Adverse drug reactions, a guide for dentists

Adverse drug reactions (ADRs) are unintended or harmful effects due to the use of a medicine. Antibiotics and analgesics, which incidentally, are commonly prescribed by dentists, result in most of the ADRs globally. As with most healthcare professionals, dentists do not report on ADRs regularly. Therefore, the aim of the review was to explore the drugs most used in dental practice in South Africa (SA), their associated ADRs and the ADR reporting channels. The study undertook a literature review that focused on studies of adverse drug reactions specifically in dentalpractices. An electronic search was done on EBSCO host to source articles published from 2000 to 2022. There was a plethora of ADRs that were found to occur with the medicines that are prescribed by dentists that ranged from minor to serious. Although all medicines have a risk of ADRs, amoxicillin can result in gastrointestinal disturbances and anaphylactic reactions, while clindamycin has a risk of Clostridium difficile infection. Patients need to be alerted to the risk of a disulfiram reaction with metronidazole and alcohol. Hepatic failure can occur with paracetamol use especially in patients with underlying liver disease, an alcoholic or in an overdose. Ibuprofen, caution in patients with underlying ulcers as gastrointestinal bleeding is a risk. Local anesthetics pose a high threat of severe reactions such as tissue necrosis and direct neurotoxicity while anterograde amnesia, respiratory depression and thrombosis can occur with benzodiazepines.Dentists can prevent ADRs by having a good knowledge of their prescribed drugs, monitoring their patients and by being judicious in their prescribing habits

Phenolic compounds and ascorbic acid in black currant (Ribes nigrum L.)

Black currant is an edible soft fruit crop that is now attracting increased scientific attention due to its high content of potentially beneficial phenolic compounds and ascorbic acid. Using HPLC and spectrophotometry, this thesis examined the content of phenolic compounds in buds, leaves and fruits of black currant plants grown in southern and northern Sweden. In addition, the content of ascorbic acid, soluble solids, titratable acidity and total anthocyanins were studied in the fruits. Differences due to genotype, ontogenetic stage, harvest date and location were determined. The genotypes 'Ben Finlay', 'Poesia' and 'JHI 8944-13' had the highest content of several compounds in both buds and fruits. Among the different bud ontogenetic stages, dormant buds had the highest content of total phenols. In the leaves, the content of phenolic compounds generally varied depending on the position of the leaf on the shoot and on harvest date. A higher content of total phenols was recorded late in the season, except in the basal leaves. Black currant fruits grown in the south had higher contents of most phenolic compounds, ascorbic acid and soluble solids than those grown in northern Sweden. Buds picked from plants grown in the north had higher content of flavan-3-ols, phenolic acids and several flavonols than buds from the south. In conclusion, proper selection of genotype and location for cultivation is essential for promoting the food and health attributes of black currant. Moreover, knowledge related to influence of ontogenetic stage and harvest time on content of specific bioactive compounds in black currant could help tailor functional foods or pharmaceutical products. Black currant production could thereby be carefully planned to enhance the content of specific compounds for product optimisation

Relationship between adherence and health-related quality of life among HIV-patients in South Africa : findings and implications

Greater access to highly active antiretroviral treatment (HAART) has increased survival of people living with HIV and AIDS (PLWHA) and health-related quality of life (HRQoL) has emerged as an important indicator of treatment outcomes. However, the success of HAART depends on consistent and optimum adherence. Various cross-sectional studies and few longitudinal studies identified the relationship between HRQoL and HAART, however their association over time is still unclear. The objective of this study was to investigate the relationship between HRQoL and adherence to HAART over time. 431 PLWHA were followed for one year at 4-monthly intervals. A descriptive adherence self-report rating scale and WHOQOL-HIV BREF were administered to collect adherence and HRQoL data respectively. Optimum adherence was set at ≥95%. Significant differences (p< 0.05) in the overall mean HRQoL scores of the HAART adherent (≥95%) and non-adherent (<95%) patients were observed amongst patients on HAART for the periods 9-28 months, 49-64 months and 81-120 months. This study established a strong relationship between adherence to HAART and HRQoL over time. Adherence to HAART is still a challenge and needs to be addressed through appropriate interventions

Effect of dehydration on phenolic compounds and antioxidant activity of blackcurrant (Ribes nigrum L.) pomace

This study examined the effect of dehydration on the phenolic compounds and antioxidant activity of blackcurrant (Ribes nigrum L.) pomaces (DBP) subjected to hot air oven drying (HOD), industrial rotary drying (IRD) and freeze drying (FD). Temperature and residence time were evaluated for HOD, whereas air-on and air-off temperature, ratio of drum rotor speed to air speed and particle size were evaluated for IRD. The highest total anthocyanins (ATC) and flavonols (FLV) were obtained in particle size of > 5.0 mm using IRD at 475°C/97°C (air-on/air-off) and higher ratio of drum rotor speed to air speed. Smaller size particles were found susceptible to degradation due to high temperature and retention time applied in IRD, resulting in loss of phenolic compounds in DBP, thus HOD was deemed more suitable. Overall, drying method selection and parameters of operation are key in preserving the concentrations of individual HCA and FLV in DBP

At a glance:the largest Niemann-Pick type C1 cohort with 602 patients diagnosed over 15 years

Niemann-Pick type C1 disease (NPC1 [OMIM 257220]) is a rare and severe autosomal recessive disorder, characterized by a multitude of neurovisceral clinical manifestations and a fatal outcome with no effective treatment to date. Aiming to gain insights into the genetic aspects of the disease, clinical, genetic, and biomarker PPCS data from 602 patients referred from 47 countries and diagnosed with NPC1 in our laboratory were analyzed. Patients’ clinical data were dissected using Human Phenotype Ontology (HPO) terms, and genotype–phenotype analysis was performed. The median age at diagnosis was 10.6 years (range 0–64.5 years), with 287 unique pathogenic/likely pathogenic (P/LP) variants identified, expanding NPC1 allelic heterogeneity. Importantly, 73 P/LP variants were previously unpublished. The most frequent variants detected were: c.3019C &gt; G, p.(P1007A), c.3104C &gt; T, p.(A1035V), and c.2861C &gt; T, p.(S954L). Loss of function (LoF) variants were significantly associated with earlier age at diagnosis, highly increased biomarker levels, and a visceral phenotype (abnormal abdomen and liver morphology). On the other hand, the variants p.(P1007A) and p.(S954L) were significantly associated with later age at diagnosis (p &lt; 0.001) and mildly elevated biomarker levels (p ≤ 0.002), consistent with the juvenile/adult form of NPC1. In addition, p.(I1061T), p.(S954L), and p.(A1035V) were associated with abnormality of eye movements (vertical supranuclear gaze palsy, p ≤ 0.05). We describe the largest and most heterogenous cohort of NPC1 patients published to date. Our results suggest that besides its utility in variant classification, the biomarker PPCS might serve to indicate disease severity/progression. In addition, we establish new genotype–phenotype relationships for “frequent” NPC1 variants.</p

BacHBerry: BACterial Hosts for production of Bioactive phenolics from bERRY fruits

BACterial Hosts for production of Bioactive phenolics from bERRY fruits (BacHBerry) was a 3-year project funded by the Seventh Framework Programme (FP7) of the European Union that ran between November 2013 and October 2016. The overall aim of the project was to establish a sustainable and economically-feasible strategy for the production of novel high-value phenolic compounds isolated from berry fruits using bacterial platforms. The project aimed at covering all stages of the discovery and pre-commercialization process, including berry collection, screening and characterization of their bioactive components, identification and functional characterization of the corresponding biosynthetic pathways, and construction of Gram-positive bacterial cell factories producing phenolic compounds. Further activities included optimization of polyphenol extraction methods from bacterial cultures, scale-up of production by fermentation up to pilot scale, as well as societal and economic analyses of the processes. This review article summarizes some of the key findings obtained throughout the duration of the project

Black currant (Ribes nigrum L.) - an insight into the crop

There is an increasing interest in the inclusion of berries, especially the black currant in the human diet mainly for the health benefits associated with their consumption. Black currant (Ribes nigrum L.) belonging to the genus Ribes is widely cultivated across temperate Europe, Russia, New Zealand, parts of Asia and to a lesser extent North America. Besides high content of tasty juice, black currant is a valuable source of bioactive compounds like vitamin C and polyphenols, acting as antioxidants, with a potential to protect against disorders such as cardiovascular events, cancer and other degenerative symptoms. Industrially, black currant fruits are considered to be of importance; however other anatomical parts like buds and leaves are also excellent sources of phenolic compounds. The leaf and bud extracts are of relevance as raw material for the food and health industry thereby making black currant a lucrative product for use as functional food ingredient. Research until now has investigated the content of different polyphenolic fractions of the fruits and to lesser extent on content of these fractions on plant parts like buds and leaves. The breeding of black currant is mainly focussed on national and international requirements, as related to specific quality desired from the processing sector alongside with important agronomic characters. Black currant cultivation is in different areas limited by a lack of climate adaptation in the existing cultivars as well as susceptibility of these cultivars to different pests and diseases. Also, the levels of bioactive compounds in black currant like content of ascorbic acid and polyphenols are influenced by genotype, environment and genotype x environment interactions. Durable resistance towards damaging pest and diseases together with an increase in content of health promoting compounds and adaptability to local climates remain to be of high priority for breeders. Additionally flavour, mouth feel, aroma and after taste are important primary quality factors for the fresh fruit market and juice industry. This introductory paper focuses on the history of development and biology of black currant; their ecology and environmental adaptability; crop utilisation; bioactive compounds, genetic, biochemical and phenotypic diversity. The breeding objectives and important pest and diseases are also presented. This paper is an attempt to review important work that has been done so far and the background literature, whilst providing the scope for the current PhD study