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1.
J Food Sci ; 84(9): 2666-2673, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31441517

RESUMO

Natural plant extracts are increasingly used as functional feed ingredients in animal husbandry and food ingredients in human alternative medicine to improve welfare and health. We investigated in 20 growing pigs via functional magnetic resonance imaging (fMRI) the brain blood oxygen level-dependent (BOLD) responses to olfactory stimulation with two sensory functional feed ingredients, A and B, at two different concentrations. Functional ingredient A contained extracts from Citrus sinensis (60% to 80%), and ingredient B contained a mixture of extracts Oreganum vulgarae (40% to 55%) and Cymbopogon flexuosus (20% to 25%). Increased concentration of ingredients induced a higher activation in reward and cognitive areas compared to lower concentrations. Moreover, considering both ingredients at the highest concentration, the ingredient A elicited higher brain responses in brain areas involved in hedonism/pleasantness compared to ingredient B, and more specifically in the caudate nucleus and orbitofrontal cortex. Our findings shed new light in the scope of emotion regulation through olfactory modulation via sensory functional ingredients, which opens the way to further preclinical studies in animal models and translational research in the context of nutrition, welfare, and health. PRACTICAL APPLICATION: Functional food/feed ingredients are gaining interest for improving health and welfare in humans and animals. Besides representing an alternative to antibiotics for example, food ingredients and their sensory characteristics might have a positive impact on emotions and consequently on well-being. Functional brain imaging in large animals such as in the pig model is a promising approach to investigate the central and behavioural effects of food ingredients, and determine the most effective blends and concentrations to modulate internal and emotional states.


Assuntos
Estimulantes do Apetite/farmacologia , Encéfalo , Imagem por Ressonância Magnética , Olfato , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Emoções/efeitos dos fármacos , Emoções/fisiologia , Ingredientes de Alimentos , Alimento Funcional , Extratos Vegetais , Olfato/efeitos dos fármacos , Olfato/fisiologia , Suínos
2.
Curr Gastroenterol Rep ; 21(10): 51, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31444689

RESUMO

PURPOSE OF REVIEW: This review provides an approach for resolving a variety of feeding difficulties in children, ranging from normal eating behavior that is misperceived as a problem to substantial feeding disorders. RECENT FINDINGS: Criteria to identify pediatric feeding disorders have been thoroughly addressed in the newly established designations of avoidant restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD). These diagnostic criteria improve the accuracy of identifying, classifying, and managing significant feeding disorders in young children. While recent definitions of feeding difficulties are particularly appropriate in multidisciplinary settings, in this paper, we advocate for a progressive approach of managing feeding problems in all clinical settings. It begins by identifying red flags indicative of serious threats to the child, screening for oral motor dysfunction, stabilizing nutrient intake, and eliminating aversive feeding practices. The next step, if eating behavior does not improve, involves strategies that target specific eating behaviors and parental feeding styles. In severe or resistant cases, referral to specialists or interdisciplinary feeding teams is advised.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Apetite , Estimulantes do Apetite/uso terapêutico , Transtorno da Evitação ou Restrição da Ingestão de Alimentos , Criança , Medo , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Seletividade Alimentar , Preferências Alimentares , Humanos , Poder Familiar , Equipe de Assistência ao Paciente/organização & administração
3.
Int Urol Nephrol ; 51(9): 1631-1638, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31359357

RESUMO

PURPOSE: Malnutrition, inflammation and poor quality of life are prevalent among elderly haemodialysis patients. Megestrol acetate (MA) is a synthetic progestin that is widely used to increase appetite and weight in various clinical settings. MA has been indicated to be effective in improving quality of life in patients with cancers. The aim of the present study was to evaluate the efficacy and safety of MA in treating malnourished elderly haemodialysis patients. METHODS: A randomized controlled study involving 46 hypoalbuminemia haemodialysis patients aged 70 years or older was conducted. The patients in MA-treated group (n = 23) took 160 mg of MA daily, while those in control group (n = 23) were enrolled without any intervention. Anthropometric parameters and laboratory results, including height, dry weight, body mass index, and modified subjective global assessment score as well as serum albumin, triglyceride, total cholesterol, hsCRP, IL-1b and IL-6 concentrations were measured in all patients before and after the intervention. Health-related quality of life was also evaluated using the KDQOL-SF 1.3. RESULTS: In the MA-treated group, a total of 18 patients finished the therapy over a 3-month period. Appetite was reported as improved by 15 patients, and a statistically significant increase was observed in dry weight (53.36 ± 6.15 vs. 54.24 ± 6.32, P < 0.01) and serum albumin concentration (29.05 ± 3.91 vs. 37.67 ± 4.88, P < 0.01) in the MA-treated group compared to those of the control group. The quality of life in both the physical domain (46.73 ± 18.17 vs. 63.37 ± 22.35, P < 0.01) and the mental domain (50.28 ± 20.36 vs. 68.02 ± 25.48, P < 0.01) was also improved in the same group. There was no significant change in the inflammatory marker concentrations after the intervention. No serious or unexpected adverse events were observed except that one patient who withdrew due to excessive fluid gain between haemodialysis sessions. CONCLUSION: Our data suggest that MA can be effective in improving nutritional status and quality of life by increasing appetite in elderly haemodialysis patients with acceptable side effects; however, MA might not ameliorate inflammation.


Assuntos
Estimulantes do Apetite/uso terapêutico , Inflamação/tratamento farmacológico , Desnutrição/tratamento farmacológico , Acetato de Megestrol/uso terapêutico , Qualidade de Vida , Diálise Renal , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
4.
Adv Food Nutr Res ; 88: 275-298, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31151726

RESUMO

The production of engineered nanomaterials (ENMs) has increased exponentially over the last few decades. ENMs, made from use of engineered nanoparticles (ENPs), have been applied to the food, agriculture, pharmaceutical, and automobile industries. Of particular interest are their applications in packaging nanocomposites for consumer and non-consumer goods. ENPs in nanocomposites are of interest as a packaging material because they reduce the amount of polymer needed, while improving the physical properties. However, the transformation of ENPs in nanocomposite production, their fate, and their toxicity remain unknown while in contact with the package content or after the end of life. The objectives of this chapter are (a) to provide an overview of the main nanoclays used in packaging; (b) to categorize the main polymeric packaging nanocomposites; (c) to provide an overview of the fate and mass transport of ENPs, especially nanoclays; (d) to describe the mass transfer of nanoclays in food simulants and in compost environments; and (e) to identify current and future research needs.


Assuntos
Estimulantes do Apetite/metabolismo , Argila , Compostagem/normas , Embalagem de Alimentos/métodos , Nanocompostos/normas , Argila/química , Argila/classificação , Argila/normas , Compostagem/métodos , Embalagem de Alimentos/normas , Nanocompostos/toxicidade , Pesquisa/normas , Pesquisa/tendências
5.
Vet Clin North Am Small Anim Pract ; 49(5): 837-854, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31176457

RESUMO

Appetite influences perceived quality of life for a dog or cat with cancer. Inappetence often is multifactorial, complicating treatment. Cancer-related anorexia/cachexia syndrome is a metabolic, paraneoplastic syndrome characterized by decreased food intake, involuntary weight loss, and loss of fat and muscle. If weight loss/cachexia has an impact on canine and feline cancer patients as in humans, management may improve survival times and quality of life. The challenge is having effective, proved therapies available for clinical use. Recent Food and Drug Administration approvals for appetite stimulation have renewed interest and discussion and has the potential to alter the course of case management.


Assuntos
Anorexia/veterinária , Caquexia/veterinária , Doenças do Gato/terapia , Doenças do Cão/terapia , Neoplasias/veterinária , Animais , Anorexia/complicações , Anorexia/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estimulantes do Apetite/uso terapêutico , Caquexia/complicações , Caquexia/terapia , Canabidiol/uso terapêutico , Doenças do Gato/etiologia , Gatos , Doença Crônica , Doenças do Cão/etiologia , Cães , Neoplasias/complicações , Qualidade de Vida
6.
Br Poult Sci ; 60(3): 317-322, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30892928

RESUMO

1. The aim of the current study was to determine the effects of the central dopaminergic system on N/OFQ-induced feed intake in 3-h feed-deprived neonatal broilers. 2. In experiment 1, chicken received intracerebroventricular (ICV) injections of a control solution, SCH 23 390 (D1 receptors antagonist, 5 nmol), N/OFQ (16 nmol) or their combination (SCH23 390 + N/OFQ). In experiment 2, a control solution, AMI-193 (D2 receptors antagonist, 5 nmol), N/OFQ (16 nmol) or their combination (AMI-193 + N/OFQ) were ICV injected into chickens. In experiment 3, birds received ICV injections of a control solution, NGB2904 (D3 receptors antagonist, 6.4 nmol), N/OFQ (16 nmol) and co-injection of NGB2904 + N/OFQ. In experiment 4, ICV injections of the control solution, L-741,742 (D4 receptors antagonist, 6 nmol), N/OFQ (16 nmol) or their combination (L-741,742 + N/OFQ) were applied to broilers. In experiment 5, birds were ICV injected with control solution, L-DOPA (dopamine precursor, 125 nmol), N/OFQ (16 nmol) and L-DOPA + N/OFQ. Cumulative feed intake was recorded until 120 min after injection. 3. According to the results, ICV injection of N/OFQ significantly increased feed intake (P < 0.05). Co-injection of N/OFQ and D1 receptor antagonist (SCH 23390) amplified hyperphagic effect of N/OFQ (P < 0.05). The N/OFQ-induced feed intake was increased by the D2 receptor antagonist (P < 0.05). The hyperphagic effect of N/PFQ was weakened by co-injection of L-DOPA + N/OFQ (P < 0.05). 4. These results suggested that an interaction exists between dopamine and N/OFQ via D1 and D2 receptors on central feed intake in neonatal broiler chickens.


Assuntos
Estimulantes do Apetite/farmacologia , Galinhas/fisiologia , Comportamento Alimentar/efeitos dos fármacos , Peptídeos Opioides/farmacologia , Ração Animal , Animais , Animais Recém-Nascidos/fisiologia , Estimulantes do Apetite/administração & dosagem , Benzazepinas/administração & dosagem , Injeções Intraventriculares/veterinária , Peptídeos Opioides/administração & dosagem
7.
Appetite ; 137: 62-72, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30825493

RESUMO

OBJECTIVE: A systematic review identifying the use of cyproheptadine (CY) as an appetite stimulant was completed. METHOD: Studies of any design exploring the efficacy of CY as an appetite stimulant in all age groups and populations were included. Primary outcomes of studies included were weight gain, appetite stimulation, and/or caloric/nutritional intake increase. The review was completed in accordance with PRISMA standards. RESULTS: A total of 46 articles across 21 different treatment populations met criteria for the review, including 32 randomized controlled trials, 4 prospective cohort studies, 4 retrospective cohort studies, 4 case reports and 2 case series. Of these, 39 demonstrated that CY resulted in significant weight gain in the sample under study. Studies exploring the use of CY in those with malignant/progressive disease states, such as HIV and cancer, showed minimal to no benefit of the medication. Transient mild to moderate sedation was the most commonly reported side effect. Studies included were heterogeneous in terms of methods as well as study patient demographics, characteristics and concurrent medical conditions. Few studies provided objective measures of appetite change. DISCUSSION: CY appears to be a safe, generally well-tolerated medication that has utility in helping facilitate weight gain in patients drawn from a variety of underweight populations. Future prospective randomized controlled studies in low weight patients that include objective measures of appetite and intake are needed to better understand the mechanism by which CY augments weight gain.


Assuntos
Estimulantes do Apetite/farmacologia , Apetite/efeitos dos fármacos , Ciproeptadina/farmacologia , Ganho de Peso , Anorexia Nervosa/tratamento farmacológico , Humanos , Desnutrição/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Magreza/tratamento farmacológico
8.
Future Oncol ; 15(9): 1035-1049, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30720344

RESUMO

Despite remaining one of the most widely abused drugs worldwide, Cannabis sativa exhibits remarkable medicinal properties. The phytocannabinoids, cannabidiol and Δ-9-tetrahydrocannabinol, reduce nausea and vomiting, particularly during chemotherapy. This is attributed to their ability to reduce the release of serotonin from enterochromaffin cells in the small intestine, which would otherwise orchestrate the vomiting reflex. Although there are many preclinical and clinical studies on the effects of Δ-9-tetrahydrocannabinol during nausea and vomiting, little is known about the role that cannabidiol plays in this scenario. Since cannabidiol does not induce psychotropic effects, in contrast to other cannabinoids, its use as an anti-emetic is of great interest. This review aims to summarize the available literature on cannabinoid use, with a specific focus on the nonpsychotropic drug cannabidiol, as well as the roles that cannabinoids play in preventing several other adverse side effects of chemotherapy including organ toxicity, pain and loss of appetite.


Assuntos
Antineoplásicos/efeitos adversos , Dor do Câncer/prevenção & controle , Canabidiol/uso terapêutico , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Náusea/tratamento farmacológico , Vômito/tratamento farmacológico , Analgésicos não Entorpecentes/farmacologia , Analgésicos não Entorpecentes/uso terapêutico , Antieméticos/farmacologia , Antieméticos/uso terapêutico , Apetite/efeitos dos fármacos , Estimulantes do Apetite/farmacologia , Estimulantes do Apetite/uso terapêutico , Dor do Câncer/induzido quimicamente , Canabidiol/farmacologia , Cannabis/química , Transtornos da Alimentação e da Ingestão de Alimentos/induzido quimicamente , Humanos , Náusea/induzido quimicamente , Neoplasias/tratamento farmacológico , Vômito/induzido quimicamente
10.
Brain Res Bull ; 146: 310-319, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30716394

RESUMO

Alcohol use disorder and depression show a high comorbidity at clinical level with no treatment available selectively for this condition. A hyperfunction of acid sphingomyelinase (ASM) and resulting ceramide overload were recently identified as one pathway into this comorbidity. Here we analyzed the involvement of ASM, one of the main enzymes involved in ceramide synthesis, in the molecular control of monoaminergic systems in their basal activity and in response to pharmacological and natural reinforcers. The effects of alcohol and a palatable food on the extracellular levels of dopamine (DA), serotonin (5-HT), and noradrenaline (NE) were measured by in-vivo microdialysis in ASM overexpressing mice (tgASM). We found reduced basal extracellular DA levels in the nucleus accumbens (Nac) and dorsal hippocampus (DH) of tgASM mice with little effect on 5-HT and NE levels. In contrast, ASM overexpression potentiated the DA response to alcohol (2 g/kg, i.p.) in the DH and Nac, but reduced NE responses. DA and NE responses to a food stimulus were not altered in tgASM mice, but the Nac 5-HT response was enhanced. An immunohistochemical analysis of the DH showed a preserved dopaminergic and serotonergic innervation in tgASM mice and in mice that consumed alcohol for one month. These findings suggest a direct modulation of monoaminergic basal activity and/or responses to reinforcing stimuli by the sphingolipid regulatory enzyme ASM in mice.


Assuntos
Estimulantes do Apetite/metabolismo , Apetite/efeitos dos fármacos , Esfingomielina Fosfodiesterase/metabolismo , Consumo de Bebidas Alcoólicas/metabolismo , Animais , Dopamina/metabolismo , Etanol/metabolismo , Hipocampo/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Norepinefrina/metabolismo , Núcleo Accumbens/efeitos dos fármacos , Serotonina/metabolismo , Esfingomielina Fosfodiesterase/fisiologia
11.
Ann Palliat Med ; 8(1): 86-101, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30525762

RESUMO

Clinicians often believe that cachexia is caused by cancer and anorexia as a toxicity of chemotherapy or targeted anti-cancer agents. It is now recognized that chemotherapy and certain targeted agents cause sarcopenia which reduce physical function and quality of life. Pre-treatment sarcopenia predicts chemotherapy toxicity, reduced response, increased disability, poor anti-tumor response and survival. Though bioelectrical impedance and dual energy X-ray absorptiometry (DEXA) scans have been used in the past for body composition measurements, CT scan cuts at the level of the 3rd lumbar vertebral body with measurement of skeletal muscle and visceral and subcutaneous fat areas has become standard. Nonpharmacological approaches to reducing sarcopenia during chemotherapy includes resistance training and dietary counselling. Pharmacologic therapies include vitamin D replacement if depleted, omega-3 fatty acids, testosterone and selective androgen receptor modulators (SARMS) and ghrelin. A comprehensive multimodal and multiple drug approach is likely to be better than single modalities. However, this is yet to be proven. Finally, it is not known if intervening to prevent or reverse sarcopenia will have a clinical benefit in terms of better tolerance to cancer therapy, physical function, well-being, tumor response and survival. Reversing sarcopenia and improving objective outcomes should be the goal of therapy.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias/tratamento farmacológico , Sarcopenia/induzido quimicamente , Absorciometria de Fóton , Antagonistas de Receptores de Andrógenos/uso terapêutico , Estimulantes do Apetite/uso terapêutico , Terapia Combinada , Proteínas na Dieta/administração & dosagem , Ácidos Graxos Ômega-3/uso terapêutico , Grelina/uso terapêutico , Humanos , Terapia de Alvo Molecular/efeitos adversos , Doenças Musculares/induzido quimicamente , Neoplasias/dietoterapia , Obesidade/induzido quimicamente , Treinamento de Resistência/métodos , Sarcopenia/diagnóstico por imagem , Sarcopenia/terapia , Testosterona/uso terapêutico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vitamina D/administração & dosagem
12.
Ann Palliat Med ; 8(1): 33-42, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30525763

RESUMO

Cancer cachexia (CC) is common in advanced cancer and is accompanied by negative effects on health-related quality of life (HRQOL). However, methods to identify the impact of CC on HRQOL are limited. Single questionnaire items may provide insight on the effect of CC on HRQOL. Specifically, the use of "feeling of wellbeing" (FWB) on the Edmonton Symptom Assessment System (ESAS) questionnaire and the Distress Thermometer (DT) have been explored. Assessing how these two surrogate measures of HRQOL are impacted among CC stages and what drives these negative effects may allow for focused treatments. Five-hundred and twelve patients referred to a Cancer Rehabilitation Program completed the ESAS, with the question on FWB and the DT at baseline. Patients were separated into CC stages: non-cachexia (NC), pre-cachexia (PC), cachexia (C), refractory cachexia (RC). A mixed model ANOVA with post hoc Tukey adjustment was used to compare means of FWB and distress among the CC stages. To understand what was driving the differences between CC stages, a robust regression model was created with either distress or FWB as the outcome measure, dependent on the other measures in ESAS, age and sex. Finally, the use of cannabinoids in treating appetite loss was examined, as it has a detrimental effect on FWB; 54 patients underwent cannabinoid treatment for appetite loss within a community-based, physician-lead, medical cannabis clinic. A t-test to assess changes in ESAS appetite score after 3 months of cannabinoid treatment was examined. RC patients had a significantly poorer sense of wellbeing than the other cachexia stages (RC: 6.07±0.33). Significant differences in distress were identified between RC patients and those with NC and C, but not with PC (RC: 4.87±0.38, NC: 3.35±0.26, PC: 4.11±0.30, C: 3.60±0.28). FWB was negatively affected by worsening appetite in all CC stages except NC (PC: 0.19±0.08, P=0.022; C: 0.26±0.06, P<0.001; RC: 0.23±0.08, P=0.007). ESAS score for lack of appetite significantly improved between baseline (5.07±3.21) and follow-up (3.56±3.15, P=0.003) after cannabinoid treatment, with no significant difference in weight (baseline: 70.7±14.6 kg, 3-month follow-up: 71.0±14.8 kg). Future research should validate both multidimensional and single-item tools to measure HRQOL in patients at different stages of CC. Improvement of HRQOL via appetite stimulation, may be achieved through a multidisciplinary approach, which includes cannabinoid therapy.


Assuntos
Caquexia/psicologia , Neoplasias/psicologia , Qualidade de Vida/psicologia , Corticosteroides/uso terapêutico , Anorexia/etiologia , Estimulantes do Apetite/uso terapêutico , Canabinoides/uso terapêutico , Ciproeptadina/uso terapêutico , Feminino , Nível de Saúde , Humanos , Hidrazinas/uso terapêutico , Masculino , Acetato de Megestrol/uso terapêutico , Pessoa de Meia-Idade , Oligopeptídeos/uso terapêutico , Antagonistas da Serotonina/uso terapêutico , Índice de Gravidade de Doença , Estresse Psicológico/etiologia , Inquéritos e Questionários
13.
Ann Pharmacother ; 53(3): 261-267, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30229678

RESUMO

BACKGROUND: Hospitalized patients are subject to acute illness and stress which may impact appetite or weight. Loss of appetite may lead to increased morbidity or mortality. Medications such as dronabinol, megestrol, and mirtazapine are used for weight gain in the outpatient setting; however, there is limited information about safety or effectiveness when initiated inpatient. OBJECTIVES: To analyze the effectiveness and safety of appetite-stimulating medications in hospitalized patients. METHODS: This was a retrospective cohort study of hospitalized patients initiated on dronabinol, megestrol, or mirtazapine for appetite. The primary outcome was change in meal intake between drug initiation and discontinuation. Secondary outcomes included documented improvement in appetite, change in weight and various laboratory parameters, and incidence of adverse effects. RESULTS: A total of 38 patients met inclusion criteria, and mirtazapine was most commonly used (42%). There was no significant difference between groups of appetite-stimulating medications with regard to mean change in meal intake, weight, albumin, or documented improvement in diet. Within groups, each agent showed numerical improvement in percentage meal intake, with a mean change from initiation to discontinuation of 17.12%. Almost half (48%) of the patients experienced improvement in diet after the start of medications. No serious adverse effects were observed. Conclusion and Relevance: In inpatients, there was no difference in change in meal intake or weight between dronabinol, megestrol, or mirtazapine, but they may show numerical improvements in meal intake. To our knowledge, this is the first study to evaluate the use of dronabinol, megestrol, and mirtazapine initiated in the inpatient setting.


Assuntos
Regulação do Apetite/efeitos dos fármacos , Estimulantes do Apetite/uso terapêutico , Apetite/efeitos dos fármacos , Ganho de Peso/efeitos dos fármacos , Adulto , Estimulantes do Apetite/administração & dosagem , Dronabinol/administração & dosagem , Dronabinol/uso terapêutico , Ingestão de Alimentos/efeitos dos fármacos , Feminino , Humanos , Pacientes Internados , Masculino , Megestrol/administração & dosagem , Megestrol/uso terapêutico , Pessoa de Meia-Idade , Mirtazapina/administração & dosagem , Mirtazapina/uso terapêutico , Estudos Retrospectivos
14.
Ann Palliat Med ; 8(1): 50-58, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29860861

RESUMO

Cancer-associated anorexia, or loss of appetite, is prevalent, distressing to patients and their families, and associated with poorer outcomes in patients with advanced cancer. A well-defined therapeutic strategy remains to be defined. We present here a review of appetite loss in cancer patients with a summary of how best to manage this symptom.


Assuntos
Anorexia/terapia , Neoplasias/complicações , Cuidados Paliativos/métodos , Corticosteroides/uso terapêutico , Anorexia/etiologia , Estimulantes do Apetite/uso terapêutico , Caquexia/etiologia , Canabinoides/uso terapêutico , Humanos , Hidrazinas/uso terapêutico , Oligopeptídeos/uso terapêutico
15.
J Vet Pharmacol Ther ; 42(2): 179-188, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30506924

RESUMO

Mirtazapine is classified as a weight gain drug in cats, and the purpose of this study was to evaluate its efficacy in cats experiencing unintended weight loss. This was a multi-center, double-blind, placebo-controlled, randomized clinical study in client-owned cats ≥1 year of age, weighing ≥2 kg, with a documented loss (≥5%) in body weight. Cats were treated once daily with either 2 mg/cat mirtazapine transdermal ointment (n = 83) or placebo (n = 94) (Per Protocol population) applied to the inner surface of the pinna for 14 ± 3 days. Physical examination, body weight, complete blood count, serum chemistry, and urinalysis were performed prior to treatment and on Day 14. Changes in body weight between the mirtazapine and placebo groups were evaluated from Day 1 to Day 14 and compared using a two-sample t test. The mean percent change in body weight was +3.9% (standard deviation ±5.4%) in the mirtazapine group and +0.4% (±3.3%) in the placebo group (p < 0.0001). The most common adverse event was mild erythema at the application site in 17.4% of placebo and 10.4% of mirtazapine-treated cats. Application of mirtazapine transdermal ointment was well tolerated both topically and systemically and resulted in significant weight gain in cats experiencing unintended weight loss associated with various underlying diseases.


Assuntos
Estimulantes do Apetite/uso terapêutico , Doenças do Gato/tratamento farmacológico , Mirtazapina/uso terapêutico , Perda de Peso/efeitos dos fármacos , Administração Cutânea , Animais , Estimulantes do Apetite/administração & dosagem , Gatos , Método Duplo-Cego , Feminino , Masculino , Mirtazapina/administração & dosagem , Pomadas , Distribuição Aleatória , Ganho de Peso/efeitos dos fármacos
16.
Sci Adv ; 4(10): eaav1966, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30402545

RESUMO

How appetite is modulated by physiological, contextual, or pharmacological influence is still unclear. Specifically, the discovery of appetite modulators is compromised by the abundance of side effects that usually limit in vivo drug action. We set out to identify neuroactive drugs that trigger only their intended single behavioral change, which would provide great therapeutic advantages. To identify these ideal bioactive small molecules, we quantified the impact of more than 10,000 compounds on an extended series of different larval zebrafish behaviors using an in vivo imaging strategy. Known appetite-modulating drugs altered feeding and a pleiotropy of behaviors. Using this multibehavioral strategy as an active filter for behavioral side effects, we identified previously unidentified compounds that selectively increased or reduced food intake by more than 50%. The general applicability of this strategy is shown by validation in mice. Mechanistically, most candidate compounds were independent of the main neurotransmitter systems. In addition, we identified compounds with multibehavioral impact, and correlational comparison of these profiles with those of known drugs allowed for the prediction of their mechanism of action. Our results illustrate an unbiased and translational drug discovery strategy for ideal psychoactive compounds and identified selective appetite modulators in two vertebrate species.


Assuntos
Depressores do Apetite/farmacologia , Estimulantes do Apetite/farmacologia , Apetite/fisiologia , Comportamento Animal/efeitos dos fármacos , Descoberta de Drogas , Ensaios de Triagem em Larga Escala/métodos , Animais , Apetite/efeitos dos fármacos , Avaliação Pré-Clínica de Medicamentos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Modelos Animais , Natação , Peixe-Zebra
17.
Dement Geriatr Cogn Disord ; 46(3-4): 186-192, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30286455

RESUMO

BACKGROUND: The effects of the glucocorticoid and progesterone receptor agonist megestrol on declarative memory, and the ability of phenytoin to block these effects, were assessed. METHODS: Healthy volunteers received each medication combination (placebo and megestrol, phenytoin and megestrol, and placebo and placebo) using a randomized, crossover design. The Rey Auditory Verbal Learning Test assessed declarative memory. RESULTS: Megestrol was associated with a significant reduction in declarative memory (p = 0.0008), which was attenuated by phenytoin, and was associated with significant cortisol suppression compared to placebo (p < 0.001). CONCLUSION: Changes in memory and cortisol suppression were found in healthy volunteers given megestrol.


Assuntos
Hidrocortisona/sangue , Acetato de Megestrol , Memória/efeitos dos fármacos , Adulto , Estimulantes do Apetite/administração & dosagem , Estimulantes do Apetite/efeitos adversos , Cognição/efeitos dos fármacos , Estudos Cross-Over , Monitoramento de Medicamentos , Feminino , Voluntários Saudáveis , Humanos , Masculino , Acetato de Megestrol/administração & dosagem , Acetato de Megestrol/efeitos adversos , Fenitoína/administração & dosagem , Fenitoína/efeitos adversos , Receptores de Progesterona/agonistas , Resultado do Tratamento
18.
J Vet Intern Med ; 32(6): 1951-1957, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30307637

RESUMO

BACKGROUND: Liver disease (LD) prolongs mirtazapine half-life in humans, but it is unknown if this occurs in cats with LD and healthy cats. HYPOTHESIS/OBJECTIVES: To determine pharmacokinetics of administered orally mirtazapine in vivo and in vitro (liver microsomes) in cats with LD and healthy cats. ANIMALS: Eleven LD and 11 age-matched control cats. METHODS: Case-control study. Serum was obtained 1 and 4 hours (22 cats) and 24 hours (14 cats) after oral administration of 1.88 mg mirtazapine. Mirtazapine concentrations were measured by liquid chromatography with tandem mass spectrometry. Drug exposure and half-life were predicted using limited sampling modeling and estimated using noncompartmental methods. in vitro mirtazapine pharmacokinetics were assessed using liver microsomes from 3 LD cats and 4 cats without LD. RESULTS: There was a significant difference in time to maximum serum concentration between LD cats and control cats (median [range]: 4 [1-4] hours versus 1 [1-4] hours; P = .03). The calculated half-life of LD cats was significantly prolonged compared to controls (median [range]: 13.8 [7.9-61.4] hours versus 7.4 [6.7-9.1] hours; P < .002). Mirtazapine half-life was correlated with ALT (P = .002; r = .76), ALP (P < .0001; r = .89), and total bilirubin (P = .0008; r = .81). The rate of loss of mirtazapine was significantly different between microsomes of LD cats (-0.0022 min-1 , CI: -0.0050 to 0.00054 min-1 ) and cats without LD (0.01849 min-1 , CI: -0.025 to -0.012 min-1 ; P = .002). CONCLUSIONS AND CLINICAL IMPORTANCE: Cats with LD might require less frequent administration of mirtazapine than normal cats.


Assuntos
Estimulantes do Apetite/farmacocinética , Doenças do Gato/metabolismo , Hepatopatias/veterinária , Mirtazapina/farmacocinética , Animais , Estimulantes do Apetite/sangue , Estudos de Casos e Controles , Gatos , Feminino , Meia-Vida , Técnicas In Vitro , Hepatopatias/metabolismo , Masculino , Microssomos Hepáticos/metabolismo , Mirtazapina/sangue
19.
Home Healthc Now ; 36(5): 312-318, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30192276

RESUMO

The increasing older adult population guarantees that healthcare providers are more likely to encounter patients requiring treatment for unintended weight loss. Due to physiologic changes that occur in the older adult, it is important to know how to assess for, and diagnose unintended weight loss, as well as understand the treatment options. In addition to the use of enteral and parenteral nutrition, appetite stimulants have been used in older adults. Understanding the dosage, side effects, and proper usage of appetite stimulants, such megestrol acetate, mirtazapine, and dronabinol, is crucial in order to provide safe and effective patient care.


Assuntos
Estimulantes do Apetite/uso terapêutico , Perda de Peso , Idoso , Envelhecimento , Humanos , Desnutrição/complicações , Magreza/diagnóstico , Magreza/tratamento farmacológico , Magreza/etiologia , Magreza/enfermagem , Perda de Peso/efeitos dos fármacos
20.
Yakugaku Zasshi ; 138(8): 1011-1016, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-30068840

RESUMO

We investigated the role of zinc in regulation of food intake using male SD rats during early-stage of zinc deficiency (the 3rd day of the feeding) without decreased zinc concentrations in tissues (hypothalamus and liver). As a result, we found that orally but not intraperitoneal administered zinc stimulates food intake in the short-term zinc-deficient rats. The mRNA expressions of hypothalamic peptides, such as orexin (OX) and neuropeptide Y (NPY), were increased after oral administration of zinc to increase food intake. Pretreatment with an antagonist for the NPY Y1 receptor or the orexin OX1 receptor blocked orexigenic activity by zinc administration. The stimulation of food intake by oral administration of zinc was also abolished by vagotomy. Taken together, our results indicate that zinc stimulates food intake in short-term zinc-deficient rats through the afferent vagus nerve followed by activating the hypothalamic peptide associated with food intake regulation. This study showed the first evidence that gastrointestinal zinc signal is indispensable for the food appetite induction in the experimentally anorexigenic rat. However, since it has not yet been clarified the mechanism involved in zinc sensing by the epithelial membrane of the gastrointestinal tract, further detailed investigations are necessary.


Assuntos
Estimulantes do Apetite , Apetite/efeitos dos fármacos , Ingestão de Alimentos/efeitos dos fármacos , Orexinas/genética , Orexinas/metabolismo , Zinco/administração & dosagem , Zinco/farmacologia , Administração Oral , Animais , Masculino , Neuropeptídeo Y/genética , Neuropeptídeo Y/metabolismo , RNA Mensageiro/metabolismo , Ratos Sprague-Dawley , Nervo Vago/fisiologia , Zinco/deficiência
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