Mean Weight Increase Research Articles

Evaluating the impact of 2006 Australasian Clinical Practice Guidelines for nutrition in children with cystic fibrosis in Australia.

To determine the association between the implementation of the 2006 Australasian Clinical Practice Guidelines for Nutrition in Cystic Fibrosis (CF) and the nutritional status of children participating in the Australian Cystic Fibrosis Data Registry (ACFDR). This research consisted of a quantitative study using ACFDR data and a survey of clinicians and dietitians treating children with CF. Two independent cohorts of children (2-5 years and 6-11 years) were selected from ACFDR between 1998 and 2014 (N = 2304). Generalised estimating equation model was used to assess weight, height and body mass index (BMI) z-scores for each patient before and after the implementation of the nutrition guidelines. A nationwide online survey was sent to 48 clinicians to explore the enablers and barriers to implementation of the guidelines. Data analysis showed significant increase (p < 0.05) in mean weight, height and BMI z-scores ranging from 0.06 to 0.18 after implementation of the guidelines in both cohorts of children. Nineteen (39%) clinicians participated in the survey. The majority of the respondents adopted the recommendations into their practice and used the guidelines as part of their professional development. Structural barriers included a lack of adequate staff resources and clinic space for consultations, inappropriate staff classification, high staff turnover and lack of mentoring support. In children participating in the ACFDR, nutritional status improved after the implementation of the 2006 guidelines. Survey results revealed enablers and barriers to guideline implementation and will inform implementation strategies for the revised Australasian nutrition guidelines for CF, released in 2017.

Abstract 3269: Metformin to prevent metabolic syndrome associated with androgen deprivation therapy (ADT): Metabolic analysis from a placebo-controlled study of metformin in non-diabetic men initiating ADT for advanced prostate cancer (PCa)

Abstract Background: ADT results in metabolic syndrome, characterized by hyperinsulinemia, insulin resistance and obesity. The hyperinsulinemia may result in ADT resistance; therefore preventing metabolic syndrome could have a therapeutic impact on PCa. Metformin decreases glucose &amp; insulin by inhibiting hepatic gluconeogenesis. There is preclinical evidence for additional antineoplastic activity due to mTOR inhibition secondary to AMPK activation. Methods: We analyzed serum and PBMC from a recently completed clinical study of men with advanced PCa on ADT that were randomized 1:1 to metformin at 500mg TID or color matched placebo. Subjects serum insulin/glucose, metformin levels, weight and waist circumference (WC) was assessed at baseline, week 12 and 28. The primary endpoint of study was the metabolic consequences of metformin vs placebo cohort. Secondary endpoints were PSA response and PBMC analysis of downstream target of mTOR, phospho-S6 kinase. Results: There were 36 evaluable men. The mean age on study was 68.4. Mean weight, WC and insulin at baseline in metformin cohort was 187 lbs, 41.14 cm and 10.03 mIU/L respectively, and 177.65 lbs, 40.52 cm and 8.02 mIU/L in placebo cohort. An increase in mean weight, WC and insulin levels was seen in both cohorts. At week 12 and 28, no statistical difference in weight, WC and insulin was observe in either cohort. Four men randomized to metformin had undetectable serum drug levels despite drug-diary suggesting compliance; excluding them did not result in significant metabolic change. Assessing efficacy, 50% in metformin and 53.3% in placebo cohort achieved undetectable PSA at week 28; difference not statistically significant. PBMC analysis demonstrated variable down-regulation of phospho-S6 kinase in the metformin cohort. Conclusion: This study detected no impact of MET addition to ADT on the risk of metabolic syndrome and no additional anti-tumor effects. Control of hyperinsulinemia related to diabetes by MET does not necessarily imply MET has a similar action on hyperinsulinemia due to ADT. Citation Format: Devalingam Mahalingam, Salih Hanni, Christos Fountzilas, Joel Michalek, John Sarantopoulos, Sureshkumar Mulampurath Achuthan Pillai, John Kuhn, Michael Pollak, Ian Thompson. Metformin to prevent metabolic syndrome associated with androgen deprivation therapy (ADT): Metabolic analysis from a placebo-controlled study of metformin in non-diabetic men initiating ADT for advanced prostate cancer (PCa) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3269.

Pengaruh Pemberian Tablet Fe Saat Menstruasi Mencegah Penurunan Kadar Hemoglobin

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Increasing baby's growth and development can be done by providing stimulation, such as massage. Baby massage is beneficial to increase baby's weight. The monthly report of the Ganjar Agung Health Center in January-March 2017 contains an average of 14.7% of babies who do not gain weight. &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Purpose: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The study aims to determine the effectiveness of infant massage on weight gain in infants aged 0-3 months in the Ganjar Agung Metro Barat Health Center in 2017.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Methods: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;This study uses a pre-experimental design with non-equivalent control group design. The intervention given is baby massage. The research sample was all infants aged 0-3 months totaling 25 babies taken by consecutive sampling technique. Data analysis using paired t test.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Results: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The results showed a mean increase in baby's body weight after massage of 0.916 kg (SD 0.1214kg) and there was an effect of infant massage on weight gain in infants aged 0-3 (p = 0.000).&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Conclusion: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The conclusion of the study is that infant massage can be one of the interventions to increase the baby's weight. Efforts to socialize baby massage programmatically need to be improved as one of the interventions to increase the growth (weight) of the baby.&lt;/em&gt;&lt;/p&gt;

Efektifitas Pijat Bayi terhadap Peningkatan Berat Badan pada Bayi Usia 0 – 3 Bulan

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Increasing baby's growth and development can be done by providing stimulation, such as massage. Baby massage is beneficial to increase baby's weight. The monthly report of the Ganjar Agung Health Center in January-March 2017 contains an average of 14.7% of babies who do not gain weight. &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Purpose:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The study aims to determine the effectiveness of infant massage on weight gain in infants aged 0-3 months in the Ganjar Agung Metro Barat Health Center in 2017.&lt;/em&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;This study uses a pre-experimental design with non-equivalent control group design. The intervention given is baby massage. The research sample was all infants aged 0-3 months totaling 25 babies taken by consecutive sampling technique. Data analysis using paired t test. &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Results:&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The results showed a mean increase in baby's body weight after massage of 0.916 kg (SD 0.1214kg) and there was an effect of infant massage on weight gain in infants aged 0-3 (p = 0.000).&lt;/em&gt;&lt;strong&gt;&lt;em&gt;Conclusion:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The conclusion of the study is that infant massage can be one of the interventions to increase the baby's weight. Efforts to socialize baby massage programmatically need to be improved as one of the interventions to increase the growth (weight) of the baby.&lt;/em&gt;&lt;/p&gt;

A multicenter randomized clinical trial of etonogestrel and levonorgestrel contraceptive implants with nonrandomized copper intrauterine device controls: effect on weight variations up to 3 years after placement

ObjectivesTo evaluate weight changes in women randomized to either the etonogestrel (ENG)- or the levonorgestrel (LNG)-releasing contraceptive implants and to compare with users of the TCu380A intrauterine device (IUD). Study designA multicenter randomized trial with 1:1 allocation ratio of the ENG and the LNG implants with nonrandomized, age-matched control group of women choosing TCu380A IUD. The primary objective was to assess contraceptive efficacy and method continuation rates and, secondarily, the incidence of common complaints and side effects (including weight changes) associated with use of the three contraceptives. All women were enrolled in nine centers at seven countries. Weight change was evaluated from time at device(s) placement. Confounders were sociodemographic, baseline weight and body mass index, center and time from insertion. We used a linear mixed-effects regression modeling with random intercept and slope. Weight was compared between the two implants groups and between the implants and the IUD groups through linear mixed multivariable regression model. ResultsA total of 995, 997 and 971 users in the ENG implant, LNG implant and IUD groups, respectively, were included. At 36 months of use, ENG and LNG implant users had similar significant mean weight increase of 3.0 kg [95% confidence interval (CI) 2.5–3.5] and 2.9 kg (95% CI 2.4–3.4), respectively (p<.0001), while IUD users had an increase of 1.1 kg (95% CI 0.5–1.7) (p=.0003). On adding the group–time interaction term to the stratified baseline weight models, implant users gained 0.759 kg (standard error [SE] .11) and 0.787 kg (SE .22) more weight than their IUD-user counterparts per year since placement if their baseline weight was in the category 51–69 kg (p<.0001) or ≥70 kg (p=.0005), respectively. ConclusionsENG and LNG implant as well as IUD users had a small but significant weight increase with little clinical significance during the 3 years of follow-up, and it was slightly higher among implant than IUD users weighing >50 kg. ImplicationsThese findings must be useful for clinicians to counsel implant users which could improve method continuation.

Agronomic characteristics of pumpkin fruits of “Tetsukabuto”hybrid as a function of 2,4-D doses

Due to the short flowering period of the pumpkin hybrid ‘Tetsukabuto’, a poor pollination may influence the fruit production. In thissense, the objective of this study was to evaluate agronomic characteristics of the pumpkin hybrid (Tetsukabuto) as a function of 2,4-D doses as phytohormonal inducer. The experiment was conducted in the field, in a randomized block design with four replications and five plants per plot. It was established with eight treatments, seven of them increasing doses of 2,4-Dichlorophenoxyacetic acid (187.5, 200, 212.5, 225, 237.5, 250 and 262.5 mg L-1) and a control (flowers fertilized with pollen). At 110 days after sowing it was made a fruit harvest, evaluating the following characteristics: yield, fruit mean weight, texture of bark, fruit shape and cycle. The fruits mean weight, yield and days from planting to harvest with the use of 2,4-D were superior to natural pollination. Increasing the dose of 2,4-D resulted in an increase in yield and fruit mean weight until to dose 250 mg L-1. There was a reduction in the cycle culture with increasing in the 2,4-D doses.

Supplementation with Oligonol, Prevents Weight Gain and Improves Lipid Profile in Overweight and Obese Saudi Females.

Background: Obesity is a global health problem, increasing susceptibility to Type 2 Diabetes (T2DM) and Cardiovascular Disease (CVD). Varieties of products have been proposed for treatment with varying degrees of success. Recent studies, suggested Oligonol; an optimized phenolic product mixture from Lychee Fruit Polyphenols (LFP); as such treatment in Japanese population.Objectives: We aimed to investigate the effect of oligonol on weight, insulin resistance by (HOMA-IR), lipids profile, leptin, Adiponectin, and resistin in healthy overweight and obese Saudi females.Subjects and Methods: 60 Saudi healthy overweight and obese females were enrolled in a double blind case/control study to take either Oligonol or placebo for 12 weeks without dietary or lifestyle re-strictions. Weight, height, Waist Circumference (WC), hip circumference (HC), and blood pressure were measured, and fasting blood samples of participants were taken before, and at the end of study. Total cholesterol, HDL-cholesterol, triglycerides, glucose, insulin, leptin, adiponectin, and resistin were meas-ured. LDL- cholesterol, HOMA-IR were calculated by equation.Results: 47 subjects completed the study, 25 in placebo group, and 22 in Oligonol group. No ill effects were noted in any participant. Oligonol reduced means of serum triglycerides (P=0.008), and resistin (P=0.045) significantly. In addition, no weight gain was noted in oligonol group, unlike placebo group which exhibited significant increase in mean weight (P= 0.036), WC (P=0.027), HC (P= 0.047), and leptin (P <0.001).Conclusion: Oligonol could be suggested as future hypolipidemic and weight controlling agent for overweight and obese Saudi females.

O7.5. LONG-TERM SAFETY AND TOLERABILITY OF BREXPIPRAZOLE IN PATIENTS WITH SCHIZOPHRENIA

BackgroundLong-term maintenance treatment is recommended to control the symptoms of schizophrenia1,2; therefore, safety monitoring for longer than the period required to treat an acute exacerbation is warranted. The aim of the present study (Lighthouse extension; NCT01810783) was to assess the long-term safety and tolerability of open-label treatment with brexpiprazole (flexible dose 1–4 mg/day) in adult patients with schizophrenia. Brexpiprazole is a serotonin-dopamine activity modulator that acts as a partial agonist at the serotonin 5-HT1A and dopamine D2 receptors, and as an antagonist at the 5-HT2A and noradrenaline α1B/2C receptors, all with subnanomolar potency. Brexpiprazole is approved in the US as adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD) and in the US, Australia and Canada as monotherapy for treatment of schizophrenia.MethodsPatients rolled over into this 52-week open-label study from a randomized, double-blind, placebo-controlled, active referenced, Phase 3 study (Lighthouse3; NCT01810380). The primary endpoint was safety and tolerability. Efficacy was assessed as an exploratory endpoint using the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions – Severity of illness (CGI-S) and Improvement (CGI-I) scales, and the Personal and Social Performance (PSP) scale. Changes from baseline were analyzed using a mixed model repeated measurements (MMRM) approach.Results210 patients were enrolled, and 101 (48.3%) completed the study. The mean and mean modal doses of brexpiprazole were 3.07mg/day and 3.18mg/day, respectively; at last visit, 50% of the patients received 4mg/day. Among patients who took ≥1 dose of brexpiprazole, the incidence of discontinuation due to treatment-emergent adverse events (TEAEs) was 17.2%. TEAEs with an incidence of ≥5.0% were schizophrenia (worsening of the underlying disease; 11.5%), weight increase (10.5%), headache (8.6%), and insomnia (8.1%). Most TEAEs were mild or moderate in severity. The mean increase in body weight from baseline to Week 52 was 2.6kg (observed cases [OC]) and 19.6% of patients had a weight increase ≥7% at any time during the study. There were no clinically relevant findings for either metabolic parameters (lipids and glucose), or for events related to ECGs, vital signs, extrapyramidal symptoms, or prolactin. Patients’ symptoms and functioning showed continual improvement; at Week 52, mean change from baseline in PANSS was -6.8 (95% confidence interval [CI]: -9.3, -4.2); CGI-S: -0.4 (95%CI: -0.5, -0.2); and PSP: 4.2 (95%CI: 2.2, 6.1). The CGI-I score at Week 52 was 2.8 (95%CI: 2.6, 3.1). The percentage of responders (reduction of ≥30% from baseline in PANSS total score or a CGI-I score of 1 [very much improved] or 2 [much improved]) increased throughout the study, from 16% (OC and last observation carried forward [LOCF]) at Week 1 to 48% (OC) and 35% (LOCF) at Week 52.DiscussionTreatment with open-label brexpiprazole 1–4 mg/day was generally well tolerated for up to 52 weeks in patients with schizophrenia. Further, long-term treatment with brexpiprazole was associated with continued improvement in efficacy measures and functional outcomes.

31.1 OPTIMISING THE TREATMENT AND MANAGEMENT OF FIRST-EPISODE SCHIZOPHRENIA: THE OPTIMISE CLINICAL TRIAL

BackgroundVery few prospective, sequential studies are available that could guide decisions which have to be made in every day clinical routine. Some of the simplest questions of clinicians remain unanswered. For example: If the first antipsychotic used has not worked, is switching to another drug effective? Or should we perhaps increase the dose? And when should we start clozapine, the most efficacious drug? These questions are most urgent for patients with a first episode of psychosis.MethodsOPTiMiSE is an international clinical trial, conducted in 27 research centers located in 14 countries across Europe and Israel. Among other purposes, OPTiMiSE was designed to test a three-stage treatment algorithm. The 446 participants of OPTiMiSE were diagnosed with a first episode of schizophrenia, schizophreniform or schizoaffective disorder. Each participant started with a 4-week open label amisulpride treatment. After these 4 weeks, non-remitters are randomized to switch to another antipsychotic versus continuation of amisulpride for 6 weeks, in a double-blind fashion (phase 2). After these additional 6 weeks, non-remitters were switched to clozapine for another 12 weeks.ResultsDescription of the sample:Mean age at inclusion was 26 years, 30% of the patient sample was female. The median duration of illness was 4 months and none of the participants had been using antipsychotic medication for more than 2 weeks. All patients were treated on a voluntarily basis. The patient sample was moderately ill at baseline, with a mean score on the Positive And Negative Syndrome Scale (PANSS) of 78 (sd 19).Phase 1Patients started on 200–800 mg/day amisulpride treatment, with a target dose of 400 mg/day. Drop-out rate was 20%. Out of the 446 patients who were initiated on amisulpride, 56% met remission criteria, based on the eight remission items of the PANSS. Side effects were mild, with a mean weight increase of 2.7 kg (sd 3.3).Phase 2At the end of phase 1, 121 patients did not meet remission criteria. Out of the 93 patients who continued into the double-blind treatment phase, 72 patients completed the 6-week treatment phase. Remission rate in phase 2 was 35%. There was no significant difference between the two treatment arms regarding remission rate, nor regarding the drop out rate. Patients randomized to olanzapine gained significantly more weight compared to amisulpride.Phase 3At the end of phase 2, 40 patients did not meet remission criteria. Out of the 28 patients who continued into the open-label clozapine treatment phase, 18 patients completed this 12-week treatment from which only 5 patients met remission criteria, translating into a remission rate of only 18%. Non-remitters generally did improve to a great extent but failed to meet the stringent remission criteria.DiscussionAmisulpride is confirmed to be a good option for initiating pharmacotherapy in first episode patients, resulting in a high remission rate. There was no advantage related to remission rates or drop out rates for switching non-responders after 4 week of treatment to another antipsychotic versus continuing the initiated antipsychotic for another 6 weeks; continuing the first antipsychotic may have the benefit of avoiding new side effects related to introducing a new antipsychotic. Despite a low remission rate following clozapine treatment, non-remitters generally did show a substantial reduction in symptoms, demonstrating that clozapine should be an option for non-responding psychotic patients early in the illness.

Evidence for energetic tradeoffs between physical activity and childhood growth across the nutritional transition

Despite broad implications for understanding human life history, energetics, and health, the impact of physical activity on childhood growth remains unclear. Particularly understudied is the effect of secular changes in physical activity on child development. We address these shortcomings using data spanning the transition from traditional to semi-developed economy among Yucatec Maya agriculturalists. Anthropometric and behavioral observation data were collected from children living in a subsistence-based rural community in 1992 and again in 2012 following the introduction of a school and mechanized technologies but minimal overt dietary change. Multiple regression analyses demonstrate dramatic twenty-year transformations in how children spent their time. This behavioral change was associated with large declines in estimated physical activity level (PAL), associated activity energy expenditure savings of several hundred kilocalories/day, and sizable increases in mean height, weight, and triceps skinfold thickness. Controlling for observed frequency of market food consumption, PAL was inversely related to child body size and subcutaneous fat stores and significantly mediated the effects of data collection year on anthropometric indices. These findings indicate that physical activity can considerably influence childhood growth, highlighting the role of energy allocation tradeoffs between physical activity and competing life tasks in shaping patterns of human ontogeny and health.

Effects of Electromagnetic Radiation of Mobile Phones on Hematological and Biochemical Parameters in Male Albino Rats

The widespread usage of mobile phones in recent years has raised concern for potential dangers and subsequent research activities. Many have tried to determine the effects of the emitted electromagnetic radiation of mobile phones. The present study was aimed at evaluating the effects of EMR from mobile phones on behavior, some hematological (RBC, MCV, WBC, HGB, MCH, MCHC, LYM, LYM %) and biochemical parameters (AST, ALT and ALP) in experimental rats. The results indicated that there is increase in mean weight of animals exposed to low EMR but the increment was less as the exposure period increases. No changes were observed in terms of their behavior. The values of RBC, HGB and MCH in 100% of the experimental animals in all groups of low and high EMR have exceeded that of the control. However, the values of WBC in 100% of experimental animals have not exceeded that of the control group. The mean values of AST and ALT in 30% of high EMR exposed rats has exceeded the control groups. There is no significant difference between high and low EMR exposed rats in terms of hematological parameters (RBC, MCV, WBC, HGB, MCH, MCHC, LYM, LYM %) and biochemical parameters (ALT, AST and ALP) (P>0.05).

Metformin to treat prostate cancer (PCa) and prevent metabolic syndrome associated with androgen deprivation therapy (ADT): Results of a randomized double-blind placebo-controlled study of metformin in non-diabetic men initiating ADT for advanced PCa.

e16502 Background: ADT results in metabolic syndrome, characterized by hyperinsulinemia, insulin resistance and obesity. The hyperinsulinemia may result in ADT resistance; therefore preventing metabolic syndrome could have a therapeutic impact on PCa. In diabetes, metformin (MET) decreases glucose &amp; insulin by inhibiting hepatic gluconeogenesis. There is preclinical evidence for additional antineoplastic activity due to mTOR inhibition secondary to AMPK activation. Methods: Men with biochemical relapse or advanced PCa due to receive ADT were randomized 1:1 in a double blind manner to MET (500mg TID) or placebo (P). Subjects required normal oral glucose tolerance test at baseline, with fasting serum insulin/glucose, PSA, MET, weight and waist circumference (WC) monitored at baseline, week 12 and 28. The primary endpoint of study was the metabolic consequences of MET vs P. Secondary endpoints were PSA response and PBMC analysis of downstream target of mTOR, phospho-S6 kinase. Results: 36 men were randomized to MET or P, mean age 68.4; biochemical failure (n = 15) &amp; metastatic disease (n = 21). Mean weight, WC and insulin at baseline in MET cohort was 187 lbs, 41.14 cm and 10.03 mIU/L respectively, and 177.65 lbs, 40.52 cm and 8.02 mIU/L in P cohort. An increase in mean weight, WC and insulin levels was seen in both cohorts. At wk 12 and 28, no statistical difference in weight, WC and insulin was observe in either cohort. 4 men randomized to MET had undetectable serum drug levels despite drug-diary suggesting compliance; excluding them did not result in significant metabolic change. Assessing efficacy, 50% in MET and 53.3% in P cohort achieved undetectable PSA at wk 28; difference not statistically significant. PBMC analysis demonstrated variable down-regulation of phospho-S6 kinase in the metformin cohort. Conclusions: This study detected no impact of MET addition to ADT on the risk of metabolic syndrome and no additional anti-tumor effects. Control of hyperinsulinemia related to diabetes by MET does not necessarily imply MET has a similar action on hyperinsulinemia due to ADT. Clinical trial information: NCT02620423.

Effects of Selected Herbs and Vegetables on the Nutritional Quality of Beef Burger and Rat Bioassay

Rat bioassay was used to evaluate the nutritional quality of beef burger as influenced by the addition of selected herbs and vegetables. The selected herbs and vegetables used were pucuk ubi (Mannihot esculenta), pucuk gajus (Anacardium occidentale), pegaga (Centella asiatica) and jantung pisang (Musa paradisiaca) as treatment group with casein and skimmed milk as reference. The rats were fed with herbs and vegetables at the rate of 0.5 (low dose) and 25 (high dose) g/kg body weight. The samples were analyzed for proximate analysis, protein quality and protein digestibility. The rats fed with pucuk ubi (high dose) (364.30 ± 25.34 g) indicated the highest mean of increased body weight (121.05 ± 14.65 g) while rats fed with skimmed milk (310.98 ± 18.92 g) showed the lowest mean increase in body weight (88.33 ± 14.25 g). As for the Protein Efficiency Ratio (PER) value, all the rats fed with herbs diet showed PER values that were significantly lower (p<0.05) compared to the casein. As for the in vivo apparent protein digestibility test, casein showed the highest digestibility value (86.33 ± 4.20) while pucuk gajus (high dose) (59.59 ± 5.41) showed the lowest. As for the in vitro digestibility analyses, casein indicated the highest value for in vitro digestibility (93.84 ± 0.33). Administration of herbs and vegetables at low and high doses show significant effects (p<0.05) on nutritional quality of beef burger. In conclusion, it was found that antinutritional factors in selected herbs and vegetables might affect the nutritional quality of beef burger.

The anticancer activity of the combination therapy of Gemcitabine and Doxorubicin encapsulated in a nanoemulsion

Doxorubicin (DOX) is a chemotherapeutic drug used for treatment of a wide variety of cancers. It is known to cause cardiotoxicity. Gemcitabine (GEM) is an anticancer drug, but it has certain limitations like short biological half-life. A new paradigm to improve DOX and GEM therapeutic index is to administer them in nanoparticles (NPs). Nanoemulsions (NEs) are well-characterized NPs drug carriers that have been broadly implemented in the delivery of anticancer therapeutics. In this study, the antitumor activity of the combination formulas of GEM and DOX, either loaded in water (GEM+DOX-Sol) or NEs (GEM+DOX/LNE), were evaluated in Ehrlich ascites carcinoma (EAC) bearing swiss albino mice. The anticancer assessment of the NEs formulas in 200 mice divided into 10 groups included the detection of the change in body weight, hematological and serum biochemical profiles and studying the histopathological alterations of the heart, liver and kidney tissues. Results showed that mice treated with GEM+DOX/LNE which has z-average 155.38 nm and zeta potential -38.5 mV, recorded a decrease in the mean tumor weight and significant increase in the cumulative mean survival time (MST), which was 60 days, as compared to the EAC control group, which has MST of 28 days. It also showed no significant changes in hematological and serum biochemical profiles compared to the normal group. In conclusion, the present study suggested that GEM treatment may significantly reduce cardiotoxicity induced by DOX in EAC-bearing mice. Also, GEM enhances the antitumor properties of DOX by increasing its inhibitory effect on tumor growth.

Toxicity of oil sands acid-extractable organic fractions to freshwater fish: Pimephales promelas (fathead minnow) and Oryzias latipes (Japanese medaka)

The Alberta oil sands are one of the largest global petroleum deposits and, due to non-release practices for oil sands process-affected waters, produced tailings are stored in large ponds. The acid extractable organic (AEO) compounds in oil sands process-affected water are of greatest concern due to their persistence and toxicity to a variety of aquatic biota. The present study evaluated the toxicity of the five AEO fractions to two fish species: Oryzias latipes (Japanese medaka) and Pimephales promelas (fathead minnow). The fractions (F1-F5) were comprised of AEO with increasing mean molecular weight and subsequent increases in cyclicity, aromaticity, degree of oxygenation, and heteroatom content. The lowest molecular weight fraction, F1, displayed the lowest acute toxicity to both fish species. For fathead minnow, F5 displayed the greatest toxic potency, while F2 to F4 displayed intermediate toxicities. For Japanese medaka, F2 and F3 displayed the greatest acute toxicities and F1, F4 and F5 were significantly less potent. Overall, fathead minnow were more acutely sensitive to AEO than Japanese medaka. The present study indicates that AEO toxicity may not be solely driven by a narcotic mode of action, but chemical composition such as aromaticity and heteroatom content and their relation to toxicity suggest other drivers indicative of additional modes of toxic action.

Characterization of Body Composition and Fat Mass Distribution 1 Year After Kidney Transplantation.

In some recipients, significant weight gain occurs after kidney transplantation. Weight gain is associated with poor outcomes, particularly increased cardiovascular risk. In this study, we characterized changes in body mass index and body fat mass and compared them based on gender and race. Fifty-two kidney transplant recipients (aged ≥18 years old, 50% men, 58% African American) were enrolled into a prospective study. Body mass index and body fat mass were measured at baseline and 12 months posttransplant. Body fat mass was determined by dual-energy X-ray absorptiometry. The mean increase in body weight was 3.7kg at 12 months; 36.5% (n=19) gained at least 10% of their baseline body weight. Body mass index, percentage of total body fat, and trunk fat were significantly increased. In subgroups, women and African American showed significant increases in body mass index and body fat measures. More participants were classified as obese based on total body fat compared to body mass index. Calories from fat were significantly increased at 12 months and associated with increased body mass index, total body fat, and trunk fat. Days of physical activity were significantly increased. Both body mass index and total body fat mass were significantly increased at 12 months following kidney transplantation, especially for women and African Americans. Importantly, more participants were classified as obese based on total body fat compared to body mass index. Relevant nutrition and physical intervention should be provided, and both body mass index and body fat mass should be evaluated when monitoring weight gain.

Depression, Antidepressants, and Weight Gain in Children.

Very few areas in medicine have been as fraught with controversy as the treatment of children with psychotropic medicines. There were significant increases in the prescribing of psychotropic medications in general and antidepressants in particular to children and adolescents since the early 1990s (1). This has led to a common perception that mental disorders are overdiagnosed and that treatment is often unnecessary and even harmful, a view that is amplified in the case of children (2). In fact there is strong evidence that antipsychotics are associated with weight gain and metabolic disease in children (3). However, is the same true for antidepressants? Analyzing these associations is complicated by the observation that depression itself is associated with weight gain, at least in adults (4). Schwartz et al. (5) in this issue of Obesity have addressed the relationships between depression, antidepressant treatment, and increases in BMI using data from a large sample of children extracted from an electronic health record database. The approach modeled the effects of several interactive factors on trajectories of BMI change over time: depression diagnosis, nonmental health comorbidities (e.g., asthma or diabetes), anxiety comorbidity, and antidepressant prescriptions. The study used a mixed-effects linear regression approach that tested for both independent and interactive effects of the predictor variables. Both prior depression diagnosis and antidepressant treatment were significantly associated with increases in BMI, and each showed effects that were independent of the other. From these data the authors concluded that depression itself and treatment with antidepressants were independently associated with increases in BMI. One year of antidepressant exposure was associated with 2.1 kg (4.6 lbs) of weight gain (2.5 kg for SSRIs) at age 18. While this change in weight is by no means trivial and it may be associated with an increased risk of metabolic disease, it is not as high as antipsychotic drugs. A recent article reported that 1 year of exposure with antipsychotics in children and adolescents was associated with a mean weight increase of 11.6 kg (6). Further, attention to the possibility of weight gain and the use of approaches to mitigate risk could prevent this problem. There is a further risk of confounding by indication as noted by the authors. Depressed children treated with antidepressants may not be identical to those not treated. The authors made a good faith effort to control for this by including some children who were treated with antidepressants but were not diagnosed with depression and by adjusting for covariates. However, the possibility of residual confounding remains: that is, the effects of differences in the disease state may persist even after adjusting for covariates. This is suggested by the observation that both comorbid anxiety and longer durations of antidepressant exposure, which might be surrogates for more severe or chronic illness, increased the drug effect. However, overall the results are very similar to findings in adults and suggest that depressed children with or without antidepressant therapy should be carefully monitored for weight gain.

Clinical and financial implications of disease-related malnutrition in a department of Internal Medicine: Prospective cohort study

BackgroundDisease-related malnutrition is a challenge for Spanish hospitals. Our objective was to assess the feasibility and importance of establishing a nutritional screening strategy in our community. Patients and methodsA prospective cohort study was conducted in a department of internal medicine for 3 months. The nutritional screening was conducted at admission and was repeated weekly using the Malnutrition Universal Screening Tool. We analysed the clinical data, mean stay and expenses. ResultsThe study included 330 patients (53.9% men), with a mean age of 77.8 years. The mean stay was 7 days, and the Charlson comorbidity index was 5.4. At admission, the Malnutrition Universal Screening Tool detected 26.9% of patients with a risk of malnutrition. Eighteen percent of the patients with a good nutritional state developed malnutrition during the hospitalisation. The patients with initially severe malnutrition had a longer mean stay. The patients whose nutritional state worsened during the hospitalisation had a significantly longer stay (2.5 days) compared with those whose state did not worsen. These cases of malnutrition caused a cost overrun of €767 per hospitalisation (35% greater), which entailed a malnutrition-related excess expenditure of €646,419.93 annually in the studied department. The appropriate coding resulted in an increase in mean weight from 2.11 to 2.81, which represented €82,568.52 and has not been previously quantified. ConclusionThe high prevalence and clinical and financial implications of disease-related malnutrition in patients hospitalised in internal medicine warrants establishing protocols for its early detection and treatment.

Repercusiones clínicas y económicas de la desnutrición relacionada con la enfermedad en un servicio de Medicina Interna: estudio de cohortes prospectivas

BackgroundDisease-related malnutrition is a challenge for Spanish hospitals. Our objective was to assess the feasibility and importance of establishing a nutritional screening strategy in our community. Patients and methodsA prospective cohort study was conducted in a department of internal medicine for 3 months. The nutritional screening was conducted at admission and was repeated weekly using the Malnutrition Universal Screening Tool. We analysed the clinical data, mean stay and expenses. ResultsThe study included 330 patients (53.9% men), with a mean age of 77.8 years. The mean stay was 7 days, and the Charlson comorbidity index was 5.4. At admission, the Malnutrition Universal Screening Tool detected 26.9% of patients with a risk of malnutrition. Eighteen percent of the patients with a good nutritional state developed malnutrition during the hospitalisation. The patients with initially severe malnutrition had a longer mean stay. The patients whose nutritional state worsened during the hospitalisation had a significantly longer stay (2.5 days) compared with those whose state did not worsen. These cases of malnutrition caused a cost overrun of €767 per hospitalisation (35% greater), which entailed a malnutrition-related excess expenditure of €646,419.93 annually in the studied department. The appropriate coding resulted in an increase in mean weight from 2.11 to 2.81, which represented €82,568.52 and has not been previously quantified. ConclusionThe high prevalence and clinical and financial implications of Disease-related malnutrition in patients hospitalised in internal medicine warrants establishing protocols for its early detection and treatment.

Effect of Preventive Chlamydia abortus Vaccination in Offspring Development in Sheep Challenged Experimentally

Ovine enzootic abortion, caused by Chlamydia abortus, leads to important economic losses worldwide. In addition to reproductive failures, infection may impact lamb growth during the first weeks after birth, yet this effect has not been well characterized. Vaccination can help to control the disease but variable efficacy values have been described, possibly related with factors associated with the host, the vaccine, the parameter used for efficacy determination, and the challenge conditions. In this context, we evaluated the efficacy of an inactivated standard commercial vaccine and a 1/2 diluted dose in pregnant sheep challenged with C. abortus by examining multiple indicators of vaccine effect (including incidence of reproductive failures, bacterial excretion, and evolution of weight gain of viable lambs during the first month of life). Three groups of ewes [control non-vaccinated, C (n = 18); vaccinated with standard dose, SV (n = 16); and vaccinated with 1/2 dose, DV (n = 17)], were challenged approximately 90 days post-mating and tested using direct PCR (tissue samples and vaginal swabs) and ELISA (serum) until 31 days post-reproductive outcome. There were not significant differences in the proportions of reproductive failures or bacterial shedding after birth/abortion regardless the vaccination protocol. However, a beneficial effect of vaccination on offspring growth was detected in both vaccinated groups compared with the controls, with a mean increase in weight measured at 30 days of life of 1.5 and 2.5 kg (p = 0.056) and an increase in the geometric mean of the daily gain of 8.4 and 9.7% in lambs born from DV and SV ewes compared with controls, respectively. Our results demonstrate the effect of an inactivated vaccine in the development of the offspring of C. abortus-infected ewes at a standard and a diluted dose, an interesting finding given the difficulty in achieving sufficient antigen concentration in the production of enzootic abortion of ewes-commercial vaccines.