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PubMed1989

Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder.

In recent years, lower serum levels have been recommended for maintenance therapy with lithium. We studied 94 patients with bipolar disorder in a randomized, double-blind, prospective trial of two different doses of lithium for maintenance therapy: the "standard" dose, adjusted to achieve a serum lithium concentration of 0.8 to 1.0 mmol per liter, and a "low" dose, resulting in a serum concentration of 0.4 to 0.6 mmol per liter. The group medians of the patients' average serum lithium levels were 0.83 mmol per liter for the patients in the standard-range group and 0.54 mmol per liter for those in the low-range group. Six of 47 patients (13 percent) assigned to receive lithium doses that would produce serum levels in the standard range had relapses while on protocol, as compared with 18 of 47 (38 percent) assigned to the low-dose range. The risk of relapse was 2.6 times higher (95 percent confidence interval, 1.3 to 5.2) among patients in the low-range group than among those in the standard-range group. Side effects, including tremor, diarrhea, urinary frequency, weight gain, and a metallic taste in the mouth, were more frequent in the standard-range group. We conclude that doses resulting in serum lithium levels from 0.8 to 1.0 mmol per liter are more effective in treating bipolar disorder than those that result in lower serum lithium concentrations, although the higher doses are associated with a higher incidence of side effects. Recent findings about the limited nephrotoxicity of lithium, along with our observations, suggest that physicians should attempt to maintain serum lithium levels between 0.8 and 1.0 mmol per liter in most patients with bipolar disorder and that they should attempt to enhance patients' understanding of and compliance with this regimen.

Adolescent↗
PubMedDate not supplied

Sensory acuity and reasoning in delusional disorder.

Systematic research on delusional disorder (DD) is limited. The goal of this study was to assess DD patients in the following areas: sensory capacities, decision-making style, and complex reasoning. Ten DD patients and 10 matched normal controls completed the following (1) smell, taste, and vision testing; (2) a probabilistic inference test in which subjects made probability decisions; and (3) a gambling task assessing complex reasoning. No significant difference was found between DD subjects and normals for taste acuity, olfactory acuity, or olfactory discrimination. No difference in visual acuity was noted, but sample size was limited. In addition, DD subjects required significantly less data to make probability decisions than normal controls. Despite using less data, DD subjects were as certain as controls regarding the accuracy of their decisions. As for complex reasoning, DD subjects performed as well as normal controls, but tended to surmise the purpose of the task sooner than normals, a difference that approached significance. In conclusion, these results suggest no differences between DD and normal subjects regarding olfaction, taste, and vision. The reasoning studies suggest that DD subjects may have a "cognitive set" that predisposes them to make conclusions with significantly less data than normals. Further, the study suggests that this reasoning difference generalizes to events outside the DD subjects' delusional realm and can be evoked in an experimental environment.

Adult↗
PubMed1986

Regurgitation in gorillas: possible model for human eating disorders (rumination/bulimia).

Regurgitation and reingestion behavior in gorillas is compared with two human disorders, rumination and bulimia. Eighty-four percent of captive gorillas that are more than 5 years old regurgitate and reingest. Comparisons are made on the basis of ontogeny, context, motor pattern, and intervention. There are more similarities between regurgitation and reingestion and rumination than between regurgitation and reingestion and bulimia. Regurgitation and reingestion resembles bulimia in parental/infant separation, lack of eating control, methods of induction, and some aspects of motor pattern. Regurgitation and reingestion resembles rumination in disrupted maternal/infant communication, context of the behavior (enjoy the taste of the regurgitant), several aspects of motor pattern, and treatment (increased food volume).

Animals↗
PubMedDate not supplied

[Taste receptor response to sodium chloride and natriuresis in the workers and employees of an industrial enterprise].

Studied in the course of one-stage epidemiologic survey of 1191 individuals were the threshold of gustatory sensitivity to table salt and nycterine natriuresis, relation of these indices to dietary habits, some risk factors for cardiovascular disorders and clinical parameters. Differing relations were established between gustatory sensitivity to table salt and natriuresis and age and gender of the examinees, the level of blood pressure, aggravated heredity in respect of arterial hypertension, smoking and alcohol abuse, this enabling one to embark upon a differential approach to dietetic correction of salt consumption.

Adult↗
PubMed2004

Zinc deficiency in patients with idiopathic taste impairment with regard to angiotensin converting enzyme activity.

OBJECTIVE: The present study aimed at measuring the ratio of apo/holo activities of angiotensin converting enzyme (ACE) ratio in the serum of patients with taste impairment to evaluate their status of zinc nutrition. METHODS: Nineteen patients complaining of taste impairment were divided into two groups: zinc-deficiency taste impairment (n=6) and idiopathic taste impairment (n=13) and compared to 30 volunteers. Zinc concentrations in the serum were measured by atomic absorption spectrometry (normal values: 64-111 microg/dl). Patients with zincemia values of <63 microg/dl with no history of other disorder or medication known to cause dysgeusia were diagnosed as zinc deficient, while those with the same condition and values >64 microg/dl were considered to belong to the idiopathic group. The activities of ACE in the serum were measured spectrophotometrically as the activity of the holo-ACE, and after addition of 80 microM of zinc to the serum in vitro, the increase of ACE activity over initial value in the serum was determined as that of the apo-ACE. Finally, the apo/holo-ACE activities ratio was used as an index of zinc nutritional status. RESULTS: The mean concentrations of zinc in the serum were 77.4+/-8.4 microg/dl in volunteers, 77.6+/-8.4 microg/dl in the idiopathic patients and significantly decreased at 55.7+/-5.8 microg/dl in zinc-deficiency patients. ACE activities in the serum were 14.7+/-7.6, 14.5+/-4.0 and 14.1+/-3.3 IU/l in volunteers, the idiopathic group and zinc-deficiency taste impairment group, respectively. The mean ACE ratios were 1.10+/-0.6% in volunteers and significantly increased at 9.8 +/- 4.0% in the idiopathic group and at 13.7+/-6.6% in zinc-deficiency taste impairment group. CONCLUSION: The results of the present study indicated that zinc deficiency is a predominant factor underlying hypogeusia even when zinc concentrations are within normal ranges in the serum and show that clinically, ACE ratio may be a more sensitive indicator of the zinc nutritional status than measuring zinc concentration in the serum.

Dysgeusia↗
PubMedDate not supplied

[Therapy of Helicobacter pylori infection using Lactobacillus acidophilus].

INTRODUCTION: In vitro experiments with Lactobacillus acidophilus have revealed its inhibitory effect on Helicobacter pylori and its application in treatment of Helicobacter pylori positive gastritis was examined. MATERIAL AND METHODS: 15 patients have undergone gastroscopy with biopsy and by histopathological examination. Helicobacter pylori positive gastritis was detected. During a two-month period these patients took acidophilus milk (3 x 250 ml a day) prepared according to a special protocol and which contained 4 x 10(9)-1 x 10(10) live cells of Lactobacillus acidophilus at the moment of preparation. Lactobacillus acidophilus strain NAS, gained from lyophilized preparation Bio-Nate (Natren Inc. USA) was used as a test organism. Control gastroscopy was performed 2 months later. RESULTS: 14 patients have completed the examination. All of them were satisfied with the taste of acidophilus milk and could stand it well, whereas in 6 out of 14 Helicobacter pylori was eradicated. DISCUSSION: Helicobacter pylori eradication therapy is recommended in all cases of Helicobacter pylori positive gastritis associated with peptic ulcer, as well as in absence of ulcer when subjective difficulties occur. Antibiotic therapy is often unsuccessful and most often associated with risks of significant adverse effects, being the consequence of intestinal microflora disorders. The aim of using Lactobacillus acidophilus in the therapy is to reduce risks of adverse effects. In our study, by using acidophilus milk only, without other therapy, eradication of Helicobacter pylori was achieved in 6 out of 14 patients. All patients could stand the therapy well and were satisfied with the taste of the preparation. The number of examinees was small in regard to making conclusions, but the results are encouraging and show that apart from established in vitro effect. Lactobacillus acidophilus has a potential in vivo effect.

Adult↗
PubMed1982

The dopaminergic mediation of a sweet reward in normal and VMH hyperphagic rats.

The role of dopamine in mediating the rewarding quality of a sweet saccharin-glucose (SG) solution was investigated by comparing the effects of the dopamine receptor blocker pimozide, the bitter adulterant quinine, and solution dilution on the consummatory response to the solution in normal and VMH rats. Experiments 1 and 2 demonstrated that pimozide and quinine caused a dose/concentration dependent dependent reduction in the intake of and the licking response to a SG solution. Pimozide treatment caused an equivalent suppression in the intake of the normal and VMH rats, in both the dynamic and static phases, whereas quinine adulteration caused a greater suppression in the intake of the VMH rats. The effects of pimozide and quinine on initial lick rate were also different. Experiment 3 demonstrated that dilution of a SG solution produced a concentration related decrease in intake and licking response. Dilution of the SG solution, like pimozide treatment, affected the intake of the normal and VMH rats in an equivalent manner. The effects of solution dilution and pimozide treatment on the licking response were also similar. The results suggest that the mechanisms by which pimozide and quinine reduce the hedonic quality of natural rewards are functionally dissimilar. The similarity between pimozide treatment and solution dilution suggests that pimozide reduces the positive affective quality of natural reinforcers. The results are discussed in terms of the dopamine theory of reward, the role of dopamine in hypothalamic hyperphagia, and VMH finickiness.

Animals↗
PubMed2004

Effects of age, gender, bolus volume, bolus viscosity, and gustation on swallowing apnea onset relative to lingual bolus propulsion onset in normal adults.

The purpose of this study was to ascertain the normal relation of swallowing apnea (SA) onset relative to lingual bolus propulsion along with factors that may alter this relation. Forty adults, composed of 10 men and 10 women in each of 2 age groups (i.e., 20-30 and 63-79 years) participated. SA onset was assessed during 5- and 20-ml bolus volumes of water and apple juice across 3 trials. The effects of age, gender, bolus volume, bolus viscosity, and gustation on SA onset relative to lingual bolus propulsion were examined. A significant interaction of Age x Gender x Volume was found. In general, older adults initiated SA onset earlier than young adults, and large boluses elicited an earlier SA onset than small boluses regardless of group. Young men demonstrated significantly later SA onset than the older men for large volumes; this difference was not observed for small volumes, nor was it found between young and older women. SA onset also was assessed during 5-ml bolus volumes of thin apple juice, thick apple juice, and applesauce across three trials. A significant main effect of viscosity was found revealing that SA onset was initiated later as bolus viscosity increased. Thus, the results of this investigation provided data on the relation of SA onset relative to lingual bolus propulsion in individuals with normal swallowing and how this relation changes as a function of age, gender, bolus volume, bolus viscosity, and gustation.

Adult↗
PubMed1995

Effects of neonatal ethanol exposure on saccharin consumption.

Prenatal ethanol exposure has been associated with alterations in a variety of sexually dimorphic behaviors in rats. This study examined the effects of neonatal ethanol exposure on saccharin consumption, a sexually dimorphic behavior in rats. Subjects were Sprague-Dawley rats that were artificially reared (AR) from postnatal day (PN) 4-PN12 through gastrostomy tubes with ethanol exposure limited to PN4-PN10. The AR groups included two ethanol doses (6 g/kg/day and 4 g/kg/day) and an isocaloric maltose-dextrin control. A sham surgery control group was also included. The AR subjects were returned to their dams on PN13. At 21 days of age, subjects were housed with one same-sex sibling and free access to rat chow and water until testing. Subjects were tested for saccharin preference and consumption at 110 days of age. Typically, male rats consume less saccharin than females, and this was evident in the 4 g/kg ethanol group and both control groups. However, this was not apparent among the 6 g/kg ethanol-exposed males. Furthermore, saccharin preference seemed to be reduced in the females exposed to 6 g/kg ethanol. These data suggest that the "sensitive period" for ethanol's effects on sex differences in saccharin consumption extends into postnatal life.

Animals↗
PubMedDate not supplied

Plasma membrane ordering agent pluronic F-68 (PF-68) reduces neurotransmitter uptake and release and produces learning and memory deficits in rats.

A substantial body of evidence indicates that aged-related changes in the fluidity and lipid composition of the plasma membrane contribute to cellular dysfunction in humans and other mammalian species. In the CNS, reductions in neuronal plasma membrane order (PMO) (i.e., increased plasma membrane fluidity) have been attributed to age as well as the presence of the beta-amyloid peptide-25-35, known to play an important role in the neuropathology of Alzheimer's disease (AD). These PMO increases may influence neurotransmitter synthesis, receptor binding, and second messenger systems as well as signal transduction pathways. The effects of neuronal PMO on learning and memory processes have not been adequately investigated, however. Based on the hypothesis that an increase in PMO may alter a number of aspects of synaptic transmission, we investigated several neurochemical and behavioral effects of the membrane ordering agent, PF-68. In cell culture, PF-68 (nmoles/mg SDS extractable protein) reduced [3H]norepinephrine (NE) uptake into differentiated PC-12 cells as well as reduced nicotine stimulated [3H]NE release. The compound (800-2400 microg/kg, i.p., resulting in nmoles/mg SDS extractable protein in the brain) decreased step-through latencies and increased the frequencies of crossing into the unsafe side of the chamber in inhibitory avoidance training. In the Morris water maze, PF-68 increased the latencies and swim distances required to locate a hidden platform and reduced the time spent and distance swam in the previous target quadrant during transfer (probe) trials. PF-68 did not impair performance of a well-learned working memory task, the rat delayed stimulus discrimination task (DSDT), however. Studies with 14C-labeled PF-68 indicated that significant (pmoles/mg wet tissue) levels of the compound entered the brain from peripheral (i.p.) injection. No PF-68 related changes were observed in swim speeds or in visual acuity tests in water maze experiments, rotorod performance, or in tests of general locomotor activity. Furthermore, latencies to select a lever in the DSDT were not affected. These results suggest that PF-68 induced deficits in learning and memory without confounding peripheral motor, sensory, or motivational effects at the tested doses. Furthermore, none of the doses induced a conditioned taste aversion to a novel 0.1% saccharin solution indicating a lack of nausea or gastrointestinal malaise induced by the compound. The data indicate that increases in neuronal plasma membrane order may have significant effects on neurotransmitter function as well as learning and memory processes. Furthermore, compounds such as PF-68 may also offer novel tools for studying the role of neuronal PMO in mnemonic processes and changes in PMO resulting from age-related disorders such as AD.

Animals↗
PubMed2006

Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis.

BACKGROUND & AIMS: In children, eosinophilic esophagitis (EE) is predominantly, but not exclusively, a food-hypersensitivity disorder. A crystalline amino acid-based elemental diet (ELED) formula currently remains the most effective nutritional treatment in inducing clinical and histologic remission. However, compliance with an exclusive, poor-tasting liquid formulation is difficult. METHODS: This retrospective observational study assessed the short-term clinical and histologic responses of 2 cohorts of children with EE evaluated during 2 different time periods: one was treated with the standard 6-food elimination diet (SFED) and the other was treated with ELED. Of the 60 children who met the inclusion criteria and were compliant with the dietary protocol, 35 were treated with a diet excluding cow-milk protein, soy, wheat, egg, peanut, and seafood while allowing all other table foods and 25 were treated exclusively with ELED. Repeat esophageal biopsy specimens were obtained at least 6 weeks later. RESULTS: Twenty-six of 35 (74%) in the SFED group and 22 of 25 (88%) in the ELED group achieved significant improvement of esophageal inflammation (</=10 eosinophils/high-power field). The pretreatment and posttreatment peak eosinophil counts for the SFED were 80.2 +/- 44.0 and 13.6 +/- 23.8 (P < .0001) and 58.8 +/- 31.9 and 3.7 +/- 6.5 (P < .001) for the ELED group, respectively. CONCLUSIONS: SFED treatment was associated with clinical and histologic improvement in EE in an observational study. It offers advantages of better acceptance, cost, and compliance than ELED and should be considered as an option in the initial management of children with EE.

Adolescent↗
PubMed2003

The role of palatable food and hunger as trigger factors in an animal model of stress induced binge eating.

OBJECTIVE: Dieting and stress are etiological factors in eating disorders, and dieting strongly predicts stress-induced overeating in the nonclinical population. We developed an animal model of binge eating in sated rats that is evoked by stress, but only in rats with a history of caloric restriction and only if highly palatable food (HPF) is available after stress. This study investigated the effect of known binge triggers, a taste of HPF and of hunger, on this type of binge eating. METHOD: Female rats were cycled through the R/S protocol but this time were given just a taste of HPF with ad lib regular chow. After another R/S cycle, rats were stressed during restriction (while hungry) and were given HPF and chow. RESULTS: Although binge eating did not occur if only chow was available after stress, just a taste of HPF sufficed to increase chow intake to more than 160% (p < 0.001) of rats with a history of restriction only, stress-only, or neither. Hunger increased the proportion of chow consumed by both restricted groups, but stress magnified this hunger-induced overeating by increasing HPF intake to 137% of restriction-only rats (p < 0.001). DISCUSSION: These effects suggest that binge eating in this model is motivated by reward, not metabolic need, and parallels observations of binge triggers described in clinical binge-eating disorders. This strengthens the validity of using this animal model to target the physiology and treatment of eating disorders preceded by dieting and stress.

Animals↗
PubMed1992

Indigenous phytotherapy of gastrointestinal disorders in a lowland Mixe community (Oaxaca, Mexico): ethnopharmacologic evaluation.

Gastrointestinal disorders are one of the major health problems in developing countries. Sixty-five plants used popularly in the treatment of such disorders in a Mixe Indian community in Oaxaca (Mexico) and collected during a fieldstudy of 15 months are described. According to indigenous criteria a plant is used in the treatment of a certain illness because of the plant's characteristic smell and taste. Plants with astringent properties are particularly valued to treat diarrhoea and dysentery. Bitter, aromatic and bitter-aromatic plants are especially employed to treat gastrointestinal cramps and pain. Additionally, the efficacy of these plants was evaluated using ethnobotanical, phytochemical and pharmacologic information on the plants. The majority of the plants contain chemicals that may produce the effects desired by the Mixe. Frequently tannin-containing drugs are used to treat diarrhoea and dysentery. A large number of the plants used by the Mixe in the treatment of gastrointestinal pain contain essential oil or bitter principles. As a result of this evaluation, plants were selected which should be studied phytochemically and pharmacologically with priority, to evaluate further their potential in the treatment of gastrointestinal disorders.

Diarrhea↗
PubMed2001

[Endoscopic multi-color deglutition study].

BACKGROUND: The complexity of the diagnostic/therapeutic problem in ENT-specific as well as in neurogenic dysphagia requires that test foods be offered in a variety of consistencies (viscosities), at different temperatures, and with various tastes. The swallowing assessment is undertaken with different head and trunk postures, using different swallowing techniques. METHODS: A series of test foods of varied viscosities is prepared with different food colorings. It is given to the patient according to an individually-tailored viscosity plan, but usually in the same (repeatable) color sequence of blue-yellow or blue-yellow-black, an order which offers optimal color contrasts. RESULTS, CONCLUSIONS: During repeated swallowing assessments, the "multicolor technique" is more useful for endoscopic observation of the pharyngolaryngeal route of the food bolus than the "methylene blue swallow". Food coloring is cheap and it changes neither the taste nor the pH of the food.

Deglutition↗