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Barbre Pedersen P, Berthelsen R, Rades T, Astrup Jørgensen S, Vilmann P, Bar-Shalom D, Baldursdottir S, Müllertz A. Physico-chemical characterization of aspirated human and simulated human gastric fluids to study their influence on the intrinsic dissolution rate of cinnarizine. Int J Pharm 2022; 622:121856. [PMID: 35618175 DOI: 10.1016/j.ijpharm.2022.121856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/29/2022] [Accepted: 05/20/2022] [Indexed: 11/15/2022]
Abstract
To elucidate the critical parameters affecting drug dissolution in the human stomach, the intrinsic dissolution rate (IDR) of cinnarizine was determined in aspirated and simulated human gastric fluids (HGF). Fasted aspirated HGF (aspHGF) was collected from 23 healthy volunteers during a gastroscopic examination. Hydrochloric acid (HCl) pH 1.2, fasted state simulated gastric fluid (FaSSGF), and simulated human gastric fluid (simHGF) developed to have rheological, and physico-chemical properties similar to aspHGF, were used as simulated HGFs. The IDR of cinnarizine was significantly higher in HCl pH 1.2 (952±27 µg/(cm2∙min)) than in FaSSGF pH 1.6 (444±7 µg/(cm2∙min)), and simHGF pH 2.5 (49±5 µg/(cm2∙min)) due to the pH dependent drug solubility and viscosity differences of the three simulated HGFs. The shear thinning behavior of aspHGF had a significant impact on the IDR of cinnarizine, indicating that the use of FaSSGF, with viscosity similar to water, to evaluate gastric drug dissolution, might overestimate the IDR by a factor of 100-10.000, compared to the non-Newtonian, more viscous, fluids in the human stomach. The developed simHGF simulated the viscosity of the gastric fluids, as well as the IDR of the model drug, making it very promising medium to study gastric drug dissolution in vitro.
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Affiliation(s)
| | - Ragna Berthelsen
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Rades
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | | | - Peter Vilmann
- GastroUnit, Copenhagen University hospital Herlev, DK-2730 Herlev, Denmark
| | - Daniel Bar-Shalom
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark; Bioneer:FARMA, Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark
| | | | - Anette Müllertz
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark; Bioneer:FARMA, Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
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Brunner E, Schaumann A, Pennacchietti V, Schulz M, Thomale UW. Retrospective single-center historical comparative study between proGAV and proGAV2.0 for surgical revision and implant duration. Childs Nerv Syst 2022; 38:1155-1163. [PMID: 35353205 PMCID: PMC9156487 DOI: 10.1007/s00381-022-05490-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Cerebrospinal fluid (CSF) diversion shunt systems remain to be the most common treatment for pediatric hydrocephalus. Different valve systems are used to regulate CSF diversion. Preventing complications such as occlusions, ruptures, malpositioning, and over- or underdrainage are the focus for further developments. The proGAV and proGAV2.0 valve system are compared in this retrospective study for revision-free survival and isolated valve revision paradigms. METHODS In the first part of the study, the shunt and valve revision-free survival rates were investigated in a retrospective historical comparison design for a period of 2 years in which each valve was used as standard valve (proGAV: July 2012-June 2014; proGAV2.0: January 2015-December 2016) with subsequent 30-month follow-up period, respectively. In the second part of the study, the implant duration was calculated by detecting isolated valve (valve-only) revisions together with another valve explantation during the entire period of the first study and its follow-up period. RESULTS Two hundred sixty-two patients (145 male and 117 female, mean age 6.2 ± 6.1 years) were included in the cohort of revision-free survival. During the 30-month follow-up period, 41 shunt revisions, including 27 valve revisions (shunt survival rate: 72.1%, valve survival rate: 81.6%) were performed in the proGAV cohort and 37 shunt revisions, including 21 valve revisions (shunt survival rate: 74.8% and valve survival rate: 85.0%) were performed in the proGAV2.0 cohort without showing statistically significant differences. In the second part of the study, 38 cases (mean age 4.0 ± 3.9 years) met the inclusion criteria of receiving a valve-only-revision. In those patients, a total of 44 proGAV and 42 proGAV2.0 were implanted and explanted during the entire study time. In those, a significantly longer implant duration was observed for proGAV (mean valve duration 961.9 ± 650.8 days) compared to proGAV2.0 (mean length of implantation period 601.4 ± 487.8 days; p = 0.004). CONCLUSION The shunt and valve revision-free survival rates were found to be similar among the groups during 30 month follow-up. In patients who received "valve only" revisions and a subsequent explanation, the implant duration was significantly longer in the proGAV. Although the amount of patients with valve-only-revisions are small compared to the entire cohort certain patients seem to be at higher risk for repeated valve revisions.
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Affiliation(s)
- E Brunner
- grid.6363.00000 0001 2218 4662Present Address: Pediatric Neurosurgery, Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - A Schaumann
- grid.6363.00000 0001 2218 4662Present Address: Pediatric Neurosurgery, Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - V Pennacchietti
- grid.6363.00000 0001 2218 4662Present Address: Pediatric Neurosurgery, Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - M Schulz
- grid.6363.00000 0001 2218 4662Present Address: Pediatric Neurosurgery, Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - UW Thomale
- grid.6363.00000 0001 2218 4662Present Address: Pediatric Neurosurgery, Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
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Nutritious mushroom protein crisp – healthy alternative to starchy snack. FOOD PRODUCTION, PROCESSING AND NUTRITION 2021. [DOI: 10.1186/s43014-021-00077-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Abstract
Global salty snacks category had reached USD 137 billion in sales in 2018. Due to growing health concerns and awareness, consumers are looking for healthy snack choices by avoiding ingredients such as fat, sugar, cholesterol, and sodium and selecting baked and salt free multigrain chips. A sizable number of consumers are concerned about snack nutrition and look for quality ingredients and minimally processed foods called as “Good Health Snack (GHS)”. In this work, we present the development of method of producing and testing mushrooms protein crisps (MPC), a healthy alternative to conventional starchy snacks that are rich in protein, nutraceutical compounds, minerals, vitamin, dietary fiber, and immunity inducing beta-glucans. The methods of producing MPC with different seasoning and hydrolyzed protein, calorie, nutritional and chemical composition, consumer response, shelf life after packing and market analysis are described. These systematic studies will help to market potential of this product which is a healthy alternative to other calorie rich snacks sold in the market benefiting the consumers.
Graphical abstract
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Slater T, Mode WJA, Hough J, James RM, Sale C, James LJ, Clayton DJ. Effect of the perception of breakfast consumption on subsequent appetite and energy intake in healthy males. Eur J Nutr 2021; 61:1319-1330. [PMID: 34766208 PMCID: PMC8921169 DOI: 10.1007/s00394-021-02727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022]
Abstract
Purpose This study aimed to assess the effects of consuming a very-low-energy placebo breakfast on subsequent appetite and lunch energy intake. Methods Fourteen healthy males consumed water-only (WAT), very-low-energy, viscous placebo (containing water, low-calorie flavoured squash, and xanthan gum; ~ 16 kcal; PLA), and whole-food (~ 573 kcal; FOOD) breakfasts in a randomised order. Subjects were blinded to the energy content of PLA and specific study aims. Venous blood samples were collected pre-breakfast, 60- and 180-min post-breakfast to assess plasma acylated ghrelin and peptide tyrosine tyrosine concentrations. Subjective appetite was measured regularly, and energy intake was assessed at an ad libitum lunch meal 195-min post-breakfast. Results Lunch energy intake was lower during FOOD compared to WAT (P < 0.05), with no further differences between trials (P ≥ 0.132). Cumulative energy intake (breakfast plus lunch) was lower during PLA (1078 ± 274 kcal) and WAT (1093 ± 249 kcal), compared to FOOD (1554 ± 301 kcal; P < 0.001). Total area under the curve (AUC) for hunger, desire to eat and prospective food consumption were lower, and fullness was greater during PLA and FOOD compared to WAT (P < 0.05). AUC for hunger was lower during FOOD compared to PLA (P < 0.05). During FOOD, acylated ghrelin was suppressed compared to PLA and WAT at 60 min (P < 0.05), with no other hormonal differences between trials (P ≥ 0.071). Conclusion Consuming a very-low-energy placebo breakfast does not alter energy intake at lunch but may reduce cumulative energy intake across breakfast and lunch and attenuate elevations in subjective appetite associated with breakfast omission. Trial registration NCT04735783, 2nd February 2021, retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02727-5.
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Affiliation(s)
- Tommy Slater
- Musculoskeletal Physiology Research Group, Nutrition and Exercise Physiology, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Clifton Campus, Nottingham Trent University, Nottingham, NG11 8NS, Nottinghamshire, UK
| | - William J A Mode
- Musculoskeletal Physiology Research Group, Nutrition and Exercise Physiology, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Clifton Campus, Nottingham Trent University, Nottingham, NG11 8NS, Nottinghamshire, UK
| | - John Hough
- Musculoskeletal Physiology Research Group, Nutrition and Exercise Physiology, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Clifton Campus, Nottingham Trent University, Nottingham, NG11 8NS, Nottinghamshire, UK
| | - Ruth M James
- Musculoskeletal Physiology Research Group, Nutrition and Exercise Physiology, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Clifton Campus, Nottingham Trent University, Nottingham, NG11 8NS, Nottinghamshire, UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Nutrition and Exercise Physiology, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Clifton Campus, Nottingham Trent University, Nottingham, NG11 8NS, Nottinghamshire, UK
| | - Lewis J James
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, Leicestershire, UK
| | - David J Clayton
- Musculoskeletal Physiology Research Group, Nutrition and Exercise Physiology, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Clifton Campus, Nottingham Trent University, Nottingham, NG11 8NS, Nottinghamshire, UK.
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Characterization of fasted human gastric fluid for relevant rheological parameters and gastric lipase activities. Eur J Pharm Biopharm 2013; 85:958-65. [DOI: 10.1016/j.ejpb.2013.05.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 04/23/2013] [Accepted: 05/15/2013] [Indexed: 01/10/2023]
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Ardila-Hani A, Soffer EE. Review article: the impact of bariatric surgery on gastrointestinal motility. Aliment Pharmacol Ther 2011; 34:825-31. [PMID: 21854401 DOI: 10.1111/j.1365-2036.2011.04812.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Obesity is a major medical problem worldwide. Different treatment modalities have emerged to treat obese patients, but the best long-term results are achieved with bariatric surgery. Currently, the interventions most commonly performed are laparoscopic adjustable gastric banding (LAGB), Roux-en-Y- gastric bypass (RYGB) and sleeve gastrectomy. AIM To review the gastrointestinal motor complications associated with each of these types of bariatric interventions and the clinical implications of such complications. METHODS Search of medical database (PubMed) on English-language articles from January 1996 to March 2011. The search terms used were laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (LSG), roux-en-Y-gastric bypass (RYGB), using the AND operator with the terms: complications, motility, GERD, reflux, gastric emptying, esophagitis, dysphagia. RESULTS Of the three bariatric interventions reviewed, LAGB was the most studied. Most studies reported short follow-up, of ≤ 1 year. Oesophageal motor dysfunction is the most common motility complication following the bariatric interventions that were reviewed and is mainly observed after LAGB. Some data suggest that oesophageal motor function testing predicts development of post-operative symptoms and oesophageal dilation. RYGB offers protection from gastro-oesophageal reflux. Sleeve gastrectomy was the least studied and was associated with an acceleration of gastric emptying. CONCLUSIONS The effects of these interventions on GI motility should be considered when selecting patients for bariatric surgery. There is scant information regarding the overall effect of sleeve gastrectomy on gastro-oesophageal reflux patterns and oesophageal motility.
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Affiliation(s)
- A Ardila-Hani
- Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, CA, USA
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Physiology of the small bowel: A new approach using MRI and proposal for a new metric of function. Med Hypotheses 2011; 76:834-9. [DOI: 10.1016/j.mehy.2011.02.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 02/14/2011] [Indexed: 02/08/2023]
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Changes in satiety, supra- and infraband transit, and gastric emptying following laparoscopic adjustable gastric banding: a prospective follow-up study. Obes Surg 2011; 21:217-23. [PMID: 21136303 DOI: 10.1007/s11695-010-0312-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Laparoscopic adjustable gastric banding (LAGB) induces and sustains weight loss, likely by activating the peripheral satiety mechanism. Recent data suggests that food is not retained above the optimally adjusted LAGB, suggesting that an alternate mechanism is inducing satiety. How transit and gastric emptying change following LAGB and correlate with satiety and weight loss have not been adequately defined. METHODS LAGB patients underwent preoperative and 12-month follow-up nuclear scintigraphic assessments of esophageal transit and gastric emptying. A new technique that allowed the calculation of emptying times and transit through the supra- and infraband compartments was used to assess emptying and transit patterns postoperatively. RESULTS Postoperatively, patients reported increased satiety both after a standard fast (3.7 ± 2.3 vs. 4.8 ± 2.1, p = 0.04) and following a standard semisolid meal (5.9 vs. 7.8 ± 1.7, p = 0.003). The mean percent excess weight loss was 48.5 ± 23.2%. The gastric emptying half-time (minutes) did not change significantly (63.5 ± 41.1 vs. 73.3 ± 26.8, p = 0.64). Semisolid transit into the infraband stomach was delayed briefly postoperatively in more patients (11 vs. 2, p = 0.001). There was minimal retention of the meal above the LAGB 2 min after commencing the gastric emptying study (median, 3%; interquartile range, 1.75-10); therefore, an emptying half-time of the supraband region could not be defined. CONCLUSIONS Weight loss, satiety, and early satiation following LAGB were associated with briefly delayed bolus transit into the infraband stomach. Retention of the semisolid meal above the LAGB was not observed. This is further evidence that suggests satiety develops following LAGB without physical restriction of meal size.
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Dietary fibres in the regulation of appetite and food intake. Importance of viscosity. Appetite 2010; 56:65-70. [PMID: 21115081 DOI: 10.1016/j.appet.2010.11.147] [Citation(s) in RCA: 180] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 11/19/2010] [Indexed: 11/23/2022]
Abstract
Dietary fibres have many functions in the diet, one of which may be to promote control of energy intake and reduce the risk of developing obesity. This is linked to the unique physico-chemical properties of dietary fibres which aid early signalling of satiation and prolonged or enhanced sensation of satiety. Particularly the ability of some dietary fibres to increase viscosity of intestinal contents offers numerous opportunities to affect appetite regulation. Few papers on the satiating effect of dietary fibres include information on the physico-chemical characteristics of the dietary fibres being tested, including molecular weight and viscosity. For viscosity to serve as a proxy for soluble dietary fibres it is essential to have an understanding of individual dietary fibre viscosity characteristics. The goal of this paper is to provide a brief overview on the role of dietary fibres in appetite regulation highlighting the importance of viscosity.
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Effects of Adjustable Gastric Bands on Gastric Emptying, Supra- and Infraband Transit and Satiety: A Randomized Double-Blind Crossover Trial Using a New Technique of Band Visualization. Obes Surg 2010; 20:1690-7. [DOI: 10.1007/s11695-010-0278-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg 2009; 19:1515-21. [PMID: 19714384 DOI: 10.1007/s11695-009-9954-z] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 08/12/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sleeve gastrectomy (SG) has been accepted as an option for surgical treatment for obesity. This operation could be associated with motor gastric dysfunction and abnormal gastric emptying. The purpose of this prospective study is to present the results of gastric emptying to liquids and solids using scintigraphy in patients who underwent SG compared to normal subjects. METHODS Twenty obese patients were submitted to laparoscopic SG and were compared to 18 normal subjects. Gastric emptying of liquids and solids was measured by scintigraphic technique. Results were expressed as half time of gastric emptying and the percentage of retention at 20, 30, and 60 min for liquids and at 60, 90, and 120 min for solids. RESULTS In the group of operated patients, 70% of them (n = 14) presented accelerated emptying for liquids and 75% (n = 15) for solids compared to 22.2% and 27.7%, respectively, in the control group. The half time of gastric emptying (T (1/2)) in patients submitted to SG both for liquids and solids were significantly more accelerated compared to the control group (34.9 +/- 24.6 vs 13.6 +/- 11.9 min for liquids and 78 +/- 15.01 vs 38.3 +/- 18.77 min for solids; p < 0.01). The gastric emptying for liquids expressed as the percentage of retention at 20, 30, and 60 min was 30.0 +/- 0.25%, 15.4 +/- 0.18%, and 5.7 +/- 0.10%, respectively, in operated patients, significantly less than the control subjects (p < 0.001). For solids, the percentage of retention at 60, 90, and 120 min was 56 +/- 28%, 34 +/- 22%, and 12 +/- 8%, respectively, for controls, while it was 25.3 +/- 0.20%, 9 +/- 0.12%, and 3 +/- 0.05%, respectively, in operated patients (p < 001). CONCLUSIONS Gastric emptying after SG is accelerated either for liquids as well as for solids in the majority of patients. These results could be taken in consideration for the dietary indications after surgery and could play a significant role in the definitive results during the late follow-up.
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