Faecal short chain fatty acids in healthy subjects participating in a randomised controlled trial examining a soluble highly viscous polysaccharide versus control.

BACKGROUND: Short chain fatty acids (SCFA) are produced by the bacterial fermentation of dietary fibre and have been linked with intestinal health. The present study examined faecal SCFA concentrations in subjects consuming a novel soluble highly viscous polysaccharide (HVP) or control for 3 weeks. A total of 54 healthy adults participated in a randomised, double-blind, placebo-controlled study. METHODS: Subjects were randomised to consume HVP or control (skim milk powder). A dose of 5 g day(-1) was consumed in the first week, followed by 10 g day(-1) in the second and third weeks (n = 27 per group). The primary outcome was SCFA concentrations in faecal samples collected at baseline (visit 1, V1), at 1 week (V2) and at 3 week (V3). RESULTS: The reduction in faecal acetate from V1 to V3 in control subjects was not observed in subjects consuming HVP. There were no differences in propionate, butyrate, valerate or caproate concentrations. There was a significant treatment effect (P = 0.03) for total SCFA, with higher concentrations observed in subjects consuming HVP versus control. CONCLUSIONS: HVP is a viscous functional fibre that may influence gut microbial fermentation. Further work is warranted to examine the fermentative properties of HVP and possible links with appetite regulation and reduced serum low-density lipoprotein cholesterol concentrations.

Effects of a 3-month supplementation with a novel soluble highly viscous polysaccharide on anthropometry and blood lipids in nondieting overweight or obese adults.

BACKGROUND: High viscosity fibre is known to exert many beneficial effects on appetite and metabolism. It could potentially help in weight management, in dieting or nondieting individuals. The present study investigated the effects of the daily intake of a novel high viscosity polysaccharide (HVP) over 3 months in nondieting obese or overweight men and women. METHODS: The study comprised a double-blind, randomised controlled clinical trial. Participants ingested 5-15 g per day of either HVP (n = 29, experimental group) or inulin (n = 30, control group) for 15 weeks. Changes in anthropometry (weight, waist and hip circumferences), blood lipids and glucose tolerance were studied from the beginning to the end of administration. Compliance and tolerance were examined. RESULTS: Differences appeared between HVP and inulin supplementation in female participants only. Mean (SD) decreases in body weight [1.6 (3.2) kg; approximately 2% of initial weight] and hip circumference [2.8 (3.6 ) cm] occurred in women of the HVP group but not in controls (Time × Group interactions, P ≤ 0.002). Total, high-density lipoprotein and low-density lipoprotein-cholesterol were lower at the end of supplementation in the women of the HVP group compared to controls (P ≤ 0.021). No effect appeared in waist circumference and triacylglycerol. No difference was noted in the number or severity of the adverse effects reported in both groups. Adverse effects were mild and agreed with commonly reported reactions to intake of dietary fibre. CONCLUSIONS: Beneficial although modest effects appeared after several weeks of daily HVP intake in nondieting obese or overweight women. The effects of HVP should be investigated in the context of a weight loss programme.

[Polytrauma and femoral fracture]. / Polytrauma und Femurfraktur.

From 1976 to 1986 1.003 polytraumatized patients were treated at our institution. 88% had suffered fractures of spine, pelvis and limbs. Of particular relevance are the femoral fractures (36% of all cases) in the management of those patients. In not adequately immobilized femoral fractures the rate of general and local complications in this group is elevated. Impaired microcirculation and the required high doses of analgesics can lead to an increased risk of eventually lethal ARDS. From 1976 to 1983 we used the conventional approach and stabilized femoral fractures using plates and IM nails. Due to the time required for the operation, the eventual blood loss and the invasiveness of the operation, we could operate only on 44% of the femoral fractures within the first 24 hours. In 1984 we introduced the DAF device in our service and used it in compound femurs and unstable patients with femoral fractures. In the other cases the locking nail (GK Nail) was used. With this concept we managed to increase the rate of surgery of femoral fractures in polytrauma victims within the first 24 hours to 80%. Further assessment of the date showed a significant drop of 27.3% in mortality, mainly due to a decreased rate in late ARDS-related deaths. The advantage of the DAF concept in the stabilization of these fractures in polytrauma victims we see in the less time consuming fixation, the minimal blood loss, easier ICU care and fewer local complications. The DAF device is used as a definitive management tool and does not generally require a change to another method of fixation.

Effect of PGX, a novel functional fibre supplement, on subjective ratings of appetite in overweight and obese women consuming a 3-day structured, low-calorie diet.

INTRODUCTION: Dietary factors that help control perceived hunger might improve adherence to calorie-reduced diets. OBJECTIVES: The objective of the study was to investigate the effect of supplementing a three-day, low-calorie diet with PolyGlycopleX (PGX), a highly viscous fibre, on subjective ratings of appetite compared with a placebo. METHODS: In a double-blind crossover design with a 3-week washout, 45 women (aged 38±9 years, body mass index 29.9±2.8 kg m(-2)) were randomised to consume a 1000-kcal per day diet for 3 days, supplemented with 5 g of PGX or placebo at each of breakfast, lunch and dinner. Subjective appetite was assessed using 100 mm visual analogue scales that were completed daily before, between and after consumption of meals. RESULTS: Thirty-five women completed the study. Consumption of PGX compared with placebo led to significantly lower mean area under the curve for hunger on day 3 (440.4 versus 375.4; P=0.048), prospective consumption on day 3 (471.0 versus 401.8; P=0.017) and the overall 3-day average (468.6 versus 420.2; P=0.026). More specifically, on day 3 PGX significantly reduced total appetite, hunger, desire to eat and prospective consumption for 2.5 and 4.5 h after lunch and before dinner times, with hunger also being reduced 2.5 h after dinner (P<0.05). CONCLUSION: The results show that adding 5 g of PGX to meals during consumption of a low-calorie diet reduces subjective ratings of prospective consumption and increases the feelings of satiety, especially during afternoon and evening. This highly viscous polysaccharide may be a useful adjunct to weight-loss interventions involving significant caloric reductions.

Increased plasma PYY levels following supplementation with the functional fiber PolyGlycopleX in healthy adults.

BACKGROUND/OBJECTIVES: A variety of dietary fibers have been shown to alter satiety hormone gene expression and secretion. The objective of this study was to examine plasma satiety hormone concentrations in healthy subjects consuming either PolyGlycopleX (PGX) or control (skim milk powder) for 21 days. SUBJECTS/METHODS: A randomized, double-blind, placebo-controlled clinical study was conducted in 54 healthy male and female adults. Participants consumed 5 g per day of PGX or control for 1 week followed by 2 additional weeks of 10 g per day of assigned product (n=27 per group). Primary outcomes measured at three visits (V1, V2 and V3) were plasma active glucagon-like peptide-1 (GLP-1) total ghrelin, peptide YY (PYY) and insulin. RESULTS: There was a significant effect of visit for fasting PYY with control participants experiencing decreased PYY levels over time while PGX prevented this decline. When stratified by body mass index (BMI), PGX increased fasting PYY levels from week 1 to week 3 compared with control in participants with BMI <23 kg/m(2). There was a significant effect of visit for fasting ghrelin with levels decreasing in both PGX and control groups over time. No differences were detected in fasting GLP-1 levels. Although there was a 14% reduction in fasting insulin between V1 and V3 with PGX this was not significantly different from control. CONCLUSIONS: PGX is a highly viscous, functional fiber that modifies satiety hormone secretion in healthy adults. Its' potential to act similarly in overweight adults warrants investigation.

Effects of PGX, a novel functional fibre, on acute and delayed postprandial glycaemia.

BACKGROUND: Viscous fibre in food has established health benefits, but few functional fibre preparations are both effective and palatable. Our objective was to determine the most effective dose, formulation and timing of consumption of a novel fibre supplement (PolyGlycopleX (PGX)) in reducing postprandial glycaemia. SUBJECTS/METHODS: Three trials were undertaken, each with 10 subjects (8M and 8F; age 24.4 ± 2.6 years). Granular supplement was tested at four doses (0, 2.5, 5.0 and 7.5 g) with breakfast (study 1). Granular and capsule forms of the supplement were given in a single dose (5 g for granules and 4.5 g in capsules) at -60, -45, -30, -15 and 0 before, and +15 min after a bread meal (study 2). Capsules at increasing doses (1.5, 3, 4.5 and 6 g) were consumed with the evening meal to determine effects on glucose tolerance at breakfast (study 3). Incremental area under the blood glucose curve was determined. RESULTS: Granular PGX at breakfast time at doses of 2.5, 5 and 7.5 g reduced the incremental area under the curve by up to 50% in a linear dose-response fashion (P<0.001). The granular form of PGX (5 g), but not the capsules, reduced glycaemia by up to 28% when consumed from -45 to +15 min (P<0.001). Capsules containing 3, 4.5 and 6 g PGX consumed with the evening meal reduced glycaemia at breakfast by up to 28% (P<0.001). CONCLUSIONS: PGX has biologically important, dose-related effects on acute and delayed (second meal) postprandial glycaemia.

Dynamics of field-induced ordering in magnetic colloids studied by new time-resolved small-angle neutron-scattering techniques.

The reversal of magnetic moments of nanoparticles in concentrated Co ferrofluids was monitored in an oscillating magnetic field by new time-resolved stroboscopic small-angle neutron-scattering techniques. Time resolution in the micros range was achieved by using a pulsed beam technique, TISANE, while in continuous mode resolution was limited by the wavelength spread to about 1 ms. The frequency dependence of anisotropic scattering patterns has been modeled using Langevin dynamics. The dynamics follows a two step mechanism: field-induced ordering is governed by fast Brownian rotation of nanoparticles with a characteristic time of about 160 micros. Magnetic relaxation of locally ordered domains of about 100 nm in size takes place within a few seconds by Brownian rotation or by Néel type rotation of magnetic moments.

[Nosocomial infections in surgical intensive medicine. Results of a 5-year prospective study]. / Nosokomiale Infektionen in der operativen Intensivmedizin. Ergebnisse einer 5jährigen prospektiven Erhebung.

All the ICU patients were continuously studied during the first quarter of 5 consecutive years for infections according to a standard protocol. The investigators--the infection control officer and a well-trained infection control nurse--decided if the patient was infected by referring to medical and nursing record, temperature charts, laboratory and x-ray reports and, where necessary, by clinical examination. Definitions and criteria for infections comply with the CDC and the algorithms of the Senic Project. Only the first quarter of each year from 1980-1984 was analysed. The first quarter of 1980 was analysed retrospectively, the following years were examined prospectively. In 1984 a new ICU (ICU I) in addition to the old ICU (ICU II) was opened. The two ICUs differ in building construction but have similar patients, nursing staff and medical standards. The frequency of nosocomial infection was not affected by the different building constructions. The number of patients surveyed was 1009, 60% were males and 40% females. The average age was 45.5 years and the average period of stay about 4 days. 733 patients (72.6%) were intubated and artificially ventilated for 3 days. A fatal outcome resulted in 13.2% of all patients. 1129 nosocomial infections were registered in 311 patients, which means an infection rate of 32.8%. The most frequent nosocomial infections were those of the respiratory tract. Wound infections developed in 16.6%. The urinary tract was affected in 8.8%. Nosocomial septicaemias were observed in 8.7%. Catheter-associated infections were noticed in 6.7% of the patients. A fatal outcome resulted in 26% of the patients with nosocomial infections and in 6.9% of the non-infected patients, respectively.

[Monitoring infection at the intensive care unit--a multicenter pilot study]. / Infektionsüberwachung an Intensivstationen--eine multizentrische Pilotstudie.

During a period of 3 months an infection survey was carried out in 4 intensive care units (ICUs), 2 in Vienna, Austria, and one each in Ulm and Münster, Federal Republic of Germany, using a common protocol. A total of 329 patients was monitored prospectively. This pilot study was performed to evaluate the usefulness of parameters included in the monitoring form. It was attempted to characterize the patient populations of the four units. Mean duration of stay (1-12 days), mortality (8-26%), leading diagnosis upon admission, intubation rate (41-91%) and use of pulmonary artery catheter (12-35%) were distinctly different. The rate of patients admitted already with an infection was 9-43%, septicemia was diagnosed in up to 27% of the diseased. The rate of infection acquired in the unit was between 12 and 37%, the most frequent types were bronchopneumonia, septicemia and urinary tract infection. When septicemia patients were compared to non-septicemia patients who had been admitted for more than 3 days, it appeared that the latter stayed significantly shorter at the ICU and showed less frequently bronchopneumonia or urinary tract infection at the time of admission. Septicemia patients acquired more frequently additional infections like broncho-pneumonia or urinary tract infection while staying at the ICU. The median day of onset of septicemia was the fifth day and only in a quarter of cases diagnosis could be supported by a positive blood culture. The use of antibiotics in the 4 ICUs is compared and shows marked differences. Based upon experience with this type of infection survey a new modified protocol is introduced, which displays the time course of documented events.