Nucleotide supplementation: a randomised double-blind placebo controlled trial of IntestAidIB in people with Irritable Bowel Syndrome [ISRCTN67764449]

BACKGROUND: Dietary nucleotide supplementation has been shown to have important effects on the growth and development of cells which have a rapid turnover such as those in the immune system and the gastrointestinal tract. Work with infants has shown that the incidence and duration of diarrhoea is lower when nucleotide supplementation is given, and animal work shows that villi height and crypt depth in the intestine is increased as a result of dietary nucleotides. Dietary nucleotides may be semi-essential under conditions of ill-health, poor diet or stress. Since people with Irritable Bowel Syndrome tend to fulfil these conditions, we tested the hypothesis that symptoms would be improved with dietary nucleotide supplementation. METHODS: Thirty-seven people with a diagnosis of Irritable Bowel gave daily symptom severity ratings for abdominal pain, diarrhoea, urgency to have a bowel movement, incomplete feeling of evacuation after a bowel movement, bloating, flatulence and constipation for 28 days (baseline). They were then assigned to either placebo (56 days) followed by experimental (56 days) or the reverse. There was a four week washout period before crossover. During the placebo and experimental conditions participants took one 500 mg capsule three times a day; in the experimental condition the capsule contained the nutroceutical substances. Symptom severity ratings and psychological measures (anxiety, depression, illness intrusiveness and general health) were obtained and analysed by repeated measures ANOVAs. RESULTS: Symptom severity for all symptoms (except constipation) were in the expected direction of baseline>placebo>experimental condition. Symptom improvement was in the range 4 – 6%. A feeling of incomplete evacuation and abdominal pain showed the most improvement. The differences between conditions for diarrhoea, bloating and flatulence were not significant at the p < .05 level. There were no significant differences between the conditions for any of the psychological measures. CONCLUSION: Dietary nucleotide supplementation improves some of the symptoms of irritable bowel above baseline and placebo level. As expected, placebo effects were high. Apart from abdominal pain and urgency to have a bowel movement, the improvements, while consistent, are modest, and were not accompanied by improvements in any of the psychological measures. We suggest that the percentage improvement over and above the placebo effect is a physiological effect of the nucleotide supplement on the gut. The mechanisms by which these effects might improve symptoms are discussed

Investigación de lateralidad en recién nacidos prematuros

O estudo objetivou investigar a existência de coordenação mão-boca e preferência manual em recém-nascidos (RNs) prematuros a partir da estimulação gustativa, comparando a lateralidade dos bebês e seus genitores. Trata-se de estudo experimental e analítico, com procedimento duplo-cego. Participaram 90 RNs prematuros de uma maternidade pública de Sergipe. O teste durou 15 minutos, dividido em 3 períodos de 5 minutos. Nos primeiros 5 minutos, linha de base inicial - LB1, nenhum estímulo foi aplicado. No segundo momento, houve estimulação gustativa com sacarose para análise (PA) a 12% ou água, em 5 doses de 0,2 mL a cada minuto; e no último período, linha de base final - LB2, houve observação do recém-nascido sem aplicação de estímulo, durante 5 minutos. Foi realizado registro da frequência e duração dos comportamentos das mãos direita (MBD) e/ou esquerda (MBE) na região oral e sucção das mãos direita (SMD) e/ou esquerda (SME) dos RNs durante os estados comportamentais (sono profundo, sono leve, sonolento, alerta, agitado/irritado e choro) apresentados por estes. Os dados foram executados no software Statistical Package for the Social Sciences. Como resultado encontrou-se correlação forte de MBD e SMD na LB2, independente do estímulo recebido, evidenciando que a estimulação aumentou a correlação dos comportamentos do lado direito do corpo. Sugere-se realização de novas pesquisas sobre lateralidade, contemplando maior número de pais sinistros na amostra. _________________________________________________________________________________________ RESUMEN: El objetivo del estudio fue investigar la existencia de coordinación mano-boca y la preferencia manual en recién nacidos prematuros a partir de la estimulación gustativa, comparando la lateralidad de los bebes y sus progenitores. Se trata de un estudio experimental y analítico, con procedimiento doble ciego. Participaron 90 recién nacidos prematuros de una maternidad pública de Sergipe. El test duró 15 minutos, dividido en tres períodos de cinco minutos. En los primeros cinco minutos, línea de base inicial - LB1, ningún estímulo fue aplicado. En un segundo momento, existió estimulación gustativa con sacarosa PA a 12% o agua, en cinco dosis de 0,2 mL a cada minuto, y en el último período, línea de base final - LB2, existió observación del recién nacido sin aplicación de estímulo, durante cinco minutos. Fue realizado registro de la frecuencia y duración de los comportamientos en la mano derecha (MBD) y/o mano izquierda (MBI) en la región oral y succión de la mano derecha (SMD) y/o izquierda (SMI) de los recién nacidos durante los estados comportamentales (sueño profundo, sueño leve, somnoliento, alerta, agitado/irritado y llanto) presentados por estos. Los datos fueron analizados en el software Stastistical Package for the Social Sciences. Como resultado se encontró correlación fuerte de MBD y SMD en la LB2, independiente del estímulo recibido, evidenciando que la estimulación aumentó la correlación de los comportamientos del lado derecho del cuerpo. Se sugiere realización de nuevas investigaciones sobre lateralidad, contemplando mayor número de padres zurdos en la muestra

New targets for therapy in breast cancer: Mammalian target of rapamycin (mTOR) antagonists

Mammalian target of rapamycin (mTOR) is a serine-threonine kinase member of the cellular phosphatidylinositol 3-kinase (PI3K) pathway, which is involved in multiple biologic functions such as transcriptional and translational control. mTOR is a downstream mediator in the PI3K/Akt signaling pathway and plays a critical role in cell survival. In breast cancer this pathway can be activated by membrane receptors, including the HER (or ErbB) family of growth factor receptors, the insulin-like growth factor receptor, and the estrogen receptor. There is evidence suggesting that Akt promotes breast cancer cell survival and resistance to chemotherapy, trastuzumab, and tamoxifen. Rapamycin is a specific mTOR antagonist that targets this pathway and blocks the downstream signaling elements, resulting in cell cycle arrest in the G(1 )phase. Targeting the Akt/PI3K pathway with mTOR antagonists may increase the therapeutic efficacy of breast cancer therapy

Quality of life assessment as a predictor of survival in non-small cell lung cancer

<p>Abstract</p> <p>Background</p> <p>There are conflicting and inconsistent results in the literature on the prognostic role of quality of life (QoL) in cancer. We investigated whether QoL at admission could predict survival in lung cancer patients.</p> <p>Methods</p> <p>The study population consisted of 1194 non-small cell lung cancer patients treated at our institution between Jan 2001 and Dec 2008. QoL was evaluated using EORTC-QLQ-C30 prior to initiation of treatment. Patient survival was defined as the time interval between the date of first patient visit and the date of death from any cause/date of last contact. Univariate and multivariate Cox regression evaluated the prognostic significance of QoL.</p> <p>Results</p> <p>Mean age at presentation was 58.3 years. There were 605 newly diagnosed and 589 previously treated patients; 601 males and 593 females. Stage of disease at diagnosis was I, 100; II, 63; III, 348; IV, 656; and 27 indeterminate. Upon multivariate analyses, global QoL as well as physical function predicted patient survival in the entire study population. Every 10-point increase in physical function was associated with a 10% increase in survival (95% CI = 6% to 14%, p < 0.001). Similarly, every 10-point increase in global QoL was associated with a 9% increase in survival (95% CI = 6% to 11%, p < 0.001). Furthermore, physical function, nausea/vomiting, insomnia, and diarrhea (p < 0.05 for all) in newly diagnosed patients, but only physical function (p < 0.001) in previously treated patients were predictive of survival.</p> <p>Conclusions</p> <p>Baseline global QoL and physical function provide useful prognostic information in non-small cell lung cancer patients.</p

Development of an educational intervention for patients with Irritable Bowel Syndrome (IBS) – a pilot study

<p>Abstract</p> <p>Background</p> <p>Many IBS patients experience that they receive limited information and that the health care system does not take their complaints seriously. We aimed to develop a structured patient education, an 'IBS school', and investigate if the efficacy could be evaluated in terms of improved knowledge, symptom severity and health related quality of life (HRQOL).</p> <p>Methods</p> <p>The IBS school consisted of six weekly two hour sessions in a group setting. Five different health care professionals were responsible for one session each. Questionnaires covering patients' experience of the education, perceived knowledge about IBS, gastrointestinal symptoms, and HRQOL, were used for evaluation at baseline and at three, six, and twelve months after education.</p> <p>Results</p> <p>Twelve IBS patients were included. The patients were overall satisfied with the IBS school. In line with this, the gastrointestinal symptoms, HRQOL, and perceived knowledge about IBS improved significantly after the education.</p> <p>Conclusion</p> <p>An IBS school seems to be a proper method to meet the patients' need of information about IBS and also to improve the patients' gastrointestinal symptoms, HRQOL, and knowledge about IBS. Further controlled studies are now needed in larger numbers of patients to confirm these preliminary results in order to implement this intervention in clinical practice.</p

Effects of gustatory stimulation on the behavioral states of premature newborns

OBJETIVO: Observar os estados comportamentais apresentados por recém-nascidos prematuros a partir de oferta de estímulos gustativos. MÉTODOS: Estudo experimental, analítico, duplo cego. Participaram 90 recém-nascidos prematuros nascidos em uma maternidade pública de Sergipe. O teste foi filmado, dividido em três etapas de cinco minutos. Na primeira e na última, não houve estímulo; na segunda aconteceu estimulação gustativa, sendo que os recém-nascidos foram divididos em dois grupos (água ou sacarose para análise 12%). Os estados comportamentais observados foram sono profundo, sono leve, sonolento, alerta, irritado/agitado e choro. Os dados foram analisados estatisticamente. RESULTADOS: No grupo sacarose houve correlação forte nos estados comportamentais sono leve e alerta, durante e após a estimulação, e redução de correlação nos estados sonolento, agitado/irritado e choro. Já no grupo água, após a estimulação houve aumento de correlação nos estados agitado/irritado e choro. CONCLUSÃO: A permanência ou mudança do estado comportamental do recém-nascido prematuro foi influenciada positivamente pela administração de estímulo gustativo, apontando para o possível uso da sacarose na contribuição de estados comportamentais favoráveis nessa população. _________________________________________________________________________________________ ABSTRACT: Purpose: To observe the behavioral states presented by premature new-borns in response to gustatory stimulation. Methods: Experimental, analytical and double-blind study. Ninety premature newborns born in a public maternity hospital in Sergipe took part in the test which was filmed and divided into three parts of five minutes. In the first and last, there was no stimulus; in the second, the gustatory stimulation was applied and the newborn children were divided into two groups (water or analysis for sucrose 12%). The observed behavioral states were deep sleep, light sleep, drowsy, alert, agitated/irritated and crying. The data were statistically analyzed. Results: In the sucrose group, during and after stimulation, the correlation was strong in the light sleep and alert behavioral states and decreased in the drowsy, agitated/irritated and crying states. In the water group there was an increase in correlation in the agitated/irritated and crying states after stimulation. Conclusion: The continuity or change of the behavioral state of the premature newborns was positively influenced by the administration of gustatory stimulus, pointing to the possibility of using sucrose in benefit of the favorable behavioral states of that population

Integrated sensory motor system in prematurely born children

Objetivo: Investigar a existência de sistema sensório motor integrado em recém-nascidos (RNs) prematuros submetidos à estimulação gustativa. Métodos: Estudo experimental analítico e duplo-cego. Participaram 90 RNs prematuros, divididos em dois grupos (água e sacarose para análise (PA) 12%), filmados durante 15 minutos (primeiro e último momentos, sem estimulação; e segundo momento com estimulação gustativa). Três juízes independentes analisaram os comportamentos mão na boca direita e esquerda e sucção da mão direita e esquerda durante os diversos estados comportamentais, inseridos no banco de dados do Statistical Package for Social Science, sendo considerados em concordância os eventos observados por pelo menos dois deles. Empregou-se teste de correlação de Spearman com nível de significância valor de p<0,05. Resultados: Tanto ao serem considerados os grupos separadamente quanto juntos, mão na boca direita e esquerda tiveram inicialmente correlação moderada, sendo que mão na boca direita manteve-se forte no final e mão na boca esquerda finalizou com correlação moderada e forte, de acordo com cada estado comportamental. Sucção de mão direita na totalidade e em sacarose apresentou-se inicialmente com correlação forte no estado sonolento, passando para moderada ao final. No estado alerta houve inicialmente correlação fraca em ambos os estímulos, finalizando com correlação moderada em sacarose e forte em água. Sucção de mão esquerda apresentou-se inicialmente correlação moderada em alerta, finalizando com correlação fraca no grupo sacarose, o que não ocorreu na água, que iniciou e finalizou forte. Conclusão: A estimulação oral influenciou na coordenação mão-boca, independente do estímulo, evidenciando integração sensório motora precoce, mas não inferindo sobre capacidade de discriminação gustativa nos prematuros. _________________________________________________________________________________________ ABSTRACT: Purpose: To investigate about an integrated sensory motor system existence in premature newborns, submitted to gustatory stimulation. Methods: Analytical and experimental study of contents, double-blind. Being participants 90 premature newborns, divided into two groups (water or sucrose analysis 12%). Recorded by 15 minutes (first and last moments, without stimulation; and second time with gustatory stimulation). Three independent judges analyzed the behaviors in the right hand and left hand in the mouth and suction in the left and right and hand during the various behavioral states, those being inserted in the database of Statistical Package for Social Science, being then considered that the events observed by at least two of them. It was made use of Spearman’s rank correlation test on a significance level by p<0.05. Results: Considering the groups both separately and together, right and left had initially moderate correlation, being right hand in the mouth remained strong at the end and left hand in the mouth finished on moderate and strong correlation, according to each behavioral state. Right hand suction in its total and sucrose showed a strong correlation initially in drowsy state, becoming moderate at the end. In alertness state there was initially a weak correlation in both stimuli ending in moderate correlation in sucrose and strong in water. Left hand suction presented initially moderate correlation on the alert state, ending in weak correlation in sucrose stimuli, which did not occur in the water that started and finished strong. Conclusion: The oral stimulation influenced the hand-mouth coordination, showing early motor sensory integration. However, there was no discrimination about the gustatory capacity on the newborns

Influences of club connectedness among young adults in Western Australian community-based sports clubs

Background: Along with physical benefits, community-based sport provides opportunities to enhance connectedness, an important protective factor of social and emotional health. However, young Australians participating in sport have been found to drink alcohol at higher levels than their non-sporting peers, and many clubs serve unhealthy food and beverages. This study explored the association between the dependent variable, level of alcohol consumption (AUDIT-C) and connectedness to club and other health behaviours among young people aged 18-30 years who play club sport in Western Australia. Methods: An online cross sectional survey measured levels of alcohol consumption (AUDIT-C), alcohol-related harm, connectedness (including volunteering and team cohesion), mental wellbeing, healthy food options and club sponsorship among young adults aged 18-30 years involved in sports clubs in Western Australia (n = 242). Relationships and association between the dependent variable (AUDIT-C) and independent variables were assessed. Results: Male sportspeople were more likely to drink alcohol at high-risk levels than females (p <.001), and respondents belonging to a club that received alcohol-related sponsorship were more likely to drink at high-risk levels (p =.019). Females were significantly more likely to want healthy food and beverage options provided at their clubs (p = 0.011). When all factors were considered team cohesion (p = 0.02), alcohol expectations (p = <.001), occurrences of experienced alcohol-related harm (p = <.001) and length of club membership (p = 0.18) were significant predictors of high-risk AUDIT-C (R 2 =.34, adjusted R 2 =.33, F (4, 156) = 20.43, p = <.001). High-risk AUDIT-C and club connectedness predicted strong team cohesion (R 2 =.39, adjusted R 2 =.39, F (2, 166) = 53.74, p = <.001). Conclusions: Findings from this study may inform policy and practice to enhance healthy behaviours among young adults participating in community sports clubs in Australia and other countries