Influence of a subsequent meal on the oro-cecal transit time of a solid test meal

Oro-cecal transit time (OCTT) is determined for clinical diagnostics of intestinal complaints and research purposes. Ingestion of a subsequent meal during the test period shortens the OCTT of a liquid test meal (glucose solution), as previously reported. This study was conducted to determine whether the same phenomenon occurs after ingestion of a solid test meal. The OCTT of a pancake was measured with the lactose-[C-13]-ureide breath test on two occasions in 28 volunteers. All the volunteers took the same subsequent meal once at 4 h and at 6 h after ingestion of the pancake. In 16 of the 56 tests no increase in breath-(CO2)-C-13 was observed. No statistically significant difference was found between the OCTTs of the test meal after ingestion of the subsequent meal at 4 h or 6 h (367; 311-405 min and 290; 370-405 min, median quartiles, respectively) (P = 0.14, n = 18). Only a subgroup (n = 4) with a short OCTT in the test with the 4-h subsequent meal (278; 259-296 min) tended to have a longer OCTT in the test with the 6-h subsequent meal (390; 379-401 min; P = 0.059). The effect of the ingestion of a subsequent meal on the transit time of a test meal is shown to be dependent on the physical form and/or caloric content of the test meal

Oro-cecal transit time: influence of a subsequent meal

Background Small intestinal and oro-cecal transit time (OCTT) is determined for clinical diagnostics and research purposes. Experimental protocols used vary with respect to the inclusion of a subsequent meal during the test period. This study was conducted to elucidate whether the ingestion of a subsequent meal during the test period influences the OCTT of the test meal. Materials and methods The OCTT of a liquid test meal, measured with the lactose-[C-13]ureide breath test, was compared between four groups of healthy volunteers (n = 36) who consumed the subsequent meal at different time points. Also, the OCTT was determined twice in eight subjects; a subsequent meal was ingested after 180 min (test A) and after 360 min (test B). Results An apparently meal-related increase in median OCTT was observed. The OCTT of the eight volunteers measured in test A (210; 210-349 median; quartiles) was significantly shorter than that found in test B (345; 300-375 min, P = 0.016). As result of the ingestion of the subsequent meal at 180 min the OCTT was shortened by 90; 64-116 min in 7/8 subjects. Conclusion These data indicate that the ingestion of a subsequent meal affects the OCTT of a liquid test meal. This phenomenon could be explained by the increased intestinal motility in response to a meal, and should be taken into account when designing protocols for measurements of the OCTT and in the interpretation of small intestinal absorption studies

DARE TO ASK! Suicidal patients’ experiences of nurses’ treatment

Introduktion Varje år begås ca 1500 självmord och 20000 självmordsförsök. Som sjuksköterska kommer man med stor sannolikhet att vårda självmordsnära patienter. Patienterna kan reagera på olika sätt och att som sjuksköterska bemöta dem på ett bra sätt är många gånger svårt. Travelbees teorier kan då vara ett gott stöd för sjuksköterskan. Syfte Att belysa hur patienter upplever att de har blivit bemötta av sjuksköterskan efter ett självmordsförsök för att få vägledning i vad som är ett gott bemötande. Metod Litteraturstudie av artiklar sökta och funna via databasen Cinahl med sökorden suicide attempt, patients´ perspective och nursing care. Resultat Det huvudtema som framträdde var bemötande. Därtill hörde underrubrikerna lyhördhet, stöd, kommunikation och bekräftelse med ytterligare tillhörande begrepp. De var väl överrensstämmande med Travelbees begreppsvärld. Sjuksköterskan fyller en viktig funktion och kan med sitt bemötande avgöra om patientens behandling ska lyckas eller inte. Diskussion Det är bara patienten som kan avgöra om sjuksköterskans bemötande är gott eller inte, men är man som sjuksköterska professionell i sitt bemötande blir de allra flesta patienter nöjda. Tyvärr verkar det dock som om mången sjuksköterska räds att närma sig en självmordsnära patient. Göteborgs Universitet bör utbilda sjuksköterskestudenterna mer i att inte vara rädda för att närma sig det som är svårt. Liksom Travelbee anser vi att sjuksköterskans människosyn avspeglas i hur patienterna tas omhand. Konklusion Det är viktigt att våga vara nära självmordsnära patienter – att våga fråga. Att ha en teori/modell att utgå ifrån i sin sjuksköterskeroll underlättar

An explorative study of in vivo digestive starch characteristics and postprandial glucose kinetics of wholemeal wheat bread

<p><b>Background</b></p> <p>Based on in vitro measurements, it is assumed that starch in wholemeal bread is rapidly digestible, which is considered to be less desirable for health.</p> <p><b>Aim of the study</b></p> <p>To evaluate the in vitro prediction, we characterized starch digestion of wholemeal wheat bread (WB) and postprandial glucose kinetics in healthy volunteers.</p> <p><b>Methods</b></p> <p>In a crossover study 4 healthy men ingested either intrinsically <sup>13</sup>C-enriched WB (133 g) or glucose (55 g) in water. Plasma glucose and insulin concentrations were monitored during 6 h postprandially. Using a primed continuous infusion of D-[6,6-<sup>2</sup>H2] glucose, the rate of systemic appearance of glucose was estimated (reflecting glucose influx) and the endogenous glucose production calculated.</p> <p><b>Results</b></p> <p>The glucose influx rate after WB was comparable with that after glucose in the early postprandial phase (0–2 h) (<i>P</i> = 0.396) and higher in the late postprandial phase (2–4 h) (<i>P</i> = 0.005). Despite the same initial glucose influx rate the 0–2 h incremental area under the curve (IAUC) of insulin after WB was 41% lower than after glucose (<i>P</i> = 0.037). Paradoxically endogenous glucose production after WB was significantly more suppressed than after glucose (0–2 h IAUC: <i>P</i> = 0.015, 2–4 h IAUC: <i>P</i> = 0.018).</p> <p><b>Conclusions</b></p> <p>Starch in WB seems to be partly rapidly and partly slowly digestible. Postprandial insulin response and endogenous glucose production after WB ingestion might not solely be determined by the digestive characteristics of starch; other components of WB seem to affect glucose homeostasis. In vitro measurements might not always predict in vivo starch digestion precisely.</p&gt