Alterations in the plasma metabolite profile associated with improved hepatic function and glycemia in mice fed lingonberry supplemented high-fat diets.

SCOPE: Lingonberries have been shown to reduce the detrimental effects of high-fat diet (HFD) on weight gain, plasma glucose, and inflammation. However, the extent of effects was recently shown to vary between different batches of berries. Here, we examine the metabolic response to two independent batches of lingonberries. METHODS AND RESULTS: Alterations in the phenotype and circulating metabolome elicited by three matched HFDs, two of which containing lingonberries (L1D and L2D) from different sources, were investigated. Glycemia was improved only in mice fed L1D, whereas liver function was improved and inflammation reduced in mice fed both L1D and L2D, compared to mice fed HFD. The unique improvement in glycemia elicited by L1D was associated with a 21% increase in circulating levels of fatty acids. Increased levels of phosphatidylcholines (62%) and lysophosphatidylcholines (28%) and decreased levels of serine (-13%) and sphingomyelins (-26%) were observed in mice fed L1D and L2D, as compared to HFD. CONCLUSION: The unique improvement in glycemia in mice fed L1D was associated with a normal metabolic control with an altered set point. Moreover, the batch-independent reduction in liver steatosis and inflammation, was associated with an altered sphingomyelin metabolism.

In vitro interactions with repeated grapefruit juice administration--to peel or not to peel?

Interactions of acutely administered grapefruit juice (GFJ) with cytochrome P450 isoform 3A4 (CYP3A4) and P-glycoprotein (Pgp) function are well established. In this study, we investigated in vitro the effect of repeated administration of GFJ and its major constituents (the flavonoid naringin, its aglycone naringenin and the furanocoumarin bergamottin) on mRNA expression of MDR1 and CYP3A4 in LS180 cells. Since the bergamottin content is higher in the peel than in the fruit, we compared GFJ containing peel (GFJP+) with juice without any peel extract (GFJP-). GFJP- (1%) showed no significant effect on MDR1 and CYP3A4 mRNA expression, whereas 1% GFJP+ increased expression of MDR1 3.7-fold (P<0.01) and CYP3A4 2.3-fold (P<0.05). Of the tested constituents, only 10 microM bergamottin and 200 microM naringenin induced MDR1 mRNA levels 2.9- and 4.0-fold, respectively (P<0.01 for both), and CYP3A4 mRNA levels 3.2- and 15.6-fold (P<0.01 for both), respectively. Western blot analysis and rhodamine 123 uptake experiments partly confirmed these findings on the protein and the functional level. In summary, GFJ containing no peel extract may have a lower potential for interactions with CYP3A4 or P-glycoprotein.

Autologous blood donation in cardiac surgery: reduction of allogeneic blood transfusion and cost-effectiveness.

OBJECTIVE: The purpose of this study was to assess transfusion requirements in patients undergoing cardiac surgery with and without autologous blood donation and to calculate the costs of predonation from the hospital perspective. DESIGN: Observational study. SETTING: Single university hospital. PARTICIPANTS: Four thousand three hundred twenty-five patients undergoing elective cardiac surgery with and without autologous blood donation. INTERVENTIONS: Eight hundred forty-nine patients (20%) underwent autologous blood donation, whereas 3,476 (80%) did not. Perioperative allogeneic blood transfusion was recorded as the primary endpoint. To avoid selection bias, patients were stratified according to their preoperative risk score. A decision model was derived from acquired data for the optimization of autologous blood donation. MEASUREMENTS AND MAIN RESULTS: Allogeneic blood transfusion rate was 13% in patients with predonation versus 48% without predonation (p < 0.05). This difference remained statistically significant even after risk stratification. The predonation of 1, 2, or 3 units reduced the probability of receiving allogeneic blood to 24%, 14%, and 9%, respectively. An efficient program of predonation within the department of anesthesiology allowed keeping the costs of predonation low. Decision-tree analysis revealed that predonation of 2 autologous units of blood saved the most allogeneic blood for the smallest increase in costs. Incremental cost for male patients predonating 2 units was dollars 33 (US), whereas for females predonation could be done at no extra cost in comparison to patients without predonation. CONCLUSION: Autologous blood donation significantly reduces allogeneic blood requirement in cardiac surgery. If adjusted for diagnosis and gender, autologous blood donation is a cost-effective alternative to reduce allogeneic blood consumption.

Cost-of-illness in patients with moderate and severe chronic psoriasis vulgaris in Germany.

BACKGROUND: Data regarding costs of outpatient and office-based care, as well as out-of-pocket expenses, for psoriasis patients in Germany are not available. Aim of this study was to assess average annual cost and cost per flare of outpatient and office-based care for patients with moderate to severe chronic psoriasis vulgaris from several perspectives. METHODS: In this multi-center, cross-sectional, retrospective and prospective cost-of-illness study, direct (medical and non-medical) and indirect costs were considered from patient, third-party payer (TPP) and societal perspectives. RESULTS: Out of 227 patients enrolled consecutively in 17 centers, 192 cases could be analyzed. On average, TPP reimbursed 864 per patient annually, 60 % for prescribed medication and 22 % for hospitalization. Patients spent 596 yearly mainly for alternative therapies and OTC-medication/skin care products as well as for additional expenses (e. g. ultraviolet lamp, clothes or cleaning agents). Indirect costs per patient amounted to 1,440 yearly. Total annual costs per patient were 2,866 and 4,985 if treated with systemic drugs additionally. 1,173 if treated topically and/or with phototherapy. CONCLUSIONS: The relatively high average annual costs per patient indicate need for efficient control of psoriasis. This cost-of-illness study provides basic data for further decision making, including economic assessment of innovative therapies for psoriasis.