-
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 -
Public Health Nutrition Oct 2023To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic disease risk factors.
DESIGN
A controlled trial of ethnically diverse, full-time employees who consumed SSB heavily (sales ban 315; control 342). Outcomes included standardised measures of change in SSB consumption in the workplace (primary) and at home between baseline and 6 months post-sales ban.
SETTING
Sutter Health, a large non-profit healthcare delivery system in Northern California.
PARTICIPANTS
Full-time employees at Sutter Health screened for heavy SSB consumption.
RESULTS
Participants were 66·1 % non-White. On average, participants consumed 34·7 ounces (about 1 litre) of SSB per d, and the majority had an elevated baseline BMI (mean = 29·5). In adjusted regression analyses, those exposed to a workplace SSB sales ban for 6 months consumed 2·7 (95 % CI -4·9, -0·5) fewer ounces of SSB per d while at work, and 4·3 (95 % CI -8·4, -0·2) fewer total ounces per d, compared to controls. Sales ban participants with an elevated BMI or waist circumference had greater post-intervention reductions in workplace SSB consumption.
CONCLUSIONS
Workplace sales bans can reduce SSB consumption in ethnically diverse employee populations, including those at higher risk for cardiometabolic disease.
Topics: Humans; Sugar-Sweetened Beverages; Beverages; Workplace; Cardiovascular Diseases
PubMed: 37465952
DOI: 10.1017/S1368980023001386 -
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 -
JAMA Network Open Jul 2023Taxes on sweetened beverages are being implemented around the globe; an understanding of these taxes on individual-level behavior is necessary.
IMPORTANCE
Taxes on sweetened beverages are being implemented around the globe; an understanding of these taxes on individual-level behavior is necessary.
OBJECTIVE
To evaluate the degree to which the sweetened beverage tax in Philadelphia, Pennsylvania, was associated with changes in beverage prices and individual-level purchasing over time at a national pharmacy chain in Philadelphia compared with Baltimore, Maryland.
DESIGN, SETTING, AND PARTICIPANTS
Using a difference-in-differences approach and generalized linear mixed models, this cohort study examined beverage purchases made by loyalty cardholders at a national chain pharmacy retailer with stores in Philadelphia and Baltimore (control city) from before tax to after tax. Beverage sales (in US dollars) were linked by unique loyalty card numbers to enable longitudinal analyses. Data were collected from January 1, 2015, through December 31, 2017 (2 years before tax and 1 year after tax); data analyses were conducted from January through October 2022.
EXPOSURE
Implementation of Philadelphia's 1.5 cents/oz tax on sweetened beverages.
MAIN OUTCOMES AND MEASURES
The outcomes were the change in mean beverage price per-ounce and mean beverage volume purchased per cardholder transaction. Individual-level point-of-sale scanner data from all beverage purchases were analyzed.
RESULTS
A total of 1188 unique beverages were purchased from the same stores before tax and after tax. There were 231 065 unique cardholders in Philadelphia and 82 517 in Baltimore. Mean prices of taxed beverages (n = 2 094 220) increased by 1.6 (95% CI, 1.3-2.0) cents/oz (106.7% pass-through) in Philadelphia compared with Baltimore from before tax to after tax. Philadelphia cardholders purchased 7.8% (95% CI -8.1% to -7.5%) fewer ounces of taxed beverages and 1.1% (95% CI, 0.6%-1.7%) more ounces of nontaxed beverages per transaction. Taxed beverages made up a smaller percentage of cardholders' overall beverage purchases after tax (-13.4% [95% CI, -14.2% to -12.6%]), while nontaxed beverages made up a larger share (9.3% [95% CI, 7.7%-10.7%]).
CONCLUSIONS AND RELEVANCE
In this longitudinal cohort study of the Philadelphia beverage tax, the tax was completely passed through to prices and was associated with a 7.8% decline in ounces of taxed beverages purchased at a national pharmacy chain.
Topics: Humans; Longitudinal Studies; Philadelphia; Cohort Studies; Beverages; Taxes; Pharmacy
PubMed: 37440231
DOI: 10.1001/jamanetworkopen.2023.23200 -
The American Journal of Geriatric... Nov 2023
Topics: Humans; Palliative Care; Pneumonia; Dementia
PubMed: 37407383
DOI: 10.1016/j.jagp.2023.06.011 -
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 -
Acta Odontologica Scandinavica Nov 2023Cryotherapy using ice chips has been successfully used to prevent chemotherapy-induced oral mucositis. Although effective, concerns have been raised that the low...
BACKGROUND
Cryotherapy using ice chips has been successfully used to prevent chemotherapy-induced oral mucositis. Although effective, concerns have been raised that the low temperatures that are obtained in the oral mucosa during cooling may be potentially harmful to taste and smell perception. Thus, this study aimed to investigate whether intraoral cooling permanently affects taste and smell perception.
SUBJECTS AND METHODS
Twenty subjects inserted an ounce of ice chips and moved the ice around in the mouth to cool as large a part of the oral mucosa as possible. Cooling continued for 60 min. At baseline (T0 - minutes), and following 15, 30, 45, and 60 min of cooling, taste and smell perception were registered, using the Numeric Rating Scale. The same procedures were repeated 15 min (T75 - minutes) after completion of cooling. Taste and smell were evaluated using four different solutions and a fragrance, respectively.
RESULTS
A statistically significant difference was seen for taste perception with Sodium chloride, Sucrose, and Quinine at all the follow-up time points tested as compared to baseline ( < .05). Citric acid and smell perception proved to be significantly different from baseline following 30 min of cooling. When the same assessments were carried out 15 min following completion of cooling, i.e. T75, all taste and smell perceptions had recovered to some extent. For taste perception, however, a statistically significant difference was still seen for all solutions tested as compared to baseline ( < .01).
CONCLUSION
In healthy individuals, intraoral cooling with IC leads to a temporary reduction in taste and smell perception, with a tendency to return to baseline values.
PubMed: 37339460
DOI: 10.1080/00016357.2023.2223643 -
The American Surgeon Oct 2023Self-inflicted gunshot wounds (SIGSWs) remain a leading, preventable cause of death in the United States. The present study evaluated patient demographics, operative...
BACKGROUND
Self-inflicted gunshot wounds (SIGSWs) remain a leading, preventable cause of death in the United States. The present study evaluated patient demographics, operative characteristics, in-hospital outcomes, and resource utilization between patients with SIGSW and other GSW.
METHODS
The 2016-2020 National Inpatient Sample was queried for patients ≥16 years old admitted following gunshot wounds. Patients were categorized as SIGSW if they were injured through self-harm. Multivariable logistic regression was used to evaluate the association of SIGSW on outcomes. The primary endpoint was in-hospital mortality with complications, costs, and length of stay secondarily considered.
RESULTS
Of an estimated 157,795 surviving to hospital admission, 14,670 (9.30%) were SIGSW. Self-inflicted gunshot wounds were more commonly female (18.1 vs 11.3%), insured by Medicare (21.1 vs 5.0%), and white (70.8 vs 22.3%) (all P < .001) compared to non-SIGSW. Psychiatric illness was more prevalent in SIGSW (46.0 vs 6.6%, P < .001). Additionally, SIGSW more frequently underwent neurologic (10.7 vs 2.9%) and facial operations (12.5 vs 3.2%) (both P < .001). After adjustment, SIGSW was associated with greater odds of mortality (AOR: 12.4, 95% CI: 10.4-14.7). Length of stay (β: +1.5 days, 95% CI: .8-2.1) and costs (β: +$3.6 K, 95% CI: 1.4-5.7) were significantly greater in SIGSW.
CONCLUSIONS
Self-inflicted gunshot wounds are associated with increased mortality compared to other GSW, likely due to the increased proportion of injuries in the head and neck region. This lethality, coupled with the high prevalence of psychiatric illness in this population, indicates that efforts must be made to intervene through primary prevention, including enhanced screening and weapon safety considerations for those at risk.
Topics: Humans; Female; Aged; United States; Adolescent; Firearms; Wounds, Gunshot; Medicare; Self-Injurious Behavior; Hospitalization; Retrospective Studies
PubMed: 37208921
DOI: 10.1177/00031348231177927 -
European Journal of Nutrition Sep 2023To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose,...
PURPOSE
To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, central obesity, and blood pressure.
METHODS
This cross-sectional analysis used data from 22,687 adults (aged ≥ 18 years) involved in seven cycles (2005-2018) of the National Health and Nutrition Examination Survey (NHANES). Habitual nut and seed intakes were estimated by the Multiple Source Method using data from two 24-h dietary recalls. Metabolic syndrome was ascertained using biochemical data and self-reported medication use. Sex-specific effect estimates were obtained using logistic and linear regressions adjusting for lifestyle and socioeconomic confounders.
RESULTS
Compared to non-consumers, female, but not male, habitual consumers of either nuts or seeds had lower odds of having metabolic syndrome (OR: 0.83, 95% CI 0.71, 0.97). Both nut intake alone and seed intake alone were inversely associated with high fasting glucose and low HDL-cholesterol in females compared to non-consumers. When restricted to habitual consumers only, the combined intake of nuts and seeds at 6 g/day was associated with the lowest triglycerides and highest HDL-cholesterol in females. Combined consumption of nuts and seeds up to one ounce-equivalent (15 g) per day, but not in higher intake levels, was inversely associated with metabolic syndrome, high fasting glucose, central obesity, and low HDL-cholesterol in females.
CONCLUSIONS
Nut and seed consumption, both separately or combined, below 15 g/day was inversely associated with metabolic syndrome and its component conditions in females but not males.
Topics: Adult; Male; Humans; Female; Metabolic Syndrome; Nutrition Surveys; Nuts; Obesity, Abdominal; Cross-Sectional Studies; Obesity; Diet; Triglycerides; Seeds; Cholesterol, HDL; Glucose
PubMed: 37115204
DOI: 10.1007/s00394-023-03157-1