Author's Reply to O ka and Colleagues Nagai, Kojiro; Tsuchida, Kenji; Ishihara, Noriyuki ...
Therapeutic apheresis and dialysis,
02/2018, Letnik:
22, Številka:
1
Journal Article
The growth responses of a variety of human intestinal bacteria to partially hydrolyzed guar gum (PHGG) were investigated in vitro and in vivo. In an in vitro experiment, PHGG moderately enhanced ...growth of some bacterial strains including Bacteroides ovatus, clostridium coccoides, C. butyricum, and Peptostreptococcus productus. Effects of PHGG intake on fecal microflora,bacterial metabolites, and pH were investigated using mine healthy human volunteers. The count of Bifidobacterium spp. and the percentage of these species in the total count increased significantly during the PHGG intake periods. Among the acid-forming bacteria, Lactobacillus spp. also increased. The fecal pH and fecal bacterial metabolites such as beta-glucuronidase activity, putrefactive products, and ammonia content were significantly decreased by PHGG intake. Two weeks after the end of PHGG intake, the bacterial counts and their biological manifestations appeared to return to the former state
This study aimed to clarify the efficacy, safety, and pharmacokinetics of piperacillin-tazobactam (PIPC-TAZ) in late elderly Japanese patients. This is the first antimicrobial pilot study in late ...elderly patients with nursing and healthcare associated pneumonia. After PIPC-TAZ administration, PIPC concentrations in plasma were measured chromatographically and the pharmacokinetic parameters were estimated. Efficacy, safety, and bacteriological evaluations were also carried out. The mean age was 85.0 years old and most of the patients were late elderly. Chest X-rays, body temperature, white blood cell count, and C reactive protein all improved significantly, and a high efficacy ratio of 90.9% was observed. Serious nephrotoxicity was observed in 4 cases (18.2%) after administration of PIPC-TAZ. Creatinine clearance (mean+-S.D.) measured before PIPC-TAZ therapy was significantly lower in the nephrotoxicity group (32.5+-4.4mL/min) than in the non-nephrotoxicity group (46.1+-16.7mL/min), although the ages were not different between the 2 groups. In the pharmacokinetic parameters for PIPC, total clearance was slightly lower in the nephrotoxicity group than in the non-nephrotoxicity group. However, no significant difference was observed in plasma PIPC levels between the 2 groups. In patients with renal impairment, especially with a creatinine clearance of <40mL/min, renal impairment was found to be an influencing factor for severe nephrotoxicity following PIPC-TAZ administration. In conclusion, the results suggest that physicians should pay close attention in order to avoid possible toxicity, and that deliberate administration planning and careful follow-up are required in late elderly patients with comprised organ dysfunction.
Effects of tea polyphenol intake (0.4 g/volunteer, 3 times per day, for four weeks) on fecal microflora, bacterial metabolites, and pH were investigated using eight healthy human volunteers. Counts ...for Clostridium perfringens and other Clostridium spp. were significantly decreased during the tea polyphenol intake periods. Percentage of volunteers having C. perfringens in their feces decreased significantly, but not for other Clostridium spp. Percentage of Bifidobacterium spp. (the acid forming bacteria) in total counts and the content of volatile fatty acids including acetic and propionic acids increased significantly, which might have reduced the fecal pH. However, the tea polyphenols had no effect on fecal enzyme activities, ammonia, or putrefactive products. Two weeks after discontinuing the intake, the microflora counts and their biological parameters appeared to have returned to normal.
A partially hydrolyzed guar gum preparation (PHGG, average molecular weight: 20, 000), obtained as a water-soluble dietary fiber by digestion of guar gum with β-D-endomannanase, was ad-ministered as ...a beverage (11g a day, bid) to 15 constipated women for 3 weeks. Defecating frequency, pH, weight, moisture, and bacterial flora of the feces were investigated and compared with the control periods. Average total dietary fiber taken from food was 9.7±0.1g/day during the experiment. PHGG caused an increase in the defecating frequency from 0.46±0.05 (frequency/day, M±SE) to 0.63±0.05. Fecal moisture signif-icantly increased from 69.1% in the control period to 73.8% by ingestion of PHGG. Fecal moisture content also increased consistent with lowering the pH of feces (γ=-0.478). The frequency of Lactobacillus spp. occurrence in feces significantly increased (p<0.05) compared with the control period. These results clearly indicate that PHGG softens and improves the output of feces.
Abstract We hypothesized that infusing partially hydrolyzed guar gum (PHGG) into the duodenum would reduce increases in postprandial plasma glucose by decreasing the rate of glucose diffusion from ...the small intestine luminal digesta of the rat. The postprandial plasma glucose and apparent glucose disappearance from the small intestine were measured after infusing artificial digesta containing 0 (control), 3.0, or 6.0 g/L PHGG into the duodenum via a cannula under anesthesia in experiments 1 and 2. The diffusion of glucose in the artificial digesta was estimated using dialysis tubing, filled with the same artificial digesta, soaked in a buffer in experiment 3. In experiment 1, the plasma glucose concentration was lower in the digesta containing 3.0 and 6.0 g/L PHGG than in the control digesta at 120 minutes ( P < .05). The plasma insulin concentration was lower for the digesta containing 6.0 g/L PHGG than for the control digesta at 60 minutes ( P < .05) and lower for the digesta containing 6.0 g/L PHGG than for that containing 3.0 g/L PHGG at 120 minutes ( P < .05).The area under the curve of plasma glucose and insulin (experiment 1), apparent disappearance of glucose in the lumen of the small intestine (experiment 2), and net disappearance of glucose in the dialysis tube depended negatively on the viscosity of the artificial digesta ( P < .05, .05, .001, and .05), which was increased by adding PHGG. Therefore, PHGG can decrease the postprandial blood glucose by lowering the rate of absorption from the small intestine in the rat by reducing the diffusion of glucose in the lumen.
A study was conducted on salt intake in hemodialysis patients. We studied 547 patients who had been undergoing maintenance hemodialysis treatment for over two years as of April 2005 to measure the ...distribution and fluctuation of their salt intake and examine the connection between age, weight and blood pressure. Using the calculation of salt intake at the start of the observation, which was stratified into five groups (less than 6 grams, 6 to 8 grams, 8 to 10 grams, 10 to 12 grams, over 12 grams), and the survival rates measured during the period of the observation, we performed a comparison of salt intake and survival rate in patients below the age of 66 as well as those over the age of 66. The salt intake declined with increase in age and was higher in patients with higher body mass index, but no correlation was found with blood pressure (average BP). The hazard ratio was lower at all levels of salt intake from 6 to 12 g than at less than 6 g by regression analysis. Therefore, it cannot be said that a better prognosis can be maintained by a salt intake of less than 6g. In the group aged over 66, patients with a lot of salt intake were not significantly different, but the survival rate was higher. The recommended salt intake for HD patients is less than 6 grams per day to prevent overflow; however, we believe it is necessary to set a target value for each individual considering age, weight, or level of physical activity, especially since salt intake is largely associated with diet. For elderly patients whose appetites are declining, nutritional guidance should focus on “maintaining the physical condition,” not on the “limitation” of salt and water intake.
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