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1.
Phytother Res ; 33(11): 2904-2917, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31423662

RESUMO

Stevia rebaudiana Bertoni, a plant from South America and indigenous of Paraguay, has shown several biological effects and healthy properties, although it is especially used in South America and some Asiatic regions. In addition, it is a natural sweetener, almost 300 times sweeter than sucrose, being attributed to its phytoconstituents prominent antioxidant, antimicrobial, antidiabetic (antihyperglycemic, insulinotropic, and glucagonostatic), antiplatelet, anticariogenic, and antitumor effects. In this sense, this work aims to provide an extensive overview on the historical practices of stevia and its effects in human health based on its chemical composition and applications for both food and pharmaceutical industries.


Assuntos
Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Stevia , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Ensaios Clínicos como Assunto/métodos , Diterpenos de Caurano/isolamento & purificação , Diterpenos de Caurano/farmacologia , Diterpenos de Caurano/uso terapêutico , Avaliação Pré-Clínica de Medicamentos , Glucosídeos/isolamento & purificação , Glucosídeos/farmacologia , Glucosídeos/uso terapêutico , Humanos , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Extratos Vegetais/química , Folhas de Planta/química , Folhas de Planta/fisiologia , Stevia/química , Stevia/fisiologia , Edulcorantes/química , Edulcorantes/farmacologia , Edulcorantes/uso terapêutico
2.
Pain ; 160(5): 1059-1069, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31008815

RESUMO

The taste of sucrose is commonly used to provide pain relief in newborn humans and is innately analgesic to neonatal rodents. In adulthood, sucrose remains a strong motivator to feed, even in potentially hazardous circumstances (ie, threat of tissue damage). However, the neurobiological mechanisms of this endogenous reward-pain interaction are unclear. We have developed a simple model of sucrose drinking-induced analgesia in Sprague-Dawley rats (6-10 weeks old) and have undertaken a behavioral and pharmacological characterization using the Hargreaves' test of hind-paw thermal sensitivity. Our results reveal an acute, potent, and robust inhibitory effect of sucrose drinking on thermal nociceptive behaviour that unlike the phenomenon in neonates is independent of endogenous opioid signalling and does not seem to operate through classical descending inhibition of the spinal cord circuitry. Experience of sucrose drinking had a conditioning effect whereby the apparent expectancy of sucrose enabled water alone (in euvolemic animals) to elicit a short-lasting placebo-like analgesia. Sweet taste alone, however, was insufficient to elicit analgesia in adult rats intraorally perfused with sucrose. Instead, the sucrose analgesia phenomenon only appeared after conditioning by oral perfusion in chronically cannulated animals. This sucrose analgesia was completely prevented by systemic dosing of the endocannabinoid CB1 receptor antagonist rimonabant. These results indicate the presence of an endogenous supraspinal analgesic circuit that is recruited by the context of rewarding drinking and is dependent on endocannabinoid signalling. We propose that this hedonic sucrose-drinking model may be useful for further investigation of the supraspinal control of pain by appetite and reward.


Assuntos
Hiperalgesia/terapia , Limiar da Dor/efeitos dos fármacos , Medula Espinal/fisiologia , Sacarose/uso terapêutico , Edulcorantes/uso terapêutico , Animais , Antagonistas de Receptores de Canabinoides/farmacologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Comportamento de Ingestão de Líquido/efeitos dos fármacos , Adjuvante de Freund/toxicidade , Temperatura Alta/efeitos adversos , Hiperalgesia/induzido quimicamente , Injeções Espinhais/métodos , Masculino , Naloxona/farmacologia , Antagonistas de Entorpecentes/farmacologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Sprague-Dawley , Tempo de Reação/efeitos dos fármacos , Rimonabanto/farmacologia , Medula Espinal/efeitos dos fármacos , Privação de Água/fisiologia
3.
Int J Hyperthermia ; 36(1): 302-312, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30729822

RESUMO

Controlling the magnetic properties of a nanoparticle efficiently via its particle size to achieve optimized heat under alternating magnetic field is the central point for magnetic hyperthermia-mediated cancer therapy (MHCT). Here, we have shown the successful use of stevioside (a natural plant-based glycoside) as a promising biosurfactant to control the magnetic properties of Fe3O4 nanoparticles by controlling the particle size. The biocompatibility and cellular uptake efficiency by rat C6 glioma cells and calorimetric magnetic hyperthermia profile of the nanoparticles were further examined. Our finding suggests superior properties of stevioside-coated magnetite nanoparticles in comparison to polysorbate-80 and oleic acid coated nanomagnets as far as particle size reduction, biocompatibility, hyperthermic effect, and cellular uptake by the glioblastoma cancer cells are concerned. The stevioside-coated nanomagnets exhibiting the maximum temperature rise were further investigated as heating agents in in vitro magnetic hyperthermia experiments (405 kHz, 168 Oe), showing their efficacy to induce cell death of rat C6 glioma cells after 30 min at a target temperature T = 43 °C.


Assuntos
Diterpenos de Caurano/uso terapêutico , Glucosídeos/uso terapêutico , Hipertermia Induzida/métodos , Nanopartículas de Magnetita/química , Edulcorantes/uso terapêutico , Animais , Diterpenos de Caurano/farmacologia , Glucosídeos/farmacologia , Humanos , Ratos
4.
Int J Med Sci ; 16(1): 1-7, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30662322

RESUMO

The objective of this study was to determine the relationship between glucose dosage in parenteral nutrition and reductions in levels of body thiamine in rats. Vitamin-free infusions with differing amounts of glucose were administered to normal or thiamine-deficient rats for 5 days, after which urinary thiamine excretion and the amounts of thiamine in the blood, liver, brain, and skeletal muscles were measured. The total energy dosage was set at three levels (98, 140, and 196 kcal/kg), and the dose of amino acids was constant among all groups. Urinary thiamine excretions on Day 5 decreased with increasing glucose dosage in the infusions. In normal rats, the amount of thiamine in the blood and all organs decreased compared with the diet group; however, no significant differences were found among the infusion groups. In thiamine-deficient rats, on the other hand, the amount of thiamine in the liver and skeletal muscles did not differ significantly among infusion groups; however, the amount of thiamine in the brain and blood decreased with increasing glucose dosage. An organ-specific correlation was found between glucose dosage in infusions and reductions in levels of thiamine. To prevent thiamine deficiencies from affecting the central nervous system, greater caution must be exercised during high-caloric parenteral nutrition. However, a constant supply of thiamine seemed to be essential, irrespective of the amount of energy supplied via parenteral nutrition, to maintain a sufficient level of thiamine in the body.


Assuntos
Glucose/administração & dosagem , Edulcorantes/metabolismo , Deficiência de Tiamina , Tiamina/sangue , Tiamina/urina , Complexo Vitamínico B/sangue , Complexo Vitamínico B/urina , Aminoácidos/administração & dosagem , Animais , Encéfalo/metabolismo , Eletrólitos/administração & dosagem , Glucose/uso terapêutico , Japão , Fígado/metabolismo , Masculino , Músculo Esquelético/metabolismo , Especificidade de Órgãos , Nutrição Parenteral , Ratos , Ratos Sprague-Dawley , Edulcorantes/administração & dosagem , Edulcorantes/uso terapêutico , Tiamina/metabolismo , Deficiência de Tiamina/tratamento farmacológico , Deficiência de Tiamina/metabolismo
5.
Hosp Pediatr ; 8(9): 515-523, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30076160

RESUMO

OBJECTIVES: Pain in hospitalized children remains under-assessed and undertreated. With this study, we aim to describe results from a repeat single-day, hospital-wide survey of children's pain and its treatment after the initiation of a hospital-wide quality improvement initiative used to reduce or eliminate pain caused by needle procedures. METHODS: All patients and parents listed on the inpatient morning census, in emergency department and outpatient surgery registration lists, were invited to participate in a brief single-day point prevalence survey of their experience with pain and its management in the hospital setting. Results were compared with a survey conducted 2 years earlier, before implementation of a system-wide Children's Comfort Promise needle pain treatment and prevention protocol. RESULTS: A total of 194 children and their parents participated in the current survey. A higher percentage of children reported having no pain compared with the previous survey (33% vs 24%; P = .07; not significant) and fewer experienced severe pain (score ≥7 out of 10). Fewer children identified pain caused by needles as the cause of the worst pain (21% vs 30%), although it remained the highest reported cause of the most painful experience overall. The number of pain management strategies administered and offered to children with needle pain (distraction, positioning, numbing cream, and sucrose and/or breastfeeding for infants) increased. CONCLUSIONS: The implementation of a mandatory Comfort Promise protocol used to minimize or prevent pain caused by elective needle procedures was associated with a significant reduction in overall pain prevalence and improved use of evidence-based practices for needle pain management.


Assuntos
Manejo da Dor/estatística & dados numéricos , Dor Processual/epidemiologia , Punções/métodos , Analgésicos/uso terapêutico , Anestésicos Locais/uso terapêutico , Aleitamento Materno , Criança , Criança Hospitalizada , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Agulhas , Dor Processual/prevenção & controle , Pais , Posicionamento do Paciente , Prevalência , Sacarose/uso terapêutico , Inquéritos e Questionários , Edulcorantes/uso terapêutico , Estados Unidos/epidemiologia
6.
BMJ Open ; 8(8): e020941, 2018 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-30082349

RESUMO

INTRODUCTION: Xylitol (or 'birch sugar') is a naturally occurring sugar with antibacterial properties that has been used as a natural non-sugar sweetener in chewing gums, confectionery, toothpaste and medicines. In this preventative randomised trial, xylitol will be tested for the prevention of acute otitis media (AOM), a common and costly condition in young children. The primary outcome will be the incidence of AOM. Secondary outcomes will include upper respiratory tract infections (URTIs) and dental caries. METHODS AND ANALYSIS: This study will be a pragmatic, blinded (participant and parents, practitioners and analyst), two-armed superiority, placebo-controlled randomised trial with 1:1 allocation, stratified by clinical site. The trial will be conducted in the 11 primary care group practices participating in the TARGet Kids! research network in Canada. Eligible participants between the ages of 2-4 years will be randomly assigned to the intervention arm of regular xylitol syrup use or the control arm of regular sorbitol use for 6 months. We expect to recruit 236 participants, per treatment arm, to detect a 20% relative risk reduction in AOM episodes. AOM will be identified through chart review. The secondary outcomes of URTIs and dental caries will be identified through monthly phone calls with specified questions. ETHICS AND DISSEMINATION: Ethics approval from the Research Ethics Boards at the Hospital for Sick Children and St. Michael's Hospital has been obtained for this study and also for the TARGet Kids! research network. Results will be submitted for publication to a peer-reviewed journal and will be discussed with decision makers. TRIAL REGISTRATION NUMBER: NCT03055091; Pre-results.


Assuntos
Otite Média/prevenção & controle , Edulcorantes/uso terapêutico , Xilitol/uso terapêutico , Canadá , Pré-Escolar , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Pragmáticos como Assunto
7.
CEN Case Rep ; 7(2): 292-295, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29978296

RESUMO

Spinal muscular atrophy (SMA) is a genetic neuromuscular disease characterized by progressive muscle weakness and atrophy. We report a case of a 36-year-old man with SMA type 3 who presented to our emergency department with epigastric pain and vomiting. He was found to have severe ketoacidosis on laboratory evaluation. The patient's symptoms and ketoacidosis resolved after dextrose infusion and a relatively small amount of sodium bicarbonate infusion. Given the severity of the ketosis that seemed inconsistent with moderate starvation alone, we postulate that there must have been other contributing factors besides moderate starvation that might explain the severity of acidosis in this particular patient. These factors include low muscle mass, disturbed fatty acid metabolism, hormonal imbalances and defective glucose metabolism. Ketoacidosis is an under-recognized entity in patients with neuromuscular diseases and requires a high index of suspicion for prompt diagnosis and management.


Assuntos
Cetose/diagnóstico , Cetose/etiologia , Atrofia Muscular Espinal/complicações , Adulto , Diagnóstico Diferencial , Glucose/administração & dosagem , Glucose/uso terapêutico , Humanos , Infusões Intravenosas , Cetose/sangue , Cetose/terapia , Masculino , Atrofia Muscular Espinal/classificação , Atrofia Muscular Espinal/patologia , Índice de Gravidade de Doença , Bicarbonato de Sódio/administração & dosagem , Bicarbonato de Sódio/uso terapêutico , Edulcorantes/administração & dosagem , Edulcorantes/uso terapêutico , Resultado do Tratamento
8.
Rev Bras Enferm ; 71(3): 1092-1098, 2018 May.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29924160

RESUMO

OBJECTIVE: To verify the effectiveness of nursing interventions based on the Imogene King's Theory of Goal Attainment, on improving care for people with diabetes and adherence to treatment. METHOD: Quasi-experimental, longitudinal, randomized, simple study in a Primary Health Care Unit, in the city of Fortaleza, Ceará state, Brazil. The sample consisted of 60 people with diabetes, divided into intervention and control groups, whose collection occurred from February to August 2013. RESULTS: In the intervention group, a significant adherence of the patients to the goals defined in the study was found. In the control, there was improvement in some aspects of the treatment. CONCLUSION: With these results, it was possible to conclude the feasibility of using Theory of Goal Attainment in the positive aspects for adherence to diabetes treatment and improvement of quality of life.


Assuntos
Diabetes Mellitus/enfermagem , Cuidados de Enfermagem/métodos , Teoria de Enfermagem , Edulcorantes/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Medicine (Baltimore) ; 97(23): e10978, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29879053

RESUMO

RATIONALE: Perineural injection with dextrose could be a novel intervention for peripheral entrapment neuropathy. However, this intervention has not been reported for treating radial nerve palsy (RNP). Here, we present a case with RNP having outstanding improvement after 2 sessions of ultrasound-guided perineural injection with 5% dextrose (D5W). PATIENT CONCERNS: A 62-year-old woman presented with difficulty and weakness in extension of her left wrist and fingers after she slept with the arm compressed against her body. DIAGNOSES: On the basis of the findings of electrophysiological study and ultrasonography, the RNP with axonal injury was diagnosed. INTERVENTIONS: Initially, the patient received 2-months conservative treatments without any improvement. Two sessions of ultrasound-guided perineural injection with total 15cc D5W with an interval of 1 month were performed 2 months after symptom onset. OUTCOMES: A noteworthy improvement in sensory and motor functions was observed after ultrasound-guided perineural injection with D5W. LESSONS: This case shows that ultrasound-guided perineural injection with D5W may be an effective and novel intervention for RNP.


Assuntos
Glucose/uso terapêutico , Síndromes de Compressão Nervosa/tratamento farmacológico , Paralisia/tratamento farmacológico , Nervo Radial/fisiopatologia , Neuropatia Radial/fisiopatologia , Ultrassonografia de Intervenção/métodos , Feminino , Glucose/administração & dosagem , Humanos , Injeções , Pessoa de Meia-Idade , Bloqueio Nervoso/métodos , Nervo Radial/lesões , Edulcorantes/uso terapêutico , Resultado do Tratamento , Ultrassonografia/métodos
10.
J Pediatr ; 198: 151-155.e1, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29625731

RESUMO

OBJECTIVE: To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care. STUDY DESIGN: We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring. RESULTS: In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring. CONCLUSIONS: Use of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12608000623392.


Assuntos
Glucose/economia , Hipoglicemia/tratamento farmacológico , Edulcorantes/economia , Custos e Análise de Custo , Árvores de Decisões , Géis , Glucose/uso terapêutico , Recursos em Saúde/economia , Humanos , Hipoglicemia/economia , Recém-Nascido , Terapia Intensiva Neonatal/economia , Tempo de Internação/economia , Nova Zelândia , Edulcorantes/uso terapêutico
11.
Biomed Res Int ; 2018: 4806534, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29511682

RESUMO

Noncaloric sweeteners (NCS) are food additives used to provide sweetness without adding calories. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to show the state of the art about the intake of noncaloric sweeteners in children, as well as their benefits and consumption risk. Scientific searchers were used (PUBMED, Scopus, and Scielo) to analyze articles that included keywords (noncaloric sweeteners/saccharin/cyclamate/acesulfame potassium/aspartame/sucralose/stevia/children) in English, Spanish, and Portuguese. Authors conclude that it is imperative that health professionals judiciously and individually evaluate the overall benefits and risks of NCS use in consumers before recommending their use. Different subgroups of the population incorporate products containing NCS in their diet with different objectives, which should be considered when recommending a diet plan for the consumer. In childhood, in earlier age groups, this type of additives should be used as a dietary alternative when other forms of prevention in obesity are not sufficient.


Assuntos
Ingestão de Energia , Aditivos Alimentares/uso terapêutico , Obesidade/dietoterapia , Edulcorantes/uso terapêutico , Aspartame/efeitos adversos , Aspartame/uso terapêutico , Criança , Ciclamatos/efeitos adversos , Ciclamatos/uso terapêutico , Aditivos Alimentares/efeitos adversos , Humanos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Medição de Risco , Sacarina/efeitos adversos , Sacarina/uso terapêutico , Stevia/química , Sacarose/efeitos adversos , Sacarose/análogos & derivados , Sacarose/uso terapêutico , Edulcorantes/administração & dosagem , Tiazinas/efeitos adversos , Tiazinas/uso terapêutico
12.
Niger J Clin Pract ; 21(3): 306-311, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29519978

RESUMO

Aim: The aim of this study was to evaluate the effect of fluoride, Xylitol, Probiotic, and Whitening toothpastes on the permanent teeth enamel roughness and microhardness. Materials and Methods: One hundred and twenty teeth were randomly divided into 2 groups, each group having 60 samples. G1: The group in which enamel roughness was examined (n = 60). G2: The group in which enamel microhardness was examined (n = 60). Then, these groups were randomly divided into 4 groups among themselves (n = 15). Each group was brushed using four different toothpastes for 1 week with a battery-powered toothbrush in the morning and evening for 2 min. Vicker's hardness tester was used to measure the changes in microhardness, and the profilometer was used to measure the changes in surface roughness. Results: No statistically significant differences were found on surface roughness and microhardness values measured after tooth brushing process in group brushed with Colgate MaxFresh toothpaste (P > 0.01). Statistically significant decrease was observed on Vicker's hardness values measured after tooth brushing process in groups brushed with Ipana White Power Carbonate toothpaste, Xyliwhite Toothpaste Gel, and Periobiotic Probiotic Toothpaste (P < 0.01). Statistically significant increase was observed on surface roughness values in groups brushed with Ipana White Power Carbonate toothpaste, Xyliwhite Toothpaste Gel, Periobiotic Probiotic Toothpaste (P < 0.01). Conclusions: As a result, Colgate MaxFresh abrasive-free toothpaste with fluoride has no effect on permanent tooth enamel surface roughness and microhardness. Xyliwhite, Periobiotic, and Ipana White Power Carbonate-containing abrasive toothpastes led to changes negatively on permanent tooth enamel surface roughness and microhardness.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Fluoretos/uso terapêutico , Dureza/efeitos dos fármacos , Fosfatos/farmacologia , Probióticos/uso terapêutico , Fluoreto de Sódio/farmacologia , Edulcorantes/uso terapêutico , Escovação Dentária , Cremes Dentais/farmacologia , Xilitol/uso terapêutico , Fluoretos/farmacologia , Humanos
13.
Biomed Res Int ; 2018: 8718053, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29546070

RESUMO

The objective of the current research was to review and update evidence on the dietary effect of the consumption of tagatose in type 2 diabetes, as well as to elucidate the current approach that exists on its production and biotechnological utility in functional food for diabetics. Articles published before July 1, 2017, were included in the databases PubMed, EBSCO, Google Scholar, and Scielo, including the terms "Tagatose", "Sweeteners", "Diabetes Mellitus type 2", "Sweeteners", "D-Tag". D-Tagatose (D-tag) is an isomer of fructose which is approximately 90% sweeter than sucrose. Preliminary studies in animals and preclinical studies showed that D-tag decreased glucose levels, which generated great interest in the scientific community. Recent studies indicate that tagatose has low glycemic index, a potent hypoglycemic effect, and eventually could be associated with important benefits for the treatment of obesity. The authors concluded that D-tag is promising as a sweetener without major adverse effects observed in these clinical studies.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Hexoses/uso terapêutico , Obesidade/dietoterapia , Edulcorantes/uso terapêutico , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Humanos , Hipoglicemiantes/sangue , Hipoglicemiantes/uso terapêutico , Obesidade/sangue
14.
CJEM ; 20(S2): S61-S63, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29397808

RESUMO

ABSTRACTCases of liraglutide overdose are rare in the literature. Prior reports have not found hypoglycemia related to the medication overdose. We describe a case of a non-diabetic patient who intentionally overdosed on liraglutide leading to severe hypoglycemia. The patient required admission to the intensive care unit for a dextrose infusion and close monitoring. Glucagon-like protein-1 agonists are recognized for their safety and rarely causing hypoglycemia in diabetic patients. However, in this case the patient's non-diabetic status may have put him at risk for hypoglycemia in contrast to prior cases showing no hypoglycemia in diabetic patients. The case highlights the possible dangers of liraglutide overdose and need for blood glucose monitoring in the acute presentation.


Assuntos
Hipoglicemia/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Liraglutida/efeitos adversos , Tentativa de Suicídio , Glucose/uso terapêutico , Humanos , Hipoglicemia/terapia , Masculino , Pessoa de Meia-Idade , Octreotida/uso terapêutico , Edulcorantes/uso terapêutico
15.
Curr Diabetes Rev ; 14(4): 350-362, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28571543

RESUMO

BACKGROUND: Individuals with Type II Diabetes (T2D) have to manage blood glucose levels to sustain health and longevity. Artificial sweeteners (including aspartame) are suggested sugar alternatives for these individuals. The safety of aspartame in particular, has long been the centre of debate. Although it is such a controversial product, many clinicians recommend its use to T2D patients, during a controlled diet and as part of an intervention strategy. Aspartame is 200 times sweeter than sugar and has a negligible effect on blood glucose levels, and it is suggested for use so that T2D can control carbohydrate intake and blood glucose levels. However, research suggests that aspartame intake may lead to an increased risk of weight gain rather than weight loss, and cause impaired blood glucose tolerance in T2D. OBJECTIVE: This review consolidates knowledge gained from studies that link aspartame consumption to the various mechanisms associated with T2D. METHOD: We review literature that provides evidence that raise concerns that aspartame may exacerbate T2D and add to the global burden of disease. RESULT: Aspartame may act as a chemical stressor by increasing cortisol levels, and may induce systemic oxidative stress by producing excess free radicals, and it may also alter gut microbial activity and interfere with the N-methyl D-aspartate (NMDA) receptor, resulting in insulin deficiency or resistance. CONCLUSION: Aspartame and its metabolites are safe for T2D is still debatable due to a lack of consistent data. More research is required that provides evidence and raise concerns that aspartame may exacerbate prevalence of pathological physiology in the already stressed physiology of T2D.


Assuntos
Aspartame/uso terapêutico , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Edulcorantes/uso terapêutico , Animais , Aspartame/efeitos adversos , Biomarcadores/sangue , Glicemia/metabolismo , Tomada de Decisão Clínica , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Ingestão de Energia , Microbioma Gastrointestinal/efeitos dos fármacos , Humanos , Hidrocortisona/sangue , Resistência à Insulina , Estresse Oxidativo/efeitos dos fármacos , Seleção de Pacientes , Medição de Risco , Fatores de Risco , Edulcorantes/efeitos adversos , Resultado do Tratamento
16.
BMJ Open ; 7(11): e017516, 2017 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-29170288

RESUMO

INTRODUCTION: Neonatal hypoglycaemia is a common condition that can cause developmental delay. Treatment of neonatal hypoglycaemia with oral dextrose gel has been shown to reverse hypoglycaemia and reduce admissions to neonatal intensive care for hypoglycaemia. An evidence-based clinical practice guideline was written to guide the use of dextrose gel to treat neonatal hypoglycaemia in New Zealand. However, it is unclear what clinical discipline might most effectively lead the implementation of the guideline recommendations. OBJECTIVE: To determine if midwife or doctor local opinion leaders are more effective in implementing a clinical practice guideline for use of oral dextrose gel to treat hypoglycaemia in babies on postnatal wards. METHODS AND ANALYSIS: A cluster-randomised, blinded, controlled trial. New Zealand maternity hospitals that care for babies born at risk of neonatal hypoglycaemia will be randomised to having either a local midwife or doctor lead the guideline implementation at that hospital. The primary outcome will be the change in the proportion of hypoglycaemic babies treated with dextrose gel from before implementation of the guideline to 3 months after implementation. ETHICS AND DISSEMINATION: Approved by Health and Disability Ethics Committee: 15/NTA/31. Findings will be disseminated to peer-reviewed journals, guideline developers and the public. TRIAL REGISTRATION NUMBER: ISRCTN61154098.


Assuntos
Glucose/uso terapêutico , Implementação de Plano de Saúde/organização & administração , Hipoglicemia/tratamento farmacológico , Tocologia , Médicos , Edulcorantes/uso terapêutico , Administração Oral , Análise por Conglomerados , Medicina Baseada em Evidências , Feminino , Géis , Humanos , Lactente , Recém-Nascido , Guias de Prática Clínica como Assunto , Gravidez
17.
Adv Neonatal Care ; 17(5): 372-380, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28885227

RESUMO

BACKGROUND: Breastfeeding (BF), skin-to-skin care (SSC), and sucrose effectively reduce babies' pain during newborn blood work, but these strategies are infrequently used. Our team developed a parent-targeted video intervention showing the effectiveness of the 3 pain management strategies. PURPOSE: To evaluate neonatal intensive care unit (NICU) parents' (1) baseline knowledge and previous use of BF, SSC, and sucrose for procedural pain management; (2) intention to advocate/use BF, SSC, or sucrose for their infants' future blood work after viewing the video; (3) intention to recommend the video to other parents; and (4) perceptions of the video and identify areas for improvement. METHODS: Cross-sectional survey of parents in an NICU. RESULTS: Fifty parents were enrolled: 33 mothers and 17 fathers. More than two-thirds (68%) of parents had prior knowledge of analgesic effects of sucrose; knowledge of SSC and BF as pain-reduction strategies was lower: 44% and 34%, respectively. Eighty-six percent of parents felt the video was the right length; 7 (14%) felt the video was too long. After viewing the video, 96% of parents intended to advocate for BF, SSC, or sucrose for pain management and 88% parents would recommend the video to other parents. IMPLICATIONS FOR PRACTICE: The video is acceptable to parents, is feasible to deliver to parents in an NICU, and has potential to increase parents' intent to advocate for pain management strategies for their infants. IMPLICATIONS FOR RESEARCH: Future studies are required to evaluate the effectiveness of this parent-targeted intervention on increasing actual use of pain management in clinical practice.


Assuntos
Aleitamento Materno/métodos , Método Canguru/métodos , Manejo da Dor/métodos , Dor Processual/prevenção & controle , Pais/educação , Sacarose/uso terapêutico , Edulcorantes/uso terapêutico , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Projetos Piloto , Gravação em Vídeo
18.
Nutr. hosp ; 34(3): 532-539, mayo-jun. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-164106

RESUMO

Objetivo: el objetivo de este estudio fue comparar el índice glicémico (IG), la carga glicémica (CG) y la insulina posprandial de dos fórmulas isoglucídicas con distintos edulcorantes y fibra en adultos sanos y diabéticos tipo 2 (DM2). Metodología: en este estudio aleatorizado, cruzado y doble ciego, once sujetos sanos y seis diabéticos consumieron dos fórmulas en cuatro ocasiones (Glucerna SR® Laboratorios Abbott C.A [FG] y Enterex Diabetic®, Victus, C.A [FE], edulcoradas con fructosa y sucralosa respectivamente, con distintas fuentes de fibra), además de solución glucosada (SG) en una ocasión. Se obtuvieron muestras de sangre en ambos grupos a los tiempos 0, 15, 30, 45, 60, 90 y 120 minutos; en los diabéticos se adicionó el minuto 150 y 180 para medición de glicemias e insulina basal/posprandial de dos y tres horas. Resultados: el área de incremento bajo la curva de glucosa (IAUC) fue menor para las fórmulas que para SG. En sanos fue de 12.857 ± 422 para FE y 11.601 ± 272 para FG (p < 0,014). En diabéticos resultó más disminuida para FG (28.656 ± 123) comparada con FE (29.855 ± 496) (p < 0,01). El IG resultó 58,07 ± 8,4 y 60,7 ± 2 para FG y FE respectivamente en controles, y 65,16 ± 0,2 y 68,06 ± 1 en diabéticos, sin diferencias; igualmente en la insulina posprandial. Conclusiones: el IG y la CG de ambas fórmulas resultaron en un valor intermedio en los dos grupos, con perfil glicémico inferior al de SG. No se observaron diferencias en el comportamiento insulínico, evidenciando que la velocidad de absorción de los carbohidratos de estas fórmulas es prolongada, con impacto glicémico menor que el producto patrón, lo que sugiere que es aceptable su indicación en el diabético (AU)


Objective: The aim of this study is to compare the glycemic index (GI) and glycemic load (GL) of two formulas with the same glucose content with different sweeteners and dietary fi ber for diabetics in healthy adults and in patients with type-2 diabetes (DM2). Methodology: In this randomized, double-blind crossover research, eleven healthy people and six with DM2 consumed two enteral formulas, Glucerna SR®, Laboratorios Abbott C.A. (GF) and Enterex Diabetic®, Victus C.A. (EF), sweetened with fructose y sucralose, with 1.2 and 1.3 g/100 ml of fiber source respectively (four times). Additionally, they consumed glucose solution once, obtaining blood samples at 0, 15, 30, 45, 60, 90 and 120 min for controls; in the diabetics, minutes 150 and 180 were added for measuring blood glucose, basal and postprandial insulin after two and three hours. Results: The incremental area under the curve (IAUC) was lower for the formulas rather than for SG. In the healthy controls was 12,857 ± 422 for EF and 11,601 ± 272 for GF (p < 0.014). In diabetics, this curve reduced for GF (28,656 ± 123) compared to EF (29,855 ± 496) (p < 0.01). The IG resulted in 58.07 ± 8.4 and 60.7 ± 2 for GF and EF, respectively, in the controls, and 65.16 ± 0.2 and 68.06 ± 1 in diabetics, without significant differences, as well as in post-prandial insulin. Conclusions: The GI and the GL of the two formulas resulted in an intermediate value in both groups, with a glycemic profile inferior to SG. No significant differences were observed regarding insulin behavior, showing that the absorption rate of carbohydrates in these formulas is slower, with a lower glycemic impact than the pattern product; thus, making its indication acceptable for the diabetic patient (AU)


Assuntos
Humanos , Adulto , Índice Glicêmico/fisiologia , Carga Glicêmica/fisiologia , Hiperglicemia/dietoterapia , Edulcorantes/uso terapêutico , Adoçantes Calóricos , Fibras na Dieta , Hiperglicemia/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/dietoterapia , Voluntários Saudáveis , Método Duplo-Cego , Alimentos Formulados , Glicemia/análise , Índice de Massa Corporal
19.
Am J Otolaryngol ; 38(4): 383-389, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28390807

RESUMO

OBJECTIVE: To evaluate the efficacy of xylitol nasal irrigation (XNI) treatment on chronic rhinosinusitis (CRS) and to investigate the effect of XNI on nasal nitric oxide (NO) and inducible nitric oxide synthase (iNOS) mRNA in maxillary sinus. MATERIALS AND METHODS: Patients with CRS were enrolled and symptoms were assessed by Visual Analog Scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22). Nasal NO and iNOS mRNA in the right maxillary sinus were also examined. Then, they were treated with XNI (XNI group) or saline nasal irrigation (SNI, SNI group) for 30days, after which their symptoms were reassessed using VAS and SNOT-22, and nasal NO and iNOS mRNA in the right maxillary sinus were also reexamined. RESULTS: Twenty-five out of 30 patients completed this study. The scores of VAS and SNOT-22 were all reduced significantly after XNI treatment, but not after SNI. The concentrations of nasal NO and iNOS mRNA in the right maxillary sinus were increased significantly in XNI group. However, significant changes were not found after SNI treatment. Furthermore, there were statistical differences in the assessments of VAS and SNOT-22 and the contents of nasal NO and iNOS mRNA in the right maxillary sinus between two groups. CONCLUSIONS: XNI results in greater improvement of symptoms of CRS and greater enhancement of nasal NO and iNOS mRNA in maxillary sinus as compared to SNI.


Assuntos
Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Edulcorantes/uso terapêutico , Xilitol/uso terapêutico , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Seio Maxilar/metabolismo , Pessoa de Meia-Idade , Lavagem Nasal , Óxido Nítrico/genética , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase/genética , Óxido Nítrico Sintase/metabolismo , RNA Mensageiro/metabolismo , Rinite/complicações , Rinite/metabolismo , Sinusite/complicações , Sinusite/metabolismo
20.
Clin Oral Investig ; 21(9): 2733-2740, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28303470

RESUMO

OBJECTIVES: The caries preventive effect of long-term use (1 year) of low-dosage (2.5 g/die) of xylitol chewing gum in a high-caries-risk adult population was evaluated. MATERIALS AND METHODS: In this randomized clinical trial, 179 high-caries-risk adults were assigned to two experimental groups, xylitol and polyols. Caries status, salivary mutans streptococci (MS), and plaque pH were re-evaluated after 2 years from baseline in 66 xylitol and 64 polyol subjects. Outcomes (the net caries increment for initial, moderate, and extensive caries lesions and for the caries experience) were evaluated using the nonparametric Mann-Whitney U test. RESULTS: The total caries experience increment was 1.25 ± 1.26 in the xylitol group and 1.80 ± 2.33 in the polyol group (p = 0.01). Subjects treated with xylitol chewing gums had a reduction of risk rate at tooth level of 23% with respect to those treated with polyols with a number needed to treat of 55 teeth. The area under the curve at pH 5.7 was statistically significantly lower (p = 0.02) during the experimental period in the xylitol group. A decrease of the concentration of salivary MS was noted in the xylitol group (p < 0.01). CONCLUSIONS: Subjects using the low-dose xylitol chewing gum showed a significantly lower increment of initial and extensive caries lesions and overall a lower increment of caries experience. CLINICAL RELEVANCE: One-year use of chewing gums provides an effective means for the prevention of caries disease. TRIAL REGISTRATION NUMBER: NCT02310308.


Assuntos
Goma de Mascar , Cárie Dentária/prevenção & controle , Edulcorantes/uso terapêutico , Xilitol/uso terapêutico , Adulto , Cárie Dentária/epidemiologia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Saliva/microbiologia , Álcoois Açúcares/administração & dosagem , Álcoois Açúcares/uso terapêutico , Edulcorantes/administração & dosagem , Xilitol/administração & dosagem
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