Exploring Acceptability Drivers of Oral Antibiotics in Children: Findings from an International Observational Study.

Antibiotics are among the most commonly prescribed drugs in children. Adherence to the treatment with these drugs is of the utmost importance to prevent the emergence of resistant bacteria, a global health threat. In children, medicine acceptability is likely to have a significant impact on compliance. Herein we used a multivariate approach, considering simultaneously the many aspects of acceptability to explore the drivers of oral antibiotic acceptability in children under twelve, especially in toddlers and in preschoolers. Based on 628 real-life observer reports of the intake of 133 distinct medicines, the acceptability reference framework highlighted the influence of many factors such as age and sex of patients, previous exposure to treatment, place of administration, administration device, flavor agent in excipients and active pharmaceutical ingredient. These findings from an international observational study emphasize the multidimensional nature of acceptability. Therefore, it is crucial to consider all these different aspects for assessing this multi-faceted concept and designing or prescribing a medicine in order to reach adequate acceptability in the target population.

Creaming behavior prediction of argan oil in water emulsion stabilized by lacto-fermentation: creaming index.

BACKGROUND: In order to improve the taste acceptability of certain nutritional oils, it has been decided in this study to introduce them in an emulsion whose surfactant is casein, then to carry out a lacto-fermentation, leading to a dairy-like product with added nutritional value and health benefit. In this context, a plan of mixtures has been proposed for the preparation of emulsions based on argan oil, sodium caseinate and starch, with concentrations ranged between (10-20%) and (0-2%) and (0-1.5%) respectively. All emulsions were homogenized at two high stirring velocities (10,000-20,000 rpm) and two stirring times (5-20 min). The physical stability was assessed by visual analysis and microstructural measurements. The Creaming index was calculated for selected emulsions to predict their creaming behavior. RESULTS: All emulsions showed a creaming behavior except one emulsion that required the highest values of all factors, which showed the highest creaming index with an average particle size of 11.27 µm. The absence or the variation of one or all factors led to various degrees of instabilities verified in all other emulsions. Due to the synergistic action of all parameters, the emulsion stability was attributed to the reduction of droplets size, the increase of continuous phase viscosity and the decrease of coalescence. CONCLUSION: The parameters that played a major role in the stability of the emulsion consists of: stirring velocity and time, sodium caseinate/oil ratio and starch/sodium caseinate ratio. The underlying structure and the interaction of the fluid droplets within the solid like product is what holds the stability of the product against settling or separation during fermentation.

Medicines Acceptability in Hospitalized Children: An Ongoing Need for Age-Appropriate Formulations.

Although knowledge on medicine acceptability remains fragmented, this multi-faceted concept has emerged as a key factor for compliance in pediatrics. In order to investigate the acceptability of medicines used in the University Medical Centre Ibn Sina (CHIS) of Rabat, Morocco, an observational study was conducted. Using a multivariate approach integrating the many aspects of acceptability, standardized observer reports were collected for 570 medicine intakes in patients up to the age of 16, then analyzed on a reference framework. Tablets appeared to be well accepted in children greater than 6 years old, but were crushed/dissolved for 90% of the 40 children aged from 3 to 5, and 100% of the 38 patients younger than 3. Moreover, the prescribed dose was fully taken for only 52% and 16% of these younger children, respectively. Despite this, tablets represented 24% of evaluations in children from 3 to 5 and 20% in infants and toddlers. Oral liquid preparations appeared to be better accepted than tablets in preschoolers, but not for those under 3. Overall, these findings highlight the lack of suitable alternatives for the younger children, especially for formulations of antiepileptics, antithrombotic, and psycholeptic agents in the local context.

Syneresis investigations of lacto-fermented sodium caseinate in a mixed model system.

BACKGROUND: The textural characteristics of fermented dairy products are important quality parameters that play a major role in their stability and consumer's acceptance. The aim of this study was to investigate the influence of sodium caseinate, starch, lactose and lactic acid bacteria as ferment on the syneresis in a mixed model system, and to evaluate their impact on the acid gel formation throughout pH and zeta potential monitoring. Accordingly, a protocol was designed to perform an experimental design by using a mixture of the selected factors. RESULTS: A significant decrease of syneresis was detected in all mixtures at 8% of sodium caseinate, ranging between a minimum of 1.8% and a maximum of 20.6% compared to the mixtures at 3% of sodium caseinate in which the syneresis decrease had ranged between a minimum of 22.2% and a maximum of 47.8%. The addition of starch had a significant impact on the acidification profile and on the syneresis of the fermented mixed model. Moreover, the monitoring of pH and zeta potential during the lacto-fermentation process has also led to a better understanding of the acid gelation and the syneresis variations. CONCLUSION: Syneresis varies very closely with sodium caseinate concentration, starch concentration and also with their association, regardless of the concentrations of lactose and ferment. In fact syneresis could be reduced to an optimum level if a sodium caseinate-starch mixed system is employed: Less syneresis gels could be obtained at a sodium caseinate concentration above 5% if starch is used above 1%.

The effect of dietary and/or cosmetic argan oil on postmenopausal skin elasticity.

BACKGROUND: During menopause, the decrease of estrogenic secretion induces the disruption of skin functioning, thus causing the decline in skin elasticity characteristic of skin aging. The purpose of this study was to evaluate in postmenopausal women the effect of daily consumption and/or application of argan oil on skin elasticity. MATERIALS AND METHODS: Sixty postmenopausal women consumed butter during the stabilization period and were randomly divided into two groups for the intervention period: the treatment group of 30 participants received dietary argan oil, the control group of 30 participants received olive oil, and both groups applied cosmetic argan oil in the left volar forearm during a 60-day period. Assessments of skin elasticity parameters, ie, the three R-parameters (R2 or gross-elasticity of the skin, R5 or net elasticity of the skin, and R7 or biological elasticity), and the resonance running time (RRT) at both volar forearms of the two groups were performed during three visits: before starting oils consumption and application, after 30 days of oils consumption and application, and after 60 days of oils consumption and application. RESULTS: The consumption of argan oil led to a significant increase of gross-elasticity of the skin (R2) (P<0.001), net elasticity of the skin (R5) (P<0.001), biological elasticity (R7) (P<0.001), and a significant decrease of RRT (P=0.002). The application of argan oil led to a significant increase of gross-elasticity of the skin (R2) (P<0.001), net elasticity of the skin (R5) (P<0.001), biological elasticity (R7) (P=0.001), and a significant decrease of RRT (P<0.001). CONCLUSION: Our findings suggest that the daily consumption and/or topical application of argan oil have an anti-aging effect on the skin demonstrated by the improvement of skin elasticity, characterized by an increase of R-parameters (R2, R5, and R7) and a decrease of RRT.

Skin hydration in postmenopausal women: argan oil benefit with oral and/or topical use.

THE AIM OF THIS STUDY: The aim of this study was to evaluate the effect of daily consumption and/or application of argan oil on skin hydration in postmenopausal women. MATERIAL AND METHODS: Sixty postmenopausal women consumed butter during the stabilization period and were randomly divided into two groups for the intervention period: the treatment group absorbed alimentary argan oil (n = 30) and the control group olive oil (n = 30). Both groups applied cosmetic argan oil in the left volar forearm during a sixty days' period. Evaluation of skin hydration, i.e. transepidermal water loss (TEWL) and water content of the epidermis (WCE) on both volar forearms of the two groups, were performed during three visits at D0, D30 and after sixty days (D60) of oils treatment. RESULTS: The consumption of argan oil has led to a significant decrease in TEWL (p = 0.023) and a significant increase in WCE (p = 0.001). The application of argan oil has led to a significant decrease in TEWL (p = 0.01) and a significant increase in WCE (p < 0.001). CONCLUSIONS: Our findings suggest that the daily consumption and application of argan oil have improved the skin hydration by restoring the barrier function and maintaining the water-holding capacity.

Argan oil and postmenopausal Moroccan women: impact on the vitamin E profile.

Vitamin E supplements could be beneficial for postmenopausal women. To evaluate the effect of edible argan oil consumption on the antioxidant status of postmenopausal women, the vitamin E serum level of 151 menopausal women consuming either olive or argan oil was determined. Serum level of vitamin E was increased in the argan oil consumer group. Therefore, an argan oil-enriched diet can be recommended to help prevent some postmenopausal disorders.

Antibacterial activity, structure and CMC relationships of alkanediyl alpha,omega-bis(dimethylammonium bromide) surfactants.

Some alpha,omega-alkanediyl bis-dimethylammonium bromide compounds (gemini surfactants) referred as "m-s-m" have been synthesized, purified and characterized by usual spectroscopic methods. These compounds have been screened for antibacterial activity against Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Their activity was compared. The compounds tested showed excellent in vitro antibacterial activity against Staphylococcus aureus ranging from 1.5 to 20 microg/ml and had variable activity against E. coli with minimum minimum inhibitory concentration (MIC) of 50 microg/ml. These compounds are less active against P. aeruginosa. On the other hand, contrary to the antibacterial activity of these products against S. aureus, a relation between the MIC and the critical micellar concentration (CMC) was found and relationship between chain's Length and antibacterial activity was found.