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PubMed2004

[Influence of antiretroviral therapy characteristics on pediatric patient adherence].

OBJECTIVE: To analyze difficulties in achieving optimal adherence to antiretroviral therapy as perceived by pediatric patient caregivers in relation to treatment characteristics. METHODS: Design of a subjective numeric scale-based questionnaire, and its administration to caregivers of pediatric patients undergoing active antiretroviral therapy in our hospital, after verbal informed consent for interviewing. The questionnaire aimed to assess on a scale from 0 (no difficulty for adherence) to 5 (maximal difficulty) a number of treatment-related factors: a) number of drugs and dosage regimen; b) organoleptic properties of drugs; c) treatment administration; d) adverse events; and e) antiretroviral therapy effectiveness perceived by caregiver. The questionnaire was proposed to all caregivers, and was performed by a pharmacist in a private space within the pharmacy department. RESULTS: The questionnaire was administered to 28 caregivers of the 32 pediatric patients undergoing active antiretroviral therapy. The following factors were evaluated as entailing moderate difficulties: smell, deglutition, and the immediate gastrointestinal adverse effects of protease inhibitors in liquid dosage form. The only factor evaluated as entailing great difficulty was protease inhibitors flavour in the liquid dosage form. Therapy effectiveness perception was evaluated as high. CONCLUSIONS: According to the overall results from our survey, caregivers evaluated the following factors as entailing moderate to high difficulties for correct adherence: number of drugs in the antiretroviral combination, organoleptic properties (smell, taste) of protease inhibitors (PI), PI-related deglutition problems, and PI-related immediate gastrointestinal adverse events. These factors may be considered potential obstacles for adequate adherence to antiretroviral therapy in pediatric patients.

Adolescent↗
PubMed2002

Prediction of the bitterness of single, binary- and multiple-component amino acid solutions using a taste sensor.

The purpose of this study was to develop a quick, quantitative, prediction method for the determination of the bitterness of solutions containing one or more of five amino acids (L-isoleucine, L-leucine, L-valine, L-phenylalanine, and L-tryptophan), using an artificial taste sensor. The bitterness of various solutions containing different concentrations (1, 3, 10, 30, and 100 mM) of five amino acids, singly and in combination, was estimated using a multichannel taste sensor and compared with the results of human gustatory sensation tests with nine volunteers. The relative response electric potential patterns were similar for all five amino acids. Large sensor outputs were observed in channels 1-4 (which are negatively charged) while there were no responses in channels 5-8 (positively charged). The sensor output for channel 1, which was the largest output value, was used for prediction of bitterness. The change of membrane potential caused by adsorption (CPA), which corresponds to aftertaste, could not be used as an explanatory variable since the adsorption of the amino acids to the sensor membrane was weak and CPA values were small. The bitterness intensity scores for single, binary, and multi-component amino acid solutions, could be easily predicted on the basis of the sensor output value of channel 1 using regression analysis. Principal component analysis of the sensor output data suggested that the sourness, astringency and/or smell of the solutions also played a role in the perception of bitterness.

Amino Acids↗
PubMed2005

Structure-sweetness relationship in egg white lysozyme: role of lysine and arginine residues on the elicitation of lysozyme sweetness.

Lysozyme is one of the sweet-tasting proteins. To clarify the structure-sweetness relationship and the basicity-sweetness relationship in lysozyme, we have generated lysozyme mutants with Pichia systems. Alanine substitution of lysine residues demonstrated that two out of six lysine residues, Lys13 and Lys96, are required for lysozyme sweetness, while the remaining four lysine residues do not play a significant role in the perception of sweetness. Arginine substitution of lysine residues revealed that the basicity, but not the shape, of the side chain plays a significant role in sweetness. Single alanine substitutions of arginine residues showed that three arginine residues, Arg14, Arg21, and Arg73, play significant roles in lysozyme sweetness, whereas Arg45, Arg68, Arg125 and chemical modification by 1,2-cyclohexanedione did not affect sweetness. From investigation of the charge-specific mutations, we found that the basicity of a broad surface region formed by five positively charged residues, Lys13, Lys96, Arg14, Arg21, and Arg73, is required for lysozyme sweetness. Differences in the threshold values among sweet-tasting proteins might be caused by the broadness and/or the density of charged residues on the protein surface.

Amino Acid Substitution↗
PubMed2003

Two multicenter, randomized, single-blind, single-dose, crossover studies of specific sensory attributes of budesonide aqueous nasal spray and fluticasone propionate nasal spray.

BACKGROUND: Intranasal corticosteroids are effective for the treatment of allergic rhinitis. Sensory attributes associated with these sprays may affect patient preference and adherence to treatment regimens. OBJECTIVES: These 2 studies compared patients' perceptions of and preferences for specific sensory attributes of budesonide aqueous nasal spray (BANS) and fluticasone propionate nasal spray (FPNS). METHODS: In 2 multicenter, randomized, single-blind (patient), single-dose, 2-period, 1-day crossover studies, adults with mild to moderate allergic rhinitis received single doses of BANS (one 32-pg spray per nostril in both studies, 64-microg total dose) and FPNS (two 50-microg sprays per nostril in study 1, 200-pg total dose; one 50-microg spray per nostril in study 2, 100-microg total dose). Study 1 compared the once-daily recommended starting doses of BANS and FPNS, and study 2 compared BANS with half the once-daily recommended dose of FPNS to balance the number of actuations for delivery of study drug. Patients completed the 23-item Sensory Perceptions Questionnaire and indicated their product preference (if any). RESULTS: A total of 110 women and 71 men in study 1 and 136 women and 54 men in study 2 were randomized to treatment. None had previously used BANS or FPNS. In both studies, fewer patients perceived scent or taste (both P < 0.001 in both studies), forceful spray (P < 0.001 in both studies), and a wet feel in both the nose and throat (study 1, P < 0.004; study 2, P < 0.002) with BANS than with FPNS. In addition, more patients in both studies liked the spray force (study 1, P < 0.01; study 2, P < 0.001) and moisture content in the throat (study 1, P < 0.001; study 2, P < 0.006) of BANS and indicated a greater overall satisfaction with the sensory features of BANS than those of FPNS (study 1, P < 0.001; study 2, P < 0.015). In analyses that included all responding patients, 54.4% of patients in study 1 preferred BANS and 37.8% preferred FPNS (P < 0.022). In study 2, 47.4% preferred BANS and 41.1% preferred FPNS (not significant). Of the 92.2% of patients in study 1 and 88.4% in study 2 who specified a product preference, 59.0% preferred BANS and 41.0% preferred FPNS in study 1 (P = 0.021), and 53.6% preferred BANS and 46.4% preferred FPNS in study 2 (not significant). CONCLUSIONS: On the basis of perceptions of specific sensory attributes reported after 1 administration in these 2 studies, BANS was rated as more pleasing and preferred over the recommended QD starting dose of FPNS, and was also rated as more pleasing than half the QD recommended starting dose of FPNS.

Administration, Intranasal↗
PubMed2005

Factors associated with perceived oral health status in older individuals.

AIM: To assess factors associated with perception of oral health in older individuals. DESIGN: A cross sectional study. SETTING: A densely populated urban area in Sri Lanka. PARTICIPANTS: 585 older adults aged 60 years and above of which 475 were living at home and 110 in institutions. The present analysis is limited to 235 subjects who were subjected to a clinical oral examination. METHOD: The data were collected by means of an interviewer-administered questionnaire and a clinical oral examination. RESULTS: Overall, 48% of the dentate and 42% of the edentate perceived their oral health as poor. The final model of the hierarchical logistic regression analysis for the dentate revealed that presence of retained roots, mobile teeth, >20 missing teeth and perceived need for dental care were significantly associated with poor perceived oral health status. For the edentate, perceived need for dental care, loss of taste sensation and difficulty in eating were significantly associated with poor perceived oral health status. CONCLUSIONS: Factors associated with perceived oral health status differed between the dentate and the edentate. Clinical oral health indicators emerged as significant predictors of perceived oral health status in the dentate although the explanatory power of these indicators on perception of oral health was low.

Aged↗
PubMed2006

Food attitudes, eating behavior, and the information underlying food attitudes.

This research examined healthiness perceptions and how the information underlying food attitudes more generally relate to attitudes and behaviors. Participants completed attitudinal measures and various card-sorting tasks in which they rank ordered foods (pictures and/or nutrition labels) in terms of healthiness. Taste was found to be a stronger predictor of attitudes and past eating behavior than other information underlying attitudes (health, guilt, comfort). Furthermore, participants' healthiness rankings of pictures were not correlated to rankings of the corresponding nutrition labels, suggesting that when determining a food's healthiness, participants do not rely on (or are not aware of) the actual nutritional makeup.

Adult↗
PubMed2005

Nicotine injected into the antennal lobes induces a rapid modulation of sucrose threshold and improves short-term memory in the honeybee Apis mellifera.

In honeybee, although it is known that the food perception and the olfactory memory can be modulated by many environmental and biochemical factors, nothing is known on the effects of nicotine on these processes. Using microinjections of nicotine in the antennal lobes, we show that nicotine at 10(-3) M and 10(-4) M but not at 10(-5) M induced an increase of sucrose sensitivity and that post-training injection of 10(-5) M nicotine improved retention of olfactory learning. These results demonstrate that potentiation of the cholinergic system in the honeybee enhances sucrose perception and facilitates olfactory memory.

Animals↗
PubMed2007

Formulation considerations of intranasal corticosteroids for the treatment of allergic rhinitis.

OBJECTIVE: To examine how various aspects of an intranasal corticosteroid (INS) formulation may influence the efficacy, tolerability, and patient preference and adherence to INS therapy. DATA SOURCES: A PubMed search of the literature was conducted for studies on allergic rhinitis published between January 1977 and January 2006 using the keywords intranasal corticosteroid, preservatives, benzalkonium chloride, and tonicity. STUDY SELECTION: Prospective studies, retrospective studies, and case reports were selected for inclusion in this review. RESULTS: Currently available INSs are effective first-line treatments for allergic rhinitis. Differences in patient preference for a particular INS are largely attributable to sensory attributes of the nasal spray, which arise from characteristics of the formulation. Additives and preservatives can cause tolerability issues by irritating the mucosal membranes and causing nasal drying, or they can confer an unpleasant odor or taste to an INS formulation. The relative osmotic pressure, or tonicity, of an INS can modulate nasal absorption and retention, thereby potentially influencing the clinical efficacy. Characteristics such as delivery device and spray volume can affect a patient's perception and experience with a particular INS. Newer INSs, such as ciclesonide, are in development for the treatment of allergic rhinitis, and consideration of the formulation characteristics of these agents is an important part of the development process. CONCLUSIONS: INSs are an effective treatment option for patients with allergic rhinitis; however, there is room for formulation improvement. Optimization of formulation may increase the efficacy, tolerability, and patient preference and adherence to INSs.

Administration, Intranasal↗
PubMed1994

Varieties of disgust faces and the structure of disgust.

In 3 facial expression identification studies, college students matched a variety of disgust faces to verbally described eliciting situations. The faces depicted specific muscle action movements in accordance with P. Ekman and W. V. Friesen's (1978) Facial Action Coding System. The nose wrinkle is associated with either irritating or offensive smells and, to some extent, bad tastes. Gape and tongue extrusion are associated primarily with what we call core or food-offense disgust and also oral irritation. The broader range of disgust elicitors, including stimuli that remind humans of their animal origins (e.g., body boundary violations, inappropriate sex, poor hygiene, and death), a variety of aversive interpersonal contacts, and certain moral offenses are associated primarily with the raised upper lip. The results support a theory of disgust that posits its origin as a response to bad tastes and maps its evolution onto a moral emotion.

Adult↗
PubMed2000

Adherence to medication regimens among children with human immunodeficiency virus infection.

BACKGROUND: Rigorous adherence to antiretroviral medication regimens is necessary to achieve and maintain undetectable viral levels. This study describes adherence in a population of children with HIV infection. METHODS: Caregivers of HIV-infected children were interviewed about their experiences with administration of medications for treatment of HIV, opinions regarding medication-related issues and the potential usefulness of interventions to improve adherence. RESULTS: In the 90 caregiver interviews completed, 78% of the children were taking 3 or more medications, 17% missed a dose in the previous 24 h and 43% missed at least 1 dose in the previous week. Children whose caregivers reported no missed doses in the previous week (adherent) were more likely to have an HIV viral load <400 copies/ml (50% vs. 24%, P = 0.04). Nonadherent caregivers (who reported 1 or more missed doses in the previous week) were more likely than adherent caregivers to agree with a statement that full adherence is impossible (44% vs. 12%, P = 0.001) and express the need for more help with medication administration (26% vs. 6%, P = 0.02). They were less likely to have informed the school or day-care site about the child's HIV infection (42% vs. 67%, P = 0.05) and more concerned about the child's teachers and friends finding out (54% vs. 31%, P = 0.05). Of 10 potential interventions 6 were rated by a majority of respondents as "very helpful": better tasting medications (81%); longer dosing intervals (72%); medications that did not require refrigeration (63%); access to 24-h telephone advice (62%); a follow-up call from a health care provider (57%); and a pill organizer (56%). CONCLUSIONS: Caregivers' perceptions that adherence is too difficult or concerns about loss of privacy may affect their ability to adhere to complicated medication regimens. Caregivers felt that the most helpful interventions would be modifications to improve the convenience and palatability of medications and increased access to medical advice.

Adolescent↗
PubMedDate not supplied

Opinions and feelings on eating with complete dentures: a qualitative inquiry.

Our knowledge of variables affecting the coping strategies that lead to acceptance of foods in populations wearing complete dentures is limited. Focus groups were conducted with the specific aim of determining factors responsible for successful adaptation to chewing with complete dentures. Each of the five focus groups consisted of eight to 15 participants (mean = 11; mean age = 64 yrs), of mixed gender, with at least five years of denture-wearing experience (mean = 7 years), and with groups varying in their socio-economic and ethnic backgrounds. Participants' statements (n = 324) were sorted for their content, by consensus between the two investigators, into 12 conceptually independent domains (listed in decreasing order of frequency of mention): foods and food textures causing difficulties when eating, foods being avoided, stability and retention of dentures, social constraints, bolus size, general satisfaction with the current dentures, general experience with dentures, sensation of temperature, experience of pain during chewing, experiences with taste, experiences with rinsing the dentures after eating, and time involved with chewing. In addition, further analysis of statements showed that food texture was the most commonly mentioned with foods that were either difficult to chew or avoided. These perceptions significantly affected the choice of food. The results of this qualitative study indicate that food texture is one of the major factors influencing the choice of a coping strategy by denture wearers when trying to overcome difficulties in chewing specific foods. As such, food texture may have a significant effect on patients' success in the process of their functional adaptation.

Adaptation, Psychological↗
PubMed2005

CD36 involvement in orosensory detection of dietary lipids, spontaneous fat preference, and digestive secretions.

Rats and mice exhibit a spontaneous attraction for lipids. Such a behavior raises the possibility that an orosensory system is responsible for the detection of dietary lipids. The fatty acid transporter CD36 appears to be a plausible candidate for this function since it has a high affinity for long-chain fatty acids (LCFAs) and is found in lingual papillae in the rat. To explore this hypothesis further, experiments were conducted in rats and in wild-type and CD36-null mice. In mice, RT-PCR experiments with primers specific for candidate lipid-binding proteins revealed that only CD36 expression was restricted to lingual papillae although absent from the palatal papillae. Immunostaining studies showed a distribution of CD36 along the apical side of circumvallate taste bud cells. CD36 gene inactivation fully abolished the preference for LCFA-enriched solutions and solid diet observed in wild-type mice. Furthermore, in rats and wild-type mice with an esophageal ligation, deposition of unsaturated LCFAs onto the tongue led to a rapid and sustained rise in flux and protein content of pancreatobiliary secretions. These findings demonstrate that CD36 is involved in oral LCFA detection and raise the possibility that an alteration in the lingual fat perception may be linked to feeding dysregulation.

Animals↗
PubMed1988

Contributions of taste factors and gender to opioid preference in C57BL and DBA mice.

C57BL/6J and DBA/2J mouse strains have been characterized as morphine preferrers and avoiders, respectively (Horowitz et al. 1977). Previously, sweetened morphine solutions were presented with a water alternative, primarily with male subjects. Because sweetness may affect the endogenous opioid system and rodents have shown strain and sex differences in taste preferences, this study looked for strain- and gender-related taste preferences that might have affected opiate consumption. Preference for sweetened and unsweetened morphine and etonitazene was compared across gender and strain. In all choice tests, the control was a similar tasting quinine sulphate solution. Under these conditions, C57BL/6J mice continued to show strong preference for morphine. However, DBA/2J mice drank approximately equal amounts of morphine and quinine solutions, rather than avoiding morphine as when water was the alternative. Both strains appeared surprisingly indifferent to the synthetic opioid etonitazene, compared because it is potent at concentrations having barely perceptible bitterness. This raises the possibility of unexpected differences in post-ingestional effects between morphine and etonitazene. Contrary to reports of gender differences in sweet preference in rats, none were found in either strain of mouse. Neither were there any significant sex differences in opiate preference in either strain. C57 mice preferred sweetness more than did DBA mice.

Animals↗
PubMed1983

Effects of sweetness perception and caloric value of a preload on short term intake.

To determine the effects of calories and sweetness perception on intake, fasted normal weight subjects drank a preload sweetened with sucrose (1.1 g/kg) or L-asparthyl-L-phenylalanyl-methyl ester (Aspartame, 0.011 g/kg), or with no added sweetener. Sweetness perception of the load was reduced in half of the subjects by oral application of Gymnema sylvestre extracts. One hour after the preload, a meal of snack foods was presented and amounts of nutrients eaten were calculated. Subjects whose perception of sweetness had been decreased for the preload ate less total and sweet calories than did those with normal perception. Calories did not affect intake. The effect of calories and perception of the load was also assessed on variables presumed to correlate with satiety. Sucrose pleasantness ratings were not related to calories, perception or intake. Subjects' estimates of the amount of milkshake that they would drink if given the opportunity to do so and hunger ratings were related to overall intake and carbohydrate intake, respectively. The findings indicate that hedonistic aspects of taste are of greater importance than calories in determining short term intake.

Diet↗
PubMed2006

Individual differences in oral thermosensation.

Although oral thermosensation is critical to the perception of food and drinks, little information is available on the organization of individual differences in these abilities. We examined the relationship between measures of cooling and warming on the tongue and lip and the association of these measures to taste sensitivity in a sample of 76 healthy subjects. Thermal abilities were assessed with a computer-controlled, 1.5 cm2 peltier plate that was placed on the anterior dorsal surface of the tongue or the lower lip. Thermal testing consisted of both cooling and warming threshold detection, and intensity ratings of warm and cool suprathreshold temperatures. Intensity ratings of different temperatures were highly correlated, especially for temperatures in the same class. Similarly, warming and cooling thresholds were highly correlated. In contrast, thermal detection abilities were largely dissociable from suprathreshold intensity ratings, especially in the cooling direction. Suprathreshold ratings of cooling on the tongue were also modestly associated with ratings of the taste intensity of 6-n-propylthiouracil (PROP). However, a similar association was observed for the lower lip, indicating that the effect does not reflect an isolated characteristic of lingual physiology. Unexpectedly, two subjects with no history of oral trauma demonstrated abnormally deficient (4 S.D. below the mean) cool threshold detection abilities for the tongue, suggesting that there may exist subjects in the population who have profoundly poor lingual temperature processing.

Adult↗
PubMed2004

Volatile flavor analysis and sensory evaluation of custard desserts varying in type and concentration of carboxymethyl cellulose.

The influence of type and concentration of carboxymethyl cellulose (CMC) on flavor and textural properties of custard desserts was examined. A synthetic strawberry flavor mixture was used to flavor the custards; it comprised 15 volatile flavor compounds. The viscosity of the custards was determined using rheometric measurements. Static headspace gas chromatography and in-nose proton transfer reaction-mass spectrometry analyses were conducted to determine the custards' volatile flavor properties. Perceived odor, flavor, and textural properties were assessed in sensory analysis experiments using magnitude estimation against a fixed modulus. Both type and concentration of CMC altered the viscosity of the custards. Softer custards had higher static headspace flavor concentrations. On the contrary, firmer custards demonstrated higher in-nose flavor concentrations. In sensory analysis, firmer custards showed higher thickness and lower sweetness intensities than their low-viscosity counterparts. The thickness perception corresponded to the viscosity of the custards. Removal of sucrose from the custards affected sweetness intensity only and not the intensity of other attributes. Therefore, the influence of the viscosity of the custards on the release of sweet-tasting components is held responsible for the effect on perceived sweetness intensity. Odor intensities were generally higher for the low-viscosity custard, whereas fruity flavor intensities were higher for the firmer custards. Odor intensities correlated with static headspace concentrations and flavor intensities related reasonably well with in-nose concentrations. Opening and closing of the nasal cavity is regarded as an important factor determining the discrepancy between static and in-nose measurements.

Carboxymethylcellulose Sodium↗