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PubMed2004

Neuroendocrinology of gastric H+ and duodenal HCO3- secretion: the role of brain-gut axis.

Gastric H+ and duodenal HCO3- secretions are precisely regulated by neuro-hormonal mechanisms at central and peripheral levels to match the rate of these secretions with the type of stimulation of sensory receptors in the head area (sight, smell, taste, etc.) and in the gastro-intestinal system. Two-way communication pathways operate between the brain and the gut, each comprising afferent fibers signaling sensory information from the gut to the brain and efferent fibers transmitting signals in opposite direction. Short intramural and long extramural reflexes are triggered as well as various gut hormones are released by feeding that "cooperate" with the "brain-gut axis" in the alteration of exocrine and endocrine gastro-duodenal secretion, motility and blood circulation. The malfunction of gastric or duodenal secretory mechanisms may lead to disturbances of gastric H+-pepsin or duodenal mucus-HCO3- secretion and to gastro-duodenal disorders and diseases. This review presents recent advances in pathophysiological mechanisms underlying gastro-duodenal secretory disorders.

Animals↗
PubMed1999

Canine zinc-responsive dermatosis.

Zinc is important in a multitude of biological functions, including regulation of the immune response, modulation of keratogenesis and wound healing, maintenance of normal reproductive function, and acuity of taste and smell. Zinc-responsive dermatosis is an uncommon disease of dogs resulting from either an absolute or relative deficiency in zinc. Dermatological lesions are characterized by erythema, alopecia, scales, and crusts that primarily affect the head. Two forms of the disease exist: a familial form affecting Alaskan Malamutes and Siberian Huskies and a form that affects growing puppies fed zinc-deficient or oversupplemented diets. The history, clinical signs, and skin biopsy results are typically diagnostic. Life-long zinc supplementation is usually necessary in the familial form of the disease, although dietary correction alone may be curative in the second form. Lethal acrodermatitis is a rare inherited disorder of Bull Terriers that does not respond to zinc supplementation and is invariably fatal.

Animals↗
PubMed1994

Safety and efficacy of nebulized lignocaine in patients with cancer and breathlessness.

Although anecdotal reports suggest nebulized lignocaine may help breathlessness in patients with cancer this has not been examined formally. We report a pilot study comparing nebulized lignocaine 100 mg and 200 mg with saline in six patients with cancer who were breathless at rest. Nebulized lignocaine was well tolerated apart from mild bronchoconstriction in two patients after the 200 mg dose and the unpleasant taste; serum concentrations were below levels at which toxicity has been reported. The effort of breathing (measured on a visual analogue scale) did not differ between treatments, whereas the distress of breathing was less after saline than after either dose of lignocaine. These findings do not support the reported benefits of nebulized lignocaine.

Administration, Intranasal↗
PubMed1995

A phenomenological study of sensory defensiveness in adults.

This article describes the experiences of five adults who are defensive toward sensations of touch, movement, vision, smell, sound, and taste that most people consider harmless. It also describes the strategies that they use when they perceive environmental stimuli to be aversive. These coping strategies are avoidance, predictability, mental preparation, talking through, counteraction, and confrontation. A conceptual framework is presented to enhance understanding and guide further study of sensory defensiveness in adults.

Adaptation, Psychological↗
PubMed1997

Temperament and food neophobia in children and their mothers.

We obtained measures of behavioral neophobia, rated neophobia, temperament, and liking for novel and familiar foods for 81 pairs of siblings (ranging in age from 5-11 years) and their mothers. The children's data revealed a decrease with age in behavioral but not rated neophobia, and there were positive correlations between both measures of neophobia and the temperament dimensions of emotionality, shyness, and negative reactions to foods. In addition, liking for good-tasting novel foods was negatively related to shyness and to negative reactions to foods. For mothers, both measures of neophobia were related to negative reactions to foods and unrelated to any other temperament dimensions. The data revealed little evidence of family resemblance (mother-child or sibling-sibling) in food neophobia.

Age Factors↗
PubMed1982

[The role of enteral and parenteral feeding in cancer therapy].

The role of nutrition support as an adjunct to cancer treatment is discussed. Many patients with advanced cancer have demonstrable nutritional deficits, the reason is still unclear. Anorexia, taste abnormalities, pain and obstruction of the gastrointestinal tract can lead to malnutrition. Different modes of therapy, like surgery, radiotherapy and chemotherapy, sometimes deteriorate nutritional status. Several investigators have indicated, that nutritional support provides some benefit. There is no indication at the present time of any disadvantage of this method of treatment in relation to tumor growth. The potential indications and methods of nutritional support are pointed out.

Enteral Nutrition↗
PubMed1995

[Illicit drug consumption among adolescents. An epidemiologic survey carried out in 1993 among 12,391 adolescents between 11 and 19 years old].

In 1993, a large epidemiological health study was carried out among a French school population, aged 11 to 19 (sample size = 12,391). Illicit drugs consumption was one of the topics investigated. 15% of French adolescents experimented illicit drugs, this proportion increased from 4% (11-12 aged old) to 30% (18 aged old and over). Young people who tasted illicit drugs went often to pubs and nightclubs. Multinomial regression analysis indicated that 1/sex, socio-economic status and parents' matrimonial status are only weakly related to drug consumption; 2/ location (urban, rural, suburban), nationality and origin (French, no French), participation to extra-curricular activities (e.g. sport) are not related to drug consumption. Involvements of prevention were suggested.

Adolescent↗
PubMed1986

Results obtained from patients referred for the investigation of complaints related to oral galvanism.

One hundred consecutive patients, 74 women and 26 men, aged between 18 and 83 years (mean = 54.8 years), referred with complaints related to oral galvanism were investigated and treated and the treatment results were evaluated after 2-3 years. Forty of the patients reported facial pain, pain from the teeth, temporomandibular joints (TMJ) and masticatory muscles and TMJ clicking and locking and 26 reported headache. Smarting in the oral mucosa, smarting of the tongue and xerostomia were reported by 26, 21 and 24 patients, respectively, and 30 patients reported an unpleasant taste, a metallic taste or a battery taste. The same patient often reported several symptoms. The patients also reported various general symptoms, above all joint symptoms, pain in the back, neck and shoulders and general muscular pain but also tiredness, weakness, difficulty in concentrating, depression and insomnia. After clinical and radiological examination, salivary tests, determination of the maximum galvanic current at metallic contacts and screening for contact allergy to dental materials, various oral diagnoses could be established. Most of the patients exhibited functional disturbances of the masticatory system, periodontitis, smarting of the oral mucosa, xerostomia, pulpitis and pulpal necrosis and mucosal lesions. The medical illnesses the patients reported themselves to be suffering from or had been treated for included cardiovascular disorders, high and low blood pressure, asthma, rheumatic disorders, diabetes, pernicious anaemia, gastritis and peptic ulcer. Seventy-six patients took drugs regularly. In most cases there were several oral, dental and medical explanations for the symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Deep brain stimulation in the internal capsule and nucleus accumbens region: responses observed during active and sham programming.

BACKGROUND: Recently, anterior limb of the internal capsule and nucleus accumbens deep brain stimulation (DBS) has been used in the treatment of medication-refractory obsessive-compulsive disorder (OCD). This region has been previously explored with lesion therapy, but with the advent of DBS there exists the possibility of monitoring the acute and chronic effects of electrical stimulation. The stimulation-induced benefits and side effects can be reversibly and blindly applied to a variety of locations in this region. OBJECTIVE: To explore the acute effects of DBS in the anterior limb of the internal capsule and nucleus accumbens region. METHODS: Ten total DBS leads in five patients with chronic and severe treatment-refractory OCD were tested. Patients were examined 30 days after DBS placement and received either "sham" testing or actual testing of the acute effects of DBS (the alternative condition tested 30 days later). RESULTS: Pooled responses were reviewed for comparability of distribution using standard descriptive methods, and relationships between the variables of interest were sought using chi2 analysis. A total of 845 stimulation trials across the five patients were recorded and pooled. Of these 16% were elicited from sham stimulation and 17% from placebo (0 V stimulation). A comparison of active to sham trials showed that sham stimulation was not associated with significant side effects or responses from patients. Non-mood-related responses were found to be significantly associated with the ventral lead contacts (0 and 1) (p = 0.001). Responses such as taste, smell and smile were strongly associated with the most ventral lead positions. Similarly, physiological responses--for example, autonomic changes, increased breathing rate, sweating, nausea, cold sensation, heat sensation, fear, panic and panic episodes--were significantly associated with ventral stimulation (p = 0.001). Fear and panic responses appeared clustered around the most ventral electrode (0). Acute stimulation resulted in either improved or worsened mood responses in both the dorsal and ventral regions of the anterior limb of the internal capsule. CONCLUSION: The acute effects of DBS in the region of the anterior limb of the internal capsule and nucleus accumbens, particularly when obtained in a blinded fashion, provide a unique opportunity to localise brain regions and explore circuitry.

Adult↗
PubMed1988

Imipramine treatment and preference for sweets.

Antidepressant-induced changes in food preference were investigated in a group of 40 depressed patients before and during treatment with imipramine. As part of a validated survey, the Pittsburgh Appetite Test, self-reported food preference was categorized by both nutrient and hedonic properties to define individual response. After 4 months of treatment, 14 patients (35%) expressed a clear desire for high-carbohydrate/high-fat foods with a sweet taste. Within this group, eight patients already preferred these foods while medication-free, while six subjects demonstrated a change in preference to these foods during treatment. The other 26 patients (65%) showed no consistent changes in food preference. These results suggest that while approximately one-third of imipramine-treated patients report a preference for sweets, only 15% actually developed this preference during treatment.

Adult↗
PubMed1990

A comparison of the efficacy, safety and withdrawal effects of zopiclone and triazolam in the treatment of insomnia.

A double-blind study comparing zopiclone and triazolam, in 48 healthy, chronic insomniacs, was undertaken in two centers to compare the hypnotic and withdrawal effects of both compounds. Comparable doses of 7.5 mg zopiclone and 0.25 mg triazolam were given at bedtime for 21 nights after a 3 day wash-out period, followed by 4 placebo nights of withdrawal monitoring. During the investigation, a 17 item post-sleep questionnaire was completed daily, the Clinical Global Impression (CGI) scale weekly, and the Hamilton Anxiety Scale (HAM-A) at baseline and at the end of the study. Withdrawal effects were evaluated with a withdrawal symptom checklist and the CGI (withdrawal). Results indicated that both compounds improved sleep and were equally effective. However, a larger number of triazolam subjects withdrew from the study because of ineffectiveness or adverse side-effects. A greater number of zopiclone subjects experienced a transient modification of taste which disappeared with discontinuation of therapy. Significant deterioration in nearly all sleep parameters were noted after the first withdrawal night of triazolam; much fewer modifications of sleep parameters were observed following the discontinuation of zopiclone.

Adolescent↗
PubMed1994

Aldolase B and fructose intolerance.

Hereditary fructose intolerance is an autosomal recessive disorder that illustrates vividly the interplay between heredity and environment in the genesis of human nutritional disease. Genetically determined defects of an isozyme of fructose bisphosphate aldolase (aldolase B, which is specialized for the metabolic assimilation of dietary sugars) predispose to this widely distributed condition. Ingestion of fructose, sorbitol, or sucrose induces abdominal pain, vomiting, and metabolic disturbances--including low concentrations of blood glucose--that may prove fatal. The response to dietary exclusion is rapid and, when so treated, the disease is compatible with a normal life span. A noteworthy feature of the condition in individuals who survive the stormy period of weaning is the development of powerful aversions to fruit, nuts, and sweet-tasting foods and drinks. The incidence of dental caries is consequently much reduced.

Animals↗
PubMed2002

Distortion of olfactory perception: diagnosis and treatment.

Clinically, olfaction can fail in any of three ways: (i) decreased sensitivity (hyposmia, anosmia) and two types of distortion (dysosmia); (ii) distorted quality of an odorant stimulation (troposmia); (iii) perceived odor when no odorant is present (phantosmia, hallucination). The distortions are usually much more upsetting to a person's quality of life than a simple loss. An ipsilatersal loss of olfactory sensitivity is often identified in the nostril with any type of olfactory distortion. The pathophysiology of a stimulated distortion (troposmia) is likely a decreased number of functioning olfactory primary neurons so that an incomplete characterization of the odorant is made. In phantosmia, two possible causations include an abnormal signal or inhibition from the primary olfactory neurons or peripheral olfactory or trigeminal signals that "trigger" a central process. The clinician's goal is to carefully define the problem (e.g. taste versus smell, real versus perceived, one versus two nostrils), to perform the appropriate examination and testing and to provide therapy if possible. Treatment includes assurance with no active therapy (because many of these will naturally resolve), topical medications, systemic medications, anesthesia to parts of the nose and, rarely, referral for surgical excision of olfactory neurons. Endoscopic transnasal operations have the advantage of treating phantosmia and sometimes allowing a return of olfactory ability after the operation.

Humans↗
PubMed1995

The safety, tolerability and efficacy of transdermal nicotine (Nicotinell TTS) in initially hospitalised patients.

AIM: We studied a transdermal nicotine system with minimal behavioural intervention in hospitalised patients to assess patient acceptability, safety and efficacy. METHOD: In an open noncomparative study, 80 smoking patients (42 men and 38 women) were enrolled. They received 24-hour nicotine patches and simple support for 12 weeks and were followed for up to 26 weeks. Smoking was assessed by interview, expired air carbon monoxide and blood cotinine. RESULTS: Side effects included itch and local erythema (4), insomnia (7), abnormal taste (3). Two subjects withdrew from the study because of side effects. At 12 weeks 17 were nonsmokers. At 26 weeks 19 of 80 were nonsmokers and a further 14 had reduced their intake significantly. CONCLUSIONS: The nicotine skin patch proved to be safe and well tolerated. Efficacy was comparable to controlled trials of transdermal nicotine patches.

Administration, Cutaneous↗
PubMed1996

Survey of smokeless tobacco use in basic trainees and armor basic course officers.

In this study an all-male population of 256 U.S. Army basic trainees and 98 armor officer basic course students were surveyed concerning extent of use, knowledge of, and factors contributing to the use of smokeless tobacco (ST). The survey was administered at a dental clinic at Fort Knox, Kentucky. The data were analyzed using the SPSS computer software program. Results showed that more than 17% of this population were either occasional or regular users of ST. Nearly 24% had tried ST and more than 9% were former users. Exactly one-half had not tried ST. A typical user was white, had started ST use at age 14, had used it for 4 years, and was most likely to use snuff or dip. Higher educational level achieved was associated with increased likelihood of ST use. Nearly 22% of college graduates used ST, whereas only 15.3% of high school graduates or those with some college were users. Knowledge about the potential health effects of ST was generally high or moderately high, except for its ability to cause hypertension. This was true for both high school and college graduates, although college graduates were somewhat more informed. Few in this population had a personal attitude of approval toward ST use, and very few perceived that either their parents or their superiors in the military approved of ST use. Perceived attitude of approval was highest from friends and peers. The principle reasons for starting ST use were use by friends and curiosity about taste and effects. Influence from public figures, such as athletes, and from advertising was minimal. Enjoyment of flavor and taste was found to be the main reason for continued ST use. Health professionals were identified by the majority of respondents as the single most important information source on ST. Relatively few (27%), however, stated that their dentist or hygienist had ever discussed ST with them.

Adolescent↗
PubMed2005

Nasal sumatriptan: new dosage. For adolescents with migraine: too little benefit.

(1) The reference first-line drug therapy for migraine attacks in adolescents is a non specific analgesic such as paracetamol or a nonsteroidal antiinflammatory drug like ibuprofen. Two specific analgesics are authorised for use in this setting in France, namely ergotamine and dihydroergotamine. (2) Nasal sumatriptan is the first triptan to be licensed for this age group in France. (3) Evaluation data includes three flawed placebo-controlled trials. (4) Effects were modest at best. Only one of the three trials showed that sumatriptan was more likely than placebo to give complete pain relief within two hours. The three trials fail to show that sumatriptan is effective against symptoms such as nausea and vomiting, photophobia and phonophobia. (5) The principal known adverse effects of sumatriptan are chest tightness, flushing, and increased blood pressure. (6) In the only trial report containing relevant information, unpleasant taste was the only adverse effect more commonly associated with sumatriptan than with placebo. (7) Postmarketing follow-up revealed a number of serious adverse effects, including stroke, myocardial infarction and loss of vision. (8) The packs containing 6 or 12 spray vials carry a risk of overuse and self-induced headache. (9) In practice, sumatriptan must not be used to treat migraine attacks in adolescents.

Administration, Intranasal↗
PubMed1983

[Experiences with combined group psychotherapy in adolescents].

Adolescents in need of psychotherapy have, due to their defiant behaviour, little motivation to take part in group-centered psychotherapy although, since they are experiencing a crisis of identity, they are most in need of it. The tastes of this age group are catered for at the outset by the use of music typical of that popular among young people, arrangement of the group sessions to give the impression of a party and combining patient-centred treatment with communicative movement therapy. This is followed by training in social behaviour commensurate to the individual social situation and the deficits in the behavioural inventories of the different members of the group.

Adolescent↗
PubMed2002

Swallowing outcomes following laryngectomy and pharyngolaryngectomy.

OBJECTIVES: To determine the incidence of dysphagia (defined as the inability to manage a diet of normal consistencies) at hospital discharge and beyond 1 year postsurgery and examine the impact of persistent dysphagia on levels of disability, handicap, and well-being in patients. DESIGN: Retrospective review and patient contact. SETTING: Adult acute care tertiary hospital. PATIENTS: The study group, consecutively sampled from January 1993 to December 1997, comprised 55 patients who underwent total laryngectomy and 37 patients who underwent pharyngolaryngectomy with free jejunal reconstruction. Follow-up with 36 of 55 laryngectomy and 14 of 37 pharyngolaryngectomy patients was conducted 1 to 6 years postsurgery. MAIN OUTCOME MEASURES: Number of days until the resumption of oral intake; swallowing complications prior to and following discharge; types of diets managed at discharge and follow-up; and ratings of disability, handicap, and distress levels related to swallowing. RESULTS: Fifty four (98%) of the laryngectomy and 37 (100%) of the pharyngolaryngectomy patients experienced dysphagia at discharge. By approximately 3 years postsurgery, 21 (58%) of the laryngectomy and 7 (50%) of the pharyngolaryngectomy patients managed a normal diet. Pharyngolaryngectomy patients experienced increased duration of nasogastric feeding, time to resume oral intake, and incidence of early complications affecting swallowing. Patients experiencing long-term dysphagia identified significantly increased levels of disability, handicap, and distress. Patients without dysphagia also experienced slight levels of handicap and distress resulting from taste changes and increased durations required to complete meals of normal consistency. CONCLUSIONS: The true incidence of patients experiencing a compromise in swallowing following surgery has been underestimated. The significant impact of impaired swallowing on a patient's level of perceived disability, handicap, and distress highlights the importance of providing optimal management of this negative consequence of surgery to maximize the patient's quality of life.

Adult↗

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