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Dietary adjustments and nutritional therapy during treatment for oral-pharyngeal dysphagia.

Dietary adjustments are an important part of the therapy for dysphagia. Once dysphagia is diagnosed, the patient must be nourished safely while being taught therapeutic and compensatory strategies for dealing with the swallowing disorder. The patient's nutritional status must be maintained despite any limitations on oral intake. Liquids may be thickened and the consistency of solid foods may be adjusted to ensure an adequate diet that is safe for the patient. When the patient cannot eat safely or take adequate amounts of food orally, an alternative feeding method should be instituted.

Aged↗

Zinc deficiency does not enhance LDL uptake by P 388 D1 macrophages in vitro.

The aim of the study was to investigate the effect of zinc depletion on the susceptibility of Wistar rat low-density lipoproteins (LDL) to peroxidation and their uptake by macrophages, before and after in vitro oxidation. The rats were fed for 7 wk a Zn-adequate diet (100 ppm) ad libitum (AL), a Zn-deficient diet (0.2 ppm) ad libitum (ZD), or a Zn-adequate diet according to the pair-feeding method (PF). Zinc status was determined and, for each group, blood was pooled, and LDS were isolated and labeled with 125Iodine. An aliquot of each LDL sample was oxidized using FeII 10 microM/ascorbate 250 microM. Oxidized and nonoxidized (native) LDL were incubated with P 388 D1 macrophages, and their rates of uptake and degradation by macrophages were measured. Before oxidation, LDL uptake and degradation were not modified by the diet, suggesting that Zn deficiency did not modify rat LDL in vivo. After oxidation, both LDL uptake and degradation were significantly enhanced in the three groups. Nevertheless, we did not observe a significant effect of Zn deficiency. This observation suggests that, in our experimental conditions, Zn deficiency did not modify LDL catabolism.

Analysis of Variance↗

Perfusion cultures of human embryonic stem cells.

Human embryonic stem cells (hESC) are self-renewing pluripotent cells capable of differentiating into cells representative of all three embryonic germ layers. Hence, they hold great potential for regenerative medicine. However, significant cell numbers are required to fulfill their potential therapeutic applications. In this study, perfusion with supplemented conditioned media (SCM), produced by mouse embryonic fibroblasts (MEF), was adopted to improve cell densities of hESC cultures. Perfusion enhanced hESC numbers by 70% compared to static conditions, on both organ culture dish (OCD) and petri dish cultures. All cultures maintained healthy expression of the pluripotent marker, Oct-4 transcription factor. In vivo, perfused hESC formed teratomas in severe combined immunodeficiency (SCID) mice models that represent the three embryonic germ layers. When SCM was produced with lower concentrations of MEF, hESC densities and Oct-4 levels were reduced. Hence, perfusion with SCM is a potential feeding method for scale-up production of hESC.

Animals↗

Predicting prolonged dysphagia in acute stroke: the Royal Adelaide Prognostic Index for Dysphagic Stroke (RAPIDS).

Dysphagia is common after stroke and is associated with increased morbidity and mortality. Predicting those who are likely to have significant prolonged dysphagia is not possible at present. This study was undertaken to validate the Royal Adelaide Prognostic Index for Dysphagic Stroke (RAPIDS) in the prediction of prolonged dysphagia following acute stroke using clinical and radiographic features. A prospective study of unselected, consecutive admissions to the Royal Adelaide Hospital acute stroke unit was undertaken. Clinical and radiographic features applicable to the RAPIDS test were calculated and the sensitivity, specificity, and likelihood ratio for predicting prolonged dysphagia were calculated with 95% confidence intervals (CI). Of 104 subjects admitted with acute stroke, 55 (53%) had dysphagia and 20 (19%) had dysphagia requiring nonoral feeding/hydration for 14 days or more or died while dysphagic prior to 14 days. The RAPIDS test had sensitivity of 90% (95% CI = 70-97%) and specificity of 92% (95% CI - 84-96%) for predicting this latter group of patients. We conclude that the RAPIDS test can be used early to identify patients likely to have prolonged dysphagia. This test could form a basis for selection of patients for trials of nonoral feeding methods.

Acute Disease↗

A review of diabetic gastropathy.

Diabetes mellitus affects various organs, including the gastrointestinal tract. The stomach is commonly affected, and symptoms related to the upper GI tract are frequently reported. Management of diabetic gastropathy involves dietary modifications, pharmacological agents, and occasionally, alternative feeding methods.

Antiemetics↗

Docosahexaenoic acid-induced alteration of Thy-1 and CD8 expression on murine splenocytes.

Here we test whether the incorporation of docosahexaenoic acid (DHA, 22:6), an (n-3) fatty acid, into lymphocyte membranes affects the expression of the surface proteins Thy-1.2 and CD8. DHA was incorporated into splenocytes by three methods: feeding mice diets containing menhaden (fish) oil, fusing splenocytes with DHA-containing phosphatidylcholine vesicles, and culturing splenocytes with DHA. Thy-1.2 and CD8 expression were measured by flow cytometry and complement-mediated lysis using a panel of monoclonal antibodies. As (n-3) fatty acid incorporation into the lymphocytes increased, the expression of one Thy-1.2 epitope and one CD8 epitope decreased; the expression of two CD8 epitopes increased. Although diet-induced changes in surface protein expression may result from selective migration of cell populations or the diet's effect on protein biosynthesis, fusion with lipid vesicles demonstrated that DHA-containing phospholipids can mediate a direct and immediate effect. The decrease in Thy-1.2 expression was sustained for more than a week after removal of (n-3) fatty acids from the diet, most likely due to retention of membrane-bound (n-3) fatty acids. Because Thy-1.2 and CD8 participate in T cell activation, modulation of their expression by DHA suggests that DHA, when serving as a membrane structural element, may alter immune function.

Animals↗

The life-cycle of the bont tick Amblyomma hebraeum in vitro.

The life-cycle of the hard tick Amblyomma hebraeum was completed in vitro by feeding all life-stages of the tick through silicone membranes on bovine blood from an abattoir. Ticks were placed in a simple feeder membranes on bovine blood from an abattoir. Ticks were placed in a simple feeder consisting of a honey jar containing the blood with a glass tube insert (o.d. 42 mm) across the end of which the membrane was stretched. This feeding unit was held in a water bath (38 degrees C). Larvae and nymphs fed on a membrane (< 90 microns thick) made of silicone reinforced with Kodak lens cleaning paper, and adults on a silicone membrane (0.5 mm thick) reinforced with Terylene netting. To control microbial growth, gentamicin (5 micrograms/ml) and nystatin (100 i.u./ml) were added to the weekly open-collected blood, which was manually defibrinated. The blood was changed twice daily for nymphs and three times for adults and larvae. Attachment of ticks was induced with combinations of host hair, tick faeces, a bovine pelage extract and a synthetic aggregation-attachment pheromone mixture. The in vitro life-cycle started with unengorged "natural" adults, which had moulted from nymphs fed on steer. The life-cycle closed with unengorged, first in vitro generation adults which had moulted from nymphs fed in vitro. Although the feeding and development of larvae and nymphs were similar to in vivo controls, females fed and developed poorly in vitro. The toxicity of the systemic acaricide Ivermectin for nymphs of A. hebraeum was confirmed using the in vitro feeding method.

Animals↗

Glycosaminoglycan and surface glycoprotein syntheses by rat muscle fibroblast monolayers: response to solubilized bone matrix and effect of serum.

Glycosaminoglycan synthesis by muscle fibroblasts derived from neonatal rats has been studied using a sensitive radioisotope method. Feeding the cultures with serum-containing medium supplemented with 80 micrograms/ml of a solubilized bone matrix (SBM) preparation results in an initial enhancement of net glycosaminoglycan secretion and a later additional response, not seen in controls. A pronounced dilution of the specific radioactivity of secreted chondroitin sulfate characterizes the latter response. SBM-treated cultures (100 micrograms/ml) also demonstrate increased incorporation of radioactive glucosamine into a large molecular weight cell surface glycoprotein. SBM suppresses the growth rate and final cell densities at all serum concentrations tested. However, at similar cell densities, higher serum concentrations tend to minimize the relative stimulation of incorporation of radioactivity into the secreted glycosaminoglycans by SBM-treated cultures, compared to controls.

Animals↗

Studies on the induction of sex-linked recessive lethal mutations in Drosophila melanogaster by nitroheterocyclic compounds.

24 nitroheterocyclic compounds were investigated for their capacity to induce sex-linked recessive lethals in Drosophila, by the adult feeding technique, and in some cases injection or larval-feeding methods. Out of 9 5-nitroimidazoles, ZK 26.173 and ZK 25.095 (moxnidazole) were clearly active whereas nimorazole and ronidazole were marginally mutagenic. Out of 10 5-nitrofurans, nitrovin, furazolidone and furaltadone were unambiguously mutagenic, whereas nitrofurantoin was a borderline case. Nitrofurans were active at lower molar concentrations than nitroimidazoles. Out of a group of 5 related nitro compounds (2 nitrothiophenes, picrolonic acid, niridazole and 4-NQO), only 4-NQO was clearly mutagenic, when fed to larvae. Experiments with germ-free flies showed that, for ZK 26.173 and furazolidone, the gut flora of Drosophila do not play a role in the activation of the compounds to mutagenic metabolites. Furazolidone, 4-NAO, ZK 26.173, ZK 25.095 and furaltadone were tested in mal and cin strains, both of which lack xanthine dehydrogenase and aldehyde oxidase. The latter enzyme and xanthine oxidase are known to carry out nitro reduction in mammalian tissues. For ZK 26.173, the mutation frequencies were drastically reduced in the enzyme-deficient strains, indicating the involvement of one of these enzymes in the activation of this substance.

Animals↗

The genotoxicity of the anti-cancer drug mitoxantrone in somatic and germ cells of Drosophila melanogaster.

The novel antineoplastic drug mitoxantrone was studied for its genotoxic effects in Drosophila melanogaster. In male germ cells, the clinical preparation Novantrone, the dihydrochloride salt of mitoxantrone, did not induce sex-linked recessive lethal mutations in feeding and injection experiments with adult flies, although statistically the results were inconclusive rather than truly negative. However, the free base mitoxantrone was weakly, but significantly genotoxic in this test (0.14% lethals/mM exposure concentration); this is most probably the result of prolonged exposure. On the other hand, both forms of mitoxantrone assayed were clearly genotoxic in the somatic mutation and recombination test of the wing. This test assays the cells of the proliferating imaginal wing discs of larvae. Depending on the feeding method used, the overall clone induction frequency was in the range of about 2-6 x 10(-5) per cell and cell generation and per mM exposure dose. Correction of these frequencies according to mean clone size led to slightly higher estimates (by about 5-25% higher). Although the majority of the clone induction events are due to mitotic recombination, a significant proportion can be attributed to mutational events (gene and chromosome mutations). The genotoxicity of mitoxantrone seems to depend mainly on impaired DNA synthesis in cycling cells owing to the compound's ability to inhibit topoisomerase II by intercalation into DNA.

Animals↗

Effect of environmental conditions during soya-bean fermentation on the growth of Staphylococcus aureus and production and thermal stability of enterotoxins A and B.

During tempe manufacture, Staphylococcus aureus was able to survive in newly started soya-bean soaks (final pH 4.7), whereas it died during soaks with accelerated souring (final pH 4.0). No S. aureus were detected after subsequent heat treatment of soaked beans. S. aureus strain S6 could produce enterotoxins A and B if inoculated on cooked soya-beans. Its growth and enterotoxin production were not influenced by inoculation rate nor by the presence of actively growing Rhizopus oligosporus, the fungus responsible for tempe formation. Enterotoxin levels were highest after 48 h fermentation. Presence of lactobacilli (L. brevis or L. plantarum) during the tempe fermentation did not influence staphylococcal growth, but enterotoxin levels were reduced. Reduced oxygen pressure did not affect staphylococcal growth, but resulted in lower enterotoxin levels after 48 h incubation. The thermal stability of enterotoxin A in tempe was significantly lower than in Brain Heart Infusion broth of comparable pH. Heating of enterotoxin-containing tempe mash reduced enterotoxin A by 99.7% as measured with ELISA and animal feeding methods.

Animals↗

Lead shot ingestion by waterbirds in the Camargue, france: an investigation of levels and interspecific differences.

Between January 1988 and February 1989, gizzards were collected from 1155 birds from the groups; Anatidae, Charadriidae, Scolopacidae and Rallidae, shot in the Camargue, and examined for the presence of ingested lead shot. Shot was found in nine out of ten Anatidae species, three of 15 Scolopacidae species and all of three Rallidae species. Twenty-seven per cent of Anatidae sampled had ingested shot, 13.8% had one shot present and 6.3% had more than five. Shot ingestion levels ranged from 3-60% of birds examined according to species. The incidence of shot ingestion did not appear to vary seasonally. In Anatidae, a strong interspecific relationship was found between the grit size ingested and susceptibility to ingest shot (r = 0.94). In Scolopacidae, shot ingestion may have been related to grit size ingested, feeding method and bill length. The levels of shot ingestion presented are for most species higher than have been reported elsewhere in the world. This may result from the absence of grit and presence of high shot densities in Camargue marshes.

Journal Article↗

Mutagenic activity of the pyrrolizidine alkaloids seneciphylline and senkirkine in Drosophila and their transfer into rat milk.

Seneciphylline and senkirkine, two pyrrolizidine alkaloids that occur in animal feeds and medicinal herbs, respectively, have been tested for their ability to produce sex-linked recessive lethals in males of Drosophila melanogaster using the Basc test (3-day feeding method). Seneciphylline was found to be mutagenic at concentrations of 10(-5), 10(-4) and 10(-3)M, which produced 3.8% sex-linked recessive lethals (983 chromosomes tested). 9.0% (708) and 15.3% (327), respectively. Senkirkine (10(-5)M) produced 4.4% sex-linked recessive lethals (2541 chromosomes tested) against 0.17% (9081) in controls. Brood pattern analysis with senkirkine showed maximum sensitivity in the late spermatid stage of spermatogenesis, which agrees with evidence that pyrrolizidine alkaloids act as indirect mutagens. Flies fed with milk from lactating rats given an oral dose of 25 mg seneciphylline/kg showed 1.2% sex-linked recessive lethals (1477 chromosomes tested), against 0.3% (1533) in controls.

Animals↗

Growth, liver lipid and blood amino acids in rats fed ethanol with an adequate diet.

The weight, histology and RNA, DNA, protein and lipid content of the liver and arterial and portal plasma amino acid concentrations were determined in male Sprague-Dawley rats fed a liquid diet which met AIN-76A standards with 36% of the calories supplied by ethanol. The dietary components of the dry mixture in percentages by weight included 20% casein, 22% sucrose, 43% dextrin, 5% corn oil, vitamins, minerals and other dietary factors. For feeding these were suspended in distilled water containing 2.5% xanthan gum with or without ethanol to supply 1 kcal/ml. The feeding method employed perforated neoprene discs floated on top of the suspended diet to control evaporative losses. Animals were pair fed or ad libitum fed for 8-10 weeks. Gain/feed ratios were virtually identical for ethanol-fed rats and their pair-fed controls. Ethanol intake of ad libitum fed rats averaged 14.8, 10.3 and 7.4 g/kg BW/day after 1, 5 and 10 weeks, respectively. No chemical or histological evidence of liver fat accumulation or significant differences in arterial or portal amino acid concentrations were detected in animals fed ethanol. The lack of apparent ethanol toxicity is discussed in relation to the results of others and to our earlier report of increased orotic acid excretion by ethanol-fed rats.

Alcohol Drinking↗

Physically bonded nanoparticle networks: a novel drug delivery system.

Monodispersed nanoparticles consisting of interpenetrating polymer networks (IPNs) of polyacrylic acid (PAAc) and poly(N-isopropylacrylamide) (PNIPAM) were prepared by a seed-and-feed method. The temperature-dependent viscosity measurement revealed that the IPN nanoparticle dispersions with polymer concentrations above 2.5 wt.% underwent an inverse thermoreversible gelation at about 33 degrees C. Dextran markers of various molecular weights as model macromolecular drugs were mixed with the IPN nanoparticle dispersion at room temperature. At body temperature, the dispersion became a gel. The drug release profiles were then measured using UV-Visible spectroscopy as a function of particle size and polymer concentration. The schematic structure of the nanoparticle network was proposed based on the experimental results. The drug delivery model presented here was significant because such a dispersion and a drug was mixed without chemical reaction at room temperature to form a drug delivery liquid. This liquid could be injected into a body to form in situ a gelled drug depot to release the drug slowly.

Drug Delivery Systems↗

Emissions study of co-firing waste carpet in a rotary kiln.

Post-consumer carpet represents a high volume, high energy content waste stream. As a fuel for co-firing in cement kilns, waste carpet, like waste tires, has potential advantages. Technological challenges to be addressed include assessing potential emissions, in particular NO emissions (from nylon fiber carpets), and optimizing the carpet feed system. This paper addresses the former. Results of pilot-scale rotary kiln experiments demonstrate the potential for using post-consumer waste carpet as a fuel in cement kilns. Continuous feeding of shredded carpet fiber and ground carpet backing, at rates of up to 30% of total energy input, resulted in combustion without transient puffs and with almost no increase in CO and other products of incomplete combustion as compared to kiln firing natural gas only. NO emissions increased with carpet waste co-firing due to the nitrogen content of nylon fiber. In these experiments with shredded fiber and finely ground backing, carpet nitrogen conversion to NO ranged from 3 to 8%. Conversion increased with enhanced mixing of the carpet material and air during combustion. Carpet preparation and feeding method are controlling factors in fuel N conversion.

Air Pollutants↗

An evaluation of a high-probability instructional sequence to increase acceptance of food and decrease inappropriate behavior in children with pediatric feeding disorders.

We evaluated the effects of escape extinction with and without a high-probability (high-p) instructional sequence on food acceptance and inappropriate behavior for children diagnosed with feeding problems. The high-p sequence consisted of three presentations of a response that was similar topographically (i.e., presentations of an empty nuk, liquid on a spoon, and a preferred liquid on a spoon) to the low-p response (i.e., presentation of a nuk with food, liquid from a cup, and presentation of a nonpreferred food). Acceptance of food increased in the presence and not the absence of the high-p sequence during initial withdrawals for two of the three children. In addition, the high-p sequence plus escape extinction was associated with reduced levels of inappropriate behavior relative to escape extinction alone for two children. Data are discussed in relation to behavioral momentum, motivating operations, and the relative contributions of the high-p instructional sequence and escape extinction in the treatment of feeding problems.

Child↗