Intake Of Capsules Research Articles

Dietary intake of micronized avian eggshell membrane in aged mice reduces circulating inflammatory markers, increases microbiota diversity, and attenuates skeletal muscle aging.

Avian eggshell membrane (ESM) is a complex extracellular matrix comprising collagens, glycoproteins, proteoglycans, and hyaluronic acid. We have previously demonstrated that ESM possesses anti-inflammatory properties in vitro and regulates wound healing processes in vivo. The present study aimed to investigate if oral intake of micronized ESM could attenuate skeletal muscle aging associated with beneficial alterations in gut microbiota profile and reduced inflammation. Elderly male C57BL/6 mice were fed an AIN93G diet supplemented with 0, 0.1, 1, or 8% ESM. Young mice were used as reference. The digestibility of ESM was investigated using the static in vitro digestion model INFOGEST for older people and adults, and the gut microbiota profile was analyzed in mice. In addition, we performed a small-scale pre-clinical human study with healthy home-dwelling elderly (>70 years) who received capsules with a placebo or 500 mg ESM every day for 4 weeks and studied the effect on circulating inflammatory markers. Intake of ESM in elderly mice impacted and attenuated several well-known hallmarks of aging, such as a reduction in the number of skeletal muscle fibers, the appearance of centronucleated fibers, a decrease in type IIa/IIx fiber type proportion, reduced gene expression of satellite cell markers Sdc3 and Pax7 and increased gene expression of the muscle atrophy marker Fbxo32. Similarly, a transition toward the phenotypic characteristics of young mice was observed for several proteins involved in cellular processes and metabolism. The digestibility of ESM was poor, especially for the elderly condition. Furthermore, our experiments showed that mice fed with 8% ESM had increased gut microbiota diversity and altered microbiota composition compared with the other groups. ESM in the diet also lowered the expression of the inflammation marker TNFA in mice and in vitro in THP-1 macrophages. In the human study, intake of ESM capsules significantly reduced the inflammatory marker CRP. Altogether, our results suggest that ESM, a natural extracellular biomaterial, may be attractive as a nutraceutical candidate with a possible effect on skeletal muscle aging possibly through its immunomodulating effect or gut microbiota.

Effect of Rhodiola rosea L. roots extract on pain perception in humans.

BackgroundRhodiola rosea L. (Crassulaceae) is one of the better known plant adaptogens possessing unique protective properties against various harmful environmental factors. Among the numerous pharmacological effects of R. rosea extracts (RRE) and their active compounds, antinociceptive activity has previously been demonstrated in experimental studies. PurposeThe study was aimed to evaluate the effect of a single, high dose of RRE on pain perception induced by diverse nociceptive stimuli in healthy volunteers. Material and methodsThe study was designed as a double blind, placebo-controlled trial. Each participant underwent the trial after both placebo and RRE administration. The order of trials was randomly assigned to the participants. The threshold and tolerance to heat and pressure stimulus and cold water tolerance (cold pressor test) were assessed in a group of 142 volunteers aged 19–27 years. The subjects were tested in three subsequent trials in one-week intervals. Baseline measurements were followed by tests after a single, oral intake of hydroethanolic RRE capsules (50 mg/kg) or placebo (PL). Measurement results were analyzed for the entire study group and subgroups characterized by high and low pain sensitivity (≤ 25 and ≥ 75 percentile, respectively). ResultsAfter intake of a single dose of RRE, both pain threshold (RRE 350.5 ± 115.4 kPa vs. PL 329.4 ± 117.4 kPa; p < 0.01) and pain tolerance to pressure (RRE 1160 ± 333.3 kPa vs. PL 1119 ± 347 kPa; p < 0.05) were significantly higher compared to placebo in the entire study group. Similar effects on pressure pain threshold were shown in the subgroup with high pain sensitivity (RRE 274.3 ± 85 kPa vs. PL 240.8 ± 75.2 kPa; p < 0.01). However, the mean differences between trials do not exceed the calculated values of the minimum detectable change (MDC95). RRE had no substantial effect on thermal pain perception (contact heat and cold water) either in the entire group or in the high and low pain sensitivity subgroups. ConclusionsApplication of a single, high dose of RRE does not modify response to thermal pain (heat, cold water), but may attenuate perception of mechanical pain in young, healthy individuals, especially those with high pain sensitivity. Further studies are warranted to confirm the clinical significance of the observed effects and to determine the influence of RRE on pain perception in the general population.

Pharmacokinetics and metabolism of cinnamic acid derivatives and flavonoids after oral administration of Brazilian green propolis in humans.

Brazilian green propolis (BGP) has chemical compounds from botanical origin that are mainly cinnamic acid derivatives (artepillin C, baccharin, and drupanin) and flavonoids (kaempferide and 6-methoxykaempferide). These compounds are expected to play an important role in the pharmacological activities of BGP. However, there is little known about the pharmacokinetics and metabolism of these compounds after oral administration of BGP. The aim of this study is to investigate the pharmacokinetics and metabolism of BGP components in humans. Twelve volunteers received 3 capsules containing 360 mg of BGP ethanol extract powder. Plasma samples were collected before and up to 24 h after the intake of BGP capsules. The collected plasma samples with or without hydrolysis by the deconjugating enzyme were analyzed by LC/MS/MS. After enzymatic hydrolysis, the Cmax values of artepillin C and drupanin, which were detected mainly in plasma after ingestion of BGP capsules, were 1255 ± 517 and 2893 ± 711 nM, respectively, of which 89.3% and 88.2% were found to be the phenolic glucuronide conjugate. This is the first time that the pharmacokinetics of the BGP components of human metabolites have been reported. Our results could provide useful information for the design and interpretation of studies to investigate the mechanisms and pharmacological effects of BGP.

La insuficiencia pancreática exocrina: estado actual de su conocimiento entre los profesionales de Argentina

Background. Exocrine pancreatic insufficiency is defined as the inability to maintain pancreatic secretion or maintain normal food digestion. It is an underdiagnosed entity. Objective. To collect information from the health professionals of different specialties in our country on the current state of knowledge of exocrine pancreatic insufficiency. Material and method. During the period comprising from August to November 2018, an anonymous survey was conducted. The survey was sent by e-mail. 447 professionals responded from a total of 2054 surveys sent. Results. We observed that a significant proportion of professionals did not relate exocrine pancreatic insufficiency with various etiologies that may cause it. Typical exocrine pancreatic insufficiency symptoms such as diarrhea-steatorrhea (96.2%) and the weight loss (85%) were the most chosen. Regarding diagnostic methods, digestive symptoms (60.6%) and the fecal elastase test (59.5%) were the most selected options. Regarding treatment, most chose to indicate the intake of the PERT capsules during food ingestion (61.3%). Only the 37.4% chose the initial dose recommended by most guidelines. A varied diet without fat restriction was indicated by the 40% of the respondents. In relation to the control of response to treatment, the improvement of symptoms (87.5%) and anthropometry (59.7) were the most used parameters. Most professionals do not use clinical guidelines for the management of these patients and only 22% used the guidelines. Conclusion. Based on the data obtained in this survey, we observed that a significant proportion of professionals do not know the relevant aspects in relation to the etiology, the clinical manifestations, the diagnosis, and the nutritional and pharmacological management of exocrine pancreatic insufficiency.

Amoxicillin and Risk of Hearing Loss: Analysis of Reported Cases Submitted to the WHO Global Database.

BackgroundPenicillins have never been associated with any form of hearing disorders. The Eritrean Pharmacovigilance Centre recently received two cases of hearing disorder (including one case of deafness) following the intake of amoxicillin capsules. This study was conducted to assess the causal link between amoxicillin and deafness.MethodsData mining was carried out in the WHO global database of individual case safety reports, VigiBase, and the Austin Bradford-Hill criteria were used to assess causality.ResultsA total of 94 cases of ‘hearing disorders’ related to amoxicillin were retrieved from VigiBase. Of these, 49 (52.1%) were reported as “deafness,” and amoxicillin was marked as the sole suspected drug in 18 and the only drug administered in 13 cases. In the rest of the deafness cases (n=31), amoxicillin was concurrently administered with other drugs and reported as co-suspected. The median time to onset was three days and the outcome was marked as recovered (14), recovering (2), not recovered (16) and unknown (17). In five cases, deafness resolved following the withdrawal of amoxicillin.ConclusionThere appears a causal association between amoxicillin and hearing loss that requires further substantiation with better epidemiologic studies.

Effect of oral melatonin administration on inflammatory cytokines and acute phase proteins after the castration of dogs

Melatonin has been used perioperative to control pain, inflammation, and oxidative stress. The present paper aims to evaluate the effect of the administration of melatonin on acute phase proteins and inflammatory cytokines and compare the trends after the melatonin administration in intact and castrated dogs. Twenty healthy mature male dogs (1–3 years old) were divided randomly into 4 groups (n = 5): melatonin, castrated and melatonin, castrated, and control. Melatonin (3 mg capsule/10 kg) was administrated every 24 h for 1 month and castration was performed on day 0. Blood was collected from each dog’s jugular vein every 7 days during this period. The serum samples were tested for hormonal assay using ELISA methods. Proteins and inflammatory cytokines (α-1 acid glycoprotein (AGP), serum amyloid-A (SAA), C-reactive protein (CRP), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α)) usually elevated in the first few days after surgery and returned to normal about 7 days after the surgery. During the study, the use of melatonin in castrated dogs significantly reduced the inflammatory proteins and cytokines, but in intact dogs, it did not significantly change the proteins and inflammatory cytokines. Daily intake of melatonin capsules in dogs may be beneficial in reducing inflammation by affecting the concentration of proteins and inflammatory cytokines released after castration surgery.

Effect of oral consumption of capsules containing Lactobacillus paracasei LPC-S01 on the vaginal microbiota of healthy adult women: a randomized, placebo-controlled, double-blind crossover study.

ABSTRACTOral consumption of probiotics is practical and can be an effective solution to preserve vaginal eubiosis. Here, we studied the ability of orally administered Lactobacillus paracasei LPC-S01 (DSM 26760) to affect the composition of the vaginal microbiota and colonize the vaginal mucosa in nondiseased adult women. A total of 40 volunteers took oral probiotic (24 billion CFU) or placebo capsules daily for 4 weeks, and after a 4-week washout, they switched to placebo or probiotic capsules according to the crossover design. A total of 23 volunteers completed the study according to the protocol. Before and after capsule ingestion, vaginal swabs were collected for qPCR quantification to detect L. paracasei LPC-S01 and for 16S rRNA gene sequencing. Vaginal swabs were grouped according to their bacterial taxonomic structure into nine community state types (CSTs), four of which were dominated by lactobacilli. Lactobacillus paracasei LPC-S01 was detected in the vagina of two participants. Statistical modeling (including linear mixed-effects model analysis) demonstrated that daily intake of probiotic capsules reduced the relative abundance of Gardnerella spp. Quantitative PCR with Gardnerella vaginalis primers confirmed this result. Considering the pathogenic nature of G. vaginalis, these results suggest a potential positive effect of this probiotic capsule on the vaginal microbial ecosystem.

Safety Evaluation of Excessive Intake of &amp;lt;i&amp;gt;Lactococcus lactis&amp;lt;/i&amp;gt; Subsp. &amp;lt;i&amp;gt;lactis&amp;lt;/i&amp;gt; JCM 5805: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Trial

Background/Aims: Administration of a lactic acid bacterial strain, Lactococcus lactis subsp. lactis JCM 5805 (LC-Plasma), is reported to prevent viral infection via activation of plasmacytoid dendritic cells in mouse and human studies. As it is assumed that LC-Plasma is taken in excess when it is commercially provided as a supplement, we conducted a trial using capsules to give 250 mg LC-Plasma (5 times the effective anti-viral dose) every day for four weeks to healthy volunteers to investigate the safety of excessive intake of LC-Plasma. Trial Design: A randomized, double-blind, placebo-controlled, parallel-group trial was conducted. Methods: Forty healthy subjects were randomly assigned to the LC-Plasma group (daily intake of five capsules containing 50 mg heat-killed LC-Plasma cells per capsule) or the placebo group (daily intake of five placebo capsules with no LC-Plasma). Physical, hematological, biochemical and urinary examinations and medical interviews were used to evaluate safety. Results: No abnormal differences were observed after excessive intake of LC-Plasma capsules when compared to the intake of placebo capsules. Conclusions: There are no safety concerns associated with the excessive intake of heat-killed LC-Plasma capsules.

Effect of Oral Paprika Xanthophyll Intake on Abdominal Fat in Healthy Overweight Humans: A Randomized, Double-blind, Placebo-controlled Study.

Xanthophylls that exist in various vegetables and fruits have beneficial actions, such as antioxidant activity and an anti-metabolic syndrome effect, and daily intake of xanthophylls could play an important role in preventing lifestyle-related diseases. We investigated whether intake of xanthophylls from red paprika could decrease the abdominal fat area in the healthy overweight volunteers with a body mass index (BMI) ranging from 25 to < 30 kg/m2. In a randomized, double-blind, placebo-controlled, parallel-group study, 100 healthy volunteers were assigned to oral administration of paprika xanthophyll capsules (containing 9.0 mg of paprika xanthophylls) or placebo capsules for 12 weeks. The primary endpoint was the effect of paprika xanthophyll intake on the abdominal visceral fat area (VFA) as determined by computed tomography. The secondary endpoints were as follows: 1) changes of the abdominal subcutaneous fat area (SFA), total fat area (TFA), and BMI; 2) changes of lipid metabolism parameters, glucose metabolism parameters, and other blood parameters. After 12 weeks, VFA was smaller in the paprika xanthophyll group than in the placebo group. In the paprika xanthophyll group, there was a significant decrease of SFA, TFA, and BMI after 12 weeks compared with baseline, and the reduction of SFA, TFA, and BMI was significantly greater in the paprika xanthophyll group than in the placebo group. Moreover, total cholesterol and low-density lipoprotein cholesterol decreased significantly in the paprika xanthophyll group, but not in the placebo group. No adverse effects were caused by intake of paprika xanthophyll capsules. Intake of paprika xanthophylls for 12 weeks significantly reduced the abdominal fat area and BMI in healthy overweight volunteers without causing any adverse effects. These findings suggest that paprika xanthophyll is a safe food ingredient that improves lipid metabolism and reduces abdominal fat. UMIN-CTR UMIN000021529.

Aromatherapy - From Traditional and Scientific Evidence into Clinical Practice

Essential oils (EOs), also known as volatile oils, are concentrated natural plant products which contain volatile aroma compounds. Most EOs are derived by steam distillation, a tradition which can be traced back as many as 5000 years. They possess unique properties which result in various possibilities for application, also in modern medical contexts. Areas for medical aromatherapy include respiratory diseases, pain management or stress alleviation, amongst many others. Different modes of application exist: The rich ingredients can be absorbed by the body by anointment, gentle massage, inhalation, or oral intake of capsules. Also the risks of EO application in medical contexts should be considered, such as rare allergic reactions, overdosing, poor substance quality or overestimation of the effectiveness.

Human placenta processed for encapsulation contains modest concentrations of 14 trace minerals and elements

Maternal placentophagy has recently emerged as a rare but increasingly popular practice among women in industrialized countries who often ingest the placenta as a processed, encapsulated supplement, seeking its many purported postpartum health benefits. Little scientific research, however, has evaluated these claims, and concentrations of trace micronutrients/elements in encapsulated placenta have never been examined. Because the placenta retains beneficial micronutrients and potentially harmful toxic elements at parturition, we hypothesized that dehydrated placenta would contain detectable concentrations of these elements. To address this hypothesis, we analyzed 28 placenta samples processed for encapsulation to evaluate the concentration of 14 trace minerals/elements using inductively coupled plasma mass spectrometry. Analysis revealed detectable concentrations of arsenic, cadmium, cobalt, copper, iron, lead, manganese, mercury, molybdenum, rubidium, selenium, strontium, uranium, and zinc. Based on one recommended daily intake of placenta capsules (3300 mg/d), a daily dose of placenta supplements contains approximately 0.018 ± 0.004 mg copper, 2.19 ± 0.533 mg iron, 0.005 ± 0.000 mg selenium, and 0.180 ± 0.018 mg zinc. Based on the recommended dietary allowance (RDA) for lactating women, the recommended daily intake of placenta capsules would provide, on average, 24% RDA for iron, 7.1% RDA for selenium, 1.5% RDA for zinc, and 1.4% RDA for copper. The mean concentrations of potentially harmful elements (arsenic, cadmium, lead, mercury, uranium) were well below established toxicity thresholds. These results indicate that the recommended daily intake of encapsulated placenta may provide only a modest source of some trace micronutrients and a minimal source of toxic elements.

Glycoside-based niosomal nanocarrier for enhanced in-vivo performance of Cefixime

This study aimed to evaluate the potential of a novel glycoside non-ionic surfactant synthesized and characterized in our laboratory for increased oral bioavailability of Cefixime. The surfactant was synthesized by simple etherification of bergenin with bromoundecane and characterized by 1H NMR and mass spectroscopy (MS). Biocompatibility of the surfactant (BRM-BG) was assessed by in-vitro cytotoxicity against NIH/3T3 cells and human blood hemolysis. In-vivo acute toxicity was evaluated in mices. Cefixime loaded BRM-BG niosomes were investigated for drug entrapment efficiency using HPLC and surface morphology and vesicle size by atomic force microscopy (AFM) and dynamic light scattering (DLS). The in-vivo oral bioavailability and pharmacokinetics studies were carried out using rabbits. Cefixime loaded BRM-BG vesicles were spherical in the size range of 178.66±8.17nm with a polydipersity index (PDI) of 0.20±0.01, offering an entrapment efficiency as high as 78.4±0.83%. When the surfactant was applied on NIH 3T3 tissue culture, as high as 90.77±3.15% and 86.86±3.02%, cell viability at 1000μg/mL concentration after 24 and 48h respectively were observed. The surfactant also caused 5.49±1.62% haemolysis and was found to be safe at a dose up to 2000mg/kg. In-vivo drug plasma concentration (Cmax) was found to be 9.69±1.22μg/mL, much higher than that resulting from the intake of commercial suspension and capsules. BRM-BG demonstrated to be safe and effective as carrier of Cefixime following oral dosing in rabbits. The BRM-BG surfactant delivery nano-system is relatively safe and in animal models it is an appropriate carrier for Cefixime, offering enhanced bioavailability compared to commercially available formulations of the drug.

Study protocol of the RAND-study: a multicenter, prospective cohort study investigating response and adherence to nilotinib treatment in chronic myeloid leukemia

BackgroundThe antitumor drug nilotinib has a large inter- and intra individual variability in pharmacokinetics. Adherence to treatment may substantially influence plasma levels and has been recognized as the most important determinant of treatment failure in chronic myeloid leukemia (CML). A better understanding of the various factors contributing to the efficacy of treatment is essential for the development of interventions to optimize the treatment of chronic phase CML (CP-CML) with a protein kinase inhibitor like nilotinib.Methods/DesignIn this multicenter prospective observational cohort study 70 adult patients with CP-CML starting treatment with nilotinib will be followed up for at least 12 months. Response to treatment is evaluated after 3, 6 and 12 months. Adherence is primarily assessed by counting the daily intake of nilotinib capsules by means of a medication event monitoring system (MEMS). Before the start of nilotinib treatment and after 3, 6 and 12 months, patients are asked to fill in a comprehensive questionnaire including topics on quality of life, side effects, attitude towards disease and medication, the patients’ appreciation of information received about the medication, and discontinuation, and trough plasma levels of nilotinib are measured.DiscussionThe present study aims to get more insight into the efficacy of treatment with nilotinib and the various aspects that govern optimal response, of which adherence is a primary endpoint. We hypothesize that patients who experience inadequate response levels to nilotinib are less adherent. In addition, their plasma levels of nilotinib may be lower. We expect that our findings will be useful for health care professionals to support patients with the use of nilotinib in order to derive optimal benefit from their medication.Trial registrationNetherlands Trial Registry NTR3992.

Development and physical evaluation of Maytenus ilicifolia effervescent granules using factorial design

The medicinal plant Maytenus ilicifolia is a commonly used phytomedicine for the treatment of gastritis. The high dose required and low density of these extracts make necessary a daily intake of several capsules, hindering adherence to the medication. The purpose of this work was to develop a suitable dosage form for the administration of Maytenus ilicifolia using effervescent granules. A 23 factorial design was used to study the physical characteristics of the granules (particle size distribution, repose angle, Carr index, scanning electron microscopy and disintegration time). Moisture stability was also determined. According to the experimental design, granule size is the most important factor in determining the flow characteristics of effervescent granules. In turn, the disintegration time is controlled by the content of sodium bicarbonate present in the effervescent mixture as well as the granule size. The stability of formulations when exposed to moisture is strongly influenced by the percentage of effervescent mixture present in the vegetal granules. Precautions in handling and storage should be taken to ensure the stability of these preparations. The effervescent granules produced from Maytenus ilicifolia met the pharmacopoeial quality parameters, with appropriate mechanical and physical characteristics and proved to be a promising vehicle for plant extracts.

Phytosterol capsules and serum cholesterol in hypercholesterolemia: A randomized controlled trial

ObjectivePhytosterols are recommended in combination with diet therapy to reduce elevated LDL-cholesterol level. Meta-analyses indicate a 10% reduction in LDL-cholesterol from intake of approximately 2 g phytosterols/d incorporated into fat-based foods. However, the cholesterol lowering effect from capsules containing phytosterols is less documented. The pre-specified primary endpoint of the present study was to investigate the effect of capsules with phytosterols on circulating LDL-cholesterol in patients with mild to moderate hypercholesterolemia. MethodsIn a double-blinded, randomized, placebo-controlled crossover study, 41 men and women were randomized into two four-weeks intervention periods with softgel capsules containing either phytosterols (2.0 g/d) or sunflower oil. There was a three-weeks washout period between the intervention periods. ResultsNo significant difference in total- or LDL-cholesterol between the phytosterol and the placebo period were observed after four weeks intervention (0.0 mmol/L (95%CI: −0.3 to 0.2), P = 0.74 and −0.1 mmol/L (95%CI: −0.3 to 0.1), P = 0.32, respectively). ConclusionDaily intake of capsules containing 2 g phytosterols did not reduce total- or LDL-cholesterol significantly in a highly relevant target group for the use of phytosterol products. The present results may emphasize the importance of choosing a suitable dosage-delivery system in order to achieve optimal cholesterol lowering effect.The study was registered at www.clinicaltrials.gov, IDno:NCT00485095.

Kinetics of ʟ-Theanine Uptake and Metabolism in Healthy Participants Are Comparable after Ingestion of ʟ-Theanine via Capsules and Green Tea1–4

ʟ-Theanine, an amino acid in green tea, is suggested to improve cognition and mood. Therefore, ʟ-theanine is available as a supplement and is now used as an ingredient in functional drinks. Because data on the metabolic fate of ʟ-theanine from human studies are lacking, we investigated the kinetics of ʟ-theanine uptake and its metabolites, ethylamine and glutamic acid, in healthy participants. Within a randomized crossover study, 12 participants ingested a bolus of 100 mg ʟ-theanine via capsules or green tea. On further occasions, 3 participants received 50 and 200 mg ʟ-theanine via capsules. Blood and urine were collected before and up to 24 h postconsumption to determine the concentrations of ʟ-theanine, proteinogenic amino acids, and ethylamine in plasma, erythrocytes, and urine by HPLC. ʟ-Theanine increased in plasma, erythrocytes, and urine with comparable results after both treatments. The maximum plasma concentration of ʟ-theanine occurred 0.8 h after intake of 100 mg ʟ-theanine via capsules (24.3 ± 5.7 μmol/L) and tea (26.5 ± 5.2 μmol/L), respectively. The AUC of ʟ-theanine in plasma increased dose dependently after intake of 50, 100, and 200 mg ʟ-theanine via capsules. Moreover, ethylamine and glutamic acid increased in plasma and were excreted by urine after intake of capsules and tea. In conclusion, ʟ-theanine is rapidly absorbed and seems to be hydrolyzed to ethylamine and glutamic acid. A minor part of ʟ-theanine is retained in erythrocytes. Kinetics and urinary excretion of ʟ-theanine, ethylamine, and glutamic acid are comparable after both treatments. Thus, functional effects of ʟ-theanine intake may result from ʟ-theanine, ethylamine, or glutamic acid.

Urinary tract infection: diabetic women's strategies for prevention

Urinary tract infection (UTI) is a common problem in the female population. Women with diabetes mellitus are possibly at a higher risk. The usual medical therapy for UTI is antibiotic treatment. The aim of this study is to explore strategies employed by diabetic women for prevention and self-treatment of UTI. Forty-two women with diabetes mellitus who had experienced at least one episode of UTI in the last six months were included. Data collection included background information, questions about prevention and self-treatment strategies and a clinical examination to measure maximal urine flow, residual urine, a blood test evaluating diabetic control (HbA1c) and a urine test strip for determination of glucose, leucocytes, nitrite, blood, protein and pH. Thirty-five participants (83.3%) reported changes in daily routines like 'always keeping warm', 'increased fluid intake', 'good personal hygiene' as prevention strategies. Different herb and plant extracts were used for prevention by twenty-three participants (54.5%). Among the twenty-three (54.5%) participants who used self-treatment strategies when they noticed symptoms of UTI, intake of cranberry tablets or capsules was most common. Better knowledge of strategies for prevention and self-treatment of UTI may reduce distress and discomfort for women at risk.

Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: A randomised, double-blind, placebo-controlled cross-over study

The term histamine intolerance stands for a range of symptoms involving various effector organs after the consumption of histamine-rich food. Our intention was to objectify and quantify histamine-associated symptoms and to analyse whether oral administration of the histamine-degrading enzyme diamine oxidase (DAO) caused a reduction of symptoms. Four Austrian centres participated. Patients suspected to be histamine intolerant were recruited. The first step consisted in the open oral provocation of these patients with 75 mg of liquid histamine. Patients who developed symptoms were tested in a randomised double blind crossover provocation protocol using histamine-containing and histamine-free tea in combination with DAO capsules or placebo. Main and secondary symptoms (strongest and weaker symptoms based on a ten-point scale) were defined, the grand total of all symptoms of the individual provocation steps was determined and changes in symptoms after administration of DAO were measured. Thirty nine patients reacted to the open histamine provocation and were enrolled in the blinded part. Here, both the main and secondary symptoms were not reproducible. Subjects reacted sometimes unexpectedly and randomly. Regarding the total symptom scores, the differences between the three treatment groups were statistically significant. The intake of DAO demonstrated a statistically significant reduction of histamine-associated symptoms compared to placebo (P = 0.014). Oral provocation with 75 mg of liquid histamine failed to reproduce histamine-associated single symptoms in many patients. One may suggest that histamine-intolerant subjects reacted with different organs on different occasions. As a consequence, reproducibility of single symptoms alone may not be appropriate to diagnose histamine-intolerance whereas a global symptom score could be more appropriate. The fact, that the intake of DAO capsules compared to placebo led to a statistically significant reduction of total symptom scores, may indirectly point in the same direction.

Macronutrient selection in Nile tilapia fed gelatin capsules and challenged with protein dilution/restriction

Most animals, including fish, are known to possess "nutritional wisdom" which allows them to choose among different incomplete diets to self-compose a nutritionally balanced diet. The purpose of this research was to investigate dietary selection and the capacity of fish to associate between colour code of encapsulated diets and capsule contents. In addition, fish were subjected to different challenges (changing the relative position of capsules and their content, and protein dilution/restriction) to test whether tilapia defended a given intake target of macronutrients and energy. To help fish discriminate between diets, different relationships between capsule colour and content were used. The results revealed a clear pattern of selection: 45.4% P, 32.2% C, and 22.4% L. After diluting or restricting the protein, fish increased their intake of protein capsules to compensate for the dilution or restriction in such a way that their energy intake remained around 170 kJ/kg BW. These results confirm that tilapia, an omnivorous fish model, can select from individual macronutrients to self-compose a balanced diet, and are also able to regulate energy intake after protein dilution and selective protein deprivation. Besides, dietary selection and food intake regulation is not based on the oral properties of the diets because fish were fed tasteless gelatin capsules, suggesting that fish can associate the colour of the capsules with its nutritional effect.

Idiopathic autoimmune hemolytic anemia due to lecithin overdose: a case report

IntroductionIdiopathic Autoimmune Hemolytic Anemia is a potentially fatal condition which requires prompt and potent treatment. Diagnosis of idiopathic autoimmune hemolytic anemia requires both serologic evidence of autoantibody presence and hemolysis. Although most of the times it is considered idiopathic, several underlying causes have been identified, like autoimmune and connective tissue diseases, viral infections, drugs or hyper function of the immune system. To our knowledge, this is the first case in the international literature describing lecithin-induced autoimmune hemolytic anemia.Case PresentationThis case report is to highlight a rare but dangerous adverse reaction to overdose of lecithin. A 38 year old white female from Greece, presented to our emergency room with progressive fatigue over a period of ten days and icteric discoloration of her skin and conjunctiva. The patient had been taking lecithin supplements (1200 mg, 3 capsules a day) over a period of ten days for weight loss. She reports that the last 3 days, prior to the examination, she took 5 capsules/day, so that the supplement would take effect more rapidly. Her past medical, social and family history showed no disturbance. Relatives of the patient were requested to submit any blood-tests taken over a period of 20 days prior to the onset of symptoms caused by Lecithin. All tests proved that all functions were within normal scale. Her physical examination revealed pallor and jaundice without palpable hepatosplenomegaly. Blood biochemistry tests showed total bilirubin 7.5 mg/dl, with indirect bilirubin 6.4 mg/dl and complete blood count showed hemoglobin 7.6 g/dl with blood levels 21.4%.ConclusionIn every case of idiopathic autoimmune hemolytic anemia the administration of pharmaceutical substances should always be examined, except for the standard reasons that cause it. In this case the cause of hemolysis was attributed to the excessive intake of lecithin capsules for the loss of body weight. It is important that clinicians and immunologists are aware of this adverse effect.