N-acetylcysteine, treatment for Helicobacter pylori infection.

N-acetylcysteine, treatment for Helicobacter pylori infection.

N-Acetylcysteine (NAC), being both a mucolytic agent and a thiol-containing antioxidant, may affect the establishment and maintenance of H. pylori infection within the gastric mucus layer and mucosa.

This study demonstrates that NAC inhibits the growth of H. pylori in both agar and broth susceptibility tests and in H. pylori-infected mice. NAC did not alter the severity of H. pylori- or H. felis-induced gastritis.

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N-Acetylcysteine

Dig Dis Sci. 2004 Nov-Dec;49(11-12):1853-61.

N-acetylcysteine, a novel treatment for Helicobacter pylori infection. Huynh HQ, Couper RT, Tran CD, Moore L, Kelso R, Butler RN. Source Women's Children's Hospital, South Australia. hien.huynh@ualberta.ca Abstract N-Acetylcysteine (NAC), being both a mucolytic agent and a thiol-containing antioxidant, may affect the establishment and maintenance of H. pylori infection within the gastric mucus layer and mucosa. Agar and broth dilution susceptibility tests determined the MIC of H. pylori strain SSI to NAC. H. pylori load in SSI strain-infected C57BL mice was determined as colony forming units per gram of gastric tissue. Gastritis assessment was scored and gastric surface hydrophobicity was determined by contact angle measurement. MICs of NAC were 5 to 10 and 10 to 15 mg/ml using the agar dilution and broth dilution methods, respectively. NAC (120 mg per day for 14 days) reduced the H. pylori load in mice by almost 1 log compared with sham treatment. Pretreatment with NAC (40 mg/day) also significantly reduced the H. pylori load but did not prevent H. pylori colonization. Both H. pylori infection and NAC reduced the surface hydrophobicity of murine gastric mucosa. No significant differences were observed in the gastritis scores of H. felis- or H. pylori-infected mice receiving either NAC or sham treatments. This study demonstrates that NAC inhibits the growth of H. pylori in both agar and broth susceptibility tests and in H. pylori-infected mice. NAC did not alter the severity of H. pylori- or H. felis-induced gastritis. Read more at www.ncbi.nlm.nih.gov

 

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Gastric Bypass improves hormonal factors in Diabetes

Cardiometabolic risk factors, fasting insulin levels decreased "dramatically" from 31.7 to 7.4 mU/L

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From Medscape Medical News

Gastric Bypass Has Weight-Independent Metabolic Benefits

Kate Johnson

December 8, 2011 (Dubai, United Arab Emirates) — Gastric bypass surgery normalized metabolic, inflammatory, and vascular risk markers in obese adolescents despite continued obesity 2 years after surgery, according to results of the Swedish Adolescent Morbid Obesity Study reported here at the International Diabetes Federation (IDF) World Diabetes Congress.

"Bypass surgery seems to have a weight-independent effect, probably due to the release of GLP-1 [glucagon-like peptide-1]," said Emilia Hagman, a PhD student at the Karolinska Institutet, in Stockholm, Sweden, who reported the findings on behalf of her colleague Claude Marcus, MD, PhD, who was unwell.

The nationwide, prospective, nonrandomized study included 81 adolescents (28 males, 53 females) aged 13 to 18 years (mean age, 16.5 years) who underwent laparoscopic gastric bypass surgery between June 2006 and April 2009.

Individuals with mental retardation, severe depression, severe eating disorders, and a history of drug abuse were excluded. However, patients with attention-deficit disorder and minor psychiatric illness were included, and, in fact, 80% of the cohort had some abnormal psychiatric background, Ms. Hagman said.

At baseline, the mean weight of the patients was 133 kg and mean body mass index (BMI) was 45.5 kg/m2.

At 2 years after surgery, after a mean weight loss to 89 kg, the mean BMI of patients remained in the obese range at 30 kg/m2 but was still significantly lower than at baseline (P < .001), she reported.

In terms of cardiometabolic risk factors, fasting insulin levels decreased "dramatically" from 31.7 to 7.4 mU/L, said Ms. Hagman.

Additionally, hemoglobin A1C decreased from 4.37% to 4.17%, fasting glucose from 5.1 to 4.9 mmol/L, low-density lipoprotein cholesterol from 2.6 to 2.0 mmol/L, triglycerides from 1.2 to 0.9 mmol/L, apolipoprotein B from 1.3 to 0.7 g/L, C-reactive protein from 7.2 to 2.5 nmol/L, white blood cell count from 8.2 to 6.5 x 109/L, and blood pressure from 124/78 to 117/71 mm Hg (all changes P < .001).

Meanwhile, both apolipoprotein A increased from 1.13 to 1.33 g/L and high-density lipoprotein cholesterol increased from 1.09 to 1.37 mmol/L (both changes P < .001), she said.

Gastric bypass was chosen over gastric banding because of its better results for long-term weight loss, Ms. Hagman said. "We also know that GLP-1 release is increased with bypass and is unchanged by gastric banding, insulin levels reduce immediately after bypass as opposed to being dependent on weight loss with banding, and diabetes remission is 80% at 2 years post-bypass versus 55% after banding," she added.

Roughly 43% of patients regained some weight between 1 and 2 years after surgery, but this gain did not reverse the positive cardiometabolic changes. However, mean insulin levels were higher among patients who gained weight than in those who did not.

The treatment was generally well tolerated, with quality of life improved for all measures on the Short-Form Health Survey-36, she said.

Adverse events associated with the procedure included reoperation due to gall bladder surgeries (n = 7), intra-abdominal hernia (n = 2), unwanted pregnancy (n = 2), decreased self-esteem (n = 5), self-destructive behavior (n = 2), eating disorders (n = 2), drug abuse (n = 2), and suicide attempts (n = 2). However, the most common adverse effect was low vitamin levels, seen in 55 patients despite prescribed supplementation, she said.

"One has to remember that the psychosocial background for morbidly obese adolescents is already problematic," she said.

"Overall, if you're looking at the metabolic parameters, there's no question that they improve. The question is long-term outcome," said Arya Sharma, MD, PhD, professor of medicine and chair of Obesity Research and Management at the University of Alberta, Edmonton, Canada, who co-chaired of the session at which the study was presented.

"With some of these kids being as young as 13 years, the fact that about 50% of them developed vitamin deficiencies speaks to some of the challenges of gastric bypass surgery," he told Medscape Medical News.

"The problem with a band is that it requires a high degree of patient compliance, so you don't get the kind of weight loss with a banding operation. So, even with the risk of nutritional deficiencies, this study probably doesn't speak against doing bypass, because I know that [these children] are in a very desperate situation and that without treatment or losing weight these kids probably don't have very much of a future."

International Diabetes Federation (IDF) World Diabetes Congress 2011. Abstract #O-0531. Presented December 7, 2011. Read more at www.medscape.com

 

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Weight Loss Improves Beta Cell Function in Type 2 Diabetes

Beta cell function can improve after just 12 weeks of weight loss in patients with type 2 diabetes, according to research presented here at the International Diabetes Federation World Diabetes Congress 2011.

For the first time, these changes have been shown to correlate with a decrease in pancreatic polypeptide, reported Hana Kahleova, MD, from the diabetes centre at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic.

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Weight Loss Improves Beta Cell Function in Type 2 Diabetes

December 7, 2011 (Dubai, United Arab Emirates) — Beta cell function can improve after just 12 weeks of weight loss in patients with type 2 diabetes, according to research presented here at the International Diabetes Federation World Diabetes Congress 2011. For the first time, these changes have been shown to correlate with a decrease in pancreatic polypeptide, reported Hana Kahleova, MD, from the diabetes centre at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. "This is a novel suggestion of a mechanism through which weight loss might improve beta cell function. This is new, and it might help with therapeutic choices," said Dana Dabelea, MD, PhD, associate professor at the Colorado School of Public Health in Aurora, and cochair of the session in which the research was presented. The study involved 74 subjects with type 2 diabetes who were treated with oral hypoglycemic agents. Mean age was 56.6 years, mean body mass index was 35.8 kg/m², and mean glycated hemoglobin level was 7.7%. Subjects were prescribed 12 weeks of a weight-loss diet alone (a reduction of 500 kcal/day) followed by 12 weeks of the same diet but with aerobic exercise added. At baseline, 12 weeks, and 24 weeks, insulin sensitivity was measured using a hyperinsulinemic isoglycemic clamp, plasma concentration of gastrointestinal peptides was measured during a fasting state and during clamp-induced hyperinsulinemia, beta cell function was assessed during standard meal tests, and the insulin secretory rate was calculated by C-peptide deconvolution. In the cohort, mean weight loss was 5.0 kg (P = .001) after 12 weeks of dietary intervention; weight did not change significantly after the addition of exercise, said Dr. Kahleova. Both fasting and stimulated plasma glucose and insulin concentrations decreased in response to the diet. In the case of glucose, there was no change after the addition of exercise, but plasma insulin decreased further with exercise. Similarly, plasma concentrations of C-peptide decreased in response to the diet and further in response to exercise. In addition, peripheral insulin sensitivity and insulin secretion increased, and glucose sensitivity of beta cells increased by 26% in response to the diet without a significant change after the addition of exercise. "We also observed a marked decrease in both fasting and hyperinsulinemic concentrations of pancreatic polypeptide in response to dietary intervention," said Dr. Kahleova. There was no significant change in other gastrointestinal peptides. "Pancreatic polypeptide is a novel marker, and the authors are showing for the first time in the context of caloric restriction that a reduction in pancreatic polypeptide correlated with an improvement in beta cell function," said John Sievenpiper, MD, PhD, from McMaster University in Hamilton, Ontario, Canada, who attended the presentation. "But the bigger story for me is that they showed an improvement in beta cell function following a guidelines-based diet. Beta cell function is really an issue in type 2 diabetes in terms of the natural history and progression of the disease. Anything that can help delay the deterioration is really valuable." Read more at www.medscape.com

 

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Dangers of Sugar in "Fruit" Drinks

Dangers of Sugar in "Fruit" Drinks

Fruit drinks are the devil, apparently.

According to this illustration by healthscience.net, the sugar-pumped cocktails contain more calories than coca-cola and in some cases, a fried chicken leg!

The problem is that almost any liquid concoction can be called a "fruit drink" as long it contains some fruit juice — which more often than not is a measly 10%.

What's worse, for every 8 oz. of sugary drink per day, a child's odds of obesity increase by 60%.

No wonder Americans are getting fatter.

Read more at www.businessinsider.com

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INFOGRAPHIC: Fruit Drinks Are Making Kids Fat

Fruit drinks are the devil, apparently. According to this illustration by healthscience.net, the sugar-pumped cocktails contain more calories than coca-cola and in some cases, a fried chicken leg! The problem is that almost any liquid concoction can be called a "fruit drink" as long it contains some fruit juice — which more often than not is a measly 10%.   What's worse, for every 8 oz. of sugary drink per day, a child's odds of obesity increase by 60%.  No wonder Americans are getting fatter.  Read more at www.businessinsider.com

 

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