). Total comet scores (TCS) were calculated as: 1× UD+2× LD+3× MD+4× HD. Exfoliated mammary cells of the donors showed high (TCS≥150a.u.), moderate and low DNA damage in 10 (33.3%), 8 (26.7%) and 12 (40%) mothers, respectively. There was no significant correlation between TCS for DNA damage and the duration of previous breastfeeding, parity or age. None of the mothers was vegetarian, smoker or on any medication. Meat and chicken consumption did not significantly correlate with the TCS values. Fish consumption was significantly correlated with TCS results (Spearman's rho=0.39, p<0.05). No significant correlation was found between the DNA-damage scores and the period of residency in Istanbul, but fish consumption increased as the duration of stay was longer (Spearman's rho=0.53, p<0.01). These findings suggest that the primary causes of differences in genotoxicity detected in lactating mothers in Istanbul may be of dietary origin. Our experience also confirms that sampling breast milk from lactating mothers provides a valuable

Infantile cobalamin deficiency with cerebral lactate accumulation and sustained choline depletion.

PubMed

Horstmann, M; Neumaier-Probst, E; Lukacs, Z; Steinfeld, R; Ullrich, K; Kohlschütter, A

2003-06-01

A remarkable, intermittent sudden-onset vigilance and movement disorder in an exclusively breast-fed infant is reported, which was caused by cobalamin depletion due to maternal vitamin B12 malabsorption. The lack of cobalamin caused a severe encephalopathy in the infant, whose brain displayed a striking loss of volume and a delay of myelination. Proton magnetic resonance spectroscopy revealed an accumulation of lactate in the gray and white matter of the brain and a sustained depletion of choline-containing compounds in the white matter, reflecting a reversible disturbance of oxidative energy metabolism in brain cells and a long-lasting hypomyelination disorder. The clinical picture in conjunction with MRI and spectroscopic data of this case study yields more insight into the functions of cobalamin in the cerebral metabolism.

The effect of between-breast differences on human milk macronutrients content.

PubMed

Pines, N; Mandel, D; Mimouni, F B; Moran Lev, H; Mangel, L; Lubetzky, R

2016-07-01

Little is known about the effect of maternal handedness and preferential side of breastfeeding upon macronutrients concentration in human milk (HM). We aimed to compare macronutrients content of HM from both breasts, taking into account the self-reported preferential feeding ('dominant') breast, breast size and handedness (right versus left). We tested the null hypothesis that macronutrients content of HM is not affected by breast dominancy, breast size or maternal handedness. Fifty-seven lactating mothers were recruited. HM macronutrients were measured after mid manual expression using infrared transmission spectroscopy. Out of the 57 mothers recruited, 12 were excluded from the analyses because they brought in insufficient samples. Among the 22 who reported a size difference, 16 (73%) had a larger left breast (P<0.001). Approximately a third of women reported no breastfeeding side dominance, a third reported a right dominance and another third reported a left dominance. Breastfeeding side dominance was unaffected by either handedness or breasts size. When size asymmetry was reported (n=22) the dominant side was also the larger breast in 16 (73%) women, the smaller breast in 2 (9%) women, whereas 4 (18%) additional women with asymmetry had no preferential breastfeeding side. There were no statistically significant differences in macronutrients between the right and the left breasts. In multiple stepwise backward regression analysis, fat, carbohydrate, protein and energy contents were unaffected by maternal handedness, breast side dominance or breast size asymmetry. Macronutrients content of mid expression HM is unaffected by maternal handedness, breast size or breast side dominance.

The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment.

PubMed

Kvist, Linda J; Larsson, Bodil Wilde; Hall-Lord, Marie Louise; Steen, Anita; Schalén, Claes

2008-04-07

The role of bacterial pathogens in lactational mastitis remains unclear. The objective of this study was to compare bacterial species in breast milk of women with mastitis and of healthy breast milk donors and to evaluate the use of antibiotic therapy, the symptoms of mastitis, number of health care contacts, occurrence of breast abscess, damaged nipples and recurrent symptoms in relation to bacterial counts. In this descriptive study, breast milk from 192 women with mastitis (referred to as cases) and 466 breast milk donors (referred to as controls) was examined bacteriologically and compared using analytical statistics. Statistical analyses were also carried out to test for relationships between bacteriological content and clinical symptoms as measured on scales, prescription of antibiotics, the number of care contacts, occurrence of breast abscess and recurring symptoms. Five main bacterial species were found in both cases and controls: coagulase negative staphylococci (CNS), viridans streptococci, Staphylococcus aureus (S. aureus), Group B streptococci (GBS) and Enterococcus faecalis. More women with mastitis had S. aureus and GBS in their breast milk than those without symptoms, although 31% of healthy women harboured S. aureus and 10% had GBS. There were no significant correlations between bacterial counts and the symptoms of mastitis as measured on scales. There were no differences in bacterial counts between those prescribed and not prescribed antibiotics or those with and without breast abscess. GBS in breast milk was associated with increased health care contacts (p = 0.02). Women with >/= 10(7) cfu/L CNS or viridans streptococci in their breast milk had increased odds for damaged nipples (p = 0.003). Many healthy breastfeeding women have potentially pathogenic bacteria in their breast milk. Increasing bacterial counts did not affect the clinical manifestation of mastitis; thus bacterial counts in breast milk may be of limited value in the decision to

Alkaline phosphatase activity in human colostrum as a valuable predictive biomarker for lactational mastitis in nursing mothers.

PubMed

Bjelakovic, Ljiljana; Kocic, Gordana; Bjelakovic, Bojko; Zivkovic, Nikola; Stojanović, Dusica; Sokolovic, Danka; Mladenovic-Ciric, Ivana; Sokolovic, Dusan

2012-08-01

Biochemical investigations have shown that an indigenous milk enzyme - alkaline phosphatase (ALP) - which is detectable in the lactocytes, plays a very important diagnostic role in clinical medicine, since its activity varies in different tissues and serves as a specific indicator of disease states. The purpose of this study was to evaluate ALP activity in human colostrum as a possible early predictive biomarker for lactational mastitis in nursing mothers. During a period from May to July 2010, a total of 60 healthy nursing mothers were recruited for this study. The mean level of colostrum ALP activity from the affected breasts was significantly higher when compared with ALP activity from the contralateral asymptomatic as well as 'healthy' breasts (p < 0.01). Determining ALP activity in colostrum could be a valuable biochemical marker for an early prediction of mastitis in nursing mothers.

Comparative transcriptome analysis reveals different molecular mechanisms of Bacillus coagulans 2-6 response to sodium lactate and calcium lactate during lactic acid production.

PubMed

Qin, Jiayang; Wang, Xiuwen; Wang, Landong; Zhu, Beibei; Zhang, Xiaohua; Yao, Qingshou; Xu, Ping

2015-01-01

Lactate production is enhanced by adding calcium carbonate or sodium hydroxide during fermentation. However, Bacillus coagulans 2-6 can produce more than 180 g/L L-lactic acid when calcium lactate is accumulated, but less than 120 g/L L-lactic acid when sodium lactate is formed. The molecular mechanisms by which B. coagulans responds to calcium lactate and sodium lactate remain unclear. In this study, comparative transcriptomic methods based on high-throughput RNA sequencing were applied to study gene expression changes in B. coagulans 2-6 cultured in non-stress, sodium lactate stress and calcium lactate stress conditions. Gene expression profiling identified 712 and 1213 significantly regulated genes in response to calcium lactate stress and sodium lactate stress, respectively. Gene ontology assignments of the differentially expressed genes were performed. KEGG pathway enrichment analysis revealed that 'ATP-binding cassette transporters' were significantly affected by calcium lactate stress, and 'amino sugar and nucleotide sugar metabolism' was significantly affected by sodium lactate stress. It was also found that lactate fermentation was less affected by calcium lactate stress than by sodium lactate stress. Sodium lactate stress had negative effect on the expression of 'glycolysis/gluconeogenesis' genes but positive effect on the expression of 'citrate cycle (TCA cycle)' genes. However, calcium lactate stress had positive influence on the expression of 'glycolysis/gluconeogenesis' genes and had minor influence on 'citrate cycle (TCA cycle)' genes. Thus, our findings offer new insights into the responses of B. coagulans to different lactate stresses. Notably, our RNA-seq dataset constitute a robust database for investigating the functions of genes induced by lactate stress in the future and identify potential targets for genetic engineering to further improve L-lactic acid production by B. coagulans.

Comparative Transcriptome Analysis Reveals Different Molecular Mechanisms of Bacillus coagulans 2-6 Response to Sodium Lactate and Calcium Lactate during Lactic Acid Production

PubMed Central

Qin, Jiayang; Wang, Xiuwen; Wang, Landong; Zhu, Beibei; Zhang, Xiaohua; Yao, Qingshou; Xu, Ping

2015-01-01

Lactate production is enhanced by adding calcium carbonate or sodium hydroxide during fermentation. However, Bacillus coagulans 2-6 can produce more than 180 g/L L-lactic acid when calcium lactate is accumulated, but less than 120 g/L L-lactic acid when sodium lactate is formed. The molecular mechanisms by which B. coagulans responds to calcium lactate and sodium lactate remain unclear. In this study, comparative transcriptomic methods based on high-throughput RNA sequencing were applied to study gene expression changes in B. coagulans 2-6 cultured in non-stress, sodium lactate stress and calcium lactate stress conditions. Gene expression profiling identified 712 and 1213 significantly regulated genes in response to calcium lactate stress and sodium lactate stress, respectively. Gene ontology assignments of the differentially expressed genes were performed. KEGG pathway enrichment analysis revealed that ‘ATP-binding cassette transporters’ were significantly affected by calcium lactate stress, and ‘amino sugar and nucleotide sugar metabolism’ was significantly affected by sodium lactate stress. It was also found that lactate fermentation was less affected by calcium lactate stress than by sodium lactate stress. Sodium lactate stress had negative effect on the expression of ‘glycolysis/gluconeogenesis’ genes but positive effect on the expression of ‘citrate cycle (TCA cycle)’ genes. However, calcium lactate stress had positive influence on the expression of ‘glycolysis/gluconeogenesis’ genes and had minor influence on ‘citrate cycle (TCA cycle)’ genes. Thus, our findings offer new insights into the responses of B. coagulans to different lactate stresses. Notably, our RNA-seq dataset constitute a robust database for investigating the functions of genes induced by lactate stress in the future and identify potential targets for genetic engineering to further improve L-lactic acid production by B. coagulans. PMID:25875592

High brain lactate is a hallmark of aging and caused by a shift in the lactate dehydrogenase A/B ratio

PubMed Central

Ross, Jaime M.; Öberg, Johanna; Brené, Stefan; Coppotelli, Giuseppe; Terzioglu, Mügen; Pernold, Karin; Goiny, Michel; Sitnikov, Rouslan; Kehr, Jan; Trifunovic, Aleksandra; Larsson, Nils-Göran; Hoffer, Barry J.; Olson, Lars

2010-01-01

At present, there are few means to track symptomatic stages of CNS aging. Thus, although metabolic changes are implicated in mtDNA mutation-driven aging, the manifestations remain unclear. Here, we used normally aging and prematurely aging mtDNA mutator mice to establish a molecular link between mitochondrial dysfunction and abnormal metabolism in the aging process. Using proton magnetic resonance spectroscopy and HPLC, we found that brain lactate levels were increased twofold in both normally and prematurely aging mice during aging. To correlate the striking increase in lactate with tissue pathology, we investigated the respiratory chain enzymes and detected mitochondrial failure in key brain areas from both normally and prematurely aging mice. We used in situ hybridization to show that increased brain lactate levels were caused by a shift in transcriptional activities of the lactate dehydrogenases to promote pyruvate to lactate conversion. Separation of the five tetrameric lactate dehydrogenase (LDH) isoenzymes revealed an increase of those dominated by the Ldh-A product and a decrease of those rich in the Ldh-B product, which, in turn, increases pyruvate to lactate conversion. Spectrophotometric assays measuring LDH activity from the pyruvate and lactate sides of the reaction showed a higher pyruvate → lactate activity in the brain. We argue for the use of lactate proton magnetic resonance spectroscopy as a noninvasive strategy for monitoring this hallmark of the aging process. The mtDNA mutator mouse allows us to conclude that the increased LDH-A/LDH-B ratio causes high brain lactate levels, which, in turn, are predictive of aging phenotypes. PMID:21041631

High brain lactate is a hallmark of aging and caused by a shift in the lactate dehydrogenase A/B ratio.

PubMed

Ross, Jaime M; Öberg, Johanna; Brené, Stefan; Coppotelli, Giuseppe; Terzioglu, Mügen; Pernold, Karin; Goiny, Michel; Sitnikov, Rouslan; Kehr, Jan; Trifunovic, Aleksandra; Larsson, Nils-Göran; Hoffer, Barry J; Olson, Lars

2010-11-16

At present, there are few means to track symptomatic stages of CNS aging. Thus, although metabolic changes are implicated in mtDNA mutation-driven aging, the manifestations remain unclear. Here, we used normally aging and prematurely aging mtDNA mutator mice to establish a molecular link between mitochondrial dysfunction and abnormal metabolism in the aging process. Using proton magnetic resonance spectroscopy and HPLC, we found that brain lactate levels were increased twofold in both normally and prematurely aging mice during aging. To correlate the striking increase in lactate with tissue pathology, we investigated the respiratory chain enzymes and detected mitochondrial failure in key brain areas from both normally and prematurely aging mice. We used in situ hybridization to show that increased brain lactate levels were caused by a shift in transcriptional activities of the lactate dehydrogenases to promote pyruvate to lactate conversion. Separation of the five tetrameric lactate dehydrogenase (LDH) isoenzymes revealed an increase of those dominated by the Ldh-A product and a decrease of those rich in the Ldh-B product, which, in turn, increases pyruvate to lactate conversion. Spectrophotometric assays measuring LDH activity from the pyruvate and lactate sides of the reaction showed a higher pyruvate → lactate activity in the brain. We argue for the use of lactate proton magnetic resonance spectroscopy as a noninvasive strategy for monitoring this hallmark of the aging process. The mtDNA mutator mouse allows us to conclude that the increased LDH-A/LDH-B ratio causes high brain lactate levels, which, in turn, are predictive of aging phenotypes.

Classification of small lesions on dynamic breast MRI: Integrating dimension reduction and out-of-sample extension into CADx methodology

PubMed Central

Nagarajan, Mahesh B.; Huber, Markus B.; Schlossbauer, Thomas; Leinsinger, Gerda; Krol, Andrzej; Wismüller, Axel

2014-01-01

Objective While dimension reduction has been previously explored in computer aided diagnosis (CADx) as an alternative to feature selection, previous implementations of its integration into CADx do not ensure strict separation between training and test data required for the machine learning task. This compromises the integrity of the independent test set, which serves as the basis for evaluating classifier performance. Methods and Materials We propose, implement and evaluate an improved CADx methodology where strict separation is maintained. This is achieved by subjecting the training data alone to dimension reduction; the test data is subsequently processed with out-of-sample extension methods. Our approach is demonstrated in the research context of classifying small diagnostically challenging lesions annotated on dynamic breast magnetic resonance imaging (MRI) studies. The lesions were dynamically characterized through topological feature vectors derived from Minkowski functionals. These feature vectors were then subject to dimension reduction with different linear and non-linear algorithms applied in conjunction with out-of-sample extension techniques. This was followed by classification through supervised learning with support vector regression. Area under the receiver-operating characteristic curve (AUC) was evaluated as the metric of classifier performance. Results Of the feature vectors investigated, the best performance was observed with Minkowski functional ’perimeter’ while comparable performance was observed with ’area’. Of the dimension reduction algorithms tested with ’perimeter’, the best performance was observed with Sammon’s mapping (0.84 ± 0.10) while comparable performance was achieved with exploratory observation machine (0.82 ± 0.09) and principal component analysis (0.80 ± 0.10). Conclusions The results reported in this study with the proposed CADx methodology present a significant improvement over previous results reported with

21 CFR 862.1440 - Lactate dehydrogenase test system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Systems § 862.1440 Lactate dehydrogenase test system. (a) Identification. A lactate dehydrogenase test system is a device intended to measure the activity of the enzyme lactate dehydrogenase in serum. Lactate... hepatitis, cirrhosis, and metastatic carcinoma of the liver, cardiac diseases such as myocardial infarction...

Brain lactate metabolism: the discoveries and the controversies

PubMed Central

Dienel, Gerald A

2012-01-01

Potential roles for lactate in the energetics of brain activation have changed radically during the past three decades, shifting from waste product to supplemental fuel and signaling molecule. Current models for lactate transport and metabolism involving cellular responses to excitatory neurotransmission are highly debated, owing, in part, to discordant results obtained in different experimental systems and conditions. Major conclusions drawn from tabular data summarizing results obtained in many laboratories are as follows: Glutamate-stimulated glycolysis is not an inherent property of all astrocyte cultures. Synaptosomes from the adult brain and many preparations of cultured neurons have high capacities to increase glucose transport, glycolysis, and glucose-supported respiration, and pathway rates are stimulated by glutamate and compounds that enhance metabolic demand. Lactate accumulation in activated tissue is a minor fraction of glucose metabolized and does not reflect pathway fluxes. Brain activation in subjects with low plasma lactate causes outward, brain-to-blood lactate gradients, and lactate is quickly released in substantial amounts. Lactate utilization by the adult brain increases during lactate infusions and strenuous exercise that markedly increase blood lactate levels. Lactate can be an ‘opportunistic', glucose-sparing substrate when present in high amounts, but most evidence supports glucose as the major fuel for normal, activated brain. PMID:22186669

[Breast is best--human milk for premature infants].

PubMed

Riskin, Arieh; Bader, David

2003-03-01

Nutrition for preterm babies is aimed at achieving expected intrauterine growth and accretion of nutrients. Early trophic feedings should be started as soon as possible for gastrointestinal priming. Mother's (breast) milk is the best food for preterm babies. Its advantages are in host defence, nutritional components and suitability for gut absorption, as well as its psychological and developmental value. The limitations of human milk for preterm babies, mainly in protein and minerals, can be compensated for by using powdered human milk fortifier. Sucking skills usually mature around 34 weeks, corrected gestational age. Thus, small preemies are initially fed by orogastric tubes, meaning that expressed breast milk is used. Support of lactation in mothers of preemies mandates protection of the mother and child bonding process and early skin to skin contact ("kangeroo care"). Methods for storage of expressed breast milk and the recommended length of storage are discussed. Milk bank mandates pasteurization and freezing of the donors' milk. Most of the nutritional and immunological advantages of human milk are preserved after such treatments. Cytomegalovirus (CMV) infections in preterm infants, that were acquired from mother's expressed breast milk, are not uncommon, and require further attention.

Effect of lactational exposure to tributyltin chloride on innate immunodefenses in the F1 generation in mice.

PubMed

Kimura, Kimiko; Kobayashi, Kazuo; Naito, Hiroyuki; Suzuki, Yoshihiko; Sugita-Konishi, Yoshiko

2005-06-01

We examined the effect of lactational exposure to tributyltin on innate immunodefenses in the F1 generation using in vivo and in vitro experiments. Pregnant C57BL/6 mice were given drinking water containing 0, 15, or 50 microg/ml of tributyltin chloride (TBTCl) from parturition to weaning. At weaning time, offspring were inoculated with Escherichia coli K-12, and bacterial clearances from the peritoneal cavity and spleen were examined. In vivo infection experiments indicated that bacterial clearance was significantly depressed in offspring breast-fed by dams exposed to 15 microg/ml of TBTCl (15 ppm F1), but not in offspring by dams exposed to 50 microg/ml of TBTCl (50 ppm F1). In vitro functional assays revealed that the killing activity of neutrophils decreased significantly in 15 ppm F1, but not in 50 ppm F1. We suggest that lactational exposure to TBT impairs innate immunodefenses in the F1 generation against non-pathogenic bacterial infection.

Overutilization of Health Care Resources for Breast Pain.

PubMed

Kushwaha, Anne C; Shin, Kyungmin; Kalambo, Megan; Legha, Ravinder; Gerlach, Karen E; Kapoor, Megha Madhukar; Yang, Wei T

2018-05-24

The objective of this study is to analyze the incidence of women with breast pain who present to an imaging center and assess the imaging findings, outcomes, and workup costs at breast imaging centers affiliated with one institution. Demographic characteristics of and imaging findings for female patients presenting with breast pain at three community breast imaging centers between January 1, 2014, and December 31, 2014, were reviewed. Patients who were pregnant, were lactating, had a history of breast cancer, or presented with palpable nipple or skin findings were excluded. A total of 799 patients met the study criteria. Pain was diffuse in 30%, was focal in 30%, and was not localized in 40%. Of the 799 patients with breast pain, 790 (99%) presented for a diagnostic evaluation; 759 (95%) of these evaluated patients had negative findings. A benign sonographic correlate was detected in the area of pain in 5% of patients (39/799). One patient had a single cancer detected in the contralateral asymptomatic breast. When correlations between breast pain and the presence of cancer in the study patients were compared with the concurrent cancer detection rate in the screening population (5.5 cases per 1000 examinations performed), breast pain was not found to be a sign of breast cancer (p = 0.027). Patients younger than 40 years (316/799) underwent a total of 454 workup studies for breast pain; all findings were benign, and the cost of these studies was $87,322. Patients 40 years or older (483/799) underwent 745 workup studies, for a cost of $152,732. Breast pain represents an area of overutilization of health care resources. For female patients who present with pure breast pain, breast imaging centers should consider the following imaging protocols and education for referring physicians: an annual screening mammogram should be recommended for women 40 years or older, and reassurance without imaging should be offered to patients younger than 40 years.

Breast-feeding initiation in low-income women: Role of attitudes, support, and perceived control.

PubMed

Khoury, Amal J; Moazzem, S Wakerul; Jarjoura, Chad M; Carothers, Cathy; Hinton, Agnes

2005-01-01

Despite the documented health and emotional benefits of breast-feeding to women and children, breast-feeding rates are low among subgroups of women. In this study, we examine factors associated with breast-feeding initiation in low-income women, including Theory of Planned Behavior measures of attitude, support, and perceived control, as well as sociodemographic characteristics. A mail survey, with telephone follow-up, of 733 postpartum Medicaid beneficiaries in Mississippi was conducted in 2000. The breast-feeding initiation rate in this population was 38%. Women who were older, white, non-Hispanic, college-educated, married, not certified for the Supplemental Nutrition Program for Women, Infants, and Children, and not working full-time were more likely to breast-feed than formula-feed at hospital discharge. Attitudes regarding benefits and barriers to breast-feeding, as well as health care system and social support, were associated with breast-feeding initiation at the multivariate level. Adding the health care system support variables to the regression model, and specifically support from lactation specialists and hospital nurses, explained the association between breast-feeding initiation and women's perceived control over the time and social constraints barriers to breast-feeding. The findings support the need for health care system interventions, family interventions, and public health education campaigns to promote breast-feeding in low-income women.

D-Lactate transport and metabolism in rat liver mitochondria.

PubMed

de Bari, Lidia; Atlante, Anna; Guaragnella, Nicoletta; Principato, Giovanni; Passarella, Salvatore

2002-07-15

In the present study we investigated whether isolated rat liver mitochondria can take up and metabolize D-lactate. We found the following: (1) externally added D-lactate causes oxygen uptake by mitochondria [P/O ratio (the ratio of mol of ATP synthesized to mol of oxygen atoms reduced to water during oxidative phosphorylation)=2] and membrane potential (Delta(psi)) generation in processes that are rotenone-insensitive, but inhibited by antimycin A and cyanide, and proton release from coupled mitochondria inhibited by alpha-cyanocinnamate, but not by phenylsuccinate; (2) the activity of the putative flavoprotein (D-lactate dehydrogenase) was detected in inside-out submitochondrial particles, but not in mitochondria and mitoplasts, as it is localized in the matrix phase of the mitochondrial inner membrane; (3) three novel separate translocators exist to mediate D-lactate traffic across the mitochondrial inner membrane: the D-lactate/H(+) symporter, which was investigated by measuring fluorimetrically the rate of endogenous flavin reduction, the D-lactate/oxoacid antiporter (which mediates both the D-lactate/pyruvate and D-lactate/oxaloacetate exchanges) and D-lactate/malate antiporter studied by monitoring photometrically the appearance of the D-lactate counteranions outside mitochondria. The D-lactate translocators, in the light of their different inhibition profiles separate from the monocarboxylate carrier, were found to differ from each other in the V(max) values and in the inhibition and pH profiles and were shown to regulate mitochondrial D-lactate metabolism in vitro. The D-lactate translocators and the D-lactate dehydrogenase could account for the removal of the toxic methylglyoxal from cytosol, as well as for D-lactate-dependent gluconeogenesis.

The Mammotome biopsy system is an effective treatment strategy for breast abscess.

PubMed

Wang, Keren; Ye, Yuqin; Sun, Guang; Xu, Zheli

2013-01-01

Although most breast abscesses can be treated with the current first-line treatment of antibiotics by needle aspiration, the therapeutic duration is lengthy and recurrences often occur. Therefore, we aimed to investigate the clinical efficacy of the Mammotome biopsy system (Johnson & Johnson Corp., New Brunswick, NJ) in a cohort of patients with breast abscesses. Forty lactating and 30 nonlactating breast abscess patients with unfavorable outcomes with antibiotic treatment and/or needle aspiration failure were recruited and treated with the Mammotome biopsy system. Skin inflammation of all patients disappeared within 6 days with no recurrence. The clinical outcomes in patients with an abscess size ≤ 3.5 cm was significantly better than those with an abscess size >3.5 cm (P = .025). The Mammotome biopsy system, an effective treatment strategy that is minimally invasive and less damaging, in combination with appropriate antibiotic therapy can be used safely as the first-line approach to breast abscess management. Copyright © 2013 Elsevier Inc. All rights reserved.

Regional body composition changes during lactation in Indian women from the low-income group and their relationship to the growth of their infants.

PubMed

Kulkarni, Bharati; Shatrugna, Veena; Nagalla, Balakrishna; Rani, K Usha

2011-02-01

Increased energy requirement during lactation may lead to maternal tissue depletion in women from poor subsistence communities. To examine the regional body composition changes in undernourished lactating women and to assess the relationship of maternal body composition changes with weight gain of the infants. Body composition was assessed using dual energy x-ray absorptiometry in 35 lactating women at 4 time points: within 1 month after delivery (baseline) and at 6, 12, and 18 months postpartum. The mean age, height, and body mass index of the women were 23.5 years, 150.7 cm, and 20.0 kg/m(2), respectively. There were no significant differences in body weight or whole-body lean as well as fat mass at 4 time points, but the percentage fat decreased significantly during lactation. There was selective mobilization of fat mass from the leg region, whereas the appendicular skeletal mass (ASM) increased significantly. When the growth of the infants in the first 6 months (proxy for the lactation performance) was assessed in relation to the maternal body composition changes during that period, it was observed that the change in fat mass had a negative relationship to the weight gain of the infant. Change in the ASM during this period, however, had a significant positive relationship with the weight gain of the infants. There were important differences in the lactation-related changes in the regional body composition parameters of these undernourished women. Regional body composition changes may be related to the weight gain of the breast-fed infants.

High expressions of LDHA and AMPK as prognostic biomarkers for breast cancer.

PubMed

Huang, Xiaojia; Li, Xing; Xie, Xinhua; Ye, Feng; Chen, Bo; Song, Cailu; Tang, Hailin; Xie, Xiaoming

2016-12-01

The purpose of this study was to investigate the potential correlation between lactate dehydrogenase A (LDHA) and AMP-activated protein kinase (AMPK) and their clinicopathologic significance in breast cancer. Western blot and qRT-PCR were used to detect the expression levels of LDHA and AMPK in eight breast cancer lines and eight breast cancer tissues. In addition, LDHA and AMPK were detected by immunohistochemistry (IHC) using breast cancer tissue microarrays (TMAs) of 112 patients. The association between LDHA and AMPK expression levels was statistically analyzed. So were the prognostic roles and clinicopathologic significances in breast cancer. The expression levels of LDHA and AMPK were relatively higher in triple-negative breast cancer (TNBC) cell lines than in non-triple-negative breast cancer (NTNBC) cell lines. LDHA and AMPK were also further up-regulated in TNBC tissues than in NTNBC tissues. Correlation analysis showed a positive correlation between LDHA and AMPK expression levels. Expression of LDHA and AMPK were significantly correlated with TNM stage, distant metastasis, Ki67 status and survival outcomes of patients. Patients with both positive expression of LDHA and AMPK showed shorter overall survival (OS) and disease-free survival (DFS). These findings improve our understanding of the expression pattern of LDHA and AMPK in breast cancer and clarify the role of LDHA and AMPK as promising prognostic biomarkers for breast cancer. Copyright © 2016. Published by Elsevier Ltd.

Palatability of sous vide processed chicken breast.

PubMed

Turner, B E; Larick, D K

1996-08-01

The influences of brine composition, internal temperature, heating rate, and storage periods up to 28 d on flavor, texture, and color of sous vide processed chicken breast were evaluated. Pectoralis major muscles containing water and sodium chloride, with or without sodium lactate, were browned and vacuum packaged. Sous vide processing was by fast or slow heating to an internal temperature of 77 or 94 C. Product was evaluated after 0, 14, and 28 d storage at 4 C. Quality was evaluated by gas chromatographic analyses of flavor volatiles, shear, color, and sensory panels. Incorporation of sodium lactate into brine did not influence oxidative stability (as measured by headspace gas chromatography) or sensory warmed-over flavor. Presence of sodium lactate did result in enhanced fresh roasted or meaty and saltiness sensory scores as well as a more yellow color. The more rapid heating rate decreased sulfur-containing compounds and did not influence other volatile concentrations. Products processed to 94 C were less juicy, less tender, and contained higher quantities of alcohols and hydrocarbons than those processed to 77 C. Storage resulted in a decline in fresh roasted or meaty flavor note and an increase in warmed-over flavor note and quantities of alcohols, aldehydes and ketones, hydrocarbons, and total headspace volatiles.

Development of an ionic-liquid-based dispersive liquid-liquid microextraction method for the determination of antichagasic drugs in human breast milk: Optimization by central composite design.

PubMed

Padró, Juan M; Pellegrino Vidal, Rocío B; Echevarria, Romina N; Califano, Alicia N; Reta, Mario R

2015-05-01

Chagas disease constitutes a major public health problem in Latin America. Human breast milk is a biological sample of great importance for the analysis of therapeutic drugs, as unwanted exposure through breast milk could result in pharmacological effects in the nursing infant. Thus, the goal of breast milk drug analysis is to inquire to which extent a neonate may be exposed to a drug during lactation. In this work, we developed an analytical technique to quantify benznidazole and nifurtimox (the two antichagasic drugs currently available for medical treatment) in human breast milk, with a simple sample pretreatment followed by an ionic-liquid-based dispersive liquid-liquid microextraction combined with high-performance liquid chromatography and UV detection. For this technique, the ionic liquid 1-octyl-3-methylimidazolium hexafluorophosphate has been used as the "extraction solvent." A central composite design was used to find the optimum values for the significant variables affecting the extraction process: volume of ionic liquid, volume of dispersant solvent, ionic strength, and pH. At the optimum working conditions, the average recoveries were 77.5 and 89.7%, the limits of detection were 0.06 and 0.09 μg/mL and the interday reproducibilities were 6.25 and 5.77% for benznidazole and nifurtimox, respectively. The proposed methodology can be considered sensitive, simple, robust, accurate, and green. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Longitudinal versus cross-sectional methodology for estimating the economic burden of breast cancer: a pilot study.

PubMed

Mullins, C Daniel; Wang, Junling; Cooke, Jesse L; Blatt, Lisa; Baquet, Claudia R

2004-01-01

Projecting future breast cancer treatment expenditure is critical for budgeting purposes, medical decision making and the allocation of resources in order to maximise the overall impact on health-related outcomes of care. Currently, both longitudinal and cross-sectional methodologies are used to project the economic burden of cancer. This pilot study examined the differences in estimates that were obtained using these two methods, focusing on Maryland, US Medicaid reimbursement data for chemotherapy and prescription drugs for the years 1999-2000. Two different methodologies for projecting life cycles of cancer expenditure were considered. The first examined expenditure according to chronological time (calendar quarter) for all cancer patients in the database in a given quarter. The second examined only the most recent quarter and constructed a hypothetical expenditure life cycle by taking into consideration the number of quarters since the respective patient had her first claim. We found different average expenditures using the same data and over the same time period. The longitudinal measurement had less extreme peaks and troughs, and yielded average expenditure in the final period that was 60% higher than that produced using the cross-sectional analysis; however, the longitudinal analysis had intermediate periods with significantly lower estimated expenditure than the cross-sectional data. These disparate results signify that each of the methods has merit. The longitudinal method tracks changes over time while the cross-sectional approach reflects more recent data, e.g. current practice patterns. Thus, this study reiterates the importance of considering the methodology when projecting future cancer expenditure.

Mammographic phenotypes of breast cancer risk driven by breast anatomy

NASA Astrophysics Data System (ADS)

Gastounioti, Aimilia; Oustimov, Andrew; Hsieh, Meng-Kang; Pantalone, Lauren; Conant, Emily F.; Kontos, Despina

2017-03-01

Image-derived features of breast parenchymal texture patterns have emerged as promising risk factors for breast cancer, paving the way towards personalized recommendations regarding women's cancer risk evaluation and screening. The main steps to extract texture features of the breast parenchyma are the selection of regions of interest (ROIs) where texture analysis is performed, the texture feature calculation and the texture feature summarization in case of multiple ROIs. In this study, we incorporate breast anatomy in these three key steps by (a) introducing breast anatomical sampling for the definition of ROIs, (b) texture feature calculation aligned with the structure of the breast and (c) weighted texture feature summarization considering the spatial position and the underlying tissue composition of each ROI. We systematically optimize this novel framework for parenchymal tissue characterization in a case-control study with digital mammograms from 424 women. We also compare the proposed approach with a conventional methodology, not considering breast anatomy, recently shown to enhance the case-control discriminatory capacity of parenchymal texture analysis. The case-control classification performance is assessed using elastic-net regression with 5-fold cross validation, where the evaluation measure is the area under the curve (AUC) of the receiver operating characteristic. Upon optimization, the proposed breast-anatomy-driven approach demonstrated a promising case-control classification performance (AUC=0.87). In the same dataset, the performance of conventional texture characterization was found to be significantly lower (AUC=0.80, DeLong's test p-value<0.05). Our results suggest that breast anatomy may further leverage the associations of parenchymal texture features with breast cancer, and may therefore be a valuable addition in pipelines aiming to elucidate quantitative mammographic phenotypes of breast cancer risk.

"Seeing Is Believing": Dermatoscope Facilitated Breast Examination of the Breastfeeding Woman with Nipple Pain.

PubMed

Naimer, Sody A; Silverman, William F

2016-09-01

It is well recognized that breastmilk provides optimal nutrition and immunological protection for infants. Many women, however, experience nipple pain while breastfeeding, leading to premature cessation of nursing. To overcome these difficulties, timely diagnosis is crucial to effectively treat the underlying pathology and permit resumption of breastfeeding. Examination of the superficial breast plays a key role in accurate diagnosis. Traditional direct inspection is clearly inadequate for this task. The dermatoscope is a useful tool, enlarging and illuminating an area of epidermis to obtain an optimal image. Improvements in dermoscopy involving polarization obviate the need for full contact with the examined surface, thereby providing anatomical detail in three dimensions. A novel practice presented in this article features clinical cases introducing this technique as it is applied to the lactating breast, conclusively distinguishing normal from abnormal and illustrating the efficacy and added diagnostic value of this approach. The dermoscope is shown to facilitate identification of the causes of nipple pain ranging from asymptomatic candidal infection to exquisitely painful, minute traumatic erosions, aiding, thereby, in diagnosis of the underlying causes of nursing difficulties. Improved wound surveillance and standardization for purposes of research documentation are additional benefits anticipated with the use of breast dermoscopy. We conclude that real-time, high-quality, magnified imaging of the lactating breast represents a recognizable advance in pursuit of a rapid and accurate technique that aids in the identification of the factors responsible for lesions affecting nursing women. Moreover, it features an already existing technology requiring little training at a reasonable cost.

The West Midlands breast cancer screening status algorithm - methodology and use as an audit tool.

PubMed

Lawrence, Gill; Kearins, Olive; O'Sullivan, Emma; Tappenden, Nancy; Wallis, Matthew; Walton, Jackie

2005-01-01

To illustrate the ability of the West Midlands breast screening status algorithm to assign a screening status to women with malignant breast cancer, and its uses as a quality assurance and audit tool. Breast cancers diagnosed between the introduction of the National Health Service [NHS] Breast Screening Programme and 31 March 2001 were obtained from the West Midlands Cancer Intelligence Unit (WMCIU). Screen-detected tumours were identified via breast screening units, and the remaining cancers were assigned to one of eight screening status categories. Multiple primaries and recurrences were excluded. A screening status was assigned to 14,680 women (96% of the cohort examined), 110 cancers were not registered at the WMCIU and the cohort included 120 screen-detected recurrences. The West Midlands breast screening status algorithm is a robust simple tool which can be used to derive data to evaluate the efficacy and impact of the NHS Breast Screening Programme.

Excessive weight gain during full breast-feeding.

PubMed

Grunewald, Maria; Hellmuth, Christian; Demmelmair, Hans; Koletzko, Berthold

2014-01-01

Breast-feeding is considered to offer optimal nutrition for healthy infant growth and development. Observational studies have linked breast-feeding to reduced obesity. CASE OBSERVATION: We observed an infant who was born macrosomic (4.56 kg) and showed excessive weight gain markedly exceeding the 97th percentile of weight during full breast-feeding. At the age of 4 months, the weight was greater than 11 kg. Clinical evaluation did not reveal any underlying pathology. After the introduction of complementary feeding and hence reduction of the breast milk intake, the excessive weight gain was attenuated and the slope of the percentile curve paralleled upper percentiles. Since this pattern suggested full breast-feeding as the driver of excessive weight gain, we analyzed the human milk composition at the infant age of 1 year and compared the results with published data on composition at this stage of lactation. The milk contents of lactose, fat, fatty acids, polar lipids, carnitine species, and insulin were similar to the reference data. The adiponectin content was increased. The most remarkable alteration was a high milk protein content (mean 1.25 g/dl, reference 0.8 g/dl). A very high protein supply in infancy has been previously shown to increase plasma concentrations of the growth factors insulin and IGF-1, weight gain, and later obesity. We speculate that interindividual variations in human milk adiponectin and protein contents may contribute to modulation of the growth of fully breast-fed infants and in this case may have contributed to excessive weight gain during full breast-feeding. This hypothesis merits being tested in future cohort studies. © 2014 S. Karger AG, Basel.

Concentration of Trichloroethylene in Breast Milk and Household Water from Nogales, Arizona

PubMed Central

Beamer, Paloma I.; Luik, Catherine E.; Abrell, Leif; Campos, Swilma; Martínez, María Elena; Sáez, A. Eduardo

2013-01-01

The United States Environmental Protection Agency has identified quantification of trichloroethylene (TCE), an industrial solvent, in breast milk as a high priority need for risk assessment. Water and milk samples were collected from 20 households by a lactation consultant in Nogales, Arizona. Separate water samples (including tap, bottled and vending machine) were collected for all household uses: drinking, bathing, cooking, and laundry. A risk factor questionnaire was administered. Liquid-liquid extraction with diethyl ether was followed by GC-MS for TCE quantification in water. Breast milk underwent homogenization, lipid hydrolysis and centrifugation prior to extraction. The limit of detection was 1.5 ng/mL. TCE was detected in 7 of 20 mothers’ breast milk samples. The maximum concentration was 6 ng/mL. TCE concentration in breast milk was significantly correlated with the concentration in water used for bathing (ρ=0.59, p=0.008). Detection of TCE in breast milk was more likely if the infant had a body mass index <14 (RR=5.2, p=0.02). Based on average breast milk consumption, TCE intake for 5% of the infants may exceed the proposed US EPA Reference Dose. Results of this exploratory study warrant more in depth studies to understand risk of TCE exposures from breast milk intake. PMID:22827160

Alcohol consumption decreases lactate clearance in acutely injured patients☆

PubMed Central

Dezman, Zachary D.W.; Comer, Angela C.; Narayan, Mayur; Scalea, Thomas M.; Hirshon, Jon Mark; Smith, Gordon S.

2017-01-01

Introduction Alcohol, a common risk factor for injury, has direct toxic effects on the liver. The use of lactate clearance has been well described as an indicator of the adequacy of resuscitation in injured patients. We investigated whether acutely injured patients with positive blood alcohol content (+BAC) had less lactate clearance than sober patients. Methods We conducted a retrospective cohort study of acutely injured patients treated at an urban Level 1 trauma centre between January 2010 and December 2012. Blood alcohol and venous lactate levels were measured on all patients at the time of arrival. Study subjects were patients transported directly from the scene of injury, who had an elevated lactate concentration on arrival (≥3.0 mmol/L) and at least one subsequent lactate measurement within 24 h after admission. Lactate clearance ([Lactate1 − Lactate2]/Lactate1) was calculated for all patients. Chi-squared tests were used to compare values from sober and intoxicated subjects. Lactate clearance was plotted against alcohol levels and stratified by age and Injury Severity Score (ISS). Results Serial lactate concentration measurements were obtained in 3910 patients; 1674 of them had +BAC. Patients with +BAC were younger (mean age: 36.6 [SD 14.7] vs 41.0 [SD 19.9] years [p = 0.0001]), were more often male (83.4% vs 75.9% [p = 0.0001]), had more minor injuries (ISS < 9) (33.8% vs 27.1% [p = 0.0001]), had a lower in-hospital mortality rate (1.4% vs 3.9% [p = 0.0001]), but also had lower average lactate clearance (37.8% vs 47.6% [p = 0.0001]). The lactate clearance of the sober patients (47.6 [SD 33.5]) was twice that of those with +BAC >400 (23.5 [SD 6.5]). Lactate clearance decreased with increasing BAC irrespective of age and ISS. Conclusions In a large group of acutely injured patients, a dose-dependent decrease in lactate clearance was seen in those with elevated BAC. This relationship will cause a falsely elevated lactate reading or prolong lactate

A multipronged approach is associated with improved breast milk feeding rates in very low birth weight infants of an inner-city hospital.

PubMed

Dereddy, Narendra R; Talati, Ajay J; Smith, Ashley; Kudumula, Ravi; Dhanireddy, Ramasubbareddy

2015-02-01

Breast milk feeding has advantages over formula feeding in premature infants, but its use in them is low. We initiated measures in our inner-city hospital such as starting a dedicated lactation service, counseling the mothers prenatally and postnatally, educating hospital staff, and advocating with our state's Medicaid insurance to provide free home breast pumps. These measures were associated with improvement in our breast milk feeding rates in very low birth weight infants from 22% to 88% over 5 years. This article describes our multipronged approach and can help encourage and guide other units with similar demographics to improve their breast milk feeding rates. © The Author(s) 2014.

21 CFR 582.5311 - Ferrous lactate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients and/or Dietary Supplements 1 § 582.5311 Ferrous lactate. (a) Product. Ferrous lactate. (b) Conditions of use. This substance...

21 CFR 582.5311 - Ferrous lactate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients and/or Dietary Supplements 1 § 582.5311 Ferrous lactate. (a) Product. Ferrous lactate. (b) Conditions of use. This substance...

21 CFR 582.5311 - Ferrous lactate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients and/or Dietary Supplements 1 § 582.5311 Ferrous lactate. (a) Product. Ferrous lactate. (b) Conditions of use. This substance...

21 CFR 582.5311 - Ferrous lactate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients and/or Dietary Supplements 1 § 582.5311 Ferrous lactate. (a) Product. Ferrous lactate. (b) Conditions of use. This substance...

21 CFR 582.5311 - Ferrous lactate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients and/or Dietary Supplements 1 § 582.5311 Ferrous lactate. (a) Product. Ferrous lactate. (b) Conditions of use. This substance...

21 CFR 582.1207 - Calcium lactate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Additives § 582.1207 Calcium lactate. (a) Product. Calcium lactate. (b) Conditions of use. This substance is generally recognized as safe when used in accordance with good manufacturing or feeding practice. ...

21 CFR 582.1207 - Calcium lactate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Additives § 582.1207 Calcium lactate. (a) Product. Calcium lactate. (b) Conditions of use. This substance is generally recognized as safe when used in accordance with good manufacturing or feeding practice. ...

21 CFR 582.1207 - Calcium lactate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Additives § 582.1207 Calcium lactate. (a) Product. Calcium lactate. (b) Conditions of use. This substance is generally recognized as safe when used in accordance with good manufacturing or feeding practice. ...

Pediatricians', obstetricians', gynecologists', and family medicine physicians' experiences with and attitudes about breast-feeding.

PubMed

Anchondo, Inés; Berkeley, Lizabeth; Mulla, Zuber D; Byrd, Theresa; Nuwayhid, Bahij; Handal, Gilbert; Akins, Ralitsa

2012-05-01

Investigate physicians' breast-feeding experiences and attitudes using a survey based on two behavioral theories: theory of reasoned action (TRA) and the health belief model (HBM). There were 73 participants included in the investigation. These participants were resident and faculty physicians from pediatrics, obstetrics/gynecology, and family medicine at a university campus, located on the US-Mexico border. The sample was reduced to 53 and 56 records for the attitude and confidence variables, respectively. Physicians answered a survey about their breast-feeding experiences and attitudes to learn about intention and ability applying constructs from TRA and HBM. An attitude scale, confidence variable (from self-efficacy items), and a lactation training index were created for the analysis. Analysis of the association between physicians' breastfeeding experiences and their attitudes revealed physicians are knowledgeable about breast-feeding and have positive attitudes towards breast-feeding. They did not seem to remember how long they breast-fed their children or whether they enjoyed breast-feeding, but they wanted to continue breast-feeding. Physicians cite work as a main reason for not continuing to breast-feed. Physicians' attitudes toward breast-feeding are positive. They are expected to practice health-promotion behavior including breast-feeding; however, physicians' breast-feeding rates are low and although they are knowledgeable about breast-feeding their training lacks on didactic depth and hands-on experience. If physicians learn more about breast-feeding and breast-feed exclusively and successfully, the rates in the United States would increase naturally.

The agreement between abnormal venous lactate and arterial lactate in the ED: a retrospective chart review.

PubMed

Bloom, B; Pott, J; Freund, Y; Grundlingh, J; Harris, T

2014-06-01

The evidence for prognostication using lactate is often based on arterial lactate (AL). Arterial sampling is painful and difficult, and carries risks. Studies comparing peripheral venous lactate (PVL) with AL showed little difference but predominantly included patients with normal lactate. The objective of this study was to measure agreement between PVL and AL in patients with elevated venous lactate. This is a retrospective cross-sectional study. ED patients age≥16, attending from October 2010 to June 2011 inclusive, with PVL≥2.0 mmol/L and AL taken within 1 hour. intravenous fluid prior to or between initial venous and arterial sampling. Primary endpoint: agreement between PVL and AL defined as mean difference±95% limits of agreement (LOA). The misclassification rate was assessed. N=232. VL median 3.50 mmol/L, range 2.00 to 15.00 mmol/L. AL median 2.45 mmol/L, range 1.0 to 13.2 mmol/L. The mean difference±SD between PVL and AL for all patients was 1.06±1.30 mmol/L (95%LOA -1.53 to 3.66 mmol/L). Using a cut-off of 2 mmol/L and 4 mmol/L, 36.2% and 17.9% of patients respectively were incorrectly classified as having elevated lactate. We report greater bias between VL and AL with broader LOA than previously documented. This may partly be due to the fact that we studied only patients with abnormal venous values, for whom close agreement would confer greatest clinical significance. The agreement between abnormal PVL and AL is poor and the high rate of misclassification may suggest that PVL is not a good substitute for AL if the venous lactate is abnormal. Copyright © 2014 Elsevier Inc. All rights reserved.

Total folate and unmetabolized folic acid in the breast milk of a cross-section of Canadian women.

PubMed

Page, Rachael; Robichaud, André; Arbuckle, Tye E; Fraser, William D; MacFarlane, Amanda J

2017-05-01

Background: Folate requirements increase during pregnancy and lactation. It is recommended that women who could become pregnant, are pregnant, or are lactating consume a folic acid (FA)-containing supplement. Objectives: We sought to determine breast-milk total folate and unmetabolized folic acid (UMFA) contents and their relation with FA-supplement use and doses in a cohort of Canadian mothers who were enrolled in the MIREC (Maternal-Infant Research on Environmental Chemicals) study. Design: Breast-milk tetrahydrofolate (THF), 5-methyl-THF, 5-formyl-THF, 5,10-methenyl-THF, and UMFA were measured with the use of liquid chromatography-tandem mass spectrometry ( n = 561). Total daily supplemental FA intake was based on self-reported FA-supplement use. Results: UMFA was detectable in the milk of 96.1% of the women. Total daily FA intake from supplements was associated with breast folate concentration and species. Breast-milk total folate was 18% higher ( P < 0.001) in supplement users ( n = 401) than in nonusers ( n = 160), a difference driven by women consuming >400 μg FA/d ( P ≤ 0.004). 5-Methyl-THF was 19% lower ( P < 0.001) and UMFA was 126% higher ( P < 0.001) in supplement users than in nonusers. Women who consumed >400 μg FA/d had proportionally lower 5-methyl-THF and higher UMFA than did women who consumed ≤400 μg FA/d. Conclusions: FA-supplement use was associated with modestly higher breast-milk total folate. Detectable breast-milk UMFA was nearly ubiquitous, including in women who did not consume an FA supplement. Breast-milk UMFA was proportionally higher than 5-methyl-THF in women who consumed >400 μg FA/d, thereby suggesting that higher doses exceed the physiologic capacity to metabolize FA and result in the preferential uptake of FA in breast milk. Therefore, FA-supplement doses >400 μg may not be warranted, especially in populations for whom FA fortification is mandatory. © 2017 American Society for Nutrition.

A new orthosis reduces pain and mechanical forces in prone position in women with augmented or natural breast tissue: a pilot study.

PubMed

Armstrong, Simon; Ried, Karin; Sali, Avni; McLaughlin, Patrick

2013-07-01

Breast augmentation, post-mastectomy patients as well as some women with natural breast tissue, and lactating, women often experience discomfort in prone activities. Our study, for the first time, examines pain levels, mechanical force and peak pressure in natural, reconstructed and augmented breast tissues with and without a new orthosis designed for reduction of displacement, compression and loading forces through the breast tissue during prone activities. Twelve females with natural, lactating or augmented breast tissue, and cup-sizes C-F volunteered for the study. Pain perception was measured using an 11-point visual-analogue-scale without and with different sizes/textures of the orthosis. Magnetic-Resonance-Imaging captured segmental transverse and para-sagittal mid-breast views, and provided linear measurements of breast tissue displacement and deformation. Capacitance-pliance® sensorstrips were used to measure force and pressure between the breast tissue and the surface of a standard treatment table. Measurements were taken whilst the participants were load bearing in prone positions with and without the orthosis. The new orthosis significantly reduced pain and mechanical forces in participants with natural or augmented breast tissue with cup-sizes C-F. Larger orthotic sizes were correlated with greater reduction in pain and mechanical forces, with all participants reporting no pain with the largest size orthotic. A size-3 orthotic decreased load on the breast tissue by 82% and reduced peak pressure by 42%. The same orthotic decreased medio-lateral spread of breast tissue and implant whilst increasing height. The new orthosis significantly reduced pain and mechanical forces in all women with natural or augmented tissues. Results are of clinical significance, as reduced mechanical forces are associated with greater comfort and reduced pressure and displacement which may lower the probability of breast implant complication. In clinical settings the orthosis

Analysis of lactate concentrations in canine synovial fluid.

PubMed

Proot, J L J; de Vicente, F; Sheahan, D E

2015-01-01

To report synovial fluid lactate concentrations in normal and pathological canine joints. Controlled, prospective study. Lactate was measured in synovial fluid using a hand-held meter and the rest of the fluid was sent to a commercial laboratory for analysis. Samples were divided into four groups; group 1: control, group 2: osteoarthritis, group 3: immune-mediated inflammatory arthritis, and group 4: septic arthritis. Statistical analysis was performed to compare lactate concentrations between the four groups and to examine the predictive value of lactate in the diagnosis of septic arthritis. A correlation was sought between synovial fluid lactate and synovial fluid total nucleated cell count and total protein. Seventy-four samples were investigated from 55 dogs. Statistical analysis found that lactate concentrations were significantly higher in the septic arthritis group than in each of the other three groups. No significant correlation could be found between synovial fluid lactate concentrations and synovial fluid total nucleated cell count or synovial fluid total protein. Lactate concentration was found to be a useful predictor of septic arthritis, with a low concentration pointing towards exclusion rather than a high concentration to the diagnosis of septic arthritis. Synovial fluid lactate concentration is not a good marker for osteoarthritis or immune-mediated inflammatory arthritis, but it is significantly increased in septic arthritis and could help the clinician in ruling out this condition in a quick and cost-effective way.

Lactate Test

MedlinePlus

... by cells as the body turns food into energy (cell metabolism). Depending on pH , it is sometimes ... level or when the primary way of producing energy in the body's cells is disrupted. Excess lactate ...

Parenchymal texture measures weighted by breast anatomy: preliminary optimization in a case-control study

NASA Astrophysics Data System (ADS)

Gastounioti, Aimilia; Keller, Brad M.; Hsieh, Meng-Kang; Conant, Emily F.; Kontos, Despina

2016-03-01

Growing evidence suggests that quantitative descriptors of the parenchymal texture patterns hold a valuable role in assessing an individual woman's risk for breast cancer. In this work, we assess the hypothesis that breast cancer risk factors are not uniformly expressed in the breast parenchymal tissue and, therefore, breast-anatomy-weighted parenchymal texture descriptors, where different breasts ROIs have non uniform contributions, may enhance breast cancer risk assessment. To this end, we introduce an automated breast-anatomy-driven methodology which generates a breast atlas, which is then used to produce a weight map that reinforces the contributions of the central and upper-outer breast areas. We incorporate this methodology to our previously validated lattice-based strategy for parenchymal texture analysis. In the framework of a pilot case-control study, including digital mammograms from 424 women, our proposed breast-anatomy-weighted texture descriptors are optimized and evaluated against non weighted texture features, using regression analysis with leave-one-out cross validation. The classification performance is assessed in terms of the area under the curve (AUC) of the receiver operating characteristic. The collective discriminatory capacity of the weighted texture features was maximized (AUC=0.87) when the central breast area was considered more important than the upperouter area, with significant performance improvement (DeLong's test, p-value<0.05) against the non-weighted texture features (AUC=0.82). Our results suggest that breast-anatomy-driven methodologies have the potential to further upgrade the promising role of parenchymal texture analysis in breast cancer risk assessment and may serve as a reference in the design of future studies towards image-driven personalized recommendations regarding women's cancer risk evaluation.

[Trace and anxiety of nursing mothers with insufficient and normal breast feeding indicators].

PubMed

Aragaki, Ilva Marico Mizumoto; Silva, Isília Aparecida; dos Santos, Jair Lício Ferreira

2006-09-01

The objective of this study was to identify and compare the trace and the anxiety state on the 10th day postpartum and the anxiety state on the 30th day postpartum of primiparous and multiparous nursing mothers who present insufficient breast feeding indicators and nursing mothers with normal breast feeding, in order to verify the possible relationships between the anxiety state of the nursing mothers in those two moments with the insufficient breast feeding indicators presented. This is an exploratory and descriptive study, whose data has been gotten from 168 nursing mothers and their children by means of interviews in nursing consultations in the 10th and 30th day postpartum. The results obtained showed that primiparous and multiparous with insufficient breast feeding and primiparous with normal lactation presented higher anxiety state trace than the anxiety state on the 10th and 30th day postpartum. There was remission of the maternal signals of anxiety with the passing of time, which may be caused by the correction of the breast feeding technique and support to the nursing mothers.

Lactation accommodation in the workplace and duration of exclusive breastfeeding.

PubMed

Bai, Yeon; Wunderlich, Shahla M

2013-01-01

The purpose of this study was to assess current lactation accommodations in a workplace environment and to examine the association between the different dimensions of support and the duration of exclusive breastfeeding. A survey was conducted with employees of a higher-education institution and clients of an obstetric hospital in New Jersey. Factor analysis identified dimensions of workplace support. The dimensions were correlated with the duration of exclusive breastfeeding using Pearson's r correlation analysis. One hundred and thirteen working mothers participated in the study. The mean (SD) number of working hours of the participants was 34.3 (2.8) hours per week. Participants were primarily white (89.4%), older (mean age, 33.8 [6.0] years), highly educated (>82% above college graduate), and married (92%). Participants indicated that in their workplaces, breastfeeding was not common, breast pumps were not available, and on-site day care was not always an option. The analysis identified 4 dimensions of breastfeeding accommodation: break time, workplace environment, technical support, and workplace policy. Technical support (r = 0.71, P = .01) and workplace environment (r = 0.26, P = .01) were significantly associated with the duration of exclusive breastfeeding. Employers can strengthen technical support and workplace environment to encourage breastfeeding continuation in working mothers. New federal laws should consider specific guidelines for minimum requirements for functional lactation support to achieve comprehensive breastfeeding benefits. © 2013 by the American College of Nurse-Midwives.

l-Lactate metabolism in HEP G2 cell mitochondria due to the l-lactate dehydrogenase determines the occurrence of the lactate/pyruvate shuttle and the appearance of oxaloacetate, malate and citrate outside mitochondria.

PubMed

Pizzuto, Roberto; Paventi, Gianluca; Porcile, Carola; Sarnataro, Daniela; Daniele, Aurora; Passarella, Salvatore

2012-09-01

As part of an ongoing study of l-lactate metabolism both in normal and in cancer cells, we investigated whether and how l-lactate metabolism occurs in mitochondria of human hepatocellular carcinoma (Hep G2) cells. We found that Hep G2 cell mitochondria (Hep G2-M) possess an l-lactate dehydrogenase (ml-LDH) restricted to the inner mitochondrial compartments as shown by immunological analysis, confocal microscopy and by assaying ml-LDH activity in solubilized mitochondria. Cytosolic and mitochondrial l-LDHs were found to differ from one another in their saturation kinetics. Having shown that l-lactate itself can enter Hep G2 cells, we found that Hep G2-M swell in ammonium l-lactate, but not in ammonium pyruvate solutions, in a manner inhibited by mersalyl, this showing the occurrence of a carrier-mediated l-lactate transport in these mitochondria. Occurrence of the l-lactate/pyruvate shuttle and the appearance outside mitochondria of oxaloacetate, malate and citrate arising from l-lactate uptake and metabolism together with the low oxygen consumption and membrane potential generation are in favor of an anaplerotic role for l-LAC in Hep G2-M. Copyright © 2012 Elsevier B.V. All rights reserved.

Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss.

PubMed

Dewey, Kathryn G; Nommsen-Rivers, Laurie A; Heinig, M Jane; Cohen, Roberta J

2003-09-01

Some mothers have difficulty initiating lactation even when highly motivated to breastfeed. The purpose of this study was to determine the incidence of and risk factors for suboptimal infant breastfeeding behavior (SIBB), delayed onset of lactation, and excess neonatal weight loss among mother-infant pairs in a population with high educational levels and motivation to breastfeed. All mothers residing in Davis, California, who gave birth to a healthy, single, term infant at 1 of 5 area hospitals during the 10-month recruitment period in 1999 were invited to participate if they were willing to attempt to breastfeed exclusively for at least 1 month. Lactation guidance was provided and data were collected in the hospital (day 0) and on days 3, 5, 7, and 14. Infant breastfeeding behavior was evaluated by trained lactation consultants using the Infant Breastfeeding Assessment Tool. Onset of lactation was defined based on maternal report of changes in breast fullness. Infant weight loss was considered excessive if it was >or=10% of birth weight by day 3. Of the 328 eligible mothers, 280 (85%) participated in the study. The prevalence of SIBB was 49% on day 0, 22% on day 3, and 14% on day 7. SIBB was significantly associated with primiparity (days 0 and 3), cesarean section (in multiparas, day 0), flat or inverted nipples, infant status at birth (days 0 and 3), use of nonbreast milk fluids in the first 48 hours (days 3 and 7), pacifier use (day 3), stage II labor >1 hour (day 7), maternal body mass index >27 kg/m(2) (day 7) and birth weight <3600 g (day 7). Delayed onset of lactation (>72 hours) occurred in 22% of women and was associated with primiparity, cesarean section, stage II labor >1 hour, maternal body mass index >27 kg/m(2), flat or inverted nipples, and birth weight >3600 g (in primiparas). Excess weight loss occurred in 12% of infants and was associated with primiparity, long duration of labor, use of labor medications (in multiparas), and infant status at

Use of Common Migraine Treatments in Breast-Feeding Women: A Summary of Recommendations

PubMed Central

Hutchinson, Susan; Marmura, Michael J.; Calhoun, Anne; Lucas, Sylvia; Silberstein, Stephen; Peterlin, B. Lee

2014-01-01

Background Breast-feeding has important health and emotional benefits for both mother and infant, and should be encouraged. While there are some data to suggest migraine may improve during breast-feeding, more than half of women experience migraine recurrence with 1 month of delivery. Thus, a thorough knowledge base of the safety and recommended use of common acute and preventive migraine drugs during breast-feeding is vital to clinicians treating migraine sufferers. Choice of treatment should take into account the balance of benefit and risk of medication. For some of the medications commonly used during breast-feeding, there is not good evidence about benefits. Methods A list of commonly used migraine medications was agreed upon by the 6 authors, who treat migraine and other headaches on a regular basis and are members of the Women's Special Interest Section of the American Headache Society. Each medication was researched by the first author utilizing widely accepted data sources, such as the American Academy of Pediatrics publication “The Transfer of Drugs and Other Chemicals Into Human Milk; Thomas Hale's manual Medications and Mothers Milk; Briggs, Freeman, and Yaffe's reference book Drugs in Pregnancy and Lactation; and the National Library of Medicine's Drugs and Lactation Database (LactMed) – a peer-reviewed and fully referenced database available online. Results Many commonly used migraine medications may be compatible with breast-feeding based on expert recommendations. Ibuprofen, diclofenac, and eletriptan are among acute medications with low levels in breast milk, but studies of triptans are limited. Toxicity is a concern with aspirin due to an association with Reye's syndrome; sedation or apnea is a concern with opioids. Finally, preventive medications not recommended include zonisamide, atenolol, and tizanidine. Conclusions Several excellent resources are available for clinicians making treatment decisions in breast-feeding women. Clinicians

Use of common migraine treatments in breast-feeding women: a summary of recommendations.

PubMed

Hutchinson, Susan; Marmura, Michael J; Calhoun, Anne; Lucas, Sylvia; Silberstein, Stephen; Peterlin, B Lee

2013-04-01

Breast-feeding has important health and emotional benefits for both mother and infant, and should be encouraged. While there are some data to suggest migraine may improve during breast-feeding, more than half of women experience migraine recurrence with 1 month of delivery. Thus, a thorough knowledge base of the safety and recommended use of common acute and preventive migraine drugs during breast-feeding is vital to clinicians treating migraine sufferers. Choice of treatment should take into account the balance of benefit and risk of medication. For some of the medications commonly used during breast-feeding, there is not good evidence about benefits. A list of commonly used migraine medications was agreed upon by the 6 authors, who treat migraine and other headaches on a regular basis and are members of the Women's Special Interest Section of the American Headache Society. Each medication was researched by the first author utilizing widely accepted data sources, such as the American Academy of Pediatrics publication "The Transfer of Drugs and Other Chemicals Into Human Milk; Thomas Hale's manual Medications and Mothers Milk; Briggs, Freeman, and Yaffe's reference book Drugs in Pregnancy and Lactation; and the National Library of Medicine's Drugs and Lactation Database (LactMed) - a peer-reviewed and fully referenced database available online. Many commonly used migraine medications may be compatible with breast-feeding based on expert recommendations. Ibuprofen, diclofenac, and eletriptan are among acute medications with low levels in breast milk, but studies of triptans are limited. Toxicity is a concern with aspirin due to an association with Reye's syndrome; sedation or apnea is a concern with opioids. Finally, preventive medications not recommended include zonisamide, atenolol, and tizanidine. Several excellent resources are available for clinicians making treatment decisions in breast-feeding women. Clinicians treating migraine should discuss both acute and

The professionalising of breast feeding--where are we a decade on?

PubMed

Barclay, Lesley; Longman, Jo; Schmied, Virginia; Sheehan, Athena; Rolfe, Margaret; Burns, Elaine; Fenwick, Jennifer

2012-06-01

This paper is an empirically informed opinion piece revisiting an argument published in Midwifery 10 years ago, that the increasing professionalisation of breast feeding was not supporting women in Australia in sustaining breast feeding. We present the last 10 years of primary research on the topic, explore major policy initiatives and the establishment and growth of lactation consultants in Australia to see if this has made a difference to sustained rates of breast feeding. We present an analysis of the only consistently collected national statistics on breast feeding and compare this with national and state level government data collections from the last decade. We have found that the considerable effort invested in trying to improve duration of breast feeding amongst women in Australia appears to have failed to improve sustained breast-feeding rates. We argue that this situation might be related to losing sight of the embodied nature of breast feeding and the relationships that must exist between the mother and baby, the knowledge and skills women quickly develop, and a loss of woman to woman support. We conclude that midwives have a major role in avoiding us reproducing similar, unintended, negative consequences to those resulting from increasing obstetrician managed normal birth. These include midwifery scrutiny and involvement in policy development and institutional practices and the design of services. Copyright © 2012 Elsevier Ltd. All rights reserved.

Lactational exposure to short-chain chlorinated paraffins in China, Korea, and Japan.

PubMed

Cao, Yang; Harada, Kouji H; Hitomi, Toshiaki; Niisoe, Tamon; Wang, Peiyu; Shi, Yuhui; Yang, Hye-Ran; Takasuga, Takumi; Koizumi, Akio

2017-04-01

To investigate short-chain chlorinated paraffin (SCCP) levels in human breast milk, pooled breast milk samples (BMSs) collected between 2007 and 2010 from Chinese (Beijing, n = 17), Korean (Seoul, Busan, n = 16), and Japanese (Kyoto, Sendai, n = 44) women were analyzed. SCCPs found in air samples in Beijing (n = 4, in 2008) were also analyzed and compared with BMSs to estimate the possible source of contamination in Beijing. The electron-capture negative ionization method demonstrated the different sensitivities for SCCPs, and pentachlorinated alkanes had the highest method detection limit (MDL) among congeners. In Beijing, SCCPs were detected in 8 of 17 pooled BMSs at concentrations more than the highest MDL of each homolog. The total SCCP concentration ranged from below the MDL to 54 ng g -1 lipid weight. Among the SCCP homologs, polychlorinated tridecanes were most frequently detected in Beijing. In Korea and Japan, no samples contained detectable total SCCP concentrations at more than the highest MDL. In Seoul, only two samples showed trace levels of polychlorinated undecanes. In Kyoto and Sendai, congeners of polychlorinated dodecanes were most frequently detected. C 10 components were the major contributors to the SCCPs in the atmosphere of Beijing. Congener profiles in breast milk in Beijing provided a clear contrast to the profiles found in food and air. The unique congener profiles necessitate the monitoring of breast milk for exposure of infants to SCCPs. The calculated mean exposure of SCCPs in 1-year-olds in China was 337 ng (kg body weight) -1  d -1 . These results demonstrate the body burden of SCCPs in the study areas and potential lactational exposure to SCCPs in Asian countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lactate Profile During Greco-Roman Wrestling Matchx

PubMed Central

Karnincic, Hrvoje; Tocilj, Zoran; Uljevic, Ognjen; Erceg, Marko

2009-01-01

The objective of this study was to determine and compare lactate profile of two groups of Greco-Roman wrestlers with different competences and training experience. Study was conducted on 10 wrestles that were members of Croatian national team and 10 wrestlers that were members of Wrestling club Split. Lactate samples were collected at four intervals during control fights that were held according to international wrestling rules of World wrestling federation FILA. Values of lactate increased as competition progressed, and they were highest at the end of the match for both groups of wrestlers. According to this study there were no significant differences in lactate between two groups at the end of the match, while significant differences were noted during the match. The information about lactate profile presented in this study can be used by coaches and wrestlers to develop condition programs. Key Points There were no significant differences in lactate concentrations at the end of the match between two proficiency levels of wrestlers. More proficient (elite) wrestlers raise lactates gradually through the wrestling match while less proficient (club) wrestlers raise it abruptly at the end of the first bout. Both groups of wrestlers are unable to sustain same level of activity through the match suggesting that they are utilizing too much energy from anaerobic glycolysis. PMID:24474881

Lactate storm marks cerebral metabolism following brain trauma.

PubMed

Lama, Sanju; Auer, Roland N; Tyson, Randy; Gallagher, Clare N; Tomanek, Boguslaw; Sutherland, Garnette R

2014-07-18

Brain metabolism is thought to be maintained by neuronal-glial metabolic coupling. Glia take up glutamate from the synaptic cleft for conversion into glutamine, triggering glial glycolysis and lactate production. This lactate is shuttled into neurons and further metabolized. The origin and role of lactate in severe traumatic brain injury (TBI) remains controversial. Using a modified weight drop model of severe TBI and magnetic resonance (MR) spectroscopy with infusion of (13)C-labeled glucose, lactate, and acetate, the present study investigated the possibility that neuronal-glial metabolism is uncoupled following severe TBI. Histopathology of the model showed severe brain injury with subarachnoid and hemorrhage together with glial cell activation and positive staining for Tau at 90 min post-trauma. High resolution MR spectroscopy of brain metabolites revealed significant labeling of lactate at C-3 and C-2 irrespective of the infused substrates. Increased (13)C-labeled lactate in all study groups in the absence of ischemia implied activated astrocytic glycolysis and production of lactate with failure of neuronal uptake (i.e. a loss of glial sensing for glutamate). The early increase in extracellular lactate in severe TBI with the injured neurons rendered unable to pick it up probably contributes to a rapid progression toward irreversible injury and pan-necrosis. Hence, a method to detect and scavenge the excess extracellular lactate on site or early following severe TBI may be a potential primary therapeutic measure. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

Lactate transport and receptor actions in cerebral malaria

PubMed Central

Mariga, Shelton T.; Kolko, Miriam; Gjedde, Albert; Bergersen, Linda H.

2014-01-01

Cerebral malaria (CM), caused by Plasmodium falciparum infection, is a prevalent neurological disorder in the tropics. Most of the patients are children, typically with intractable seizures and high mortality. Current treatment is unsatisfactory. Understanding the pathogenesis of CM is required in order to identify therapeutic targets. Here, we argue that cerebral energy metabolic defects are probable etiological factors in CM pathogenesis, because malaria parasites consume large amounts of glucose metabolized mostly to lactate. Monocarboxylate transporters (MCTs) mediate facilitated transfer, which serves to equalize lactate concentrations across cell membranes in the direction of the concentration gradient. The equalizing action of MCTs is the basis for lactate’s role as a volume transmitter of metabolic signals in the brain. Lactate binds to the lactate receptor GPR81, recently discovered on brain cells and cerebral blood vessels, causing inhibition of adenylyl cyclase. High levels of lactate delivered by the parasite at the vascular endothelium may damage the blood–brain barrier, disrupt lactate homeostasis in the brain, and imply MCTs and the lactate receptor as novel therapeutic targets in CM. PMID:24904266

[Inflammatory and infectious breast mastitis outside of pregnancy and lactation: Guidelines].

PubMed

Laas, E; Touboul, C; Kerdraon, O; Catteau-Jonard, S

2015-12-01

This work's objective was to define the various non-cancerous inflammatory and infectious mastitis, which may occur outside of pregnancy and lactation, and to identify recommendations for their care based on an exhaustive literature review. A literature review was conducted by consulting Medline, Cochrane Library, Google scholar and international recommendations in French and English until 31st August 2014. Infectious mastitis (periareolar abscess) is the most common form of non-puerperal abscesses and it is recommended that a suction/drainage needle for abscesses under 5 cm, involving antibiotic therapy (grade C). For abscesses over 5 cm, there is no evidence to recommend a first surgery or suction/drainage. Inflammatory mastitis can be primary or secondary to a systemic disease (diabetes, collagen…; LE4). In case of idiopathic granulomatous mastitis, a steroid therapy or surgery may be indicated, without one or the other of these methods can be recommended. In case of plasma cell mastitis or ductal ectasia, no treatment is recommended. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Channel-mediated lactate release by K⁺-stimulated astrocytes.

PubMed

Sotelo-Hitschfeld, Tamara; Niemeyer, María I; Mächler, Philipp; Ruminot, Iván; Lerchundi, Rodrigo; Wyss, Matthias T; Stobart, Jillian; Fernández-Moncada, Ignacio; Valdebenito, Rocío; Garrido-Gerter, Pamela; Contreras-Baeza, Yasna; Schneider, Bernard L; Aebischer, Patrick; Lengacher, Sylvain; San Martín, Alejandro; Le Douce, Juliette; Bonvento, Gilles; Magistretti, Pierre J; Sepúlveda, Francisco V; Weber, Bruno; Barros, L Felipe

2015-03-11

Excitatory synaptic transmission is accompanied by a local surge in interstitial lactate that occurs despite adequate oxygen availability, a puzzling phenomenon termed aerobic glycolysis. In addition to its role as an energy substrate, recent studies have shown that lactate modulates neuronal excitability acting through various targets, including NMDA receptors and G-protein-coupled receptors specific for lactate, but little is known about the cellular and molecular mechanisms responsible for the increase in interstitial lactate. Using a panel of genetically encoded fluorescence nanosensors for energy metabolites, we show here that mouse astrocytes in culture, in cortical slices, and in vivo maintain a steady-state reservoir of lactate. The reservoir was released to the extracellular space immediately after exposure of astrocytes to a physiological rise in extracellular K(+) or cell depolarization. Cell-attached patch-clamp analysis of cultured astrocytes revealed a 37 pS lactate-permeable ion channel activated by cell depolarization. The channel was modulated by lactate itself, resulting in a positive feedback loop for lactate release. A rapid fall in intracellular lactate levels was also observed in cortical astrocytes of anesthetized mice in response to local field stimulation. The existence of an astrocytic lactate reservoir and its quick mobilization via an ion channel in response to a neuronal cue provides fresh support to lactate roles in neuronal fueling and in gliotransmission. Copyright © 2015 the authors 0270-6474/15/354168-11$15.00/0.

An innovative model for achieving breast-feeding success in infants with complex surgical anomalies.

PubMed

Edwards, Taryn M; Spatz, Diane L

2010-01-01

This manuscript describes an innovative nurse-driven continuous quality improvement project. Infants born with congenital surgical anomalies face significant challenges within the newborn period and human milk/breast-feeding may not be viewed as a priority. In many hospitals, nurses refer families to lactation consultants for all breast-feeding assistance and support. The Transition to Breast Pathway was developed on the basis of the evidence-based standards and protocols at The Children's Hospital of Philadelphia. The pathway consists of (1) initiation of pumping and maintenance of milk supply, (2) mouth care with human milk, (3) skin-to-skin care, (4) nonnutritive sucking at the breast, (5) transitioning to at breast feeds. A sample of 80 infants were enrolled in this project. Major results of the project are as follows: (1) mother's average milk supply was approximately 603 mL/d, (2) 71% (57/80) of the infants received mouth care with human milk, (3) 48% (38/80) mother/infant dyads performed skin-to-skin care, (4) 60% (35/58) of mother/infant dyads performed nonnutritive sucking at the breast, (5) 100% (58/58) of mother-infant dyads transitioned to breast prior to discharge. This continuous quality improvement project demonstrates that nurses can and should lead the process of transitioning infants to at breast feeds.

Imperfect asymmetry of life: earth microbial communities prefer D-lactate but can use L-lactate also.

PubMed

Moazeni, Faegheh; Zhang, Gaosen; Sun, Henry J

2010-05-01

Asymmetrical utilization of chiral compounds has been sought on Mars as evidence for biological activity. This method was recently validated in glucose. Earth organisms utilize D-glucose, not L-glucose, a perfect asymmetry. In this study, we tested the method in lactate and found utilization of both enantiomers. Soil-, sediment-, and lake-borne microbial communities prefer D-lactate but can consume L-lactate if given extra time to acclimate. This situation is termed imperfect asymmetry. Future life-detection mission investigators need to be aware of imperfect asymmetry so as not to miss relatively subtle signs of life.

Electrochemical lactate biosensor based upon chitosan/carbon nanotubes modified screen-printed graphite electrodes for the determination of lactate in embryonic cell cultures.

PubMed

Hernández-Ibáñez, Naiara; García-Cruz, Leticia; Montiel, Vicente; Foster, Christopher W; Banks, Craig E; Iniesta, Jesús

2016-03-15

l-lactate is an essential metabolite present in embryonic cell culture. Changes of this important metabolite during the growth of human embryo reflect the quality and viability of the embryo. In this study, we report a sensitive, stable, and easily manufactured electrochemical biosensor for the detection of lactate within embryonic cell cultures media. Screen-printed disposable electrodes are used as electrochemical sensing platforms for the miniaturization of the lactate biosensor. Chitosan/multi walled carbon nanotubes composite have been employed for the enzymatic immobilization of the lactate oxidase enzyme. This novel electrochemical lactate biosensor analytical efficacy is explored towards the sensing of lactate in model (buffer) solutions and is found to exhibit a linear response towards lactate over the concentration range of 30.4 and 243.9 µM in phosphate buffer solution, with a corresponding limit of detection (based on 3-sigma) of 22.6 µM and exhibits a sensitivity of 3417 ± 131 µAM(-1) according to the reproducibility study. These novel electrochemical lactate biosensors exhibit a high reproducibility, with a relative standard deviation of less than 3.8% and an enzymatic response over 82% after 5 months stored at 4 °C. Furthermore, high performance liquid chromatography technique has been utilized to independently validate the electrochemical lactate biosensor for the determination of lactate in a commercial embryonic cell culture medium providing excellent agreement between the two analytical protocols. Copyright © 2015 Elsevier B.V. All rights reserved.

Maternal dietary intake in pregnancy and lactation and allergic disease outcomes in offspring.

PubMed

Venter, Carina; Brown, Kari R; Maslin, Kate; Palmer, Debra J

2017-03-01

As the prevalence of allergic disease dramatically rises worldwide, prevention strategies are increasingly being considered. Given the potential modulatory effect of nutritional factors on disease, altering maternal diet during pregnancy and/or lactation has been considered in preventing allergic disease in offspring. Although there are a number of observational studies that have examined possible associations between maternal diet and allergic outcomes in offspring, interventional trials are limited. Furthermore, there is a paucity of studies that have prospectively studied maternal dietary intake as well as measuring maternal and infant biologic samples (blood, urine, breast milk) and their relation to allergic outcomes in infants. There is also a particular need to define terminology such as 'fruit and vegetables intake', 'healthy diet', and 'diet diversity' in order to make studies comparable. In this review, we discuss current evidence of maternal dietary factors during pregnancy and/or lactation that may play a role in the offspring developing allergic disease, including factors such as overall dietary intake patterns, specific whole food consumption (fish, fruit and vegetables, and common allergic foods), and individual immunomodulatory nutrient intakes. Additionally, we discuss the limitations of previous studies and propose improvements to study design for future investigation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A breast-feeding promotion and support program a randomized trial in The Netherlands.

PubMed

Kools, Els J; Thijs, Carel; Kester, Arnold D M; van den Brandt, Piet A; de Vries, Hein

2005-01-01

In the Netherlands, the initiation rate of breast-feeding (BF) was 80% in 2002, but only 35% of the mothers continued to breast-feed for 3 months. This study examined the effectiveness of a breast-feeding promotion program to increase the continuation of breast-feeding. A cluster-randomized intervention trial was used. Ten child health care centers in three regions of the home health care were randomly allocated to the program or usual care. Elements in the program were health counseling, measures to enhance cooperation, early signaling of breast-feeding problems and continuity of care, and lactation consultancy. Pregnant mothers who applied for home health care in the intervention or usual care regions were enrolled and were followed up from pregnancy until 6 months postpartum (n = 683). The primary outcome measure was the continuation of breast-feeding until at least 3 months. The 3-month breast-feeding rate was 32% in the intervention and 38% in the control groups (OR = 0.79, 95% CI = 0.58-1.08). The program was not effective. We discuss possible explanations from the design and execution of the trial and give some points for improvement of our program, such as the categories of caregivers involved and the number and duration of contacts after parturition.

21 CFR 184.1311 - Ferrous lactate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... reacting calcium lactate or sodium lactate with ferrous sulfate, direct reaction of lactic acid with iron... section 412(a)(2) of the act (21 U.S.C. 350a(a)(2)). (d) Prior sanctions for this ingredient different...

Vedolizumab Levels in Breast Milk of Nursing Mothers With Inflammatory Bowel Disease.

PubMed

Lahat, Adi; Shitrit, Ariella Bar-Gil; Naftali, Timna; Milgrom, Yael; Elyakim, Rami; Goldin, Eran; Levhar, Nina; Selinger, Limor; Zuker, Tzufit; Fudim, Ella; Picard, Orit; Yavzori, Miri; Ben-Horin, Shomron

2018-01-05

There are no data on the transfer of vedolizumab in breast milk of nursing mothers. We aimed to assess the presence of vedolizumab in breast milk of nursing inflammatory bowel disease [IBD] patients. This was a prospective observational study of vedolizumab-treated breastfeeding patients with IBD. Serum and breast milk samples were obtained at pre-defined tim -points. The in-house developed enzyme-linked immunosorbent assay [ELISA] for measuring vedolizumab in blood was adapted and validated for measurement of the drug in breast milk. The level of vedolizumab was also measured in breast milk of a control group of nursing healthy mothers. Vedolizumab was undetectable in breast milk in IBD patients before the first infusion of vedolizumab [n = 3] and in all of the healthy controls [n = 5]. Vedolizumab was measurable in all lactating women who received vedolizumab [n = 5]. However, on serial measurements in breast milk after an infusion, drug levels did not surpass 480 ng/ml, which was roughly 1/100 of the comparable serum levels. Vedolizumab can be detected in the breast milk of nursing mothers. Although more data are imperative, the concentrations of vedolizumab in breast milk are minute and are therefore unlikely to result in systemic or gastro-intestinal immune-suppression of the infant. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

CD147 Required for Corneal Endothelial Lactate Transport

PubMed Central

Li, Shimin; Nguyen, Tracy T.; Bonanno, Joseph A.

2014-01-01

Purpose. CD147/basigin is a chaperone for lactate:H+ cotransporters (monocarboxylate transporters) MCT1 and MCT4. We tested the hypothesis that MCT1 and -4 in corneal endothelium contribute to lactate efflux from stroma to anterior chamber and that silencing CD147 expression would cause corneal edema. Methods. CD147 was silenced via small interfering ribonucleic acid (siRNA) transfection of rabbit corneas ex vivo and anterior chamber lenti-small hairpin RNA (shRNA) pseudovirus in vivo. CD147 and MCT expression was examined by Western blot, RT-PCR, and immunofluorescence. Functional effects were examined by measuring lactate-induced cell acidification, corneal lactate efflux, [lactate], central cornea thickness (CCT), and Azopt (a carbonic anhydrase inhibitor) sensitivity. Results. In ex vivo corneas, 100 nM CD147 siRNA reduced CD147, MCT1, and MCT4 expression by 85%, 79%, and 73%, respectively, while MCT2 expression was unaffected. CD147 siRNA decreased lactate efflux from 3.9 ± 0.81 to 1.5 ± 0.37 nmol/min, increased corneal [lactate] from 19.28 ± 7.15 to 56.73 ± 8.97 nmol/mg, acidified endothelial cells (pHi = 6.83 ± 0.07 vs. 7.19 ± 0.09 in control), and slowed basolateral lactate-induced acidification from 0.0034 ± 0.0005 to 0.0012 ± 0.0005 pH/s, whereas apical acidification was unchanged. In vivo, CD147 shRNA increased CCT by 28.1 ± 0.9 μm at 28 days; Azopt increased CCT to 24.4 ± 3.12 vs. 12.0 ± 0.48 μm in control, and corneal [lactate] was 47.63 ± 6.29 nmol/mg in shCD147 corneas and 17.82 ± 4.93 nmol/mg in paired controls. Conclusions. CD147 is required for the expression of MCT1 and MCT4 in the corneal endothelium. Silencing CD147 slows lactate efflux, resulting in stromal lactate accumulation and corneal edema, consistent with lactate efflux as a significant component of the corneal endothelial pump. PMID:24970254

CD147 required for corneal endothelial lactate transport.

PubMed

Li, Shimin; Nguyen, Tracy T; Bonanno, Joseph A

2014-06-26

CD147/basigin is a chaperone for lactate:H(+) cotransporters (monocarboxylate transporters) MCT1 and MCT4. We tested the hypothesis that MCT1 and -4 in corneal endothelium contribute to lactate efflux from stroma to anterior chamber and that silencing CD147 expression would cause corneal edema. CD147 was silenced via small interfering ribonucleic acid (siRNA) transfection of rabbit corneas ex vivo and anterior chamber lenti-small hairpin RNA (shRNA) pseudovirus in vivo. CD147 and MCT expression was examined by Western blot, RT-PCR, and immunofluorescence. Functional effects were examined by measuring lactate-induced cell acidification, corneal lactate efflux, [lactate], central cornea thickness (CCT), and Azopt (a carbonic anhydrase inhibitor) sensitivity. In ex vivo corneas, 100 nM CD147 siRNA reduced CD147, MCT1, and MCT4 expression by 85%, 79%, and 73%, respectively, while MCT2 expression was unaffected. CD147 siRNA decreased lactate efflux from 3.9 ± 0.81 to 1.5 ± 0.37 nmol/min, increased corneal [lactate] from 19.28 ± 7.15 to 56.73 ± 8.97 nmol/mg, acidified endothelial cells (pHi = 6.83 ± 0.07 vs. 7.19 ± 0.09 in control), and slowed basolateral lactate-induced acidification from 0.0034 ± 0.0005 to 0.0012 ± 0.0005 pH/s, whereas apical acidification was unchanged. In vivo, CD147 shRNA increased CCT by 28.1 ± 0.9 μm at 28 days; Azopt increased CCT to 24.4 ± 3.12 vs. 12.0 ± 0.48 μm in control, and corneal [lactate] was 47.63 ± 6.29 nmol/mg in shCD147 corneas and 17.82 ± 4.93 nmol/mg in paired controls. CD147 is required for the expression of MCT1 and MCT4 in the corneal endothelium. Silencing CD147 slows lactate efflux, resulting in stromal lactate accumulation and corneal edema, consistent with lactate efflux as a significant component of the corneal endothelial pump. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Cordycepin, a Natural Antineoplastic Agent, Induces Apoptosis of Breast Cancer Cells via Caspase-dependent Pathways.

PubMed

Wang, Di; Zhang, Yongfeng; Lu, Jiahui; Wang, Yang; Wang, Junyue; Meng, Qingfan; Lee, Robert J; Wang, Di; Teng, Lesheng

2016-01-01

Cordycepin, a major compound separated from Cordyceps sinensis, is known as a potential novel candidate for cancer therapy. Breast cancer, the most typical cancer diagnosed among women, remains a global health problem. In this study, the anti-breast cancer property of cordycepin and its underlying mechanisms was investigated. The direct effects of cordycepin on breast cancer cells both in in vitro and in vivo experiments were evaluated. Cordycepin exerted cytotoxicity in MCF-7 and MDA-MB-231 cells confirmed by reduced cell viability, inhibition of cell proliferation, enhanced lactate dehydrogenase release and reactive oxygen species accumulation, induced mitochondrial dysfunction and nuclear apoptosis in human breast cancer cells. Cordycepin increased the activation of pro-apoptotic proteins, including caspase-8, caspase-9, caspase-3 and Bax, and suppressed the expression of the anti-apoptotic protein, B-cell lymphoma 2 (Bcl-2). The inhibition on MCF-7-xenografted tumor growth in nude mice further confirmed cordycepin's anti-breast cancer effect. These aforementioned results reveal that cordycepin induces apoptosis in human breast cancer cells via caspase-dependent pathways. The data shed light on the possibility of cordycepin being a safe agent for breast cancer treatment.

Ethnocultural women's experiences of breast cancer: a qualitative meta-study.

PubMed

Howard, A Fuchsia; Balneaves, Lynda G; Bottorff, Joan L

2007-01-01

A growing number of studies have been conducted that explore the breast cancer experiences of women from diverse ethnocultural groups. To advance knowledge and provide a foundation for future research, a synthesis was conducted of 15 qualitative research studies focusing on women from ethnocultural groups diagnosed with breast cancer. A qualitative meta-study approach was used that included analysis of the theoretical orientations and methodological approaches underlying the research, and an interpretive synthesis of research findings. Ethnocultural groups represented in the studies included Asian American, Aboriginal, Hispanic, and African American women. The synthesis revealed diverse experiences within and among these ethnocultural groups represented in 5 major themes: (a) the "othered" experience of a breast cancer diagnosis, (b) the treatment experience as "other," (c) losses associated with breast cancer, (d) the family context of breast cancer experiences, and (e) coping with cancer through spirituality and community involvement. The integration of findings from the 15 studies also revealed how methodological and theoretical approaches to conducting this research influenced understandings of the experiences of breast cancer. Further experiential breast cancer research with ethnocultural groups is needed, as well as the use of research methods that illuminate the ways that ethnicity, class, age, and gender relations are played out in healthcare settings.

Importance of measuring lactate levels in children with sepsis.

PubMed

Anil, Nisha

2017-10-10

Sepsis is a major public health problem as well as one of the leading causes of preventable death in children because of failure to recognise the early signs and symptoms and to resuscitate rapidly. Blood lactate levels are used to assess the severity of sepsis and the effectiveness of resuscitation. Lactate levels are easily obtainable and should be checked in all patients admitted with suspected sepsis within six hours of presentation. The test should be repeated four and eight-hours post-diagnosis of sepsis. For the diagnosis of sepsis, patients' clinical symptoms, along with the combined analysis of partial pressure of oxygen, carbon dioxide and lactate levels, should be used. A multitude of factors can cause elevated lactate levels and so clinicians should use elevated levels cautiously by considering all other aetiologies. This article, which focuses on practice in Australia but makes reference to the UK, discusses the importance of measuring lactate levels in sepsis, the pathophysiology of lactate production, causes of elevated lactate levels, lactate measurement, nursing management of patients with elevated lactate levels, limitations of using lactate as a biomarker for diagnosing sepsis and implications for practice. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Evaluation of clinical breast examination and breast ultrasonography among pregnant women in Abakaliki, Nigeria

PubMed Central

Ezeonu, Paul Olisaemeka; Ajah, Leonard Ogbonna; Onoh, Robinson Chukwudi; Lawani, Lucky Osaheni; Enemuo, Vincent Chidi; Agwu, Uzoma MaryRose

2015-01-01

Background Breast cancer in pregnancy accounts for 2%–3% of all breast cancers. The increased vascularity and lymphatic drainage from the breast during pregnancy potentiate the metastatic spread of the cancer to the regional lymph nodes. However, the increased breast density in pregnancy makes it difficult to detect breast lesions early. Aim To evaluate and compare the detection rate of breast lesions using clinical breast examination (CBE) and breast ultrasonography among pregnant women. Methodology A cross-sectional comparative study involving antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, was conducted between March 3, 2014, and December 31, 2014. CBE and breast ultrasonography were done in the participants at booking and repeated at 6 weeks postpartum. Fine-needle aspiration cytology and histology were done in women with suspicious breast lesions on CBE or breast ultrasonography or both. Data analysis was both descriptive and inferential at the 95% confidence level using the Statistical Package for the Social Sciences (SPSS) software version 17.0. Test of significance was done using chi-square test. A P-value of less than or equal to 0.05 was considered statistically significant. Results A total of 320 pregnant women participated in the study. Of these, 267 (83.4%) were aware of breast cancer. Although more lesions were detected with breast ultrasonography than by CBE, there was no statistically significant difference between them (25 versus 17; P=0.26). The histology of the lesions revealed 21 benign lesions and 4 normal breast tissues. The sensitivity of breast ultrasonography was 95.2%, while that of CBE was 66.7%. The specificity, positive predictive value, and negative predictive value were similar between CBE and breast ultrasonography. Conclusion The detection rates of breast lesions by both CBE and breast ultrasonography were equivalent during pregnancy and 6 weeks postpartum, making CBE a convenient and very cost

A new role of SNAI2 in postlactational involution of the mammary gland links it to luminal breast cancer development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castillo-Lluva, Sonia; Hontecillas-Prieto, Lourdes; Blanco-Gómez, Adrian

Breast cancer is a major cause of mortality in women. The transcription factor SNAI2 has been implicated in the pathogenesis of several types of cancer, including breast cancer of basal origin. Here we show that SNAI2 is also important in the development of breast cancer of luminal origin in MMTV-ErbB2 mice. SNAI2 deficiency leads to longer latency and fewer luminal tumors, both of these being characteristics of pretumoral origin. These effects were associated with reduced proliferation and a decreased ability to generate mammospheres in normal mammary glands. However, the capacity to metastasize was not modified. Under conditions of increased ERBB2more » oncogenic activity after pregnancy plus SNAI2 deficiency, both pretumoral defects-latency and tumor load-were compensated. However, the incidence of lung metastases was dramatically reduced. Furthermore, SNAI2 was required for proper postlactational involution of the breast. At 3 days post lactational involution, the mammary glands of Snai2-deficient mice exhibited lower levels of pSTAT3 and higher levels of pAKT1, resulting in decreased apoptosis. Abundant noninvoluted ducts were still present at 30 days post lactation, with a greater number of residual ERBB2+ cells. These results suggest that this defect in involution leads to an increase in the number of susceptible target cells for transformation, to the recovery of the capacity to generate mammospheres and to an increase in the number of tumors. In conclusion, our work demonstrates the participation of SNAI2 in the pathogenesis of luminal breast cancer, and reveals an unexpected connection between the processes of postlactational involution and breast tumorigenesis in Snai2-null mutant mice.« less

A new role of SNAI2 in postlactational involution of the mammary gland links it to luminal breast cancer development

DOE PAGES

Castillo-Lluva, Sonia; Hontecillas-Prieto, Lourdes; Blanco-Gómez, Adrian; ...

2015-06-22

Breast cancer is a major cause of mortality in women. The transcription factor SNAI2 has been implicated in the pathogenesis of several types of cancer, including breast cancer of basal origin. Here we show that SNAI2 is also important in the development of breast cancer of luminal origin in MMTV-ErbB2 mice. SNAI2 deficiency leads to longer latency and fewer luminal tumors, both of these being characteristics of pretumoral origin. These effects were associated with reduced proliferation and a decreased ability to generate mammospheres in normal mammary glands. However, the capacity to metastasize was not modified. Under conditions of increased ERBB2more » oncogenic activity after pregnancy plus SNAI2 deficiency, both pretumoral defects-latency and tumor load-were compensated. However, the incidence of lung metastases was dramatically reduced. Furthermore, SNAI2 was required for proper postlactational involution of the breast. At 3 days post lactational involution, the mammary glands of Snai2-deficient mice exhibited lower levels of pSTAT3 and higher levels of pAKT1, resulting in decreased apoptosis. Abundant noninvoluted ducts were still present at 30 days post lactation, with a greater number of residual ERBB2+ cells. These results suggest that this defect in involution leads to an increase in the number of susceptible target cells for transformation, to the recovery of the capacity to generate mammospheres and to an increase in the number of tumors. In conclusion, our work demonstrates the participation of SNAI2 in the pathogenesis of luminal breast cancer, and reveals an unexpected connection between the processes of postlactational involution and breast tumorigenesis in Snai2-null mutant mice.« less

Opportunistic Breast Cancer Education and Screening in Rural Honduras

PubMed Central

Kennedy, Linda S.; Bejarano, Suyapa A.; Onega, Tracy L.; Stenquist, Derek S.

2016-01-01

Purpose In Honduras, the breast cancer burden is high, and access to women’s health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. Methods The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Results Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women’s health services in a low-tech rural setting. Conclusion The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women’s health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential. PMID:28717699

Severe physical violence between intimate partners during pregnancy: a risk factor for early cessation of exclusive breast-feeding.

PubMed

Moraes, Claudia L; de Oliveira, Alessandra S D; Reichenheim, Michael E; Lobato, Gustavo

2011-12-01

To investigate the role of severe physical violence during pregnancy (SPVP) between intimate partners in early cessation of exclusive breast-feeding (EBF). A health services survey. The revised Conflict Tactics Scale was used to characterize SPVP; premature breast-feeding cessation was identified using a current status data approach, which was based on the information reported from food recall during the preceding 7 d. The cumulative hazard function was estimated by complementary log-log transformation models, which allowed the ensuing estimation of early breast-feeding cessation rates in different age groups and the ratio of rates of weaning between women exposed and not exposed to violence. Five large public primary health-care facilities of Rio de Janeiro, Brazil. The sample comprised 811 randomly selected mothers of children under 5 months of age who were waiting to be consulted. SPVP is an independent risk factor of cessation of EBF since, after controlling for socio-economic, demographic, reproductive and lifestyle variables, women exposed to violence presented an incidence density that was 31% higher than those who were not exposed (hazard ratio = 1·30, 95% CI 1·01, 1·69). The findings corroborate the hypothesis that SPVP is an important risk factor for EBF. This indicates the need for incentives to adequately train health-care personnel in dealing with lactating women in order to gain a broader view of breast-feeding beyond the biological aspects of lactation, including the maternal psychological dimension.

Blood lactate accumulation in top level swimmers following competition.

PubMed

Bonifazi, M; Martelli, G; Marugo, L; Sardella, F; Carli, G

1993-03-01

The purposes of this study were to evaluate the significance of blood lactate values after competitions and the blood lactate-swimming speed relationship to swimming performances. Auricular blood samples (N = 421) were collected in 203 top level Italian swimmers (116 males and 87 females) at the end of competitions performed in a 25 m swimming pool. The distribution of all lactate values differed between males and females. The lowest lactate values occurred in swimmers performing the longest distances both in males (1500 m) and females (800 m). In swimmers performing freestyle events a relationship between V-4 mM (swimming speed at 4 mmol/l blood lactate value) and competition velocities was observed, in males, at 200, 400 and 1500 m and, in females, at 400 and 800 m. The predicted velocity corresponding to the competition lactate value assessed by the individual blood lactate-swimming speed relationship was found to be highly related to the actual competition velocity. Results suggest that blood lactate values in swimmers are a useful indication of individual aptitudes.

Temporal Changes of Protein Composition in Breast Milk of Chinese Urban Mothers and Impact of Caesarean Section Delivery

PubMed Central

Affolter, Michael; Garcia-Rodenas, Clara L.; Vinyes-Pares, Gerard; Jenni, Rosemarie; Roggero, Iris; Avanti-Nigro, Ornella; de Castro, Carlos Antonio; Zhao, Ai; Zhang, Yumei; Wang, Peiyu; Thakkar, Sagar K.; Favre, Laurent

2016-01-01

Human breast milk (BM) protein composition may be impacted by lactation stage or factors related to geographical location. The present study aimed at assessing the temporal changes of BM major proteins over lactation stages and the impact of mode of delivery on immune factors, in a large cohort of urban mothers in China. 450 BM samples, collected in three Chinese cities, covering 8 months of lactation were analyzed for α-lactalbumin, lactoferrin, serum albumin, total caseins, immunoglobulins (IgA, IgM and IgG) and transforming growth factor (TGF) β1 and β2 content by microfluidic chip- or ELISA-based quantitative methods. Concentrations and changes over lactation were aligned with previous reports. α-lactalbumin, lactoferrin, IgA, IgM and TGF-β1 contents followed similar variations characterized by highest concentrations in early lactation that rapidly decreased before remaining stable up to end of lactation. TGF-β2 content displayed same early dynamics before increasing again. Total caseins followed a different pattern, showing initial increase before decreasing back to starting values. Serum albumin and IgG levels appeared stable throughout lactation. In conclusion, BM content in major proteins of urban mothers in China was comparable with previous studies carried out in other parts of the world and C-section delivery had only very limited impact on BM immune factors. PMID:27548208

Lymphoma and lung cancer in offspring born to pregnant mice dosed with dibenzo[a,l]pyrene: The importance of in utero vs. lactational exposure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castro, David J.; Linus Pauling Institute, Oregon State University, Corvallis, Oregon; Center for Healthy Aging Research, Oregon State University, Corvallis, Oregon

The fetus and neonate cannot be viewed as 'little adults'; they are highly sensitive to toxicity from environmental chemicals. This phenomenon contributes to the fetal basis of adult disease. One example is transplacental carcinogenesis. Animal models demonstrate that environmental chemicals, to which pregnant women are daily exposed, can increase susceptibility of the offspring to cancer. It is uncertain to what degree in utero vs. lactational exposure contributes to cancer, especially for hydrophobic chemicals such as polyhalogenated biphenyls, ethers, dioxins, furans, etc., which can partition into breast milk. We developed a pregnant mouse model in which exposure to the polycyclic aromaticmore » hydrocarbon (PAH), dibenzo[a,l]pyrene (DBP), during late gestation, produces an aggressive T-cell lymphoma in offspring between 3 and 6 months of age. Survivors exhibit multiple lung and liver (males) tumors. Here, we adopt a cross-foster design with litters born to dams treated with DBP exchanged with those born to dams treated with vehicle. Exposure to DBP in utero (about 2 days) produced significantly greater mortality than residual DBP exposure only through breast milk (3 weeks of lactation). As previously observed pups in all groups with an ahr{sup b-1/d} ('responsive') genotype were more susceptible to lymphoma mortality than ahr{sup d/d} ('non-responsive') siblings. At termination of the study at 10 months, mice exposed in utero also had greater lung tumor multiplicity than mice exposed only during lactation. Our results demonstrate that short exposure to DBP during late gestation presents a greater risk to offspring than exposure to this very hydrophobic PAH following 3 weeks of nursing.« less

A methodology for comprehensive breast cancer Ki67 labeling index with intra-tumor heterogeneity appraisal based on hexagonal tiling of digital image analysis data.