Appetite Stimulation Research Articles

Variations in Nutrition Practices in Cystic Fibrosis: A Survey of the DIGEST Program.

Evidence-based management of gastrointestinal (GI) and nutrition manifestations of cystic fibrosis (CF) is limited, and practice variations have not been studied. Thus, a survey was developed with the purpose of evaluating current nutrition practices of CF-focused gastroenterologists, specifically utilizing awardees and mentors of the Cystic Fibrosis Foundation (CFF) Developing Innovative GastroEnterology Specialty Training (DIGEST) Program. Topics included appetite stimulation, tube feeding (TF), and aspects of nutrition assessment, specifically urine sodium and essential fatty acid (EFA) status. The response rate was 61% (22/36). About half (55%; 12/22) of respondents had 5-10 years of experience in GI, and 23% (5/22) had >10 years. In regard to appetite stimulation, the majority used cyproheptadine; however, duration and pattern of prescribing varied. Variation was noted in TF management pertaining to tube placement, formula choice, and prescribing pancreatic enzyme replacement therapy with overnight TF. The majority did not check EFAs or urine sodium. Treatment for deficiencies in EFA or abnormal urine sodium was inconsistent. The survey reveals wide variation in management of some aspects of nutrition-related manifestations of CF among experienced providers. This reflects the need for research to provide evidence-based guidelines.

Deprescribing: A Tool to Optimize Medications Across the Continuum of Care

Deprescribing: A Tool to Optimize Medications Across the Continuum of Care

Extraction and Ameliorative Effect of Camellia sinensis against toxicity induced by nickel nanoparticles in Sprague Dawley Rats

Camellia sinensis is extensively cultivated in most regions of the world. Camellia sinensis is known to have several pharmacological effects such as hypoglycemia, hypocholestrolemia, antioxidant, laxation, fungicide and appetite stimulation. Extraction of Camellia sinensis was done in Analytical lab of GC University Faisalabad. After extraction the extract were subjected to phytochemical analysis.

Study of a fodder protein supplement from plant raw materials with phytobiotic properties

The Russian market is oversaturated with grain raw materials in the composition of mixed fodders, which are characterized by a protein deficiency and poor digestibility of nutrients. One of the problems of modern animal husbandry is to increase productivity, and most importantly, to reduce the cost of production due to the efficient use of feed nutrients. Phytobiotics have antiviral, antimicrobial, and immunomodulating effects. Feed consumption is increased and the acid-base environment is normalized when they are included in any diet. Phytobiotics are safe for farm animals and birds. Studies of the amino acid composition and antioxidant activity of the protein feed additive obtained from the leafy mass of red clover plants were carried out in the work. The qualitative and quantitative composition of amino acids and the value of antioxidant activity prove the advisability of introducing a fodder protein supplement into the diet of feeding farm animals and birds. The main advantage of feeding a plant-based supplement is that farm animals and poultry are not exposed to any risks, as well as the possibility of its use as a flavoring and an appetite stimulant. It is assumed that the application of an additive from the vegetative mass of red clover will stimulate growth, reproduction, weight gain and will have antibacterial and immunostimulating effects.

Heal the heart through gut (hormone) ghrelin: a potential player to combat heart failure.

Ghrelin, a small peptide hormone (28 aa), secreted mainly by X/A-like cells of gastric mucosa, is also locally produced in cardiomyocytes. Being an orexigenic factor (appetite stimulant), it promotes release of growth hormone (GH) and exerts diverse physiological functions, viz. regulation of energy balance, glucose, and/or fat metabolism for body weight maintenance. Interestingly, administration of exogenous ghrelin significantly improves cardiac functions in CVD patients as well as experimental animal models of heart failure. Ghrelin ameliorates pathophysiological condition of the heart in myocardial infarction, cardiac hypertrophy, fibrosis, cachexia, and ischemia reperfusion injury. This peptide also exerts significant impact at the level of vasculature leading to lowering high blood pressure and reversal of endothelial dysfunction and atherosclerosis. However, the molecular mechanism of actions elucidating the healing effects of ghrelin on the cardiovascular system is still a matter of conjecture. Some experimental data indicate its beneficial effects via complex cellular cross talks between autonomic nervous system and cardiovascular cells, some other suggest more direct receptor-mediated molecular actions via autophagy or ionotropic regulation and interfering with apoptotic and inflammatory pathways of cardiomyocytes and vascular endothelial cells. Here, in this review, we summarise available recent data to encourage more research to find the missing links of unknown ghrelin receptor-mediated pathways as we see ghrelin as a future novel therapy in cardiovascular protection.

Medicinal cannabis in Thailand: 1-year experience after legalization.

Medicinal cannabis in Thailand: 1-year experience after legalization.

It Is Our Turn to Get Cannabis High: Put Cannabinoids in Food and Health Baskets.

Cannabis is an annual plant with a long history of use as food, feed, fiber, oil, medicine, and narcotics. Despite realizing its true value, it has not yet found its true place. Cannabis has had a long history with many ups and downs, and now it is our turn to promote it. Cannabis contains approximately 600 identified and many yet unidentified potentially useful compounds. Cannabinoids, phenolic compounds, terpenoids, and alkaloids are some of the secondary metabolites present in cannabis. However, among a plethora of unique chemical compounds found in this plant, the most important ones are phytocannabinoids (PCs). Over hundreds of 21-22-carbon compounds exclusively produce in cannabis glandular hairs through either polyketide and or deoxyxylulose phosphate/methylerythritol phosphate (DOXP/MEP) pathways. Trans-Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) are those that first come to mind while talking about cannabis. Nevertheless, despite the low concentration, cannabinol (CBN), cannabigerol (CBG), cannabichromene (CBC), tetrahydrocannabivarin (THCV), cannabidivarin (CBDV), cannabinodiol (CBND), and cannabinidiol (CBDL) may have potentially some medical effects. PCs and endocannabinoids (ECs) mediate their effects mainly through CB1 and CB2 receptors. Despite all concerns regarding cannabis, nobody can ignore the use of cannabinoids as promising tonic, analgesic, antipyretic, antiemetic, anti-inflammatory, anti-epileptic, anticancer agents, which are effective for pain relief, depression, anxiety, sleep disorders, nausea and vomiting, multiple sclerosis, cardiovascular disorders, and appetite stimulation. The scientific community and public society have now increasingly accepted cannabis specifically hemp as much more than a recreational drug. There are growing demands for cannabinoids, mainly CBD, with many diverse therapeutic and nutritional properties in veterinary or human medicine. The main objective of this review article is to historically summarize findings concerning cannabinoids, mainly THC and CBD, towards putting these valuable compounds into food, feed and health baskets and current and future trends in the consumption of products derived from cannabis.

Buclizine crystal forms: First Structural Determinations, counter-ion stoichiometry, hydration, and physicochemical properties of pharmaceutical relevance.

Buclizine (BCZ) is a chiral synthetic piperazine derivative which has antihistaminic, anti-muscarinic and antiemetic properties, and has been reintroduced as an appetite stimulant, especially for pediatric patients. Structural information about this drug, as well as other buclizine crystalline forms (solvates, salts and co-crystals) including the BCZ free-base (BCZ-FB), is non-existent. Here, we present for the first time the crystal structure of the monohydrochloride monohydrate salt of BCZ (BCZHCl·H2O), and of its anhydrous form, BCZHCl. Interestingly, BCZHCl·H2O was obtained by recrystallization from the raw material (BCZH2Cl2) in ethanol:water solution showing that BCZ anhydrous dihydrochloride salt changes easily to a monohydrochloride monohydrate salt modification, which raise concerns about formulation quality control. BCZHCl·H2O and BCZHCl crystallize in the orthorhombic space groups (Pna21 and Pca21) belonging to the mm2 point group and are thus classified as non-centrosymmetric achiral structures (NA). Intuitively, we expect these salts to crystallize in a space group with a center of symmetry, since less than 5% of the known racemic compounds crystallize in the NA type. The crystal structures of BCZH2Cl2 and BCZ-FB were not determined, but their existence was verified by other techniques (chloride ion analysis, PXRD, HPLC, FT-IR, DSC, TGA) and by comparison of the obtained results with those found for BCZHCl. Additionally, we have also performed an evaluation of the equilibrium solubility (at six different aqueous media) and the dissolution profile of the BCZHCl salt compared to the raw material and BCZ-FB. Different equilibrium solubility values were found comparing the three forms in acidic and neutral pH ranges and all of them were insoluble at pH>7.0. Moreover, tablets prepared with BCZH2Cl2, BCZHCl or BCZ-FB show significant differences in terms of dissolution profile.

Addressing nutritional failure in a cystic fibrosis patient using nutritional and psychological intervention

Malnutrition is associated with Cystic Fibrosis (CF) disease progression. That contributes to decreased lung function, poor quality of life, and increased morbidity and mortality. Appetite stimulants (AS) have been used to help increase caloric intake. When caloric intake is inadequate, gastrostomy tube (GT) feeding is offered and has shown to improve weight gain. In some patients, both AS and GT placement might not be adequate to insure weight gain. That could be due to the underlying psychopathological issues like anxiety and depression that are common in CF. To address malnutrition in CF. Since increasing oral caloric intake was inadequate to improve weight gain. AS and GT feeding were discussed and offered. AS was started, but was not used regularly. However, GT was still needed to improve weight gain. Because of patient's hesitations, ongoing psychological counseling was done to help patient accept the intervention. Addressing patient's depression and anxiety and the failure to gain adequate weight at the same time helped improving patient's nutritional status. The presented case report demonstrates the improvement in weight gain and body mass index in a CF patient after addressing both the patient's psychological needs and increasing caloric intake through gastrostomy tube feeding.

Hedonic contrast and the short-term stimulation of appetite

Hedonic contrast describes how liking for one item is influenced by the recent experience of other items which differ in hedonic valence. In the context of food stimuli, there is abundant evidence that hedonic contrast alters liking, but limited information on its impact on intake, and the aim here was to further clarify how hedonic impact modifies intake. Participants (96 female volunteers) rated and consumed ad libitum a sequence of four bowls of a snack (potato crisps) in one of three conditions. In the Palatable (salted crisps) and Bland (unsalted crisps) conditions, all four bowls were the same. In the Contrast condition participants alternated between salted and unsalted crisps. In total, significantly more was consumed in the Palatable (35.0 ± 2.6 g) than Bland (26.6 ± 2.4 g) condition, but most was consumed in the Contrast condition (37.0 ± 1.6 g). The impact of hedonic contrast was seen in the third serving, where those in the Contrast condition consumed the most of any serving, and significantly more than in Palatable or Bland conditions, and at the final serving, when those in the Contrast condition consumed significantly less than in Bland or Palatable conditions. Rated liking for the foods showed a similar pattern, with liking decreasing across servings in Palatable and Bland conditions. However, liking was influenced by the preceding serving in the Contrast condition, and the change in liking produced by contrast predicted subsequent intake. Overall, these data provide clear evidence that hedonic contrast can influence consumption, with intake driven by this adjusted liking.

A Pediatric Hospital Policy for Medical Marijuana Use.

Most US states have now legalized medical marijuana (MMJ) use, giving new hope to families dealing with chronic illness, despite only limited data showing efficacy. Access to MMJ has presented several challenges for patients and families, providers, and pediatric hospitals, including the discrepancy between state and federal law, potential patient safety issues, and drug interaction concerns. Colorado was one of the first states to legalize MMJ and has remained at the forefront in addressing these challenges. Children's Hospital Colorado has created and evolved its MMJ inpatient use policy and has developed a unique consultative service consisting of a clinical pharmacist and social worker. This service supports patients and families and primary clinical services in situations in which MMJ is actively being used or considered by a pediatric patient. The first 50 patients seen by this consultative service are reported. Eighty percent of patients seen had an oncologic diagnosis. Symptoms to be ameliorated by active or potential MMJ use included nausea and vomiting, appetite stimulation, seizures, and pain. In 64% of patients, MMJ use was determined to be potentially unsafe, most often because of potential drug-drug interactions. In 68% of patients, a recommendation was made to either avoid MMJ use or adjust its administration schedule. As pediatric hospitals address the topic of MMJ use in their patients, development of institutional policy and clinical support services with specific expertise in MMJ is a recommended step to support patient and families and hospital team members.

Sarcopenia, frailty and cachexia patients detected in a multisystem electronic health record database

BackgroundSarcopenia, cachexia and frailty have overlapping features and clinical consequences, but often go unrecognized. The objective was to detect patients described by clinicians as having sarcopenia, cachexia or frailty within electronic health records (EHR) and compare clinical variables between cases and matched controls.MethodsWe conducted a case-control study using retrospective data from the Indiana Network for Patient Care multi-health system database from 2016 to 2017. The computable phenotype combined ICD codes for sarcopenia, cachexia and frailty, with clinical note text terms for sarcopenia, cachexia and frailty detected using natural language processing. Cases with these codes or text terms were matched to controls without these codes or text terms matched on birth year, sex and race. Two physicians reviewed EHR for all cases and a subset of controls. Comorbidity codes, laboratory values, and other coded clinical variables were compared between groups using Wilcoxon matched-pair sign-rank test for continuous variables and conditional logistic regression for binary variables.ResultsCohorts of 9594 cases and 9594 matched controls were generated. Cases were 59% female, 69% white, and a median (1st, 3rd quartiles) age 74.9 (62.2, 84.8) years. Most cases were detected by text terms without ICD codes n = 8285 (86.4%). All cases detected by ICD codes (total n = 1309) also had supportive text terms. Overall 1496 (15.6%) had concurrent terms or codes for two or more of the three conditions (sarcopenia, cachexia or frailty). Of text term occurrence, 97% were used positively for sarcopenia, 90% for cachexia, and 95% for frailty. The remaining occurrences were negative uses of the terms or applied to someone other than the patient. Cases had lower body mass index, albumin and prealbumin, and significantly higher odds ratios for diabetes, hypertension, cardiovascular and peripheral vascular diseases, chronic kidney disease, liver disease, malignancy, osteoporosis and fractures (all p < 0.05). Cases were more likely to be prescribed appetite stimulants and caloric supplements.ConclusionsPatients detected with a computable phenotype for sarcopenia, cachexia and frailty differed from controls in several important clinical variables. Potential uses include detection among clinical cohorts for targeting recruitment for research and interventions.

Biological Properties, Bioactive Constituents, and Pharmacokinetics of Some Capsicum spp. and Capsaicinoids.

Pepper originated from the Capsicum genus, which is recognized as one of the most predominant and globally distributed genera of the Solanaceae family. It is a diverse genus, consisting of more than 31 different species including five domesticated species, Capsicum baccatum, C. annuum, C. pubescen, C. frutescens, and C. chinense. Pepper is the most widely used spice in the world and is highly valued due to its pungency and unique flavor. Pepper is a good source of provitamin A; vitamins E and C; carotenoids; and phenolic compounds such as capsaicinoids, luteolin, and quercetin. All of these compounds are associated with their antioxidant as well as other biological activities. Interestingly, Capsicum fruits have been used as food additives in the treatment of toothache, parasitic infections, coughs, wound healing, sore throat, and rheumatism. Moreover, it possesses antimicrobial, antiseptic, anticancer, counterirritant, appetite stimulator, antioxidant, and immunomodulator activities. Capsaicin and Capsicum creams are accessible in numerous ways and have been utilized in HIV-linked neuropathy and intractable pain.

Three-dimensional growth of breast cancer cells potentiates the anti-tumor effects of unacylated ghrelin and AZP-531

Breast cancer is the most common type of cancer in women and notwithstanding important therapeutic advances, remains the second leading cause of cancer-related death. Despite extensive research relating to the hormone ghrelin, responsible for the stimulation of growth hormone release and appetite, little is known of the effects of its unacylated form, especially in cancer. The present study aimed to characterize effects of unacylated ghrelin on breast cancer cells, define its mechanism of action, and explore the therapeutic potential of unacylated ghrelin or analog AZP-531. We report potent anti-tumor effects of unacylated ghrelin, dependent on cells being cultured in 3D in a biologically-relevant extracellular matrix. The mechanism of unacylated ghrelin-mediated growth inhibition involves activation of Gαi and suppression of MAPK signaling. AZP-531 also suppresses the growth of breast cancer cells in vitro and in xenografts, and may be a novel approach for the safe and effective treatment of breast cancer.

In Silico Studies on Structural Function of Melanin Concentrating Hormone Receptor 1 Through Docking Approach, Towards Designing Drug for Treating Obesity

Melanin concentrating hormone receptor 1 is a G-protein coupled protein receptor expressed in the lateral hypothalamus and zona incerta, part of the nervous system that regulates feeding behavior and energy homeostasis. It is involved in the stimulation of appetite, this was seen when synthetic MCHR1 or MCH was administered to mice and it resulted in induced obesity due to the enhanced feeding. Many researchers have successfully find out the functions of several proteins, using computational approach. It is in this context that in this study the structural function of melanin concentrating hormone receptor 1 through docking studies has been done to make sure that those who are working to address the problem of obesity while trying to discover the effective drugs gain much insight about this receptor. The in silico methods have been used to predict the model of melanin concentrating hormone receptor 1. The template used for model prediction was human delta opioid receptor with the accession number 4N6H. The predicted model has been evaluated and found to be of good quality. Docking was done to investigate the interaction between the ligand; a bifunctional peptide ‘1-oleoyl-r-glycerol’ and the predicted model of melanin concentrating hormone receptor 1 which showed that fourteen residues interacted between the predicted model and ligand. Among interacting residues, it was realized that some of them are involved in sugar metabolism. Thus this study suggests a potential candidate for drug design against cancer and diabetes.&#x0D; Keywords: obesity, MCHR-1, docking, structural function, 3D structure, phylogenetic analysis, interacting residues

No Changes In Appetite Stimulating Hormones Following Swimming And Cycling Exercise Interventions

Swimming is a favorable and ideal modality of exercise for individuals with obesity and arthritis as it encompasses a minimal weight-bearing stress and a reduced heat load. However, the available evidence indicates that regular swimming may not be effective in reducing body weight and body fatness. A current hypothesis is that exercise in cold water somehow stimulates appetite. PURPOSE: We determined the effect of swimming exercise training on fasting concentrations of ghrelin, insulin, leptin, and peptide YY in obese individuals with osteoarthritis. Cycling training was included as a non-weight bearing land-based comparison group. METHODS: Thirty-nine obese participants with osteoarthritis (age=59±1 years, BMI=33±1 kg/m2) were randomly assigned to 12 weeks of supervised swimming training (N=19) or cycling training (N=20). In the initial few weeks, participants exercised for 20-30 minutes/day, 3 days/week, at an exercise intensity of 40-50% of heart rate reserve (HRR). Subsequently, the intensity and duration of exercise were progressively increased to 40-45 minutes/day, 3 days/week, at an intensity of 60-70% of HRR. Fasting blood samples were analyzed for ghrelin, insulin, leptin, and peptide YY concentrations using ELISAs. RESULTS: There were no group differences in body weight, BMI, or appetite stimulating hormones prior to the exercise interventions. Fasting plasma concentrations of ghrelin (37±8 vs. 42±11 pg/ml), insulin (1,176±424 vs. 1,179±442 pg/ml), leptin (20,200±2,891 vs. 16,617±2,734 pg/ml), and peptide YY (51±6 vs. 54±7 pg/ml) did not change with the swimming exercise intervention (all p>0.05). Similarly, cycling exercise had no effect on ghrelin (36±10 vs. 44±8 pg/ml), insulin (978±321 vs. 964±311 pg/ml), leptin (29,261±5,438 vs. 26,308±4,771 pg/ml), or peptide YY (58±15 vs. 63±16 pg/ml) concentrations (all p>0.05). CONCLUSIONS: Our present results indicate that fasting levels of appetite stimulating hormones did not change with 12 weeks of swimming exercise intervention in obese participants with osteoarthritis and that there were no group differences in changes in these hormones between swimming and cycling exercise interventions.

P290 Successful trial with an appetite stimulator in 2 siblings with cystic fibrosis with persistent failure to thrive and poor appetite

P290 Successful trial with an appetite stimulator in 2 siblings with cystic fibrosis with persistent failure to thrive and poor appetite

P278 Use of an appetite stimulant (Periactin®) in paediatric patients with cystic fibrosis

P278 Use of an appetite stimulant (Periactin®) in paediatric patients with cystic fibrosis

Cannabinoids and the Coronavirus.

Cannabinoids and the Coronavirus.

Prospective Study of Use of Edmonton Symptom Assessment Scale Versus Routine Symptom Management During Weekly Radiation Treatment Visits.

During radiotherapy (RT), patient symptoms are evaluated and managed weekly during physician on-treatment visits (OTVs). The Edmonton Symptom Assessment Scale (ESAS) is a 9-symptom validated self-assessment tool for reporting common symptoms in patients with cancer. We hypothesized that implementation and physician review of ESAS during weekly OTVs may result in betterment of symptom severity during RT for certain modifiable domains. As an institutional quality improvement project, patients were partitioned into 2 groups: (1) 85 patients completing weekly ESAS (preintervention) but blinded to their providers who gave routine symptom management and (2) 170 completing weekly ESAS (postintervention group) reviewed by providers during weekly OTVs with possible intervention. To determine the independent association with symptom severity of the intervention, multivariate logistic regression was performed. At study conclusion, provider assessments of ESAS utility were also collected. Compared with the preintervention group, stable or improved symptom severity was seen in the postintervention group for pain (70.7% v 85.6%; P = .005) and anxiety (79.3% v 92.9%; P = .002). The postintervention group had decreased association (on multivariate analysis) with worsening severity of pain (OR, 0.13; P < .001), nausea (OR, 0.25; P = .023), loss of appetite (OR, 0.30; P = .024), and anxiety (OR, 0.19; P = .005). Most physicians (87.5%) and nurses (75%) found ESAS review useful in symptom management. Incorporation of ESAS for OTVs was associated with stable or improved symptom severity where therapeutic intervention is more readily available, such as counseling, pain medication, anti-emetics, appetite stimulants, and anti-anxiolytics. The incorporation of validated patient-reported symptom-scoring tools may improve provider management.