Effects of oral isotretinoin therapy on the nasal cavities / Efeitos nasais da terapia com isotretinoína oral

Abstract Introduction Isotretinoin (13 cis-retinoic acid) is the most effective treatment for acne vulgaris and is the only treatment option that can provide either remission or a permanent cure. Objective The aim of this study was to use both subjective and objective methods to assess the nasal complaints of patients with severe acne who received oral isotretinoin therapy. Methods Fifty-four subjects were enrolled in the study. All the subjects were assessed with subjective (NOSE and VAS questionnaires) and objective (rhinomanometry and saccharine) tests to determine the severity of their nasal complaints. Results The mean severity scores (min: 0; max: 100) for nasal dryness/crusting and epistaxis were 0.47 ± 1.48 (0-5); 0.35 ± 1.30 (0-5) at admission, 3.57 ± 4.45 (0-10); 2.26 ± 4.71 (0-20) at the first month, and 4.28 ± 6 (0-20); 2.26 ± 4.71 (0-20) at the third month of the treatment respectively. Total nasal resistance of 0.195 ± 0.079 (0.12-0.56) Pa/cm3/s at admission, 0.21 ± 0.084 (0.12-0.54) Pa/cm3/s at the first month, and 0.216 ± 0.081 (0.14-0.54) Pa/cm3/s at the third month. Conclusion Oral isotretinoin therapy can cause the complaint of nasal obstruction. In addition, nasal complaints, such as dryness/crusting and epistaxis, significantly increase in patients during the therapy schedule.

Resumo Introdução A isotretinoína (ácido-13 cis-retinóico) é o tratamento por via oral mais eficaz para acne vulgar e é a única opção de tratamento que pode produzir remissão ou cura permanente. Objetivo Usar métodos subjetivos e objetivos para avaliar as queixas nasais de pacientes com acne grave que receberam terapia com isotretinoína oral. Método Foram incluídos no estudo 54 indivíduos. Todos os indivíduos foram avaliados por meio de testes subjetivos (questionários NOSE e escala EVA) e objetivos (rinomanometria e teste de sacarina) para determinar a gravidade de suas queixas nasais. Resultados Os escores médios de gravidade (min: 0; max: 100) para ressecamento/crostas e epistaxe nasal foram de 0,47 ± 1,48 (0-5); 0,35 ± 1,30 (0-5) no início, 3,57 ± 4,45 (0-10); 2,26 ± 4,71 (0-20) no primeiro mês e 4,28 ± 6 (0-20); 2,26 ± 4,71 (0-20) no terceiro mês do tratamento, respectivamente. A resistência nasal total foi de 0,195 ± 0,079 (0,12 a 0,56) Pa/cm3/s no início, 0,21 ± 0,084 (0,12 a 0,54) Pa/cm3/s no primeiro mês e 0,216 ± 0,081 (0,14 a 0,54) Pa/cm3/s no terceiro mês. Conclusão A terapia com isotretinoína por via oral pode resultar em queixa de obstrução nasal. Além disso, queixas nasais, tais como ressecamento/formação de crostas e epistaxe, aumentam significativamente nos pacientes durante o esquema terapêutico.

The Effect of Saccharin on the Gene Expression of NF-κB and Inflammatory Cytokines in LPS-Stimulated SW480 Colon Cancer Cells

There have been no published studies concerning the anti-inflammatory effects of corn silk on colon cancer cells. Thus, this study was conducted to investigate the effect of corn silk extract containing high levels of maysin on inflammation and its mechanism of action in colon cancer cells. SW 480 human colon cancer cells were treated with 1 µg/mL of lipopolysaccharide (LPS) to induce inflammation, and next they were treated with different concentrations of corn silk extract (0, 5, 10 and 15 µg/mL). The concentrations of nitric oxide (NO) were determined. The mRNA expressions of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), tumor necrosis factor α (TNF-α), interleukin-1beta (IL-1β) and interleukin-6 (IL-6), were determined. Western blot analysis was performed to determine the protein expressions of nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinases, and the latter consists of extracellular signal-related kinase (ERK), c-jun NH2-terminal kinase (JNK) and p38 MAP kinase (p38). The concentration of NO and the mRNA expression of iNOS were significantly and dose-dependently decreased in the corn silk-treated groups (P<0.05). The mRNA expression of TNF-α, IL-1β and IL-6 were significantly increased in the LPS-treated group (P<0.05), but these expressions were significantly and dose-dependently decreased in the corn silk treated groups (P<0.05). The protein expressions of NF-κB (in a dose-dependent fashion), ERK (at 10 and 15 µg/mL), JNK (at 15 µg/mL) and p38 (at 10 and 15 µg/mL) were significantly decreased with corn silk treatments (P<0.05). In conclusion, corn silk extract containing high levels of maysin seems to inhibit the LPS-induced inflammatory responses in SW480 colon cancer cells via the NF-κB pathway.

Particularities and clinical applicability of saccharin transit time test

Introduction: The importance ofmucociliary clearance (MCC) for the respiratory system homeostasis is clear. Therefore, evaluating this defense mechanism is fundamental in scientific research and in the clinical practice of pulmonology and of associated areas. However, MCC evaluation has not been so usual due to the complexity ofmethods that use radiolabeled particles. Nevertheless, as an interesting alternative, there is the saccharin transit time (STT) test. This method is reproducible, simple to perform, noninvasive, does notdemand high costs, and has been widely used in studies of nasalMCC. Although the STT test is widely used, there is still lack of a detailed description of its realization. Objective: The present literature review aims to provide basic information related to the STT test andto present the findings of the previous studies that usedthismethod, discussing variations in its execution, possible influences on the obtained results and limitations of the method, as well as to relate our experience with the use of STT in researches. Data Synthesis: There are several factors that can alter the results obtained from STT tests, which would raise difficulties with proper interpretation and with the discussion of the results among different studies. Conclusions: Saccharin transit time is awidely usedmethod for the evaluation of nasal MCC, and therefore, the standardization related to the previous and concurrent to test orientations, and also its execution, become essential to improve its accuracy, and allow comparisons among different studies (AU)

Nasal mucociliary transportability of male and female smokers / Transportabilidade mucociliar nasal de homens e mulheres tabagistas

Abstract Introduction: Female smoker's present increased susceptibility to several diseases when compared to the opposite gender. However, there are no studies showing differences in nasal mucociliary transport behavior between male and female smokers. Objective: To compare the nasal mucociliary transportability in male and female smokers and non-smokers, taking into consideration age, anthropometric data, smoking load and pulmonary function. Methods: The analysis included 139 individuals (33 men and 37 women smokers and 32 men and 37 women non-smokers). All participants answered an initial interview to obtain personal data and smoking load. Anthropometric data and carbon monoxide in the exhaled air were assessed. Individuals also performed pulmonary function test and Saccharin Transit Time test. To compare saccharin transit time values between men and women, smokers and non-smokers, stratification of all independent variables was performed (sociodemographic, smoking and respiratory variables) into two categories: below and above the median values. Results: There was no difference between men and women, smokers and non-smokers, regarding nasal mucociliary transportability. Significant differences were only observed between non-smokers. Among those with less forced vital capacity values (<97.37% of predicted), women presented mucociliary transport faster than men. Moreover, it was observed influence of BMI and COex (women smokers), FCV and FEV1 (men non-smokers) and FEF25-75% (women non-smokers) on saccharin transit time values. Conclusion: Based on the findings of this study, nasal mucociliary transport in male and female adult smokers, apparently healthy, are similar.

Resumo Introdução: Mulheres tabagistas apresentam maior susceptibilidade à diversas doenças quando comparadas ao sexo masculino. No entanto, não há estudos mostrando diferenças no comportamento do transporte mucociliar nasal entre tabagistas do sexo masculino e feminino. Objetivo: Comparar a transportabilidade mucociliar nasal em homens e mulheres fumantes e não fumantes, levando em consideração idade, dados antropométricos, carga tabágica e função pulmonar. Método: A análise incluiu 139 indivíduos (33 homens e 37 mulheres fumantes e 32 homens e 37 mulheres não fumantes). Todos os participantes responderam a uma entrevista inicial para a obtenção de dados pessoais e a carga tabágica. Dados antropométricos e monóxido de carbono no ar expirado foram avaliados. Os indivíduos também fizeram teste de função pulmonar e o teste de trânsito de sacarina. Para comparar os valores do teste de trânsito de sacarina entre homens e mulheres, fumantes e não fumantes, foi feita a estratificação de todas as variáveis independentes (variáveis sociodemográficas, tabágicas e respiratórias) em duas categorias: abaixo e acima dos valores médios. Resultados: Não houve diferenças entre homens e mulheres, fumantes e não fumantes, em relação à transportabilidade mucociliar nasal. Diferenças significativas foram observadas apenas entre não fumantes. Entre os que apresentaram valores menores de capacidade vital forçada (< 97,37% do previsto), as mulheres apresentaram transporte mucociliar mais rápido do que os homens. Além disso, observou-se influência do IMC e COex (mulheres fumantes), CVF e VEF1 (homens não fumantes) e FEF25%-75% (mulheres não fumantes) sobre os valores do teste de trânsito de sacarina. Conclusão: Com base nos achados deste estudo, o transporte mucociliar nasal em tabagistas masculinos e femininos adultos, aparentemente saudáveis, são semelhantes.

¿Se pueden recomendar en el embarazo los edulcorantes no nutritivos? / Can we recommend nonnutritive sweeteners during pregnancy?

Pregnancy is a condition of special concern due to the need to care for both mother and fetus. One of the main recommendations during this time is weight control. Exceeding weight gain recommendations increases the risk of gestational diabetes, hypertension, obesity, pre-eclampsia, cesarean delivery, premature birth, neural tube defects, and macrosomia, among others. Thus, weight gain within guidelines decreases the chances of these complications. One recommended way to avoid excess weight gain is to replace sugar for nonnutritive sweeteners (NNS), bearing in mind that the sale of these substances, especially sodas and sweets, have increased worldwide. The aim of this study was to review the literature regarding the possible risks and benefits of perigestational consumption of NNS. NNS are widely consumed to substitute sugar and provide a sweet taste without contributing to energy intake; however there are no long-term studies in humans that confirm their safety. A study of the legal regulations of the use of NNS requires ongoing review, especially when it comes to pregnancy, since the statements of different health departments around the world are conflicting.

El embarazo es un momento de especial preocupación debido a que la atención se centra en la salud de la madre y el feto. Una de las recomendaciones para embarazadas es el control de peso. Exceder las recomendaciones sobre el incremento de peso gestacional aumenta el riesgo de padecer diabetes gestacional, hipertensión arterial, sobrepeso, obesidad, pre-eclampsia, parto por cesárea, partos prematuros, defectos del tubo neural, macrosomía, entre otros. Por lo tanto, un incremento de peso adecuado en el embarazo permite evitar estas complicaciones. Algunas de las recomendaciones para evitar el aumento de peso excesivo, es reemplazar la sacarosa por Edulcorantes no nutritivos (ENN), considerando que su consumo, y en especial de bebidas y productos azucarados, se ha incrementado a nivel mundial en los últimos años. El objetivo de este trabajo fue revisar la bibliografía disponible en relación a los posibles riesgos y beneficios de consumir ENN en el embarazo. Los ENN son ampliamente consumidos en la población, en reemplazo del azúcar, como una estrategia para el ahorro de calorías extras, sin embargo, su utilización en mujeres embarazadas no cuenta con estudios en humanos a largo plazo que avalen su seguridad. En relación al marco legal que regula el uso de ENN, se requiere de la revisión permanente para actualizar la información en relación a la seguridad de su consumo, especialmente en mujeres embarazadas, ya que al revisar las directrices de ministerios de salud de diversos países en relación a recomendar o no la utilización de ENN son discordantes.

Effect of Saccharin Intake in Restraint-induced Stress Response Reduction in Rats

PURPOSE: Stress activates the sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis and induces the release of glucocorticoids. Saccharin is 300 times sweeter than sucrose, but does not increase blood insulin levels. Thus, this study was designed to evaluate the effect of saccharin intake in restraint-induced stress response reduction in rats. METHODS: Adult male Sprague-Dawley (SD) rats had stress induced by restraint for 2 hours/day for 1 week. Saccharin was provided in sufficient amounts to allow them to intake it voluntarily at 0.1% diluted in water. The Y-maze test and forced swim test (FST) were performed to evaluate cognitive function and the depressive behavior of the rats. The protein expression of the glucocorticoid receptor (GR) in hippocampal cornu ammonis (CA) 1 was investigated by using immunohistochemistry. RESULTS: It was found that, the percentage of alternation in the Y-maze test was significantly (p<.01) higher in the Stress + saccharin group than in the Stress group. Immobility time in the FST was significantly (p<.01) lower in the Stress + saccharin group than in the Stress group. Also, the positive cells of GR in hippocampus CA1 were significantly (p<.05) lower in the Stress + saccharin group than in the Stress group. CONCLUSION: This study showed that there was an effect of saccharin intake in restraint-induced stress response reduction in rats.

Predictive Validity of Some Common Animal Models of Bipolar Disorder Using Lithium and Lamotrigine Therapy: An Attempt towards a Battery-Based Approach for the Evaluation of Mood Stabilizers

OBJECTIVE: To determine the predictive validity of some of the commonly employed models of mania and depression using standard drugs i.e. lithium (70 mg/kg) and lamotrigine (5 mg/kg) in male Wistar rats. METHODS: The depression facet of bipolar disorder was evaluated using forced swim test, tail suspension test, and chronic mild stress test. The models used to evaluate the mania facet of bipolar disorder were isolation-induced aggression test, saccharine preference test, and morphine-sensitized hyperlocomotion test. RESULTS: The immobility time was significantly (p<0.05) reduced by lamotrigine in the tail suspension test and the forced swim test, while lithium caused significant (p<0.05) reduction only in the tail suspension test. Rats exposed to chronic mild stress showed the maximal increment of 1% sucrose consumption at the 3rd week of treatment in both the lithium (p<0.001) and lamotrigine (p<0.01) groups. In the isolation-induced aggression test, the aggressive behaviour of rats was significantly reduced by both lithium [approach (p<0.001), attack (p<0.01), and bite (p<0.01)] and lamotrigine [approach (p<0.001), and attack (p<0.05)]. Neither of the drugs were effective in the saccharine preference test. Only lithium was able to significantly (p<0.05) reduce the crossing parameter in morphine-sensitized rats. CONCLUSION: Our study identifies the chronic mild stress test and isolation-induced aggression test of having the highest predictive validity in the depression and mania facets of bipolar disorder, respectively, and should be a part of a battery of tests used to evaluate novel mood stabilizers.

Artificial sweeteners: safe or unsafe?

Artificial sweeteners or intense sweeteners are sugar substitutes that are used as an alternative to table sugar. They are many times sweeter than natural sugar and as they contain no calories, they may be used to control weight and obesity. Extensive scientific research has demonstrated the safety of the six low-calorie sweeteners currently approved for use in foods in the U.S. and Europe [stevia, acesulfame-K, aspartame, neotame, saccharin and sucralose], if taken in acceptable quantities daily. There is some ongoing debate over whether artificial sweetener usage poses a health threat. This review article aims to cover the health benefits, and risks, of consuming artificial sweeteners, and discusses natural sweeteners which can be used as alternatives

Palatabilizantes em dietas de leitões recém-desmamados / Flavors in diets for weanling pigs

Com o intuito de verificar a eficácia do açúcar e do edulcorante à base de sacarina sódica e neoesperidina nas dietas de leitões, foram realizados dois experimentos, ambos com 42 leitões recém-desmamados aos 21 dias de idade. Foram oferecidas três dietas: dieta controle (DC), dieta com açúcar (DA) e dieta com edulcorante (DE). Os experimentos foram em blocos ao acaso, sendo o primeiro com sete repetições e dois animais por unidade experimental e o segundo com seis repetições, um animal por unidade experimental, e arranjo fatorial 3 x 2 + 1 (três dietas, duas épocas de abate: aos 28 e 35 dias de idade e um abate no dia do desmame). No primeiro experimento, os animais permaneceram nas instalações de creche até 63 dias de idade para avaliação do desempenho e da viabilidade econômica das dietas. No segundo experimento, os animais foram abatidos para se proceder à pesagem de órgãos, medição do comprimento do intestino delgado e coleta dos segmentos do duodeno e jejuno para realização da morfometria intestinal. Não houve diferenças entre as dietas para consumo diário de ração (CDR), ganho diário de peso (GDP) e conversão alimentar (CA) nos períodos 1 (21 aos 28 dias), 3 (21 aos 50 dias) e 4 (21 aos 63 dias de idade). No período 2 (21 aos 35 dias), os animais que consumiram a DE apresentaram maior (P<0,05) CDR e GDP, se comparados aos que consumiram a DA. Nos períodos 1, 2 e 3, foi observado menor custo da dieta por kg de peso vivo ganho e melhores índices econômico e de custo para os animais que consumiram DE. Ao se avaliar a morfometria intestinal e o peso de órgãos, não se observou diferença entre as dietas, com exceção para o peso do estômago, que foi maior nos animais que consumiram DE. A inclusão de edulcorante é eficaz em melhorar o desempenho no período 2, além de ser viável sob o ponto de vista econômico...

In order to verify the effectiveness of sugar and sweeteners containing saccharin and neohesperidin in diets of piglets, two experiments were conducted, both with 42 newborn piglets weaned at 21 days old. Were offered three diets: control diet (DC), diet with sugar (DA) and diet with sweetener (DE). The experiments were done in randomized blocks, the first of which had seven replicates and two animals per experimental unit and the second, six replicates and one animal per experimental unit comprising a factorial 3 x 2 + 1 design (three diets, two slaughter ages: at 28 and 35 days of age and slaughter on the day of weaning). In the first experiment, the animals remained in the nursery facilities until 63 days of age to evaluate the performance and the economic viability of the diets. In the second experiment, the animals were slaughtered to weigh the organs, measure the length of the small intestine and collect segments of the duodenum and jejunum to determine intestinal morphology. There were no differences between diets for the average dairy feed intake (ADFI), average dairy gain (ADG) and gain:feed (G:F) in Periods 1 (21 to 28 days), 3 (21 to 50 days) and 4 (21 to 63 days old). In Period 2 (21 to 35 days), animals that consumed DE had higher (P<0.05) ADFI and ADG, compared to those fed the DA. In Periods 1, 2 and 3 a lower cost per kg of the diet of live weight gain and better economic indicators for the animals fed DE were observed. No differences were observed between the diets when evaluating intestinal morphology and organ weights, except for the weight of the stomach, which was higher in animals fed DE. The inclusion of sweetener is effective in improving performance in Period 2, and is viable under the economical point of view...

Sweet Taste-Sensing Receptors Expressed in Pancreatic beta-Cells: Sweet Molecules Act as Biased Agonists

The sweet taste receptors present in the taste buds are heterodimers comprised of T1R2 and T1R3. This receptor is also expressed in pancreatic beta-cells. When the expression of receptor subunits is determined in beta-cells by quantitative reverse transcription polymerase chain reaction, the mRNA expression level of T1R2 is extremely low compared to that of T1R3. In fact, the expression of T1R2 is undetectable at the protein level. Furthermore, knockdown of T1R2 does not affect the effect of sweet molecules, whereas knockdown of T1R3 markedly attenuates the effect of sweet molecules. Consequently, a homodimer of T1R3 functions as a receptor sensing sweet molecules in beta-cells, which we designate as sweet taste-sensing receptors (STSRs). Various sweet molecules activate STSR in beta-cells and augment insulin secretion. With regard to intracellular signals, sweet molecules act on STSRs and increase cytoplasmic Ca2+ and/or cyclic AMP (cAMP). Specifically, when an STSR is stimulated by one of four different sweet molecules (sucralose, acesulfame potassium, sodium saccharin, or glycyrrhizin), distinct signaling pathways are activated. Patterns of changes in cytoplasmic Ca2+ and/or cAMP induced by these sweet molecules are all different from each other. Hence, sweet molecules activate STSRs by acting as biased agonists.

All in the name of flavour, fragrance & freshness: Commonly used smokeless tobacco preparations in & around a tertiary hospital in India.

Background & objectives: There is a general misconception that smokeless tobacco particularly sweetened and flavoured paan masala and gutkas are safe to use. The present study was undertaken with the objective of highlighting the deceptive and aggressive marketing techniques adopted by the manufacturers of smokeless tobacco preparations exploiting cultural, social and religious values. Another object was to highlight the lack of transparency in terms of content, weight, quality control and warning. Methods: All empty pouches of the used paan masalas, gutka, khaini or surti in and around a tertiary care hospital at east Delhi were collected. Their constituents were studied as per written declaration by the manufacturers on each packet. Information on net weight, cost, presence and type of warning, and quality assurance on each brand provided on side of the packets was noted. Results: A total of 1136 pouches of 33 brands/varieties were collected. Most of the gutka preparations contained tobacco, betel nut, unknown flavouring agents, undeclared spices and heavy metals. Warning regarding the harmful effect of tobacco was written in 90.9 per cent of brands with 81.8 per cent in English language only in minute font. Contents of the products were mentioned in 84.8 per cent of brands and only 27.3 per cent of those mentioned the net weight of the ingredients. Interpretation & conclusions: Seemingly ‘innocuous’ tobacco preparations in the form of paan masalas, gutka, khaini, surti or mouth fresheners contain various harmful substance like tobacco, betel nut, sugar coated fennel, saccharine, heavy metals like silver, unknown flavouring agents and undeclared spices in unknown quantities. Lack of transparency in terms of content, weight, quality control and warning is duping unsuspecting consumers.

Niveles de ingesta diaria de edulcorantes no nutritivos en escolares de la región de Valparaíso / Daily consumption levels of non-nutritive sweeteners in school age children from the Valparaiso region

Introduction: Artificial sweeteners are substances that do not provide energy and are added to foods to provide a sweet taste. Sweeteners are used to replace sugar either in part or entirely. Objective: To determine the consumption of artificial sweeteners in school children 6 to 14 years of age in the Valparaiso Region of Chile and to compare consumption according to nutritional status. Methods: 281 students of both sexes underwent anthropometric assessment (weight and height) and completed a food survey on the consumption of sweeteners. Results: 100% of students consume foods or products containing artificial sweeteners, although no student consumed more than the maximum allowed. When comparing by nutritional status, obese children, compared to those with normal weight had a higher consumption of sucralose, aspartame, saccharin and acesulfame potassium (p <0.05). Conclusion: The intake of sweeteners is massive, but consumption does not exceed permitted levels in this study sample.

Introducción: Los edulcorantes artificiales son sustancias que no aportan energía y que se agregan a los alimentos para proporcionarles un sabor dulce. Se emplean para reemplazar total o parcialmente el azúcar. Objetivo: Determinar el consumo de edulcorantes artificiales en escolares de 6 a 14 años de la región de Valparaíso y comparar su consumo según su estado nutricional. Métodos: A 281 estudiantes de ambos sexos se les realizó una evaluación antropométrica (peso y talla) y una encuesta alimentaria sobre consumo de edulcorantes. Resultados: El 100% de los estudiantes consumió alimentos o productos con contenido de edulcorantes, aunque ninguno de ellos sobre la dosis máxima admitida. Al comparar por estado nutricional, los estudiantes con obesidad presentaron una mayor consumo de sucralosa, aspartamo, sacarina y acesulfamo de potasio (p<0.05). Conclusión: La ingesta de edulcorantes es masiva, pero su consumo no sobrepasa los niveles permitidos por el Reglamento Sanitario de los Alimentos en la muestra estudiada.

Effect of chlorhexidine gel containing saccharin or aspartame in deaf children highly infected with mutans streptococci

Aim: Since deaf children are unable to comprehend or cooperate with dental treatment due to lack of communication, preventive measures may be an important way to control the high prevalence of dental caries in these patients. The aim of the this study was to evaluate the effect of an intensive treatment with chlorhexidine (CHX) gel, containing either saccharin or aspartame, in deaf children highly infected with mutans streptococci (MS). Methods: Eighteen children were randomly divided into two groups, according to the sweetener used to improve the CHX gel bitter taste: saccharin or aspartame. Before CHX treatment, saliva samples were collected to establish baseline microbial data for MS. CHX gel was applied on two consecutive days, four times the first day and three times the second day. Saliva samples were then taken after 7, 30, 60, 90 and 120 days to evaluate MS oral recolonization. Results: CHX gel containing saccharin was not effective on the reduction of MS levels, while the gel containing aspartame decreased significantly MS levels after treatment (P<.05). Conclusions: Although a new CHX application may be necessary after 60 days to control caries risk and MS levels, CHX treatment should be individually controlled because of variations in the response of subjects.

Effect of topical steroids on mucociliary clearance and nasal symptom score

Allergic rhinitis is one of the most common ENT diseases in Faisalabad. The affects of topical steroids on nasal mucosal environment has not been studied reliably. To see the affects of topical steroids on symptom score and mucociliary clearance in Allergic Rhinitis. To see whether symptom score change with change in mucociliary clearance after topical application of steroids. A quasi-experimental study. ENT Unit, Madina Teaching Hospital, Faisalabad [a tertiary care hospital]. [sample, sampling technique]: Non-probability convenience sampling. Fifty patients in total. Saccharine with dye: india ink [Indigocarmine] application on anterior end of inferior turbinate to check mucociliary clearance. [Main outcome measures]: To assess change in mucociliary clearance time and symptom score [total as well as individual] before and after application of steroid at one, three and six months in patients having allergic rhinitis. Each nasal symptom was scored as zero to 3 on a severity scale [absent-mild-moderatesevere]. Patients were tested for nasal mucociliary clearance and symptom score before and after application of steroid. The results showed statistically significant difference in these groups. 1.Topical steroids modify the nasal mucosal environment in terms of mucociliary clearance and thus affects the patients quality of life in terms of allergic rhinitis symptom score 2. More long term follow up and wider studies are required to study the definite affects of steroids on nasal mucosa

Effects of oropharyngeal taste stimuli in the restoration of the fasting-induced activation of the HPA axis in rats

INTRODUCTION: This study examined the regulatory mechanism underlying the meal-induced changes in the hypothalamic-pituitary-adrenal gland (HPA) axis activity. MATERIALS AND METHODS: Male Sprague-Dawley rats (250-300 g) were hired for two different experiments as follows; 1) rats received either 8% sucrose or 0.2% saccharin ad libitum after 48 h of food deprivation with the gastric fistula closed (real feeding) or opened (sham feeding). 2). rats received 5 ml of intra-oral infusion with 0.2% saccharin or distilled water after 48 h of food deprivation. One hour after food access, all rats were sacrificed by a transcardiac perfusion with 4% paraformaldehyde. The brains were processed for c-Fos immunohistochemistry and the cardiac blood was collected for the plasma corticosterone assay. RESULTS: Real feedings with sucrose or saccharin and sham feeding saccharin but not sucrose, following food deprivation decreased the plasma corticosterone level. c-Fos expression in the nucleus tractus of solitarius (NTS) of the fasted rats was increased by the consumption of sucrose but not saccharin, regardless of the feeding method. On the other hand, the consumption of sucrose or saccharin with real feeding but not the sham, induced c-Fos expression in the paraventricular nucleus (PVN) of the fasted rats. The intra-oral infusion with saccharin or water decreased the plasma corticosterone level of the fasted rats. Intra-oral water infusion increased c-Fos expression in both the PVN and NTS, but saccharin only in the NTS in the fasted rats. CONCLUSION: Neither restoration of the fasting-induced elevation of plasma corticosterone nor the activation of neurons in the PVN and NTS after refeeding requires the palatability of food or the post-ingestive satiety and caloric load. In addition, neuronal activation in the hypothalamic PVN may not be an implication in the restoration of the fasting-induced elevation of the plasma corticosterone by oropharyngeal stimuli of palatable food.

Revisão da literatura sobre recomendações de utilização de edulcorantes em gestantes portadoras de diabetes mellitus / Literature Review about recommendations of use of sweeteners in pregnant women with diabetes mellitus

Trata-se de uma revisão narrativa do conhecimento disponível na literatura sobre a recomendação de edulcorantes nos casos de diabetes na gestação, com consulta às seguintes bases de dados: Medline, Lilacs e PubMed, tendo como base os períodos de 1978 a 2009. Os edulcorantes são classificados em nutritivos e não-nutritivos. Atualmente, o aspartame é alvo de várias críticas, porém a American Diabetes Association (ADA), revisando as evidências científicas acerca da inocuidade do aspartame, declara que o edulcorante não é carcinogênico e não está associado a desordens neurológicas. Quanto à sacarina, alguns autores recomendam restrição do consumo desta por gestantes, devido à falta de informações conclusivas sobre possíveis efeitos no desenvolvimento fetal, além das poucas evidências sobre seu efeito transplacentário e transmamário. A ADA não recomenda o uso do esteviosidio como edulcorante. Os edulcorantes não-calóricos atualmente aprovados para uso pela população em geral, incluindo as gestantes são: aspartame, acesulfame-K, sacarina, sucralose e neotame. Na orientação dietética, deve-se considerar a quantidade permitida por dia e esclarecer à cliente sobre a importância de controlar a dose utilizada, além de revisar periodicamente os tipos de edulcorantes presentes nos adoçantes e produtos dietéticos disponíveis no mercado.

The present narrative review article accounts for the available knowledge about the recommended use of sweeteners in cases of gestational diabetes, according to the Medline, Lilacs and PubMed databases from 1978 to 2009. Sweeteners are classified as nutritive and non-nutritive. Currently, aspartame is being strongly criticised despite the American Diabetes Association (ADA) having stated that it is not carcinogenic nor associated with neurological disorders. As for saccharin, some authors recommend a restricted intake by pregnant women due to the lack of conclusive information about its possible effects on fetal development, and to the little evidence of its transplacental and transmammary effects. The ADA does not recommend the use of stevioside as a sweetener. The approved low-calorie sweeteners for all population, including pregnant women, are aspartame, acesulfame-K, saccharin, sucralose and neotame. During diet orientation, the allowed daily intake should be considered, the importance of controlling the dose should be explained to the patient, and the sweeteners used in diet products available in the market should be frequently revised.

Effects of Saccharin Intake on Hippocampal and Cortical Plasticity in Juvenile and Adolescent Rats

The sensory system is developed and optimized by experiences given in the early phase of life in association with other regions of the nervous system. To date, many studies have revealed that deprivation of specific sensory experiences can modify the structure and function of the central nervous system; however, the effects of sensory overload remains unclear. Here we studied the effect of overloading the taste sense in the early period of life on the synaptic plasticity of rat hippocampus and somatosensory cortex. We prepared male and female Sprague Dawley rats with ad libitum access to a 0.1% saccharin solution for 2 hrs per day for three weeks after weaning on postnatal day 22. Saccharin consumption was slightly increased in males compared with females; however, saccharin intake did not affect chow intake or weight gain either in male or in female rats. We examined the effect of saccharin-intake on long term potentiation (LTP) formation in hippocampal Schaffer collateral pathway and somatosensory cortex layer IV - II/III pathways in the 6-week old saccharin-fed rats. There was no significant difference in LTP formation in the hippocampus between the control group and saccharin-treated group in both male and female rats. Also in the somatosensory cortex, we did not see a significant difference in LTP among the groups. Therefore, we conclude that saccharin-intake during 3~6 weeks may not affect the development of physiological function of the cortical and hippocampal synapses in rats.

Padronização dos critérios de seleção em estudos sobre medicações nasais / Standardizing selection criteria in nasal medication studies

Estudos clínicos sobre medicações tópicas nasais exigem a padronização de "normalidade nasossinusal" na constituição de grupos controle através de uma avaliação específica da via aérea superior. Objetivo: Padronizar a avaliação de candidatos a grupos controle em estudos clínicos sobre medicações tópicas nasais. Material e métodos: Voluntários do sexo masculino, de 18 a 50 anos, que se declararam saudáveis, livres de doenças e assintomáticos nasossinusais foram submetidos a uma avaliação sequencial e excludente composta de uma avaliação clínica, teste cutâneo de hipersensibilidade imediata, teste da sacarina, nasofibroscopia flexível e citograma nasal. Desenho do estudo: Coorte contemporânea com corte transversal. Resultados: Dos 33 indivíduos inicialmente incluídos, 14 (42,4 por cento) foram excluídos na avaliação clínica. Dos 19 restantes, 2 (10,5 por cento) apresentaram atopia no teste cutâneo, sendo excluídos. 17 foram submetidos ao teste da sacarina demonstrando em todos os casos uma depuração mucociliar normal, sendo avaliados por nasofibroscopia flexível que detectou anormalidade em 2 casos (11,8 por cento) e excluídos. Os 15 restantes foram submetidos ao citograma nasal, demonstrando normalidade, representando 45,5 por cento dos indivíduos inicialmente incluídos. Conclusão: O protocolo proposto de avaliação sequencial e excludente foi efetivo na definição de candidatos à constituição de grupos controle em estudos clínicos sobre medicações tópicas nasais.

Clinical studies on nasal topical medications require the standardization of "nasosinusal normality" in order to establish control groups through a specific evaluation of the upper airways. AIM: to standardize the evaluation of candidates for control groups in clinical studies on nasal topical medications. Material and methods: healthy male volunteers of 18 to 50 years of age, asymptomatic from the nasosinusal standpoint were subjected to a sequential and excluding assessment made up of clinical evaluation, immediate hypersensitivity skin test, saccharin test, flexible nasofibroscopy and nasal cytology. Study design: Cross-sectional contemporary cohort. Results: Of the 33 people originally enrolled, 14 (42.4 percent) were excluded for clinical reasons. Of the 19 remaining, 2 (10.5 percent) had atopy diagnosed in the skin test and were excluded. 17 were tested with saccharin and presented normal mucociliary clearance. Evaluation by nasal endoscopy showed abnormality in 2 cases (11.8 percent) and these were excluded. The remaining 15 were submitted to nasal cytology, which proved normal, representing 45.5 percent of those initially included. Conclusion: The proposed protocol for sequential and excluding evaluation was effective in defining candidates for the establishment of control groups in clinical studies on nasal topical medications.

profile of natural sweetener - stevia

The small perennial shrub, Stevia rebaudiana Bertoni is native to valley of Rio Monday in Paraguay. It is one of 150 species of genus Stevia which contains diterpene glycosides e.g. Stevioside, Rebaudioside A, B, C [Dulcoside B], D, E, F, [Dulcoside A], Steviolmonoside, Steviolbioside and Rubusoside in its leaves. All these are responsible for making Stevia about 300 times sweeter than sucrose [0.4% solution]. Stevioside and Rebaudioside A are the abundant glycosides in this plant responsible for the potent sweet taste of the drug. Extract of Stevia leaves have been used for many years as sweetening agent in traditional treatment of diabetes in South America. Several studies demonstrated that Stevia significantly decreases glucose level and increases glucose tolerance in diabetic type II volunteers and experimental animals. Stevioside and Rebaudioside A exert hypoglycemic, insulinotropic [enhance insulin release] and glucogonostatic activities. Organoleptic evaluation of Stevia for sweetener properties demonstrated that it exerts intensively sweet taste superior to most of other sweeteners. Other pharmacological activities such as antihypertensive, anticancer, non-carcinogenic, gastroprotective, antibacterial etc. have been demonstrated by several studies. The present literature survey reveals the phytochemical and pharmacological activities of the Stevia rebaudiana Bertoni