Rapid Qualitative and Quantitative Analysis of Caffeine and Sodium Benzoate in Annaca by Infrared Spectroscopy / 法医学杂志

Objective To establish an infrared spectroscopic method for the rapid qualitative and quantitative analysis of caffeine and sodium benzoate in Annaka samples. Methods Qualitative and quantitative modeling samples were prepared by mixing high-purity caffeine and sodium benzoate. The characteristic absorption peaks of caffeine and sodium benzoate in Annaka samples were determined by analyzing the infrared spectra of the mixed samples. The quantitative model of infrared spectra was established by partial least squares （PLS）. Results By analyzing the infrared spectra of 17 mixed samples of caffeine and sodium benzoate （the purity of caffeine ranges from 10% to 80%）, the characteristic absorption peaks for caffeine were determined to be 1 698, 1 650, 1 237, 972, 743, and 609 cm-1. The characteristic absorption peaks for sodium benzoate were 1 596, 1 548, 1 406, 845, 708 and 679 cm-1. When the detection of all characteristic absorption peaks was the positive identification criteria, the positive detection rate of caffeine and sodium benzoate in 48 seized Annaka samples was 100%. The linear range of PLS quantitative model for caffeine was 10%-80%, the coefficient of determination （ R2） was 99.9%, the root mean square error of cross validation （RMSECV） was 0.68%, and the root mean square error of prediction （RMSEP） was 0.91%; the linear range of PLS quantitative model for sodium benzoate was 20%-90%, the R2 was 99.9%, the RMSECV was 0.91% and the RMSEP was 1.11%. The results of paired sample t test showed that the differences between the results of high performance liquid chromatography method and infrared spectroscopy method had no statistical significance. The established infrared quantitative method was used to analyze 48 seized Annaka samples, the purity of caffeine was 27.6%-63.1%, and that of sodium benzoate was 36.9%-72.3%. Conclusion The rapid qualitative and quantitative analysis of caffeine and sodium benzoate in Annaka samples by infrared spectroscopy method could improve identification efficiency and reduce determination cost.

Effects of hurdle technology on Monascus ruber growth in green table olives: a response surface methodology approach

ABSTRACT An ascomycetes fungus was isolated from brine storage of green olives of the Arauco cultivar imported from Argentina and identified as Monascus ruber. The combined effects of different concentrations of sodium chloride (3.5-5.5%), sodium benzoate (0-0.1%), potassium sorbate (0-0.05%) and temperature (30-40 °C) were investigated on the growth of M. ruber in the brine of stored table olives using a response surface methodology. A full 24 factorial design with three central points was first used in order to screen for the important factors (significant and marginally significant factors) and then a Face-Centered Central Composite Design was applied. Both preservatives prevented fungal spoilage, but potassium sorbate was the most efficient to control the fungi growth. The combined use of these preservatives did not show a synergistic effect. The results showed that the use of these salts may not be sufficient to prevent fungal spoilage and the greatest fungal growth was recorded at 30 °C.

Emerging trends in management of propionic acidemia / Tendências emergentes no manejo da academia propiônica

Objetivo : To evaluate the therapeutic agents used during metabolic crises and in long-term management of patients with propionic acidemia (PA).Materials and methods : The records of PA patients were retrospectively evaluated.Results : The study group consisted of 30 patients with 141 admissions. During metabolic crises, hyperammonemia was found in 130 (92%) admissions and almost all patients were managed with normal saline, ≥ 10% dextrose, and restriction of protein intake. In 56 (40%) admissions, management was done in intensive care unit, 31 (22%) with mechanical ventilation, 10 (7%) with haemodialysis, 16 (11%) with vasopressor agents, and 12 (9%) with insulin. In the rescue procedure, L-carnitine was used in 135 (96%) patients, sodium bicarbonate in 116 (82%), sodium benzoate in 76 (54%), and metronidazole in 10 (7%), biotin in about one-quarter, L-arginine in one third, and antibiotics in three-quarter of the admissions. Blood/packed RBCs were used in 28 (20%) patients, platelets in 26 (18%), fresh frozen plasma in 8 (6%), and granulocyte-colony stimulating factors in 10 (7%) admissions. All patients were managed completely/partially with medical nutrition formula plus amino acid mixture, vitamins and minerals. For long-term management 24 (80%) patients were on L-carnitine, 22 (73%) on sodium benzoate, 6 (20%) on biotin, one half on alkaline therapy and 4 (13%) on regular metronidazole use. Almost all patients were on medical formula and regular follow-up.Conclusion : Aggressive and adequate management of acute metabolic crises with restriction of protein intake, stabilization of patient, reversal of catabolism, and removal of toxic metabolites are essential steps. Concerted efforts to ensure adequate nutrition, to minimize the risk of acute decompensation and additional therapeutic advances are imperative to improve the outcome of PA patients. Arq Bras Endocrinol Metab. 2014;58(3):237-42.

Objetivo : Avaliar os agentes terapêuticos usados durante as crises metabólicas e para o manejo de longo prazo de pacientes com academia propiônica (AP).Materiais e métodos : Avaliação retrospectiva das fichas médicas de pacientes com AP.Resultados : O grupo estudado consistiu de 30 pacientes com 141 hospitalizações. Durante as crises metabólicas, a hiperamonemia foi observada em 130 (92%) pacientes hospitalizados e quase todos foram tratados com solução salina regular, ≥ 10% dextrose e restrição da ingestão de proteína. Em 56 (40%) das hospitalizações, o manejo foi feito na unidade de terapia intensiva, 31(22%) com ventilação mecânica, 10 (7%) com hemodiálise, 16 (11%) com vasopressores e 12 (9%) com insulina. Para o resgate, a L-carnitina foi usada em 135 (96%) pacientes, o bicarbonato de sódio em 116 (82%), o benzoato de sódio em 76 (54%), o metronidazole em 10 (7%), a biotina em cerca de um quarto, a L-arginina em um quarto e antibióticos em três quartos dos pacientes hospitalizados. Sangue/concentrado de hemácias foram usados em 28 (20%), plaquetas em 26 (18%), plasma fresco congelado em 8 (6%) e fatores estimulantes de colônias de granulócitos em 10 (7%) pacientes hospitalizados. Todos os pacientes foram manejados completamente/parcialmente com fórmula de nutrição hospitalar mais uma mistura de aminoácidos, vitaminas e minerais. Para o manejo de longo prazo, 24 (80%) dos pacientes foram tratados com L-carnitina, 22 (73%) com benzoato de sódio, 6 (20%) com biotina, a metade com tratamento alcalino e 4 (13%) com uso regular de metronidazole. Quase todos os pacientes foram tratados com fórmulas médicas e acompanhamento regular.Conclusão : O manejo adequado e agressivo de crises metabólicas com restrição da ingestão de proteína, ...

Basophil Activation Test with Food Additives in Chronic Urticaria Patients

The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the tested food additives. One patient responded to monosodium glutamate, showing 18.7% of CD203c-positive basophils. Another patient showed a positive BAT result to sodium benzoate. Both patients had clinical correlations with the agents, which were partly determined by elimination diets. The present study suggested that at least a small proportion of patients with CU had symptoms associated with food additives. The results may suggest the potential utility of the BAT to identity the role of food additives in CU.

Chemicals and lemon essential oil effect on Alicyclobacillus acidoterrestris viability

Alicyclobacillus acidoterrestris is considered to be one of the important target microorganisms in the quality control of acidic canned foods. There is an urgent need to develop a suitable method for inhibiting or controlling the germination and outgrowth of A.acidoterrestris in acidic drinks. The aim of this work was to evaluate the chemicals used in the lemon industry (sodium benzoate, potassium sorbate), and lemon essential oil as a natural compound, against a strain of A.acidoterrestris in MEB medium and in lemon juice concentrate. The results pointed out that sodium benzoate (500-1000-2000 ppm) and lemon essential oil (0.08- 0.12- 0.16%) completely inhibited the germination of A. acidoterrestris spores in MEB medium and LJC for 11 days. Potassium sorbate (600-1200 ppm) was more effective to inhibit the growth of the microbial target in lemon juice than in MEB medium. The effect of sodium benzoate, potassium sorbate and essential oil was sporostatic in MEB and LJC as they did not affect spore viability.

Hiperamonemia en niños: clasificación y opciones terapéuticas / Hyperammonaemia in children: classification and therapeutic options

La hiperamonemia se presenta en forma secundaria por aumento en la producción de amonio, como en la hemorragia gastrointestinal o disminución de la eliminación, como ocurre en errores innatos del metabolismo, principalmente en aquellos con defectos en el ciclo de la urea, insuficiencia hepática o fármacos. Clasificar la hiperamonemia y reportar las opciones terapéuticas en niños, su abordaje clínico y revisión de la literatura. Estudio prospectivo, descriptivo y transversal de niños con hiperamonemia. Variables: edad, género, etiología, niveles de amonio, clínica, tratamiento. 21 pacientes, 12 (57,12%) varones y 9 (42,88%) hembras. Edad promedio 3,91 años (rango:<1mes-14 años). Amonio promedio general 214,66 mmol/l (rango:110-980), clasificados según severidad: sin insuficiencia hepática 11/21 con promedio de amonio 99,44 y 201 mmol/l en hiperamonemia leve y moderada respectivamente. Clínica y laboratorio de insuficiencia hepática en 10/21 con promedio de amonio de 114,44, 287,51 y 756,66 en leve, moderada y severa hiperamonemia, con una diferencia significativa entre el nivel de amonio y la presencia o ausencia de insuficiencia hepática (p<0,0001); 5/10 con insuficiencia hepática ingresaron a terapia intensiva, 4 de ellos presentaron encefalopatía hepática, un paciente fallecido. Etiología: Error innato del metabolismo 33,33%, toxicidad por medicamentos 23,80%, hepatitis viral A fulminante 19,04% y otros virus 9,52%, hepatitis autoinmune 4,76% y urosepsis 4,76%. En los casos leves-moderados se administró lactulosa dosis respuesta vía oral 19/21 y por enema rectal 7/21 con L-carnitina en 15/21 y en Hiperamonemia severa adicionalmente Benzoato de sodio en 4/21 y hubo indicación de hemodiálisis en 3 pacientes. Restricción proteica en todos, vitaminoterapia y 6 niños tratados con ácido ursodeoxicólico. La hiperamonemia es multifactorial, requiere diagnóstico temprano, la clasificación de severidad permite el tratamiento oportuno para evitar complicaciones....

Hyperammonaemia occurs secondarily by increased production of ammonia, as gastrointestinal bleeding or decreased elimination, as occurs in inborn errors of metabolism, especially in those with defects in the urea cycle, liver failure or drugs. To classify the report hyperammonaemia and therapeutic options in children, its clinical approach and review of the literature. Prospective, descriptive and transversal children with hyperammonaemia. Variables: age, gender, etiology, ammonia levels, clinical treatment. 21 patients, 12 (57,12%) males and 9 (42,88%) females. Mean age 3,91 years (range: <1m-14a). ammonium 214,66 mmol / l (range :110-980), classified according to severity: no hepatic impairment 11/21 with 99,44 average ammonium and 201 mmol / l in Hyperammoanemia mild and moderate respectively. Clinical and laboratory liver failure 10/21 with ammonium averaging 114,44, 287,51 and 756,66 as mild, moderate and severe hyperammonemia, with a significant difference between the level of ammonia and the presence or absence of liver failure (p < 0,0001), 5/10 with liver failure admitted to intensive care, 4 of them had hepatic encephalopathy, a patient died. Etiology: An inborn error of metabolism 33,33%, 23,80% drug toxicity, fulminant viral hepatitis and other viruses 19,04% 9,52% 4,76% autoimmune hepatitis and urosepsis 4,76%. In mild-moderate cases were given oral lactulose Dose 19/21 and by enema rectal 7/21 with L-carnitine in 15/21 and further severe Hyperammonemia sodium benzoate 4/21 and was indication of hemodialysis in 3 patients. Protein restriction at all, vitamin therapy and 6 children treated with ácidoursodeoxicólico. Hyperammonemia is multifactorial, requires early diagnosis, classification of severity allows early treatment to avoid complications and development of irreversible neurological sequelae

Simultaneous determination of sodium benzoate, potassium sorbate and natamycin content in Iranian yoghurt drink [Doogh] and the associated risk of their intake through doogh consumption

Regarding the public health concerns over the use of food preservatives in yoghurt drink "Doogh", the aim of this study was the determination of sodium benzoate, potassium sorbate and natamycin in Doogh. Based on Iranian national standard, none of these preservatives are permitted to be used in Doogh. A total of 39 Doogh samples were analyzed through RP- HPLC in order to quantify sodium benzoate, potassium sorbate and natamaycin simultaneously. Exposure to each preservative is estimated by mean and maximum concentrations as the residue levels. The per capita Doogh consumption was calculated by the published data from official reports for Doogh annual production in Iran. All samples were shown to contain sodium benzoate while natamaycin was detected in 10.25% of the samples and potassium sorbate was not detected in any of them. Sodium benzoate concentration extremely varied among the investigated samples ranged from 0.94 to 9.77 mg/l. Due to the result of the exposure estimation, no serious public health concern would exist regarding the mentioned preservatives. The detection of sodium benzoate in all Doogh samples could indicate the natural production of benzoic acid in yoghurt. Sodium benzoate may be formed through the interaction of the added food grade salt to the Doogh formula which contains benzoic acid. The results of exposure estimation show the lack of health risk within the usage of preservatives in spite of the national agencies does not permit the preservative use

Hyperammonemia in a Patient with Late-Onset Ornithine Carbamoyltransferase Deficiency

Ornithine carbamoyltransferase (OTC) deficiency is a urea cycle disorder that causes the accumulation of ammonia, which can lead to encephalopathy. Adults presenting with hyperammonemia who are subsequently diagnosed with urea cycle disorders are rare. Herein, we report a case of a late-onset OTC deficient patient who was successfully treated with arginine, benzoate and hemodialysis. A 59-yr-old man was admitted to our hospital with progressive lethargy and confusion. Although hyperammonemia was suspected as the cause of the patient's mental changes, there was no evidence of chronic liver disease. A plasma amino acid and urine organic acid analysis revealed OTC deficiency. Despite the administration of a lactulose enema, the patient's serum ammonia level increased and he remained confused, leading us to initiate acute hemodialysis. After treatment with arginine, sodium benzoate and hemodialysis, the patient's serum ammonia level stabilized and his mental status returned to normal.

The First Korean Case of Lysinuric Protein Intolerance: Presented with Short Stature and Increased Somnolence

Lysinuric protein intolerance (LPI) is a rare inherited metabolic disease, caused by defective transport of dibasic amino acids. Failure to thrive, hepatosplenomegaly, hematological abnormalities, and hyperammonemic crisis are major clinical features. However, there has been no reported Korean patient with LPI as of yet. We recently encountered a 3.7-yr-old Korean girl with LPI and the diagnosis was confirmed by amino acid analyses and the SLC7A7 gene analysis. Her initial chief complaint was short stature below the 3rd percentile and increased somnolence for several months. Hepatosplenomegaly was noted, as were anemia, leukopenia, elevated levels of ferritin and lactate dehydrogenase, and hyperammonemia. Lysine, arginine, and ornithine levels were low in plasma and high in urine. The patient was a homozygote with a splicing site mutation of IVS4+1G > A in the SLC7A7. With the implementation of a low protein diet, sodium benzoate, citrulline and L-carnitine supplementation, anemia, hyperferritinemia, and hyperammonemia were improved, and normal growth velocity was observed.

Food Additives and Allergic Diseases in Childhood / 한양의대학술지

Many different additives include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, and antioxidants. Despite the multitude of additives known, only a small number has been associated with hypersensitivity reactions. A number of investigators have suggested that a significant population of patients with allergic diseases has symptoms related to the ingestion of food additives. However, the incidence and mechanism of reactions to additives in patients with chronic urticaria, angioedema, and atopic dermatitis remain unknown. A few studies of monosodium glutamate is reported to be associated with atopic dermatitis, but their relationship remains unknown. The best known dye is tartrazine. The group of azo dyes includes ponceau and sunset yellow. Amaranth (FD&C red no. 5) was banned from use in the US in 1975 because of claims related to carcinogenicity. Most of them are reported to be associated with aggravation of atopic dermatitis. Parabens are aliphatic esters of parahydroxybenzoic acid. Sodium benzoate is a closely related substance usually reported to cross-react with these compounds. These agents, which are widely used as preservatives in both food and drugs, are well recognized as causes of severe contact dermatitis. Additives would have to act as haptens to create a response mediated by IgE. The majority of these reactions are not of the immediate hypersensitivity type. Many cases of additive-provoked urticaria or dermatitis occur as late as 24 hours after challenge, arguing against an IgE-mediated mechanism. In conclusion, the exact relationship between food additives and the allergic diseases still remains to be solved.

Simultaneous determination of preservatives [sodium benzoate and potassium sorbate] in soft drinks and herbal extracts using high-performance liquid chromatography [HPLC]

Chemical preservation has become an increasingly important practice in modern food technology and herbal medicinal products with the increase in production of processed and convenience products. In the present study, a reversed-phased HPLC method for simultaneous determination of the preservatives sodium benzoate [SB] and potassium sorbate [PS] is described. The separation of SB and PS were performed on the C[18-] column and acetonitrile -ammonium acetate buffer as mobile phase. The detector wavelength was set at 254 nm. Separation of the two components [SB and PB] was achieved in less than 6 min. Analytical characteristics of the separation such as limit of detection, limit of quantification, accuracy, precision and reproducibility were evaluated. The range of preservatives found were from not detected [nd] - 2477 mg 1[-1], nd - 328 mg 1[-1] for SB, PS respectively. In This study, has shown that the concentration of SB and PS in the soft drink samples is higher that ADI even for normal consumers, based on maximum limits specified in national standards and on model diets

Efeito in vitro de concentrações de metabisulfito de sódio, benzoato de sódio e sorbato de potássio sobre fungos termorresistentes / In vitro effect of concentrations of sodium metabisulphite, sodium benzoate and potassium sorbate on heat-resistant fungi

Os fungos termorresistentes dos gêneros Byssochlamys, Neosartorya e Talaromyces representam grave problema para a indústria processadora de alimentos, especialmente de frutas e hortaliças, em virtude da ocorrência de ascosporos extremamente resistentes e/ou de micotoxinas termo estáveis. Com o propósito de fornecer subsídios quanto ao uso de quantidades mais racionais de conservantes pela indústria de alimentos e, portanto, tornar seu consumo menos danoso à população, o presente estudo determinou in vitro a concentração mínima de metabissulfito de sódio, benzoato de sódio e sorbato de potássio necessária e suficiente para inibir o crescimento micelial e a germinação de ascósporos de B. fulva, N. fischeri e T.flavus em meio de cultivo acidificado (pH 3,5). Foi demonstrado que metabissulfito de sódio em baixas concentrações é tão eficiente na inibição dos fungos mencionados quanto aos demais conservantes em altas concentrações. Por comparação com os procedimentos utilizados pelas indústrias de alimentos, é possível inferir que estas podem reformular o uso de conservantes, considerando-se o tipo de matéria-prima, a temperatura de processamento, a combinação e concentração efetivamente necessária de aditivos, bem como os efeitos tóxicos desses compostos para a saúde humana.

Efeito de diferentes concentrações de conservantes sobre o crescimento in vitro de bactérias veiculadas por alimentos / Effect of different preservatives concentrations on the in vitro growth of bacteria carried by food

Alguns micro-organismos causadores de infecções e veiculados por alimentos industrializados são removidos dos mesmos por tratamento térmico ou acidificação, enquanto outros são de difícil eliminação e requerem o uso de conservantes. Assim, acidificou-se meio de cultura TSA (Tripticase-Soja-Agar) com ácido cítrico (pH 3,5 e 5) e acrescentou-se ao mesmo quantidades específicas de meta bissulfito de sódio(MBS), benzoato de sódio (BS) e sorbato de potássio (SP). Após inoculação com suspensões aquosas (100μL = 104 células) de Escherichia coli, Bacillus cereus, Salmonella Enteritidis e S. Typhimurium, e incubação por 24-72h, mensurou-se o número de unidades formadoras de colônias (UFC) nos cultivos, visando obter a concentração mínima de cada conservante capaz de inibir (CIM) os isolados estudados in vitro e fornecer subsídios para sua utilização industrial em quantidades apropriadas. B. cereus foi o isolado mais suscetível a MBS, BS e SP (respectivamente 75, 275 e 750 mg.L-1), seguido por E. coli (respectivamente 75, 350 e 1000mg.L-1). Os isolados de Salmonella foram os mais resistentes, sendo seu crescimento completamente inibido por 1000 mg BS.L-1, mas apenas reduzido por 1250 mg SP.L-1. MBS inibiu totalmente S. Typhimurium a75 mg.L-1 e S. Enteritidis a 200 mg.L-1.

Selective HPLC-quantification of promethazine hydrochloride and its degradation products in presence of sodium benzoate

A selective and stability-indicating RP-HPLC method has been developed and validated for the simultaneous precise determination of promethazine [PROM] and sodium benzoate [SBENZ], even in the presence of the main oxidative degradation products of PROM. Good separation could be achieved on a C8-column by using a mobile phase composed of 0.008M ammonium acetate [pH 4.7] + methanol = 52 48, v/v by adopting isocratic programmed elution with UV-detection at 253 nm. The method was linear over the concentration ranges of 4- 60 micro g ml[-1] and 0.2-3 mg ml[-1], with accuracy of 100.68 +/- 1.49% and 101.82 +/- 0.91% and limits of quantitation [LOQ] of 0.8 micro g ml[-1] and 20 micro g ml[-1], for PROM and SBENZ, in orders. The method was successfully adopted for the stability-screening and -improvement of PROM in presence of SBENZ in their syrups

Food additives and Hymenolepis nana infection: an experimental study

The effect of sodium benzoate [SB] on the pathogenesis of Hymenolepis nana [H. nana] and its neurological manifestations was studied in the present work. One hundred and thirty five mice were classified into three groups. GI: received SB alone, GII: received SB before and after infection with H. nana and GIII: infected with H. nana. All groups were subjected to parasitological, histopathological, immunohistochemical and biochemical assays. The results revealed a significant decrease in TL-4 serum level with a significant increase in gamma amino butyric acid [GABA] and decrease in zinc brain levels in GI, while GII showed non significant increase in IL-4 level that resulted in a highly significant increase in the mean number of cysticercoids and adult worms with delayed expulsion as compared to GIII. This was reflected on histopathological and immunohistochemical changes in the brain. Also, there was a highly significant increase in GABA and decrease in zinc brain levels in GII to the degree that induced behavioral changes. This emphasizes the possible synergistic effect of SB on the neurological manifestations of H. nana and could, in part, explain the increased incidence of behavioral changes in children exposed to high doses of SB and unfortunately have H. nana infection

Effect of Some Food Preservatives on the Lipolytic Activity of Beef Luncheon Fungi

Beef luncheon meat is one of the most popular meals in several countries in the world including Egypt. Thirty one fungal species and 3 species varieties were recovered from 30 samples of beef luncheon meat collected from different supermarkets in Qena. Alternaria, Aspergillus, Emericella, Mucor, Mycosphaerella, Penicillium and Rhizopus were the most common genera on the two types of media. From the above genera, the most prevalent species were Alternaria alternate, Aspergillus flavus, A. fumigatus, A. niger, A. terreus, Emericella nidulans, Mucor racemosus, Mycosphaerella tassiana, Penicillium chrysogenum and Rhizopus stolonifer. Screening of fungi for their abilities to produce lipase enzyme showed that, ten isolates represented 32.26% of total isolates appeared high lipase production, while sixteen isolates (51.61%) were moderate and 5 isolates (16.13%) were low producers. Aspergillus niger, Fusarium oxysporum and Nectria haematococca produced the highest amount of lipase enzyme, so these fungi were used in further studies. The incorporation of five food preservatives (Disodium phosphate, sodium benzoate, citric acid, potassium sorbate and sodium citrate) individually in the culture medium of lipase production exhibited an inhibitive effect on the mycelial growth and enzyme production by Aspergillus niger, Fusarium oxysporum and Nectria haematococca.

Food additives and hyperactivity

Whether preservatives and colourings cause or exacerbate hyperactive behaviours is an important question for many paediatricians and parents. A recent randomised placebo controlled trial in 297 children aged 3-9 years provides evidence of increased hyperactive behaviour after they ate a mixture of food colourings and a preservative [sodium benzoate] [Brown RT et al, 2005]. In contrast to many previous studies, the children were from the general population and did not have attention-deficit/hyperactivity disorder. The trial found an adverse effect of the mixture on behaviour as measured by a global hyperactivity aggregate score. The daily dose approximated that found in two 56 g bags of sweets. In view of the potential importance of these findings, the European Food Safety Authority [EFSA] recently provided an opinion that takes other evidence into account [Cheng Y, Chen RY and Others, 2007]. The release of the EFSA findings was reported in a news article in the BMf under the headline [Agency rejects research on food additives] and the EFSA opinion was characterised as a highly critical assessment [Cincota DR et al., 2006]. The news article stated that the EFSA has [rejected suggestions of a link between hyperactivity in children and two mixtures of food colours and the preservative sodium benzoate]. Closer analysis of the EFSA report, however, does not support this negative interpretation. The EFSA panel reanalysed the data and found that their analysis with a recalculated global hyperactivity score [led to broadly similar conclusions] to the original paper. The panel concluded that, [the study provides limited evidence that the two different mixtures had a small and statistically significant effect on activity and attention.] Importantly, the trial examined a cohort of normal [not hyperactive] children, but the findings have obvious implications for children with hyperactivity. The EFSA panel reviewed the evidence linking preservatives and colourings with hyperactive behaviours. The panel reviewed 22 studies from 1975 to 1994 and two meta-analyses. Of the 22 studies, 16 reported positive effects in at least some children. In positive studies, only a subgroup of those with hyperactive behaviours were affected by the additives. The most recent meta-analysis found that artificial food colours had an overall effect size of 0.283 [95% confidence interval 0.079 to 0.488] on the hyperactivity score, and this fell to 0.210 [0.007 to 0.414] after excluding the smallest and lowest quality trials [Klassen A et al., 1999].The panel rightly pointed out that attention-deficit/hyperactivity disorder has multifactorial causes, and exclusively focusing on food additives may [detract from the provision of adequate treatment] for children with the disorder. However, it could be said that neglecting the substantial body of evidence on dietary factors may also do this. Three main treatments are available for hyperactivity in children drugs, behavioural therapy, and dietary modification. Interestingly, the use of drugs and dietary modification is supported by several trials [Klassen A etal., 1999 and McCann et al., 2007a,b] whereas behavioural therapy which is presumably thought necessary for [adequate treatment] has little or no scientifically based support McCann et al., 2007b, Preen DB et al., 2007;. A recent review of treatment by the American Academy of Paediatrics Subcommittee on Attention-Deficit/Hyperactivity Disorder said that, [the evidence strongly supports the use of stimulant medications,[whereas [behaviour therapy alone has only limited effect on symptoms Preen DB eta/., 2007J. For unknown reasons, the subcommittee did not review dietary modification. Eliminating colourings and preservatives is regarded by some as an [alternative] treatment rather than a [standard] treatment [stimulant drugs] for attention deficit disorder [Schab DW and Trinh NH, 2004] [Alternative] medicine is popular with the public- 40-50% of children attending tertiary children's hospitals in the UK and Australia have used it in the past year [Watson R, 2008] but it is rightly regarded with suspicion by many medical practitioners because of lack of evidence. However, meta-analysis shows that dietary elimination of colourings and preservatives provides a statistically significant benefit. In view of the relatively harmless intervention of eliminating colourings and preservatives, and the large numbers of children taking drugs for hyperactivity [2.4% of children in the state of Western Australia receive stimulant drugs for attention deficit disorder [Weber W and Newmark S, 2007], it might be proposed that an appropriately supervised and evaluated trial of eliminating colourings and preservatives should be part of standard treatment for individual children

Hepatic encephalopathy / 대한내과학회지

Hepatic encephalopathy, one of the major complications of cirrhosis, is a neuropsychiatric syndrome caused by accumulation of toxins in the central nervous system following dysfunction in liver detoxification. Various manifestations makes it difficulty to diagnose and categorize hepatic encephalopathy. For the consistency in diagnosis and staging of hepatic encephalopathy, standardized nomenclature regarding forms of hepatic encephalopathy was proposed recently. Due to the poor understanding of pathophysiology, effective prevention or treatment options are limited. Based on the theory that intestinal-derived ammonia plays major role in the development of hepatic encephalopathy, therapeutic approaches are directed at reducing intestinal bacterial production of ammonia and facilitating its elimination. Non-absorbable disaccharides, antibiotics such as rifaximin and L-ornithine-L-aspartate are main therapies for hepatic encephalopathy. Alternative therapies such as benzodiazepine receptor antagonists, branched-chain amino acids, sodium benzoate and acarbose have limited data supporting their use. Precipitating factors must be looked into carefully and corrected immediately because most patients are usually present with precipitating factors. Hepatic encephalopathy without precipitating factors shows poor prognosis and could be candidate of liver transplantation.

Analysis of sodium benzoate biotoxicity by atomic force microscope / 生物工程学报

Atomic force microscope (AFM) was used to study biotoxicity of food preservative sodium benzoate (SB) at the single cellular level. Lymphocyte morphology and membrane ultrastructure treated with SB at different concentrations and time were analyzed visually. As compared to the normal lymphocyte, the cell morphology and membrane was significantly changed and its ultrastructure was also complicated. After treated with SB, the Rp-v, Rq, Ra and Z values were changed. The statistical analysis of lymphocytes after treated with SB was studied, and discussed its mechanism.