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Fetal swallowing: relation to amniotic fluid regulation.

In summary, fetal swallowing activity contributes importantly to fetal and amniotic fluid homeostasis, and fetal somatic and gastrointestinal development. Human and ovine fetal swallowing increases throughout gestational with fetal swallowed volumes markedly greater (relative to body weight) than adults. Although the regulation of swallowing activity in early gestation is unknown, intact central and systemic dipsogenic mechanisms have been shown during the last third of ovine gestation. Recent studies suggest that swallowing behavior may be modulated in accordance with neurobehavioral state changes and influenced by hypoxia, hypotension and plasma osmolality changes. Whether fetal swallowing also is regulated by the development of "hunger" sensation, salt appetite, or the development of taste is uncertain. Nevertheless, it is likely that, for species in which swallowing behavior develops in utero, there are potentially dramatic influences of the maternal-fetal pregnancy environment on the imprinting of regulatory mechanisms controlling ingestive behavior. Ultimately, the regulation of fetal swallowing may aid in the prevention and/or therapy of human amniotic fluid disorders.

Adult↗

Low body weight and weight loss in the aged.

Low body weight and rapid unintentional weight loss are highly predictive of mortality and morbidity in the elderly population. Weight loss is frequently reported in elderly patients. Acute and chronic diseases are leading causes of involuntary weight loss. Whereas physical disease probably accounts for a majority of cases of involuntary weight loss, psychiatric disorders such as dementia and depression also may result in severe nutritional deficiencies. Additional physiological, psychological, and social factors may affect food intake and body weight. Changes in body composition include loss of height and lean body mass and lower basal metabolic rate. Energy requirements decrease because of the lower basal metabolic rate and reduced physical activity. These low energy requirements make it more difficult for the elderly to obtain adequate amounts of required nutrients. Food intake regulation, taste, and olfactory sensitivity may be altered. As 50% of Americans have lost all of their teeth by age 65, chewing problems are often present. Other factors that contribute to poor nutritional status include alterations in the gastrointestinal tract, functional disabilities, lowered socioeconomic status, and social isolation. Finally, because of the increase in both physical and psychiatric disease, the elderly are major users of prescription drugs. Drug/nutrient interactions can result in anorexia and weight loss. The findings indicate that factors causing unintentional weight loss are highly interrelated and difficult to separate. Health care professionals must monitor body weight in elderly persons and carefully evaluate any cases of rapid, unintentional weight loss to prevent further deterioration of health status.

Aged↗

The role of the dorsomedial prefrontal cortex, basolateral amygdala, and dorsal hippocampus in contextual reinstatement of cocaine seeking in rats.

The present study tested the hypothesis that separate neural substrates mediate cocaine relapse elicited by drug-associated contextual stimuli vs explicit conditioned stimuli (CSs) and cocaine. Specifically, we investigated the involvement of the dorsal hippocampus (DH), basolateral amygdala (BLA), and dorsomedial prefrontal cortex (dmPFC) in contextual reinstatement of cocaine-seeking behavior and the involvement of the DH in explicit CS- and cocaine-induced reinstatement. Rats were trained to self-administer cocaine in a distinct context or in the presence of CSs paired explicitly with cocaine infusions. Responding of context-trained rats was then extinguished in the previously cocaine-paired or an alternate context, whereas responding of explicit CS-trained rats was extinguished in the absence of the CSs. Subsequently, the target brain regions or anatomical control regions were functionally inactivated using tetrodotoxin (0 or 5 ng/side), and cocaine-seeking behavior (ie, nonreinforced responses) was assessed in the cocaine-paired context, in the alternate context, in the presence of the explicit CSs, or following cocaine priming (10 mg/kg, i.p.). DH inactivation abolished contextual, but failed to alter explicit CS- or cocaine-induced, reinstatement of cocaine-seeking behavior. BLA or dmPFC inactivation also abolished contextual reinstatement. Conversely, inactivation of the control brain regions failed to alter contextual reinstatement. In conclusion, the DH, BLA, and dmPFC play critical roles in contextual reinstatement. Previous findings suggest that the BLA is critical for explicit CS-induced, but not cocaine-primed, reinstatement and the dmPFC is critical for both explicit CS-induced and cocaine-primed reinstatement. Thus, distinct but partially overlapping neural substrates mediate context-induced, explicit CS-induced, and cocaine-primed reinstatement of extinguished cocaine-seeking behavior.

Acoustic Stimulation↗

Using food aversion to decrease severe pica by a child with autism.

Food aversion was shown to be effective in the reduction of plastic pica by a 4-year-old boy with autism. The participant was suffering from digestive complications due to the ingestion of plastic from a variety of toys. The intervention was initially conducted in the child's preschool classroom during instructional periods and was systematically generalized to the entire preschool classroom, and eventually to both classrooms within the preschool and across 25 teachers. The success of the intervention in decreasing pica was enhanced by its achievement in not reducing interactions with toys, considering appropriate play skills were a target goal.

Association Learning↗

Clinical potential of GABAB receptor modulators.

Metabotropic gamma-aminobutyric acid(B) (GABAB) receptors for the major inhibitory transmitter GABA, together with metabotropic glutamate (mGLuRs) receptors, the extracellular calcium-sensing receptors (CaSRs), some V2R pheromone receptors and T1R taste receptors, belong to the family of 3 G-protein-coupled receptors (GPCRs). GABAB receptors are known to control neuronal excitability and modulate synaptic neurotransmission, playing a very important role in many physiological activities. These receptors are widely expressed and distributed in the nervous system and have been implicated in a variety of neurodegenerative and pathophysiological disorders including epilepsy, spasticity, chronic pain, depression, schizophrenia and drug addiction. To form a functional receptor entity, GABAB receptors must exist as a heterodimer consisting of GABAB1 and GABAB2 receptor subtypes with two 7-transmembrane proteins, and these subunits arise from distinct genes. The GABAB1 subunit binds the endogenous ligand within its extracellular N-terminus, whilst the GABAB2 subunit is not only essential for the correct trafficking of the GABAB1 subunit to the cell surface, but is also responsible for the interaction of the receptor with its cognate G-protein. Allosteric modulation has recently been recognized as an alternative pharmacological approach to gain selectivity in drug action. It is now generally accepted that modulators acting at the allosteric sites provide a novel perspective for the development of subtype-selective agents acting at GPCRs. These agents interact with allosteric binding sites quite separate from the highly conserved agonist binding region. In this review, we present a new class of phenylalkylamines, based on the lead compound fendiline, that are potent positive potentiators of GABAB receptor-mediated function and discuss their putative clinical applications. It is proposed that these new modulators may have therapeutic value in GABAB receptor pharmacology and are capable of selectively modifying GABAB receptor function. The allosteric modulators are offering an attractive and novel means to identify new leads, that are devoid of side effects associated with GABAB receptor agonists, and may, therefore, represent a major advance in the drug discovery process.

Animals↗

Rare first symptoms of multiple sclerosis.

The most frequent first symptoms of multiple sclerosis are the following: sensory symptoms, optic neuritis, motor and cerebellar syndromes. Three female patients have been diagnosed with multiple sclerosis on the basis of Poser's criteria. The onset of the disease was manifested in these cases with non-typical and rare symptoms. Patient 1, a woman, aged 24. The first symptom of the disease was an isolated lesion of nerve VI on the right side. Patient 2, a women, aged 30. The first symptom of the disease was acute pain localised within the area of the lumbar-sacral spine. Patient 3, a woman, aged 43. The first symptom of the disease was loss of taste and smell.

Abducens Nerve Diseases↗

Rationale for cigarette smoking and for mentholation preference in cocaine- and nicotine-dependent outpatients.

We asked 43 cocaine- and nicotine-dependent outpatients at a substance abuse clinic their reasons for combining cocaine and cigarette use, and for preferring either mentholated or nonmentholated cigarettes. Responses to open-ended questions asked during a semistructured interview were categorized by an analysis of expressed motives for cigarette smoking. Responses that did not fit the categorization were analyzed separately in a qualitative design. Sedating, stimulating, or addictive effects were frequently stated as reasons for the combined use of cigarettes with cocaine. Sedating or calming effects of cigarette smoking included reduction of cocaine-induced paranoia. Cocaine-substituting and cocaine-enhancing effects of cigarette smoking were categorized as stimulating effects. Addictive effects included craving for cigarette smoking on its own or triggered by cocaine use. Sensorimotor or stimulating effects were frequently stated as reasons for a preference for mentholated or nonmentholated cigarettes. Sensorimotor effects of menthol included taste, anesthetic, cooling, and decongestant properties. Some responses provided by our patient sample suggest a need for research on the effect of cigarette smoking on absorption of smoked cocaine.

Adult↗

The controls of fat intake.

OBJECTIVE: To present evidence on the control of the size of fatty meals in the context of the result of interactions of orosensory positive-feedback and postingestive negative-feedback mechanisms activated by fat stimuli in rodent models of feeding and of obesity. METHOD: We examined the effects of orosensory stimuli and postingestive stimuli in Sprague-Dawley rats, and in the genetically obese Zucker (fa/fa) rat. We used the sham feeding rat preparation to isolate the orosensory stimulating and postingestive satiating properties of oils. The negative-feedback satiating properties of fats were elicited by intestinal infusions of fats. The Zucker rat is an animal model of obesity with abnormal control of meal size and increased intake of fats. Using this model we further examined the interaction of orosensory and postingestive stimuli in the control of meal size. RESULTS: The orosensory properties of fats are sufficient to drive sham feeding and are not dependent on the postabsorptive metabolic consequences of oils in normal and Zucker rats. The satiating action of fats must act at preabsorptive sites because reduction of intake occurs before absorption of fat. The satiating potency of fats is dependent upon their specific chemical conformation and is mediated by endogenous cholecystokinin and afferent fibers of the abdominal vagus. We have found that oils produce significantly more orosensory positive feedback in obese Zucker rats than in lean rats in experimental tests of preference. This is probably the major abnormal mechanism responsible for the increased preference for fats that is characteristic of obese rats because we have not identified any significant decrease in the postingestive satiating potency of fats in obese Zucker rats. CONCLUSIONS: Fat intake is controlled by both orosensory and postingestive stimuli in normal and genetically obese rodents. In the Zucker rat the investigation of this model of genetic obesity has produced data that is congruent with the preference for high fat foods in obese people and suggests further experiments directed toward a deeper understanding of the controls of fat intake and how they are disordered.

Animals↗

The stability of perceptual disturbances in anorexia nervosa.

Patients with anorexia nervosa have previously been shown to display disturbances in visual self-perception and interoception. In the present investigation we wished to determine the stability of these disturbances and the effects of weight gain on them. We studied 29 females, 16 patients with primary anorexia nervosa and 13 controls, who had also been studied one year previously. Each subject took part in investigations of body image, using a distorting photograph technique, and interoception, using a satiety aversion to sucrose test. We found that some anorexic subjects tend to overestimate body size and have an absence of aversion to repeated sucrose tastes. Moreover, these disturbances were stable over the year and were not affected by weight change.

Adult↗

A Swedish translation and validation of the Disgust Scale: a measure of disgust sensitivity.

The psychometric properties of a Swedish version of Haidt, McCauley and Rozin's (1994) Disgust Scale were studied. Confirmatory factor analysis of the original model with eight factors (food, animals, body products, sex, body envelope violations, death, hygiene, and magic) provided satisfactory fit to the data (N= 280), significantly better than to the alternative one-factor and five-factor models. As in the US version women scored significantly higher than men. Positive correlations with measures of food neophobia (r= 0.30, p < 0.0001) and nausea frequency (rs= 0.28, p < 0.001) indicate convergent validity. In a separate study (N= 30) a behavioral measure of the willingness to touch, hold, and taste disgusting food objects correlated negatively with the Disgust Scale (r=-0.46, p < 0.01), indicating criterion-related validity.

Adult↗

[Evaluation of a dessert in patients with deglutition changes, one more step in advanced basic feeding].

BACKGROUND: Decrease in the capacity to deglutition solids and liquids is a problem in many people, this problem decreases quality of life. The objective of our work is to evaluate the acceptance degree of a dessert (stewed fruit) (including in the normal diet of the Hospital) in a group of patients with dysphagia. METHODS: Forty seven patients were studied in Hospital Universitario del Río Hortega (Valladolid) in July of 2000. The main pathology of these patients was; (n = 12) 25.5% acute stroke, (n = 16) 34% aerodigestive tumors (Jarynx carcinoma (n = 5), cavum carcinoma (n = 9), oesophagus carcinoma (n = 2)) and 40.4% (n = 19) chronic neurologic disease (Alzheimer, vascular dementia, and parkinson). All patients took a oral triturated diet, a dessert with apple and pear (Resource fruits Instant). All patients took a portion of the dessert and after that a acceptance questionnaire was filled. RESULTS: Global acceptance of the product was 7.25 +/- 1.5, this punctuation was higher in the tumoral group 8 +/- 1.1 points, 6.86 +/- 1.4 in patients with acute stroke and 6.7 +/- 1.5 in patients with chronic neurologic disease (p < 0.05). Different organoleptic characteristics were analyzed, mean punctuation in texture was 1.79 +/- 0.6, color 2.2 +/- 0.5, smell 2.24 +/- 0.59 and taste 1.95 +/- 0.61, in a scale of 1 (very good) until 5 (very bad), a total of 57.9% patients responded very good (1) or good (2) in texture scale, 71.1% in color scale, 60.5% in smell scale and 63.2% in taste scale. CONCLUSIONS: Acceptance of this product in patients with dysphagia has been elevated, showing useful in these patients with nutrition alterations.

Aged↗

Restrictive dieting vs. "undieting" effects on eating regulation in obese clinic attenders.

This study tested predictions from restraint theory [Herman & Polivy (1984). A boundary model for the regulation of eating. In: A. J. Stunkard, & E. Stellar (Eds.), Eating and its disorders (pp. 141-156) New York: Raven Press.] and the three-factor model of dieting [Psychol. Bull. 114 (1993) 100.] using an eating regulation paradigm. Participants were 42 obese, nonbinge eaters assigned to either a weight loss group (restrictive dieters or RDs) or a group designed to eliminate dieting ("undieters" or UDs). Participants took part in an ostensible ice cream taste test with or without a preload, both before and after the weight control intervention. At pretest, restraint theory's prediction that participants would engage in counter-regulatory eating was not supported. At posttest, after 8 weeks of the dieting interventions, RDs increased and UDs decreased their intake following a preload, a pattern most consistent with the predictions of restraint theory. This counter-regulatory trend was observed in spite of a significant decrease in RDs' Disinhibition scale scores following treatment. Implications of these findings for restraint theory, the three-factor model of dieting, and relapse in obesity treatment were discussed.

Adult↗

[Iron treatment by effervescent tablets (author's transl)].

In a randomized double-blind study the new effervescent iron tablet Loesferron was tested in 57 postpartum patients. Hgb and red blood count rose significantly with this treatment. It was found that on effervescent tablet daily was sufficient for a satisfactory result of the treatment. No side effects were noted to this well tasting iron beverage. The reason is probably the prior dilution of the iron compound which delivers lower local iron potentials to the gastric mucosa.

Analysis of Variance↗

Mass spectrometry in grape and wine chemistry. Part I: polyphenols.

Mass spectrometry, had and still has, a very important role for research and quality control in the viticulture and enology field, and its analytical power is relevant for structural studies on aroma and polyphenolic compounds. Polyphenols are responsible for the taste and color of wine, and confer astringency and structure to the beverage. The knowledge of the anthocyanic structure is very important to predict the aging attitude of wine, and to attempt to resolve problems about color stability. Moreover, polyphenols are the main compounds related to the benefits of wine consumption in the diet, because of their properties in the treatment of circulatory disorders such as capillary fragility, peripheral chronic venous insufficiency, and microangiopathy of the retina. Liquid Chromatography-Mass Spectrometry (LC-MS) techniques are nowadays the best analytical approach to study polyphenols in grape extracts and wine, and are the most effective tool in the study of the structure of anthocyanins. The MS/MS approach is a very powerful tool that permits anthocyanin aglycone and sugar moiety characterization. LC-MS allows the characterization of complex structures of grape polyphenols, such as procyanidins, proanthocyanidins, prodelphinidins, and tannins, and provides experimental evidence for structures that were previously only hypothesized. The matrix-assisted-laser-desorption-ionization-time-of-flight (MALDI-TOF) technique is suitable to determine the presence of molecules of higher molecular weight with high accuracy, and it has been applied with success to study procyanidin oligomers up to heptamers in the reflectron mode, and up to nonamers in the linear mode. The levels of resveratrol in wine, an important polyphenol well-known for its beneficial effects, have been determined by SPME and LC-MS, and the former approach led to the best results in terms of sensitivity.

Agriculture↗

Treatment of unobserved trichotillomania by attention-reflection and punishment of an apparent covariant.

Frequent but primarily unobserved hairpulling, by a 3-yr-old girl was followed by a differential reinforcement procedure, attention-reflection, and punishment of thumbsucking, a possibly covarying behavior. Initially, attention-reflection reduced the hairpulling, but not to a clinically significant level. Dramatic decreases in hairpulling were achieved when thumbsucking was punished by application of a "bad tasting" substance. A brief reversal supports the contention that the two behaviors were correlated and suggests that behaviors may be controlled by targeting observable covariants.

Attention↗

Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome.

Burning mouth syndrome is a common disorder that frequently affects women in the 5th-7th decade. It is characterized by persisting painful symptoms mainly involving the anterior two-thirds of the tongue. For several years it has been attributed to psychological causes. We investigated the innervation of the epithelium of the tongue to assess whether damage of peripheral nerve fibers underlies the pathogenesis of the disease. We examined 12 patients with clinically definite burning mouth syndrome for at least 6 months. We obtained superficial biopsies of the lateral aspect of the anterior two-thirds of the tongue from all patients and nine healthy controls. Immunohistochemical and confocal microscope co-localization studies were performed with cytoplasmatic, cytoskeletric, Schwann cell, and myelin markers for pathological changes. The density of epithelial nerve fibers was quantified. Patients showed a significantly lower density of epithelial nerve fibers than controls, with a trend toward correlation with the duration of symptoms. Epithelial and sub-papillary nerve fibers showed diffuse morphological changes reflecting axonal degeneration. Our study demonstrates that burning mouth syndrome is caused by a trigeminal small-fiber sensory neuropathy and that superficial biopsy of the tongue can be helpful in assessing the diagnosis. These findings shed light into the pathogenesis of this common disorder and could contribute to evaluate targeted therapies in patients.

Aged↗

"Back from the future": a powerful age-progression technique.

This paper briefly reviews the benefits of using age-progression techniques in hypnotherapy, followed by a detailed explanation and illustration of the "back-from-the-future" technique with two case examples, including their outcome. The patients presented with feelings of helplessness, hopelessness, and a sense of futurelessness. Following the hypnotherapeutic intervention, patients were instructed to take time to reflect on the session and to write down the specific experiences they had on their voyage into the future focusing on their visual images, auditory sensations, experiences with other senses (touch, smell, and taste), as well as thoughts, emotions, and self-perceptions. Follow-up validated that the patients maintained their therapeutic accomplishments several months after the initial interventions.

Adult↗

[E-RFC (T cells) and Ig-positive cells (B cells) in the peripheral blood of patients with lymphogranulomatosis and possible immunocorrection with levamisole].

Forty patients with Hodgkin's disease were examined for cell-mediated immunity. Analysis of peripheral blood showed a decrease in the relative and absolute E-RFU counts depending on the disease stages. The changes in B-cells bearing surface immunoglobulins were negligible. E-RFC (T-cells) prevailed in the spleen of patients with Hodgkin's disease. However, some of the patients had a high enough count of B-cells in the spleen and peripheral blood. Multiple modality treatment for Hodgkin's disease, radiation therapy in particular, aggravated disorders of cell-mediated immunity. Thirty-one patients received levamisole at the definite stages of multiple modality treatment with a purpose of correcting cell-mediated immunity disorders. Two schemes of levamisole intake were tried. The drug was given in a dose of 150 mg for 21 days, the total dose amounting to 3, 150 mg, or in a dose of 150 mg for 4 days with a 10-day interval, the total dose being 2, 100 mg. Only two patients noted side effects one of them had a "gas taste" in the mouth, whereas the other one skin itch and urticaria that did not require any treatment. Application of levamisole increased the relative and absolute E-RFU counts, absolute lymphocyte count. Patients on levamisole noted the improvement of the well-being.

Adjuvants, Immunologic↗