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Canadian Journal of Anaesthesia =... Aug 2023Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) have become increasingly popular as both diabetic and weight loss therapies. One effect of this class of... (Observational Study)
Observational Study
Influence of semaglutide use on the presence of residual gastric solids on gastric ultrasound: a prospective observational study in volunteers without obesity recently started on semaglutide.
PURPOSE
Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) have become increasingly popular as both diabetic and weight loss therapies. One effect of this class of medication is delayed gastric emptying, which may impact the risk of aspiration during anesthesia delivery.
METHODS
In this prospective study, we used gastric ultrasound to evaluate the presence of solid gastric contents in both supine and lateral positions after an eight-hour fast in those taking GLP-1RA compared with controls. Participants underwent a second ultrasound evaluation two hours later after drinking 12 fluid ounces of water (approximately 350 mL).
RESULTS
Twenty adults voluntarily enrolled, giving a total of ten participants in each group. In the supine position, 70% of semaglutide participants and 10% of control participants had solids present on gastric ultrasound (risk ratio [RR], 3.50; 95% confidence interval [CI], 1.26 to 9.65; P = 0.02.) In the lateral position, 90% of semaglutide participants and 20% of control participants had solids identified on gastric ultrasound (RR, 7.36; 95% CI, 1.13 to 47.7; P = 0.005). Two hours after drinking clear liquids, the two groups did not differ in the lateral position, but in the supine position, 90% of control group participants were rated as empty compared with only 30% of semaglutide group participants (P = 0.02).
CONCLUSIONS
This study provides preliminary evidence that GLP-1RAs may affect gastric emptying and residual gastric contents following an overnight fast and two hours after clear liquids, which may have implications for aspiration risk during anesthetic care.
Topics: Adult; Humans; Hypoglycemic Agents; Diabetes Mellitus, Type 2; Prospective Studies; Glucagon-Like Peptide-1 Receptor; Obesity; Volunteers
PubMed: 37466909
DOI: 10.1007/s12630-023-02549-5 -
Journal of Mental Health (Abingdon,... Feb 2024
PubMed: 38354332
DOI: 10.1080/09638237.2023.2278103 -
The New England Journal of Medicine Aug 2023
Topics: Humans; Cardiovascular Diseases; HIV Infections
PubMed: 37486752
DOI: 10.1056/NEJMe2306782 -
JPEN. Journal of Parenteral and Enteral... Sep 2023Our goal was to quantify the pH and total acidity of human milk fortified with human milk fortifiers (HMFs), powder infant formulas, and protein additives.
BACKGROUND
Our goal was to quantify the pH and total acidity of human milk fortified with human milk fortifiers (HMFs), powder infant formulas, and protein additives.
METHODS
Commercial liquid HMFs and powder infant formulas were added to pasteurized pooled donor human milk in triplicate and stirred. The pH of unfortified and fortified human milk at 22, 24, 26, 27, 28, and 30 kcal/ounce (624, 680, 737, 765, 794, and 850 kcal/g, respectively) was determined using a pH meter. Phenolphthalein acidity at 24 and 30 kcal/ounce (680 and 850 kcal/g, respectively) was determined using diluted sodium hydroxide.
RESULTS
The pH of unfortified human milk increased within the first hour (6.52 ± 0.06 vs 6.62 ± 0.05, P < 0.0001). Changes in pH largely correlated with caloric density; however, directional changes varied considerably between HMFs and powder infant formulas. Two liquid HMFs demonstrated modest reductions in pH with increasing caloric density whereas one liquid HMF alkalinized human milk with increasing caloric density (analysis of variance P < 0.0001). Phenolphthalein acidity was significantly higher for five HMFs and lower for one HMF at 30 kcal/ounce (850 kcal/g) but not 24 kcal/ounce (680 kcal/g). Powder infant formulas generally increased pH with increasing caloric density (analysis of variance P < 0.0001), but no differences in phenolphthalein acidity were noted.
CONCLUSION
Changes in acid/base balancefor fortified human milk are variable and may be a consideration when selecting a fortifying agent for human milk.
Topics: Infant; Humans; Milk, Human; Powders; Food, Fortified; Dietary Supplements; Phenolphthaleins
PubMed: 37350060
DOI: 10.1002/jpen.2537 -
Cureus Oct 2023Background In the field of aesthetic dermatology, there is currently very little data on affordability and cost analysis regarding cosmeceuticals as more demand from...
Background In the field of aesthetic dermatology, there is currently very little data on affordability and cost analysis regarding cosmeceuticals as more demand from patients showing interest in cosmeceutical products to reduce and prevent aging continues to grow. Photoaging, a form of extrinsic aging from sun exposure, can be ameliorated by applying sunscreen and retinol products. Topical ascorbic acid and niacinamide have been shown to target the oxidative stress process that contributes to photoaging. These four products have been identified as the cosmeceutical ingredients with the most evidence-based data on photoaging prevention and treatment. Objective Given the demand for effective skin care, the paucity of data on cost differentiation, and the availability of cosmeceutical products, we analyzed the unit cost of four anti-aging products from major online and physical retailers in the United States. Such a cost comparison may facilitate more economically appropriate recommendations on skin care to consumers. Methods and materials We analyzed sunscreen, topical vitamin C (ascorbic acid), topical vitamin B3 (niacinamide), and topical vitamin A (retinol) products sold by four major United States retailers: Walmart, Ulta, Walgreens, and Amazon. The average cost in dollars per ounce (dollar/oz) was calculated for each product category at each retailer. Statistical analyses were done to determine statistical significance for each product category between retailers as well as between each category of product. Results Between the four retailers, Walmart offered the lowest cost per ounce for every product. In contrast, Amazon offered the highest cost per ounce for every product except for sunscreen. We also found that sunscreen products are less expensive per ounce as compared to retinol, ascorbic acid, and niacinamide products. Conclusion Dermatologists should be knowledgeable of product costs when providing patients with anti-aging product recommendations. Our study provides data on the financial cost by retail location of evidence-based anti-aging cosmeceuticals to better guide physicians in patient consulting and economical resource sharing.
PubMed: 37933373
DOI: 10.7759/cureus.46596 -
The American Journal of Geriatric... Nov 2023
Topics: Humans; Palliative Care; Pneumonia; Dementia
PubMed: 37407383
DOI: 10.1016/j.jagp.2023.06.011 -
Journal of Histotechnology Sep 2023Cat food production is a billion-dollar industry in the United States, with most pet owners trusting pet food companies to provide their pets with complete nutrition....
Cat food production is a billion-dollar industry in the United States, with most pet owners trusting pet food companies to provide their pets with complete nutrition. Moist or canned cat food is healthier than dry kibble for cats due to its higher water content promoting healthy kidney function, but ingredient labels on canned cat food are lengthy with ambiguous terminology including 'animal by-products.' Forty canned cat food samples were collected from grocery stores and were processed using routine histologic methods. Hematoxylin and eosin-stained tissue sections were evaluated microscopically to determine the cat food content. Many brands and flavors were composed of well-preserved skeletal muscles admixed with various animal organs, which closely approximates nutritional components found in natural feline prey. However, several samples demonstrated marked degenerative changes suggesting a delay in food processing and potential decrease in nutrient content. Four samples contained cuts consisting of skeletal muscle only with no organ meat. Surprisingly, 10 samples contained fungal spores and 15 demonstrated refractile particulate matter. A cost analysis demonstrated that although the overall quality of canned cat food increases as the average cost per ounce increases, low-cost high-quality canned cat food is available.
Topics: Animals; Cats; United States; Animal Feed; Food, Preserved; Meat; Food Handling
PubMed: 36811489
DOI: 10.1080/01478885.2023.2177815 -
Journal of Human Nutrition and... Oct 2023Limited literature has addressed the impact of nut consumption in mitigating frailty. This study aimed to investigate the association between nut consumption and frailty...
BACKGROUND
Limited literature has addressed the impact of nut consumption in mitigating frailty. This study aimed to investigate the association between nut consumption and frailty among Americans aged above 60 years, employing two 24-h dietary recalls for analysis.
METHODS
The data sets of the National Health and Nutrition Examination Survey (NHANES) (2003-2018) and the Food Patterns Equivalents Database were utilised for a weighted multiple logistic regression model to evaluate the association between nut consumption and frailty in elderly adults. Furthermore, a restricted cubic spline model was employed to investigate the nonlinear relationship between nut intake and frailty. Besides, stratified and interaction analyses were conducted to explore the sensitivity of nut consumption in reducing the risk of frailty in diverse subgroups.
RESULTS
The research study comprised 10,033 individuals aged 60 years or above, of whom 3591 were classified as frailty and 5302 consumed nuts. In the multivariate logistic regression analysis that adjusted for covariates, the weighted multivariate adjusted odds ratios demonstrated that the prevalence of frailty was lower in the nut intake group than in nonconsumers. The stratified analysis indicated that nearly all subgroups who consumed nuts had a significantly lower risk of frailty compared to nonconsumers, and an interaction was observed between nut intake and nonhypertensive populations. The optimal threshold for nut intake to decrease the risk of frailty was identified as 1.02 ounces.
CONCLUSIONS
The study concluded that nut consumption has a constructive impact on averting frailty in elderly adults, particularly in nonhypertensive individuals. Nut intake of ~1.02 ounces per day is advantageous in improving the quality of life in elderly adults.
Topics: Adult; Aged; Humans; United States; Nutrition Surveys; Nuts; Cross-Sectional Studies; Frailty; Quality of Life; Diet
PubMed: 37448140
DOI: 10.1111/jhn.13208