Search

Abstract Aims: Synovium retains lubricating fluid in the joint cavity. Synovial outflow resistance estimated as dP [sub j] /d&formmu1; (P [sub j] , joint fluid pressure and &formmu2; trans-synovial flow) is greater, however, than expected from interstitial glycosaminoglycan concentration. This study investigates whether subsynovial fluid pressure increases with intra-articular pressure, as this would reduce the estimated resistance estimate. Methods: Interstitial fluid pressure (P [sub if] ) was measured as a function of distance from the joint cavity in knees of anaesthetized rabbits, using servo-null pressure-measuring micropipettes and using an external ‘window’. Joint fluid pressure P [sub j] was either endogenous (-2.4 ± 0.4 cmH[sub 2] O, mean ± SEM) or held at ∼4, 8 or 15.0 cmH[sub 2] O by a continuous intra-articular saline infusion that matched the trans-synovial interstitial drainage rate. Results: At endogenous P [sub j] the peri-articular P [sub if] was subatmospheric (-1.9 ± 0.3 cmH[sub 2] O, n = 19). At raised P [sub j] the P [sub if] values became positive. Gradient dP [sub if] /dx was ∼20 times steeper across synovium than subsynovium. P [sub if] close to the synovium–subsynovium border (&formmu3;) increased as a non-linear function of P [sub j] to 1.4 ± 0.2 cmH[sub 2] O (n = 23) at P [sub j] = 4.3 ± 0.1 cmH[sub 2] O : 2.3 ± 0.2 cmH[sub 2] O (n = 17) at P [sub j] = 7.6 ± 0.2 cmH[sub 2] O: and 3.0 ± 0.4 cmH[sub 2] O (n = 26) at P [sub j] = 15 ± 0.2 cmH[sub 2] O (P = 0.03, anova). Conclusions: Synovial resistivity is ∼20× subsynovial resistivity. The increase in &formmu4; with P [sub j] means that true synovial resistance d(&formmu5;)/d&formmu6; is overestimated 1.5× by dP [sub j] /d&formmu7;. This narrows but does not eliminate the gap between analysed glycosaminoglycan concentration, 4 mg ml[sup -1] , and the net interstitial biopolymer concentration of 11.5 mg ml[sup -1] needed to generate the resistance. [ABSTRACT FROM AUTHOR]

Aim: A gluten-free diet (GFD) can expose children to excessive calories and fat intake. The study is intended to verify whether and how food intake, laboratory parameters, and growth are modified by a year of GFD., Methods: In 79 CD (coeliac disease) children (mean age 7.9 ± 3.8 years, 52 females, 27 males) diagnosed over 24 months, 24-h food diaries, food-frequency patterns, anthropometric and laboratory parameters (mainly blood sugar, insulin, lipid profile, and homocysteine) were prospectively collected before and during the first year of GFD. Nutrient intakes were compared over time and with recommendations. They were also used as regressors to explain the levels and changes of metabolic and growth variables. p -values < 0.05 were considered statistically significant., Results: Average macronutrient intake did not change during the year. Caloric intake remained below 90% ( p ≤ 0.0001) and protein intake above 200% ( p ≤ 0.0001) of recommendations. Lipid intake was stable at 34% of overall energy intake. Unsaturated fats increased (less omega-6 and more omega-3 with a ratio improvement from 13.3 ± 5.5 to 8.8 ± 3.1) and so did fibers, while folate decreased. The children who experienced a containment in their caloric intake during the year, presented a slower catch-up growth. Some differences were found across gender and age groups. In particular, adolescents consumed less calories, and females more omega-3. Fiber and simple sugar intakes emerged as implicated in lipid profile shift: fibers negatively with triglycerides (TG) ( p = 0.033), simple sugars negatively with high-density lipoprotein (HDL) ( p = 0.056) and positively with TG ( p = 0.004). Waist-to-height ratio was positively associated with homocysteine ( p = 0.018) and Homeostasis Model Assessment ( p = 0.001), negatively with fibers ( p = 0.004)., Conclusion: In the short run, GFD is nutritionally very similar to any diet with gluten, with some improvements in unsaturated fats and fiber intake. Along with simple sugars containment, this may offer CD patients the opportunity for a fresh start. Caloric intakes may shift and should be monitored, especially in adolescents.