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Article ; Online: Pediatric Type 1 Diabetes: Mechanisms and Impact of Technologies on Comorbidities and Life Expectancy.

Urbano, Flavia / Farella, Ilaria / Brunetti, Giacomina / Faienza, Maria Felicia

International journal of molecular sciences

2023 Volume 24, Issue 15

Abstract: Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood, with a progressively increasing incidence. T1D management requires lifelong insulin treatment and ongoing health care support. The main goal of treatment is to maintain blood ... ...

Abstract	Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood, with a progressively increasing incidence. T1D management requires lifelong insulin treatment and ongoing health care support. The main goal of treatment is to maintain blood glucose levels as close to the physiological range as possible, particularly to avoid blood glucose fluctuations, which have been linked to morbidity and mortality in patients with T1D. Indeed, the guidelines of the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommend a glycated hemoglobin (HbA1c) level < 53 mmol/mol (<7.0%) for young people with T1D to avoid comorbidities. Moreover, diabetic disease strongly influences the quality of life of young patients who must undergo continuous monitoring of glycemic values and the administration of subcutaneous insulin. In recent decades, the development of automated insulin delivery (AID) systems improved the metabolic control and the quality of life of T1D patients. Continuous subcutaneous insulin infusion (CSII) combined with continuous glucose monitoring (CGM) devices connected to smartphones represent a good therapeutic option, especially in young children. In this literature review, we revised the mechanisms of the currently available technologies for T1D in pediatric age and explored their effect on short- and long-term diabetes-related comorbidities, quality of life, and life expectation.
MeSH term(s)	Adolescent ; Humans ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 1/therapy ; Hypoglycemic Agents/therapeutic use ; Blood Glucose/metabolism ; Quality of Life ; Blood Glucose Self-Monitoring ; Insulin Infusion Systems ; Insulin/therapeutic use ; Life Expectancy
Chemical Substances	Hypoglycemic Agents ; Blood Glucose ; Insulin
Language	English
Publishing date	2023-07-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms241511980
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Musculoskeletal health in children and adolescents.

Faienza, Maria Felicia / Urbano, Flavia / Chiarito, Mariangela / Lassandro, Giuseppe / Giordano, Paola

Frontiers in pediatrics

2023 Volume 11, Page(s) 1226524

Abstract: The purpose of this narrative review was to investigate the key determinants of musculoskeletal health in childhood and adolescence, with particular attention to the role of physical activity. First, we examined the importance of bone modeling and ... ...

Abstract	The purpose of this narrative review was to investigate the key determinants of musculoskeletal health in childhood and adolescence, with particular attention to the role of physical activity. First, we examined the importance of bone modeling and remodeling in maintaining the bone health and the integrity and mechanical characteristic of the skeleton. In addition, we reported the evidence on an appropriate calcium and vitamin D intake, as well as local load variation in achieving proper peak bone mass. Proteomic and transcriptomic studies identified the skeletal muscle "secretoma", consisting of several myokines involved in endocrine and paracrine functions. Among these, we explored the role of irisin, a myokine involved in the muscle-bone crosstalk, and in the regulation of metabolic pathways. It is known that physical activity during growing positively impacts on skeleton and can protect by bone loss in adulthood. However, there are still concerns about the optimal interval duration and exercise intensity, particularly at the pubertal growth spurt which represents a window of opportunity to increase skeletal strength. We reported data from clinical trials performed in the last 5 years analyzing the impact of the type and timing of physical activity during childhood on skeletal development. Finally, we reported recent data on the significance of physical activity in some rare diseases.
Language	English
Publishing date	2023-12-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2023.1226524
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Article ; Online: Mechanisms of Bone Impairment in Sickle Bone Disease.

Giordano, Paola / Urbano, Flavia / Lassandro, Giuseppe / Faienza, Maria Felicia

International journal of environmental research and public health

2021 Volume 18, Issue 4

Abstract: Sickle bone disease (SBD) is a chronic and invalidating complication of Sickle cell disease (SCD), a multisystem autosomal recessive genetic disorder affecting millions of people worldwide. Mechanisms involved in SBD are not completely known, especially ... ...

Abstract	Sickle bone disease (SBD) is a chronic and invalidating complication of Sickle cell disease (SCD), a multisystem autosomal recessive genetic disorder affecting millions of people worldwide. Mechanisms involved in SBD are not completely known, especially in pediatric age. Among the hypothesized pathogenetic mechanisms underlying SBD are bone marrow compensatory hyperplasia and bone ischemic damage, both secondary to vaso-occlusive crisis (VOC), which leads to cell sickling, thus worsening local hypoxia with a negative impact on osteoblast recruitment. Furthermore, the hypoxia is a strong activator of erythropoietin, which in turn stimulates osteoclast precursors and induces bone loss. Hemolysis and iron overload due to a chronic transfusion regimen could also contribute to the onset of bone complications. Vitamin D deficiency, which is frequently seen in SCD subjects, may worsen SBD by increasing the resorptive state that is responsible for low bone mineral density, acute/chronic bone pain, and high fracture risk. An imbalance between osteoblasts and osteoclasts, with a relative decrease of osteoblast recruitment and activity, is a further possible mechanism responsible for the impairment of bone health in SCD. Moreover, delayed pubertal growth spurt and low peak bone mass may explain the high incidence of fracture in SCD adolescents. The aim of this review was to focus on the pathogenesis of SBD, updating the studies on biochemical, instrumental, and biological markers of bone metabolism. We also evaluated the growth development and endocrine complications in subjects affected with SCD.
MeSH term(s)	Adolescent ; Anemia, Sickle Cell/complications ; Blood Transfusion ; Bone Diseases/epidemiology ; Bone Diseases/etiology ; Child ; Humans ; Osteoclasts ; Vitamin D Deficiency
Language	English
Publishing date	2021-02-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph18041832
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Article: Genetic, epigenetic and enviromental influencing factors on the regulation of precocious and delayed puberty.

Faienza, Maria Felicia / Urbano, Flavia / Moscogiuri, Luigi Antonio / Chiarito, Mariangela / De Santis, Stefania / Giordano, Paola

Frontiers in endocrinology

2022 Volume 13, Page(s) 1019468

Abstract: The pubertal development onset is controlled by a network of genes that regulate the gonadotropin releasing hormone (GnRH) pulsatile release and the subsequent increase of the circulating levels of pituitary gonadotropins that activate the gonadal ... ...

Abstract	The pubertal development onset is controlled by a network of genes that regulate the gonadotropin releasing hormone (GnRH) pulsatile release and the subsequent increase of the circulating levels of pituitary gonadotropins that activate the gonadal function. Although the transition from pre-pubertal condition to puberty occurs physiologically in a delimited age-range, the inception of pubertal development can be anticipated or delayed due to genetic and epigenetic changes or environmental conditions. Most of the genetic and epigenetic alterations concern genes which encode for kisspeptin, GnRH, LH, FSH and their receptor, which represent crucial factors of the hypothalamic-pituitary-gonadal (HPG) axis. Recent data indicate a central role of the epigenome in the regulation of genes in the hypothalamus and pituitary that could mediate the flexibility of pubertal timing. Identification of epigenetically regulated genes, such as Makorin ring finger 3 (
MeSH term(s)	Humans ; Puberty, Precocious/genetics ; Puberty, Delayed/genetics ; Gonadotropin-Releasing Hormone/genetics ; Gonadotropin-Releasing Hormone/metabolism ; Puberty/genetics ; Epigenesis, Genetic ; Ubiquitin-Protein Ligases/genetics
Chemical Substances	Gonadotropin-Releasing Hormone (33515-09-2) ; MKRN3 protein, human (EC 2.3.2.27) ; Ubiquitin-Protein Ligases (EC 2.3.2.27)
Language	English
Publishing date	2022-12-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2022.1019468
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Article ; Online: The Cardiovascular Disease (CVD) Risk Continuum from Prenatal Life to Adulthood: A Literature Review.

Faienza, Maria Felicia / Urbano, Flavia / Lassandro, Giuseppe / Valente, Federica / D'Amato, Gabriele / Portincasa, Piero / Giordano, Paola

International journal of environmental research and public health

2022 Volume 19, Issue 14

Abstract: The risk of developing cardiovascular diseases (CVDs) arises from the interaction of prenatal factors; epigenetic regulation; neonatal factors; and factors that affect childhood and adolescence, such as early adiposity rebound (AR) and social and ... ...

Abstract	The risk of developing cardiovascular diseases (CVDs) arises from the interaction of prenatal factors; epigenetic regulation; neonatal factors; and factors that affect childhood and adolescence, such as early adiposity rebound (AR) and social and environmental influences. Thus, CVD risk varies between the group of low-risk metabolically healthy normal-weight subjects (MHNW); the intermediate-risk group, which includes metabolically healthy obese (MHO) and metabolically unhealthy normal-weight subjects (MUHNW); and the high-risk group of metabolically unhealthy obese (MUHO) subjects. In this continuum, several risk factors come into play and contribute to endothelial damage, vascular and myocardial remodeling, and atherosclerotic processes. These pathologies can occur both in prenatal life and in early childhood and contribute to significantly increasing CVD risk in young adults over time. Early intervention in the pediatric MUHO population to reduce the CVD risk during adulthood remains a challenge. In this review, we focus on CVD risk factors arising at different stages of life by performing a search of the recent literature. It is urgent to focus on preventive or early therapeutic strategies to stop this disturbing negative metabolic trend, which manifests as a continuum from prenatal life to adulthood.
MeSH term(s)	Adolescent ; Adult ; Body Mass Index ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/metabolism ; Child ; Child, Preschool ; Epigenesis, Genetic ; Humans ; Infant, Newborn ; Metabolic Syndrome/epidemiology ; Obesity/epidemiology ; Phenotype ; Risk Factors ; Young Adult
Language	English
Publishing date	2022-07-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19148282
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Article ; Online: High Dickkopf-1 levels are associated with chronic inflammation in children with sickle cell disease.

Giordano, Paola / Vecchio, Giovanni Carlo Del / Russo, Giovanna / Palmieri, Viviana Valeria / Piacente, Laura / Fidone, Carmelo / Urbano, Flavia / Faienza, Maria Felicia

European journal of haematology

2022 Volume 108, Issue 4, Page(s) 336–341

Abstract: Objectives: Sickle bone disease (SBD) is a chronic complication of sickle cell disease (SCD) whose pathogenesis is not completely understood. Chronic inflammation associated with SCD could alter bone remodeling. Our aim was to analyze the serum levels ... ...

Abstract	Objectives: Sickle bone disease (SBD) is a chronic complication of sickle cell disease (SCD) whose pathogenesis is not completely understood. Chronic inflammation associated with SCD could alter bone remodeling. Our aim was to analyze the serum levels of bone remodeling markers in a group of SCD children to evaluate their involvement in the SBD. Methods: We enrolled 26 SCD subjects and 26 age-matched controls, who lived in the same geographic area. DKK-1, sclerostin, RANKL, and OPG serum levels were evaluated. Neutrophil-lymphocyte ratio (NLR) was also evaluated as a marker of inflammation. Results: The analysis of bone remodeling markers did not show any significant difference between the two groups except for DKK-1 levels that were significantly higher in the patients than controls (p < .05). A significant direct correlation between NLR and DKK-1 (p = .004) was found. An inverse correlation between NLR and osteocalcin (p = .01) has also been observed. Conclusions: The chronic inflammation, which represents a peculiar characteristic in SCD patients, would represent the primary causal agent of the activation of osteoblastogenesis inhibitors responsible of bone impairment in these subjects. Further studies will be needed to better explain the role of these inhibitors in SCD, to prevent or treat bone damage in this population.
MeSH term(s)	Anemia, Sickle Cell/complications ; Anemia, Sickle Cell/diagnosis ; Bone Diseases ; Bone Remodeling/physiology ; Bone and Bones ; Child ; Humans ; Inflammation/etiology
Language	English
Publishing date	2022-01-10
Publishing country	England
Document type	Journal Article
ZDB-ID	392482-8
ISSN	1600-0609 ; 0902-4441
ISSN (online)	1600-0609
ISSN	0902-4441
DOI	10.1111/ejh.13741
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Article ; Online: Different Variation of Intra-familial Body Mass Index subjected to Covid-19 Lockdown.

Faienza, Maria Felicia / Colaianni, Valentina / Di Ciaula, Agostino / Bonfrate, Laonilde / Urbano, Flavia / Chiarito, Mariangela / Brunetti, Giacomina / Giordano, Paola / Corbo, Filomena / D'Amato, Gabriele / Portincasa, Piero

Journal of gastrointestinal and liver diseases : JGLD

2022 Volume 31, Issue 2, Page(s) 198–205

Abstract: Background and aims: Coronavirus disease 2019 (COVID-19) lockdown has represented an inedited model of increased metabolic risk in all age groups, due to negative changes in dietary habits, physical activity, lifestyle. These effects have been generally ...

Abstract	Background and aims: Coronavirus disease 2019 (COVID-19) lockdown has represented an inedited model of increased metabolic risk in all age groups, due to negative changes in dietary habits, physical activity, lifestyle. These effects have been generally explored at a population level in distinct age groups. Potential intra-familial, specific effects in adults and children sharing the same socio-economic, cultural level and living habits have been scarcely explored. We aimed to characterize changes of anthropometric indices in parents and in their children during COVID-19 lockdown. Methods: A cohort of 149 couple parent/children were prospectively enrolled. By a validated questionnaire we explored changes of body mass index (BMI) and individual lifestyle during a 2-month lockdown (May- July 2020). Results: BMI increased in 70.5% of parents and in 67.8% of their children, with a Δ-BMI of 1.44+0.09 kg/ m 2 and 0.36+0.02 Kg/m 2 , respectively. BMI increments, however, were only significant in adults and did not correlate in the couple parents/children. Most adults (80.5%) and children (71.4%) did not perform regular physical activity during the lockdown. Direct correlations between dietary changes and BMI variations became evident in children, mainly in terms of a decreased consumption of fresh fruit, pulses, fish, and an increased consumption of cereals, carbohydrates, dairy products, olive oil. In normal weight, overweight and obese children, but not in adults, the increase in sleep hours increased with BMI. Conclusions: Despite marked lifestyle changes imposed by the COVID-19 lockdown, BMI variations in parents were independent from those observed in their children, pointing to different outcomes in response to the same external, critical event. Thus, primary prevention measures aimed at maintaining a healthy lifestyle require different approaches according to age.
MeSH term(s)	Animals ; Body Mass Index ; COVID-19/epidemiology ; Child ; Communicable Disease Control ; Feeding Behavior ; Humans ; Life Style ; Pediatric Obesity/diagnosis ; Pediatric Obesity/epidemiology ; Pediatric Obesity/prevention & control
Language	English
Publishing date	2022-06-12
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2427021-0
ISSN	1842-1121 ; 1841-8724
ISSN (online)	1842-1121
ISSN	1841-8724
DOI	10.15403/jgld-4189
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Article: Sex Hormone-Binding Globulin (SHBG) Reduction: The Alarm Bell for the Risk of Non-Alcoholic Fatty Liver Disease in Adolescents with Polycystic Ovary Syndrome.

Urbano, Flavia / Chiarito, Mariangela / Lattanzio, Crescenza / Messa, Angela / Ferrante, Marco / Francavilla, Mariantonietta / Mehmeti, Irsida / Lassandro, Giuseppe / Giordano, Paola / Faienza, Maria Felicia

Children (Basel, Switzerland)

2022 Volume 9, Issue 11

Abstract: Polycystic ovary syndrome (PCOS) represents an endocrine condition affecting 5-18% of adolescents, frequently in association with obesity, metabolic alterations, and liver dysfunction. In this study, we aimed to evaluate the prevalence and risk factors ... ...

Abstract	Polycystic ovary syndrome (PCOS) represents an endocrine condition affecting 5-18% of adolescents, frequently in association with obesity, metabolic alterations, and liver dysfunction. In this study, we aimed to evaluate the prevalence and risk factors for developing non-alcoholic fatty liver disease (NAFLD) in a cohort of PCOS adolescents. Thirty-two girls were assessed for anthropometric and biochemical markers: total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), glucose, insulin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (γGT). In addition, LH, FSH, 17β-Estradiol (E2), prolactin, testosterone (T), free testosterone, delta 4-androstenedione (D4 A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding protein (SHBG) were also evaluated. All subjects underwent liver ultrasound to detect NAFLD. Our data demonstrated that PCOS adolescents complicated with NAFLD accounted for 37.5%, and those with obesity and lower SHBG were more predisposed to developing NAFLD. Moreover, SHBG showed a negative correlation with several parameters such as blood pressure, body mass index, waist circumference, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR). Our results demonstrated that the assessment of SHBG may allow the identification of PCOS adolescents at risk for developing NAFLD and metabolic alterations.
Language	English
Publishing date	2022-11-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children9111748
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Article ; Online: Unusual pediatric co-morbility

Urbano Flavia / Acquafredda Angelo / Aceto Gabriella / Penza Rosa / Cavallo Luciano

The Italian Journal of Pediatrics, Vol 38, Iss 1, p

autoimmune thyroiditis and cortico-resistant nephrotic syndrome in a 6-month-old Italian patient

2012 Volume 57

Abstract: Abstract We report on a case of autoimmune thyroiditis in a 6-month-old patient with cortico-resistant nephrotic syndrome. Normal serum levels of thyroid hormons and thyroid-stimulating hormone were detected with high titers of circulant antithyroid ... ...

Abstract	Abstract We report on a case of autoimmune thyroiditis in a 6-month-old patient with cortico-resistant nephrotic syndrome. Normal serum levels of thyroid hormons and thyroid-stimulating hormone were detected with high titers of circulant antithyroid antibodies and a dysomogeneous ultrasound appearance of the gland, typical of autoimmune thyroiditis. The research of maternal thyroid antibodies was negative. This is the first case of autoimmune thyroiditis found in such a young patient with pre-existing nephrotic syndrome ever described in literature. This association is random because nephrotic syndrome does not have an autoimmune pathogenesis and the genes involved in autoimmune thyroiditis are not related to those of nephrotic syndrome.
Keywords	Autoimmune thyroiditis ; Nephrotic syndrome ; Childhood ; Pediatrics ; RJ1-570 ; Medicine ; R ; DOAJ:Pediatrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2012-10-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial

Baldassarre, Maria Elisabetta / Di Mauro, Antonio / Mastromarino, Paola / Fanelli, Margherita / Martinelli, Domenico / Urbano, Flavia / Capobianco, Daniela / Laforgia, Nicola

Nutrients. 2016 Oct. 27, v. 8, no. 11

2016

Abstract: Background: Probiotic supplementation to women during pregnancy and lactation can modulate breast milk composition, with immune benefits being transferred to their infants. Aim: The aim of the study was to evaluate the effect of high-dose probiotic ... ...

Abstract	Background: Probiotic supplementation to women during pregnancy and lactation can modulate breast milk composition, with immune benefits being transferred to their infants. Aim: The aim of the study was to evaluate the effect of high-dose probiotic supplementation to women during late pregnancy and lactation on cytokine profile and secretory IgA (sIgA) in breast milk and thus to study if differences in breast milk composition can affect lactoferrin and sIgA levels in stool samples of newborns. The safety of maternal probiotic administration on neonatal growth pattern and gastrointestinal symptoms were also evaluated. Methods: In a double-blind, placebo-controlled, randomized trial, 66 women took either the probiotic (n = 33) or a placebo (n = 33) daily. Levels of interleukins (IL-6, IL-10 and IL-1β), transforming growth factor-β1 (TGF-β1), and sIgA in breast milk; and the level of sIgA and lactoferrin in newborn stool samples were analyzed at birth and then again at one month of life. Antropometrical evaluation and analysis of gastrointestinal events in newborns was also performed. Results: Probiotic maternal consumption had a significant impact on IL6 mean values in colostrum and on IL10 and TGF-β1 mean values in mature breast milk. Fecal sIgA mean values were higher in newborns whose mothers took the probiotic product than in the control group. Probiotic maternal supplementation seems to decrease incidence of infantile colic and regurgitation in infants. Conclusion: High-dose multi-strain probiotic administration to women during pregnancy influences breast milk cytokines pattern and sIgA production in newborns, and seems to improve gastrointestinal functional symptoms in infants.
Keywords	breast milk ; colic ; colostrum ; feces ; gastrointestinal system ; immunoglobulin A ; interleukin-10 ; interleukin-1beta ; interleukin-6 ; lactation ; lactoferrin ; mothers ; neonates ; perinatal period ; placebos ; pregnancy ; probiotics ; randomized clinical trials ; transforming growth factor beta 1 ; women
Language	English
Dates of publication	2016-1027
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu8110677
Database	NAL-Catalogue (AGRICOLA)

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