Metabolization of the Amadori Product N-ε-Fructosyllysine by Probiotic Bacteria

Glycation reactions in food lead to the formation of the Amadori rearrangement product (ARP) N-ε-fructosyllysine (fructoselysine, FL), which is taken up with the daily diet and comes into contact with the gut microbiota during digestion. In the present study, nine commercially available probiotic preparations as well as single pure strains thereof were investigated for their FL-degrading capability under anaerobic conditions. One of the commercial preparations as well as three single pure strains thereof was able to completely degrade 0.25 mM FL within 72 h. Three new deglycating lactic acid bacteria species, namely, Lactobacillus buchneri DSM 20057, Lactobacillus jensenii DSM 20557, and Pediococcus acidilactici DSM 25404, could be identified. Quantitative experiments showed that FL was completely deglycated to lysine. Using 13C6-labeled FL as the substrate, it could be proven that the sugar moiety of the Amadori product is degraded to lactic acid, showing for the first time that certain lactic acid bacteria can utilize the sugar moiety as a substrate for lactic acid fermentation.

Determinants of children's health care use: an investigation of psychosocial factors

Factors related to the amount of health care used by 5- to 11-year-old children in a health maintenance organization (HMO) were investigated using a comprehensive multivariate model that assessed the contribution of child health need, mental health, and social functioning; maternal mental health, social support and health care utilization; and family functioning and life events. Mothers reported on the 450 participating children. Health care visits for a two-year retrospective period were obtained from the computerized encounter system. Child health need and maternal patterns of health care use were powerful predictors of the overall amount of health care used, and these factors discriminated high users from low users of care. Family conflict was associated with a higher volume of care, while children's depressive symptoms and non-white race were related to lower use. Maternal social support, mental health, and life events were not predictive of use in either full multivariate model. Enabling factors were held relatively constant by participation of all families in a prepaid HMO. The multiple regression model explained 33% of the variance in use, slightly more than in previous studies of children's health care use. When included in a comprehensive analysis, child and family psychosocial characteristics help to explain children's health care use beyond what is possible using simple health and illness variables. The implications of these findings in the development of further research and to the practice of routine pediatric care are discussed.

Driving in patients with dementia

These pilot data suggest that driving among individuals with incapacitating dementing illness may be an unrecognized, potentially serious problem. A simple 20-item screening questionnaire was administered to 72 referrals to the Dementia Research (outpatient) Clinic of the Johns Hopkins Hospital. Thirty percent of the patient sample had at least one accident since the onset of symptoms of dementia. An additional 11% were reported by caregivers to have "caused" accidents.

Self-care capacity and anticholinergic drug levels in nursing home patients

The serum anticholinergic levels of 22 demented nursing home patients were related to their cognition and capacity for self-care. The patients with high anticholinergic levels had greater impairment in self-care capacity than patients with low levels.

Prevalence of mental illness in a community nursing home

A research psychiatrist using a standardized interview found that 94% of a random sample of residents at a large, intermediate-care nursing home had mental disorders according to DSM-III criteria. Primary degenerative dementia and multi-infarct dementia were the most common diagnoses. In addition, the majority of demented patients also had noncognitive symptoms such as delusions and hallucinations, and these residents were significantly more likely to have an associated behavioral disorder than were residents without delusions or hallucinations. Replications of these results would point out the need for major revisions in the funding and delivery of psychiatric care for nursing home residents.