Nutritional intake of opioid replacement therapy patients in community pharmacies: A pilot study

Aim: Opioid replacement therapy (ORT) is an established therapy for a patient group that has been associated with nutrition-related comorbidities. This paper aims to assess the nutritional intake and supplementation in ORT patients, determine the extent of nutritional/dietary advice supplied to ORT patients and to briefly examine patients' perception of pharmacists' provision of nutritional advice. Methods: The nutritional intake of ORT patients receiving treatment in community pharmacies within the Australian Capital Territory was assessed via a 24-hour recall survey. Food intake data were analysed via nutrient analysis software and compared with Australian Nutrition Reference Values and the nutrient intakes of the Australian population. Patients were surveyed to determine supplement use and perceptions of nutritional advice gained by pharmacists. Results: Potential insufficient intake of various macronutrients and micronutrients was observed in both sexes. Less than 25 of patients recorded supplement use. Fifteen percent of males and 21 of females stated that they had approached a pharmacist with a nutrition-related query. All patients who received nutritional advice followed the advice. Conclusions: ORT patients dosing at community pharmacies appear to have poor nutritional intake. ORT patients appear to be receptive to pharmacist's advice. Community pharmacists can potentially increase the beneficial health outcomes in this population through the proactive supply of accurate nutritional advice.

Archaeaphage therapy to control rumen methanogens

Phage therapy is becoming increasingly important as a means of eradicating or controlling microbial populations and has been raised as a potential strategy to reduce methane emissions from ruminants. To date, very little is currently known about phages which may infect the methane-producing archaeal strains (methanogens) dominant within the rumen of Australian cattle, such as the Methanobrevibacter ruminantium. This project aimed to assemble a collection of phages to be employed in phage therapy. A range of animal-derived and environmental source samples were tested using culture-based methodology, however no lytic phages of methanogens were isolated. Given the dearth of knowledge regarding phages of rumen methanogens, this project established that these naturally-occurring phages may be present in very low concentrations within the rumen and this will need to be considered in future methanogen-phage isolation investigations. The project has begun the process of developing and adapting new methodologies for detecting and examining these phages

Age-related changes in hepatic function: An update on implications for drug therapy

The accumulation of deficits with increasing age results in a decline in the functional capacity of multiple organs and systems. These changes can have a significant influence on the pharmacokinetics and pharmacodynamics of prescribed drugs. Although alterations in body composition and worsening renal clearance are important considerations, for most drugs the liver has the greatest effect on metabolism. Age-related change in hepatic function thereby causes much of the variability in older people’s responses to medication. In this review, we propose that a decline in the ability of the liver to inactivate toxins may contribute to a proinflammatory state in which frailty can develop. Since inflammation also downregulates drug metabolism, medication prescribed to frail older people in accordance with disease-specific guidelines may undergo reduced systemic clearance, leading to adverse drug reactions, further functional decline and increasing polypharmacy, exacerbating rather than ameliorating frailty status. We also describe how increasing chronological age and frailty status impact liver size, blood flow and protein binding and enzymes of drug metabolism. This is used to contextualise our discussion of appropriate prescribing practices. For example, while the general axiom of ‘start low, go slow’ should underpin the initiation of medication (titrating to a defined therapeutic goal), it is important to consider whether drug clearance is flow or capacity-limited. By summarising the effect of age-related changes in hepatic function on medications commonly used in older people, we aim to provide a guide that will have high clinical utility for practising geriatricians.

Organic diet development for black tiger prawns

The survival and growth of black tiger prawn (Penaeus monodon) juveniles (~3.3 g) were compared after feeding in tanks over one month with several prepared diets based on organically certified ingredients. The extrusion process in the manufacture of pelletised experimental diets was similar to processes used in commercial plants and was closely documented. The daily feeding rate (6% of starting mean body weight) was split equally into two feeds, one in the morning and one in the afternoon. All diets tested produced high survival (97-100%). A widely-used commercial Australian prawn feed was used as a control diet. It contained 41.2% protein with 29.5 g kg-1 lysine, and produced the highest (P<0.05) growth (117% weight gain). Three of the experimental organic diets tested (namely, 1. wheat + soy, 2. pig weaner diet + soy, and 3. pig weaner diet + dried fish waste) produced moderate growth (73–77% weight gain). These contained 33%, 36% or 31% protein, respectively, and produced better (P<0.05) growth than diets utilising a range of other prospective ingredients (eg: wheat + dried scallop gut, wheat + fish waste, wheat + chickpea, or wheat + macadamia meal, containing 23%, 25%, 29% or 24% protein, respectively). An unfed control-treatment produced the lowest (P<0.05) growth (4% weight gain). The water stability of the experimental diets that produced the best growth was poorer than the commercial diet, suggesting that improvements in this aspect of these organic feed’s manufacture could result in additional performance benefits and possibly reduced feed wastage. Analyses revealed a linear relationship between diet performance (in terms of weight gains) and the protein and lysine contents of diets. About 70% of diet performance was explained by these factors. The superior performance of the commercial diet could be attributed primarily to its formulation using mainly marine proteins, as well as a range of other unknown factors (commercial in confidence). These other factors range from use of feed attractants, better knowledge of ingredient nutrient availability, different extrusion conditions and the use of other unspecified micro-nutrients not present in the experimental diets. The organic diets studied still require a degree of fine-tuning before structured commercial uptake. This would sensibly include further detailed investigations of the composition and nutrient availabilities of these and other organic dietary ingredients, and refinement of the extrusion process for formulated diets.

Adenoviral gene therapy for non-small cell lung cancer

Adenoviral gene therapy is an experimental approach to cancer refractory to standard cancer therapies. Adenoviruses can be utilized as vectors to deliver therapeutic transgenes into cancer cells, while gene therapy with oncolytic adenoviruses exploits the lytic potential of viruses to kill tumor cells. Although adenoviruses demonstrate several advantages over other vectors - such as the unparalleled transduction efficacy and natural tropism to a wide range of tissues - the gene transfer efficacy to cancer cells has been limited, consequently restricting the therapeutic effect. There are, however, several approaches to circumvent this problem. We utilized different modified adenoviruses to obtain information on adenovirus tropism towards non-small cell lung cancer (NSCLC) cells. To enhance therapeutic outcome, oncolytic adenoviruses were evaluated. Further, to enhance gene delivery to tumors, we used mesenchymal stem cells (MSCs) as carriers. To improve adenovirus specificity, we investigated whether widely used cyclooxygenase 2 (Cox-2) promoter is induced by adenovirus infection in nontarget cells and whether selectivity can be retained by the 3 untranslated region (UTR) AU-rich elements. In addition, we investigated whether switching adenovirus fiber can retain gene delivery in the presence of neutralizing antibodies. Our results show that adenoviruses, whose capsids were modified with arginine-glycine-aspartatic acid (RGD-4C), the serotype 3 knob, or polylysins displayed enhanced gene transfer into NSCLC cell lines and fresh clinical specimens from patients. The therapeutic efficacy was further improved by using respective oncolytic adenoviruses with isogenic 24bp deletion in the E1A gene. Cox-2 promoter was also shown to be induced in normal and tumor cells following adenovirus infection, but utilization of 3 UTR elements can increase the tumor specificity of the promoter. Further, the results suggested that use of MSCs could enhance the bioavailability and delivery of adenoviruses into human tumors, although cells had no tumor tropism per se. Finally, we demonstrated that changing adenovirus fiber can allow virus to escape from existing neutralizing antibodies when delivered systemically. In conclusion, these results reveal that adenovirus gene transfer and specificity can be increased by using modified adenoviruses and MSCs as carriers, and fiber modifications simultaneously decrease the effect of neutralizing antibodies. This promising data suggest that these approaches could translate into clinical testing in patients with NSCLC refractory to current modalities.

The diet of the dingo (Canis lupus dingo and hybrids) in north-eastern Australia: a supplement to the paper of Brook and Kutt (2011)

Dingoes and other wild dogs (Canis lupus dingo and hybrids) are generalist predators that consume a wide variety of different prey species within their range. Little is known, however, of the diets of dingoes in north-eastern Australia where the potential for impacts by dingoes exists. Recently new information has been provided on the diets of dingoes from several sites in Queensland, Australia, significantly adding to the body of published knowledge on ecosystems within this region. Further information on the diet of dingoes in north-eastern Australia is added from 1460 scats collected from five sites, representing tropical savannahs, tropical offshore islands (and a matched mainland area), dry sclerophyll forests and peri-urban areas on the fringe of Townsville. Macropods, possums and bandicoots were found to be common prey for dingoes in these areas. Evidence suggested that the frequency of prey remains in scats can be an unreliable indicator of predation risk to potential prey and it was found that novel and unexpected prey species appear in dingo diets as preferred prey become unavailable. The results support the generalisation that dingoes prefer medium- to large-sized native prey species when available but also highlight the capacity for dingoes to exploit populations of both large and small prey species that might not initially be considered at risk from predation based solely on data on scats.

Honeydew as a source of nutrition for Lysiphlebus testaceipes (Cresson) (Hymenoptera: Braconidae): Effect of adult diet on lifespan and egg load

Parasitoid survival and fecundity is generally enhanced with access to carbohydrate food sources. In many agricultural ecosystems, there is often a scarcity of suitable carbohydrates for parasitoids. This study compared the suitability of aphid honeydew and buckwheat nectar as diet for the aphid parasitoid Lysiphlebus testaceipes. Wasp lifespan and egg load were both increased with access to carbohydrates, but no differences were detected between the various carbohydrates diets tested. As aphid honeydew is a sufficient source of nutrition and L.testaceipes is a short-lived species, adding additional sources of carbohydrates like floral nectar strips to the agricultural landscape is unlikely to significantly increase the biological control exerted by L.testaceipes. © 2012 Australian Entomological Society.

Diet, cell signalling, and tumourigenesis in multiple intestinal neoplasia mice

The incidence of colon cancer is high in Western societies, and in Finland it is among the three most common cancer types in both females and males. Environmental factors, including diet, affect colon cancer development. During the last few years, a vast amount of new, functional foods have been introduced to the consumers. Several products are already available that are marketed as promoting intestinal health. To be able to reliably call a dietary compound a chemopreventive substance it is of fundamental importance to understand the mechanism by which it affects tumour formation and the integrity of the epithelial cells. In this thesis, three different dietary compounds were studied in an experimental model of colon cancer. Inulin is a non-digestible fibre found naturally in chicory roots, artichokes and onions, amongst others. Nowadays it is widely used as an added dietary fibre in several food products. Conjugated linoleic acid (CLA) is a conjugated form of the fatty acid linoleic acid. CLA is formed by bacterial fermentation of linoleic acid in the rumen of cows and other ruminants. Concomitantly, it can naturally be found in milk and meat of ruminants. White currant is a colourless berry low in phenolic compounds that are believed to prevent cancer formation. Contrary to what was expected, inulin and the conjugated linoleic acid isomer trans-10, cis-12, were tumour growth promoting dietary constituents when fed to Min mice. Both diets decreased the NF-kappaB levels in the mucosa, but physiological adenoma development did not affect NF-kappaB. Diet altered beta-catenin and p53 signalling in the adenomas, confirming their involvement in adenoma growth. White currant, on the other hand, was chemopreventive, despite its low contents of phenolic compounds. The chemopreventive effect was accompanied by increased p53 levels in the mucosa, and decreased beta-catenin and NF-kappaB levels in the adenoma. This could explain the reduced adenoma number and size. The results underline the importance of carefully testing new dietary compounds in different settings to reliably confirm their health benefits. In this study two compounds that are consumed and believed to add to our health proved to be cancer promotive. A berry with low phenolic contents, on the other hand, was chemopreventive.

Diet and the development of atherosclerosis: a whole-diet approach from childhood to adulthood

Cardiovascular diseases (CVDs) are the leading cause of mortality in the world. Studies of the impact of single nutrients on the risk for CVD have often provided inconclusive results, and recent research in nutritional epidemiology with a more holistic whole-diet approach has proven fruitful. Moreover, dietary habits in childhood and adolescence may play a role in later health and disease, either independently or by tracking into adulthood. The main aims of this study were to find childhood and adulthood determinants of adulthood diet, to identify dietary patterns present among the study population and to study the associations between long-term food choices and cardiovascular health in young Finnish adults. The study is a part of the multidisciplinary Cardiovascular Risk in Young Finns study, which is an ongoing, prospective cohort study with a 21-year follow-up. At baseline in 1980, the subjects were children and adolescents aged 3 to 18 years (n included in this study = 1768), and young adults aged 24 to 39 years at the latest follow-up study in 2001 (n = 1037). Food consumption and nutrient intakes were assessed with repeated 48-hour dietary recalls. Other determinations have included comprehensive risk factor assessments using blood tests, physical measurements and questionnaires. In the latest follow-up, ultrasound examinations were performed to study early atherosclerotic vascular changes. The average intakes showed substantial changes since 1980. Intakes of fat and saturated fat had decreased, whereas the consumption of fruits and vegetables had increased. Intake of fat and consumption of vegetables in childhood and physical activity in adulthood were important health behavioural determinants of adult diet. Additionally, a principal component analysis was conducted to identify major dietary patterns at each study point. A similar set of two major patterns was recognised throughout the study. The traditional dietary pattern positively correlated with the consumption of traditional Finnish foods, such as rye, potatoes, milk, butter, sausages and coffee, and negatively correlated with fruit, berries and dairy products other than milk. This type of diet was independently associated with several risk factors of CVD, such as total and low-density lipoprotein cholesterol, apolipoprotein B and C-reactive protein concentrations among both genders, as well as with systolic blood pressure and insulin levels among women. The traditional pattern was also independently associated with intima media thickness (IMT), a subclinical predictor of CVD, in men but not in women. The health-conscious pattern, predominant among female subjects, non-smokers and urbanites, was characterised by more health-conscious food choices such as vegetables, legumes and nuts, tea, rye, fish, cheese and other dairy products, as well as by the consumption of alcoholic beverages. This pattern was inversely, but less strongly, associated with cardiovascular risk factors. Tracking of the dietary pattern scores was observed, particularly among subjects who were adolescents at baseline. Moreover, a long-term high intake of protein concurrent with a low intake of fat was positively associated with IMT. These findings suggest that food behaviour and food choices are to some extent established as early as in childhood or adolescence and may significantly track into adulthood. Long-term adherence to traditional food choices seems to increase the risk for developing CVD, especially among men. Those with intentional or unintentional low fat diets, but with high intake of protein may also be at increased risk for CVD. The findings offer practical, food-based information on the relationship between diet and CVD and encourage further use of the whole-diet approach in epidemiological research. The results support earlier findings that long-term food choices play a role in the development of CVD. The apparent influence of childhood habits is important to bear in mind when planning educational strategies for the primary prevention of CVD. Further studies on food choices over the entire lifespan are needed.

Persistence of orally administered Megasphaera elsdenii and Ruminococcus bromii in the rumen of beef cattle fed a high grain (barley) diet

When cattle are fed grain, acidotic ruminal conditions and decreased efficiency in starch utilisation can result from the rapid production and accumulation of lactic acid in the rumen. The efficacy of drenching cattle with Megasphaera elsdenii and Ruminococcus bromii to improve animal performance was investigated. A feedlot trial was undertaken with 80 Bos indicus crossbred steers (initial liveweight 347.1 (s.d. 31.7) kg) in 10 pens in a randomised complete block design. An empty-pen-buffer was maintained between treated (inoculated) and untreated (control) groups to avoid transfer of inoculant bacteria to the control steers. Inoculated steers were orally drenched with M. elsdenii YE34 and R. bromii YE282, and populations increased rapidly over 3-14 days. The steers were fed for a total of 70 days with commercial, barley-based, feedlot rations. High growth rates (1.91 kg per day) were achieved throughout the experiment in both the inoculated and control steers. Intakes averaged 21.3 g dry matter (DM) per kg liveweight per day. There was probably no acidosis achieved in this trial following challenge (i.e. no change in pH occurred). There were no differences in any production or carcass measurements between the control and inoculated steers overall. However, the control group acquired dense ruminal populations of M. elsdenii by Day 14, while R. bromii populations established at high densities within the first 2 weeks but then declined and were undetectable by Day 50. R. bromii appears to be only transiently dominant, and once its dominance waned, it appeared that Ruminobacter spp. established in the rumen. Ruminobacter spp. became dominant between 14 and 28 days in all the steers examined and persisted through to the end of the study. These Ruminobacter spp. may be of future interest in the development of probiotics for grain-fed cattle.