Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit.

BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than ß-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0005660.

Plasma pharmacokinetics and urinary excretion of isoflavones after ingestion of soy products with different aglycone/glucoside ratios in South Korean women.

Asian populations are thought to receive significant health benefits from traditional diets rich in soybeans due to high isoflavone contents. However, available epidemiologic data only weakly support this hypothesis. The present study was carried out to assess the pharmacokinetics of isoflavones in South Korean women after ingestion of soy-based foods. Twenty-six healthy female volunteers (20-30 y old) consumed three different soy products (i.e., isogen, soymilk, and fermented soybeans) with different aglycone/glucoside ratios. Plasma and urine isoflavone concentrations were measured by high-performance liquid chromatography (HPLC) after ingestion of one of the soy products. Pharmacokinetic parameters were determined using the WinNonlin program. The area under the curve (AUC) for plasma daidzein levels of the soymilk group (2,101 ± 352 ng · h/mL) was significantly smaller than those of the isogen (2,628 ± 573 ng · h/mL) and fermented soybean (2,593 ± 465 ng · h/mL) groups. The maximum plasma concentration (Cmax ) of daidzein for the soymilk group (231 ± 44 ng/mL) was significantly higher than those of the isogen (160 ± 32 ng/mL) and fermented soybean (195 ± 35 ng/mL) groups. The half-lives of daidzein and genistein in the soymilk group (5.9 and 5.6 h, respectively) were significantly shorter than those in the individuals given isogen (9.6 and 8.5 h, respectively) or fermented soybean (9.5 and 8.2 h, respectively). The urinary recovery rates of daidzein and genistein were 42% and 17% for the isogen group, 46% and 23% for the fermented soybean group, and 33% and 22% for the soymilk group. In conclusion, our data indicated that soy products containing high levels of isoflavone aglycone are more effective for maintaining plasma isoflavone concentrations. Additional dose-response, durational, and interventional studies are required to evaluate the ability of soy-based foods to increase the bioavailability of isoflavones that positively affect human health.

The effect of cardioplegic solution-induced sodium concentration fluctuation on postoperative seizure in pediatric cardiac patients.

BACKGROUND: Despite potential benefits of histidine-tryptophan-ketoglutarate (HTK) solution as a cardioplegic solution, it can cause hyponatremia, especially in pediatric patients. Fluctuations in the sodium concentration during cardiopulmonary bypass (CPB) can adversely affect the central nervous system. We evaluated the relationship between the cardioplegic solution, the fluctuation of sodium concentration, and the incidence of postoperative seizure in pediatric cardiac patients. METHODS: The medical records of 628 patients were reviewed for the occurrence of a postoperative seizure, type of cardioplegic solution (HTK or del Nido solution), and intraoperative data. A change of sodium concentration exceeding 15 mmol/L (ΔNa>15) during CPB was defined as a significant fluctuation of sodium concentration. RESULTS: Postoperative seizures were detected in 18 patients (2.9%). The ΔNa>15 was detected in 63 of 189 patients (33.3%) who received the HTK solution and in 14 of 439 patients (3.2%) who received the del Nido solution (p<0.001). The incidence of ΔNa>15 was strongly associated with postoperative seizure (odds ratio, 6.3; 95% confidence interval, 2.4 to 16.4, p=0.001). After adjusting for potential confounders, the ΔNa>15 remained significantly associated with postoperative seizure (odds ratio, 3.9; 95% confidence interval, 1.3 to 12.3, p=0.018). CONCLUSIONS: Histidine-tryptophan-ketoglutarate solution during CPB frequently causes fluctuations of sodium concentration, usually combined with hyponatremia, which is associated with postoperative seizure. Special attention to sodium concentration is required, particularly when HTK solution is used in pediatric cardiac patients.

Effect of chlorhexidine application methods on microtensile bond strength to dentin in Class I cavities.

OBJECTIVE: To evaluate the influence of chlorhexidine with different application methods on the microtensile bond strength (microTBS) to dentin in Class I cavities. METHODS: Flat dentinal surfaces with Class I cavities (4 mm long, 4 mm wide, 2 mm deep) in 50 molars were bonded with Adper Single Bond 2 etch-and-rinse adhesive system after: 1) Chlorhexidine (CHX) + rinsing + etching; 2) CHX + no rinsing + etching; 3) Etching + CHX + rinsing; 4) Etching + CHX + no rinsing; 5) Etching only as a control group. Resin composite buildups were constructed with Z-350 (3M ESPE) using a bulk method and they were polymerized for 40 seconds. For each condition, half of the specimens were immediately submitted to microtensile bond strength and half of the same group was submitted to 10,000 cycles of thermocycling between 5 degrees C and 55 degrees C before testing. The data were analyzed using the two-way ANOVA and Student t-test at a 95% significance level. RESULTS: Chlorhexidine pretreatment did not affect the bond strength of specimens tested at the immediate testing period, regardless of the application method used, compared to the control group. However, after 10,000 thermocycles, a significant bond strength reduction was found in the control group. In general, the chlorhexidine application method did not demonstrate a significant difference among the groups treated with chlorhexidine. However, there was a significant difference after thermocycling in the groups treated with chlorhexidine before etching and no significant difference in the groups treated with chlorhexidine after etching. CONCLUSION: Considering the amount of reduction in bond strength after thermocycling, the current study showed improved dentin bond strength with chlorhexidine when used after etching.

Fabrication and gas sensing properties of hollow SnO2 hemispheres.

Close packed arrays of hollow SnO2 hemispheres were prepared using PMMA microspheres as sacrificial templates for subsequent sputter-deposition of SnO2 films, leading to a threefold enhancement in gas sensitivity compared to non-templated (flat) films.