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Sample records for xylitol pediatric topical

  1. Xylitol pediatric topical oral syrup to prevent dental caries: a double-blind randomized clinical trial of efficacy.

    PubMed

    Milgrom, Peter; Ly, Kiet A; Tut, Ohnmar K; Mancl, Lloyd; Roberts, Marilyn C; Briand, Kennar; Gancio, Mary Jane

    2009-07-01

    To evaluate the effectiveness of a xylitol pediatric topical oral syrup to reduce the incidence of dental caries among very young children and to evaluate the effect of xylitol in reducing acute otitis media in a subsequent study. Double-blind randomized controlled trial. Communities in the Republic of the Marshall Islands. One hundred eight children aged 9 to 15 months were screened, and 100 were enrolled. Intervention Children were randomized to receive xylitol topical oral syrup (administered by their parents) twice a day (2 xylitol [4.00-g] doses and 1 sorbitol dose) (Xyl-2 x group) or thrice per day (3 xylitol [2.67-g] doses) (Xyl-3x group) vs a control syrup (1 xylitol [2.67-g] dose and 2 sorbitol doses) (control group). The primary outcome end point of the study was the number of decayed primary teeth. A secondary outcome end point was the incidence of acute otitis media for reporting in a subsequent report. Ninety-four children (mean [SD] age, 15.0 [2.7] months at randomization) with at least 1 follow-up examination were included in the intent-to-treat analysis. The mean (SD) follow-up period was 10.5 (2.2) months. Fifteen of 29 of the children in the control group (51.7%) had tooth decay compared with 13 of 32 children in the Xyl-3x group (40.6%) and eight of 33 children in the Xyl-2x group (24.2%). The mean (SD) numbers of decayed teeth were 1.9 (2.4) in the control group, 1.0 (1.4) in the Xyl-3x group, and 0.6 (1.1) in the Xyl-2x group. Compared with the control group, there were significantly fewer decayed teeth in the Xyl-2x group (relative risk, 0.30; 95% confidence interval, 0.13-0.66; P = .003) and in the Xyl-3x group (0.50; 0.26-0.96; P = .04). No statistical difference was noted between the 2 xylitol treatment groups (P = .22). Xylitol oral syrup administered topically 2 or 3 times daily at a total daily dose of 8 g was effective in preventing early childhood caries.

  2. Xylitol pediatric topical oral syrup to prevent dental caries: a double blind, randomized clinical trial of efficacy

    PubMed Central

    Milgrom, Peter; Ly, Kiet A.; Tut, Ohnmar K.; Mancl, Lloyd; Roberts, Marilyn C.; Briand, Kennar; Gancio, Mary Jane

    2009-01-01

    Objective To evaluate the effectiveness of a xylitol pediatric topical oral syrup to reduce the incidence of dental caries of very young children. Design Randomized, double-blinded, controlled trial. Setting Communities in the Republic of the Marshall Islands. Participants 108 children aged 9 to 15 months were screened and 100 were enrolled. Intervention Children were randomized and parents administered topical oral xylitol syrup two times (Xyl-2X, two xylitol 4.00 g/dose + one sorbitol dose) or three times (Xyl-3X, three xylitol 2.67 g/dose) per day (total 8 g) or control (one xylitol 2.67 g/dose + two sorbitol dose). Outcome Measures The outcome end-point of the study was the number of decayed primary teeth. Results Ninety-four of 100 children (mean±SD age, 15.0±2.7 months at randomization) with at least one follow-up exam were included in the intent-to-treat analysis. The mean±SD follow-up period was 10.5±2.2 months. Nearly 52% of children in the control condition had tooth decay compared to 40.6% among Xyl-3X and 24.2% among Xyl-2X conditions. The mean±SD number of decayed teeth was 1.9±2.4 for control, 1.0±1.4 for Xyl-3X, and 0.6±1.1 for Xyl-2X condition. Compared to controls, there was significantly fewer decayed teeth in the Xyl-2X (relative risk [RR], 0.30; 95% confidence interval [CI] 0.13, 0.66; P=.003) and Xyl-3X (RR, 0.50; 95% CI 0.26, 0.96; P=0.037) conditions. There was no statistical difference between the two xylitol treatment conditions (P=0.22). Conclusion Oral xylitol syrup administered topically two or three times each day at a total dose of 8 g was effective in preventing Early Childhood Caries. PMID:19581542

  3. Selected topics in pediatric gastroenterology.

    PubMed

    Magne, Michael L

    2006-05-01

    This article discusses some of the more common gastrointestinal problems encountered in pediatric patients. Topics include infectious and endoparasitic disorders, congenital esophageal and hepatic disorders, and acute or chronic intestinal diseases. Diagnostic criteria as well as treatment guidelines are presented.

  4. Topical benzocaine-induced methemoglobinemia in the pediatric population.

    PubMed

    So, Tsz-Yin; Farrington, Elizabeth

    2008-01-01

    Topical benzocaine is an anesthetic agent that is often used before procedures and clinical tests, such as esophagoscopy, bronchoscopy, and endotracheal intubation. However, a potential deadly condition known as methemoglobinemia can occur with this agent. It causes the oxidation of hemoglobin to methemoglobinemia to occur more rapidly than the reduction of methemoglobin back to hemoglobin. Certain congenital and clinical conditions that affect oxygen delivery can increase the patient's risk of having methemoglobinemia develop with the use of benzocaine. Topical benzocaine-induced methemoglobinemia can occur in the pediatric population. Prompt management with intravenous methylene blue should be initiated for reversal.

  5. A drop in pediatric subject examination scores after curriculum changes that emphasize general pediatric topics.

    PubMed

    Potts, M J; Phelan, K W

    1997-09-01

    To determine whether emphasizing a limited number of general pediatric objectives and using a test based on them would improve student knowledge of the topic areas. Before-after trial. Community-based medical school. Third-year medical students on a required clerkship in pediatrics. Six core objectives: recognizing the seriously ill child, stabilizing such a child, fluid and electrolyte requirements and therapy, newborn care, well child care, and variability of normal vital signs in children based on their age were defined and a modified essay examination was constructed. The test was given to pediatric students close to the end of their clerkship. In study year 1, no warning was given about the examination and results did not affect student grades. In study year 2, passing all items was a requirement and failure required remedial oral examination of any missed items. All students completed the National Board of Medical Examiners pediatric subject examination. For 7 of 8 essay items, significant increases in numbers of students passing were seen in study year 2, but students scored 51 points lower on the National Board of Medical Examiners pediatric subject examination (P=.002). The decrease in scores was not seen in any other clerkship or among pediatric students from a different campus of the medical school. Emphasis on core objectives and an essay examination significantly improved students' knowledge of the defined topics but decreased the scores on the National Board of Medical Examiners subject examination. This may be attributable to a difference in content between the 2 tests. Faculty proposing new curriculum guidelines need to review student assessment methods to avoid such unexpected changes in scores.

  6. Topical EMLA cream versus prilocaine infiltration for pediatric cardiac catheterization.

    PubMed

    Pirat, Arash; Karaaslan, Pelin; Candan, Selim; Zeyneloglu, Pinar; Varan, Birgul; Tokel, Kursat; Torgay, Adnan; Arslan, Gulnaz

    2005-10-01

    first-attempt cannulation success in the EMLA and control groups were 75% and 45% (p = 0.05). The study showed that EMLA cream provides adequate topical anesthesia for femoral vessel cannulation during pediatric cardiac catheterization and may also increase the likelihood of cannulation success. However, use of this cream has no effect on sedative-analgesic requirements or on the risks of hemodynamic and respiratory complications during this procedure.

  7. Do systematic reviews on pediatric topics need special methodological considerations?

    PubMed

    Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

    2017-03-06

    Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which

  8. Pediatric Traumatic Brain Injury. Special Topic Report #3.

    ERIC Educational Resources Information Center

    Waaland, Pamela K.; Cockrell, Janice L.

    This brief report summarizes what is known about pediatric traumatic brain injury, including the following: risk factors (e.g., males especially those ages 5 to 25, youth with preexisting problems including previous head injury victims, and children receiving inadequate supervision); life after injury; physical and neurological consequences (e.g.,…

  9. Xylitol and caries prevention.

    PubMed

    Duane, Brett

    2015-06-01

    Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, Web of Science Conference Proceedings, Proquest Dissertations and Theses, US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No language or year restrictions were used. Randomised controlled trials assessing the effects of xylitol products on dental caries in children and adults. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. Authors were contacted where possible for missing data or clarification where feasible. For continuous outcomes, means and standard deviations were used to obtain the mean difference and 95% confidence interval (CI). Continuous data was used to calculate prevented fractions (PF) and 95% CIs to summarise the percentage reduction in caries. For dichotomous outcomes, reported risk ratios (RR) and 95% CIs were used. As there were fewer than four studies included in the meta-analysis, a fixed effect model was used. Ten studies were included with a total of 5903 participants. One study was assessed as being at low risk of bias, two were assessed as unclear risk of bias with seven at high risk of bias. Over 2.5–3 years, low quality evidence demonstrated that with 4216 children analysed, a fluoride toothpaste with 10% xylitol (exact dosage unsure) reduced caries by 13% when compared to a fluoride only toothpaste. (PF −0.13, 95% CI −0.18 to −0.08. Remaining evidence of the use of xylitol in children has risk of bias and uncertainty of effect and was therefore insufficient to determine a benefit from xylitol. Four studies reported that there were no adverse effects from any of the interventions. Two studies reported similar rates of adverse effects between study arms. The remaining studies either mentioned adverse effects

  10. Long-term clinical and bacterial effects of xylitol on patients with fixed orthodontic appliances.

    PubMed

    Masoud, Mohamed I; Allarakia, Reem; Alamoudi, Najlaa M; Nalliah, Romesh; Allareddy, Veerasathpurush

    2015-01-01

    The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of xylitol per day for 3 months on patients with full fixed orthodontic appliances. The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the different approaches at reducing the caries risk. Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS counts than the control group nor did they have lower values at any of the time points. Chewing gum did not significantly increase the incidence of debonded brackets over the other groups. Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial counts in patients with full fixed appliances regardless of whether or not xylitol was used.

  11. A rare sugar xylitol. Part II: biotechnological production and future applications of xylitol.

    PubMed

    Granström, Tom Birger; Izumori, Ken; Leisola, Matti

    2007-02-01

    Xylitol is the first rare sugar that has global markets. It has beneficial health properties and represents an alternative to current conventional sweeteners. Industrially, xylitol is produced by chemical hydrogenation of D-xylose into xylitol. The biotechnological method of producing xylitol by metabolically engineered yeasts, Saccharomyces cerevisiae or Candida, has been studied as an alternative to the chemical method. Due to the industrial scale of production, xylitol serves as an inexpensive starting material for the production of other rare sugars. The second part of this mini-review on xylitol will look more closely at the biotechnological production and future applications of the rare sugar, xylitol.

  12. 21 CFR 172.395 - Xylitol.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CONSUMPTION (CONTINUED) FOOD ADDITIVES PERMITTED FOR DIRECT ADDITION TO FOOD FOR HUMAN CONSUMPTION Special Dietary and Nutritional Additives § 172.395 Xylitol. Xylitol may be safely used in foods for special...

  13. 21 CFR 172.395 - Xylitol.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... CONSUMPTION (CONTINUED) FOOD ADDITIVES PERMITTED FOR DIRECT ADDITION TO FOOD FOR HUMAN CONSUMPTION Special Dietary and Nutritional Additives § 172.395 Xylitol. Xylitol may be safely used in foods for special...

  14. Xylitol and Your Dog: Danger, Paws Off

    MedlinePlus

    ... Home For Consumers Consumer Updates Xylitol and Your Dog: Danger, Paws Off Share Tweet Linkedin Pin it ... vitamins mouthwash toothpaste Why is Xylitol Dangerous to Dogs, but Not People? In both people and dogs, ...

  15. Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System

    PubMed Central

    Vohra, Rais; Huntington, Serena; Koike, Jennifer; Le, Kevin; Geller, Richard J.

    2017-01-01

    Introduction Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. Methods This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. Results The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5–20%), with 4 cases reporting methemoglobin levels between 20.2%–55%. Methylene blue was administered in 4 of the cases exhibiting major effects. Conclusion The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products. PMID:28874945

  16. Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System.

    PubMed

    Vohra, Rais; Huntington, Serena; Koike, Jennifer; Le, Kevin; Geller, Richard J

    2017-08-01

    Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5-20%), with 4 cases reporting methemoglobin levels between 20.2%-55%. Methylene blue was administered in 4 of the cases exhibiting major effects. The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products.

  17. Topics

    ERIC Educational Resources Information Center

    Mathematics Teaching, 1972

    1972-01-01

    Topics discussed in this column include patterns of inverse multipliers in modular arithmetic; diagrams for product sets, set intersection, and set union; function notation; patterns in the number of partitions of positive integers; and tessellations. (DT)

  18. Topical Review: Unique Contributions of Magnetic Resonance Imaging to Pediatric Psychology Research

    PubMed Central

    Duraccio, Kara M.; Carbine, Kaylie M.; Kirwan, C. Brock

    2016-01-01

    Objective This review aims to provide a brief introduction of the utility of magnetic resonance imaging (MRI) methods in pediatric psychology research, describe several exemplar studies that highlight the unique benefits of MRI techniques for pediatric psychology research, and detail methods for addressing several challenges inherent to pediatric MRI research. Methods Literature review. Results Numerous useful applications of MRI research in pediatric psychology have been illustrated in published research. MRI methods yield information that cannot be obtained using neuropsychological or behavioral measures. Conclusions Using MRI in pediatric psychology research may facilitate examination of neural structures and processes that underlie health behaviors. Challenges inherent to conducting MRI research with pediatric research participants (e.g., head movement) may be addressed using evidence-based strategies. We encourage pediatric psychology researchers to consider adopting MRI techniques to answer research questions relevant to pediatric health and illness. PMID:26141118

  19. Xylitol concentrations in artificial saliva after application of different xylitol dental varnishes

    PubMed Central

    PEREIRA, Agnes de Fátima Faustino; da SILVA, Thiago Cruvinel; da SILVA, Thelma Lopes; CALDANA, Magali de Lourdes; BASTOS, José Roberto Magalhães; BUZALAF, Marília Afonso Rabelo

    2012-01-01

    Objective The present study analyzed xylitol concentrations in artificial saliva over time after application of varnishes containing 10% and 20% xylitol. Material and Methods Fifteen bovine enamel specimens (8x4 mm) were randomly allocated to 3 groups (n=5/group), according to the type of varnish used: 10% xylitol, 20% xylitol and no xylitol (control). After varnish application (4 mg), specimens were immersed in vials containing 500 µL of artificial saliva. Saliva samples were collected in different times (1, 8, 12, 16, 24, 48 and 72 h) and xylitol concentrations were analyzed. Data were assessed by two-way repeated-measures ANOVA (p<0.05). Results Colorimetric analysis was not able to detect xylitol in saliva samples of the control group. Salivary xylitol concentrations were significantly higher up to 8 h after application of the 20% xylitol varnish. Thereafter, the 10% xylitol varnish released larger amounts of that polyol in artificial saliva. Conclusions Despite the results in short-term, sustained xylitol releases could be obtained when the 10% xylitol varnish was used. These varnishes seem to be viable alternatives to increase salivary xylitol levels, and therefore, should be clinically tested to confirm their effectiveness. PMID:22666828

  20. [The topical problems of pediatric balneotherapy and the spa and health resort-based treatment of the children].

    PubMed

    Razumov, A N; Khan, M A

    2016-01-01

    This article is devoted to the topical problems of pediatric balneotherapy with special reference to the organization of the spa and health resort-based treatment of the children in the Russian Federation. The main issues discussed by the authors include the current state of health resort care for the children, the problem of statutory regulation of the activities of the children's spa and health resort facilities, the approaches to increasing the availability of the spa and health resort-based treatment for the children at the enhanced risk of the development of chronic diseases, disabilities, and tuberculosis. Also considered are the problems of the development of the regulatory framework for the medical rehabilitation of the children based at the spa and health resort facilities. The principal goals to be sought in climatotherapy, physiotherapy, balneotherapy, and pelotherapy in the pediatric context are outlined along with the further prospects for the development of the main areas of pediatric balneology.

  1. Topical Review: Unique Contributions of Magnetic Resonance Imaging to Pediatric Psychology Research.

    PubMed

    Jensen, Chad D; Duraccio, Kara M; Carbine, Kaylie M; Kirwan, C Brock

    2016-03-01

    This review aims to provide a brief introduction of the utility of magnetic resonance imaging (MRI) methods in pediatric psychology research, describe several exemplar studies that highlight the unique benefits of MRI techniques for pediatric psychology research, and detail methods for addressing several challenges inherent to pediatric MRI research. Literature review. Numerous useful applications of MRI research in pediatric psychology have been illustrated in published research. MRI methods yield information that cannot be obtained using neuropsychological or behavioral measures. Using MRI in pediatric psychology research may facilitate examination of neural structures and processes that underlie health behaviors. Challenges inherent to conducting MRI research with pediatric research participants (e.g., head movement) may be addressed using evidence-based strategies. We encourage pediatric psychology researchers to consider adopting MRI techniques to answer research questions relevant to pediatric health and illness. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Army's "look for xylitol first" program.

    PubMed

    Richter, Pamila; Chaffin, Jeffrey

    2004-01-01

    Xylitol is a sugar substitute not well known in the United States. This sugar substitute is not only low in calories but can also help prevent dental caries. The U.S. Army Dental Command's Health Promotion Program is constantly seeking additional prevention measures to enhance the oral health of America's Army. The Dental Command has created the "Look for Xylitol First" initiative aimed at training all members of the dental care team on the positive benefits of xylitol and to teach patients how to be smart consumers and evaluate products for their xylitol content.

  3. Analysis of readability and quality of web pages addressing both common and uncommon topics in pediatric surgery.

    PubMed

    Adorisio, Ottavio; Silveri, Massimiliano; Rivosecchi, Massimo; Tozzi, Alberto Eugenio; Scottoni, Federico; Buonuomo, Paola Sabrina

    2012-06-01

    The quality medical information on Internet is highly variable. The aim of this study is to determine if Web pages addressing four common pediatric surgical topics (CT) and four uncommon pediatric surgical topics (UT) differ significantly in terms of quality and/or characteristics. We performed an Internet search regarding four CT, addressing more frequent clinical conditions with an incidence≤1:1.500 children (inguinal hernia, varicocele, umbilical hernia, and phimosis) and four UT addressing less frequent clinical conditions with an incidence≥1:1.500 children (anorectal malformation, intestinal atresia, gastroschisis, and omphalocele), using a popular search engine (Google). We evaluated readability with the Flesch reading ease (FRE) and the Flesch-Kincaid grade (FKG) and quality of content using the site checker of the HON Code of Conduct (HON code) for each website. In this study, 30/40 websites addressing CT versus 33/50 addressing UT responded to our criteria. No differences statistically significant in advertisements between the two groups were found (15 vs. 16%) (p>0.05). No differences were found in terms of time from last update, owner/author type, financial disclosure, accreditation, or advertising. CT had higher quality level according to the HON code (6.54±1.38 vs. 5.05±1.82) (p<0.05). Mean FRE was 47.38±14.27 versus 46.24±14.56, respectively, for CT and UT (p>0.05). The mean FKG was 8.1±1.9 for CT versus 8±1.9 for UT (p>0.05). Websites devoted to pediatric surgical topics have higher readability and quality information for disease diagnosis and natural history. Otherwise, the quality of pediatric surgical information on the Internet is high for CT and UT. A high reading level is required to use these resources. Copyright © 2012 by Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Comparative Effects of Topical 0.2% Sirolimus for Angiofibromas in Adults and Pediatric Patients with Tuberous Sclerosis Complex.

    PubMed

    Lee, Young In; Lee, Ju Hee; Kim, Do Young; Chung, Kee Yang; Shin, Jung U

    2018-06-20

    Recent reports have suggested that the topical formulation of sirolimus is effective in treating facial angiofibromas in tuberous sclerosis complex (TSC). Here, we determined the safety and efficacy of 0.2% topical sirolimus for the treatment of facial angiofibroma and compared its effects based on age. This was a retrospective study which involved 36 TSC patients with facial angiofibromas who were treated with 0.2% sirolimus ointment. Its effect was evaluated using the Facial Angiofibroma Severity Index (FASI). In order to observe its comparative effect based on patient age, a subgroup analysis was performed, between the adult group (> 18 years old) and the pediatric group (≤18 years old). The total FASI as well as its subcategories (erythema, size, and extent) showed statistically significant improvements after the topical treatment with 0.2% sirolimus ointment (FASI before treatment: 7.2 ± 1.1, FASI after treatment: 4.4± 1.4, p < 0.001). Among the subcategories of FASI, the erythema was most significantly reduced with the fastest response to the treatment. In a subgroup analysis, the pediatric group showed significantly greater improvements in FASI (improvement of FASI in the pediatric group = 49.7 ± 12.2%, adult group = 27.9 ± 15.6%, p < 0.001). The serial improvement analysis also showed that the pediatric group achieved a consistently greater improvement in FASI at all visits. Its 1-year application in 3 patients demonstrated a continuous maintenance effect. No significant adverse effects were observed. 0.2% sirolimus ointment is safe and effective for facial angiofibromas. Considering its higher efficacy in younger patients, an early initiation of the treatment is recommended. © 2018 S. Karger AG, Basel.

  5. Topical review: sluggish cognitive tempo: research findings and relevance for pediatric psychology.

    PubMed

    Becker, Stephen P

    2013-11-01

    To summarize recent research on sluggish cognitive tempo (SCT) and consider the potential relevance of SCT for the field of pediatric psychology. Literature review. Recent empirical evidence shows SCT symptoms consisting of sluggish/sleepy and daydreamy behaviors to be distinct from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. SCT is associated with psychosocial functioning in children and adolescents, including internalizing symptoms, social withdrawal, and, possibly, academic impairment. The recent findings reviewed suggest that SCT is an important construct for pediatric psychologists to be aware of and may also be directly useful for the research and practice of pediatric psychology.

  6. Hot topics, urgent priorities, and ensuring success for racial/ethnic minority young investigators in academic pediatrics.

    PubMed

    Flores, Glenn; Mendoza, Fernando S; Fuentes-Afflick, Elena; Mendoza, Jason A; Pachter, Lee; Espinoza, Juan; Fernandez, Cristina R; Arnold, Danielle D P; Brown, Nicole M; Gonzalez, Kymberly M; Lopez, Cynthia; Owen, Mikah C; Parks, Kenya M; Reynolds, Kimberly L; Russell, Christopher J

    2016-12-09

    The number of racial/ethnic minority children will exceed the number of white children in the USA by 2018. Although 38% of Americans are minorities, only 12% of pediatricians, 5% of medical-school faculty, and 3% of medical-school professors are minorities. Furthermore, only 5% of all R01 applications for National Institutes of Health grants are from African-American, Latino, and American Indian investigators. Prompted by the persistent lack of diversity in the pediatric and biomedical research workforces, the Academic Pediatric Association Research in Academic Pediatrics Initiative on Diversity (RAPID) was initiated in 2012. RAPID targets applicants who are members of an underrepresented minority group (URM), disabled, or from a socially, culturally, economically, or educationally disadvantaged background. The program, which consists of both a research project and career and leadership development activities, includes an annual career-development and leadership conference which is open to any resident, fellow, or junior faculty member from an URM, disabled, or disadvantaged background who is interested in a career in academic general pediatrics. As part of the annual RAPID conference, a Hot Topic Session is held in which the young investigators spend several hours developing a list of hot topics on the most useful faculty and career-development issues. These hot topics are then posed in the form of six "burning questions" to the RAPID National Advisory Committee (comprised of accomplished, nationally recognized senior investigators who are seasoned mentors), the RAPID Director and Co-Director, and the keynote speaker. The six compelling questions posed by the 10 young investigators-along with the responses of the senior conference leadership-provide a unique resource and "survival guide" for ensuring the academic success and optimal career development of young investigators in academic pediatrics from diverse backgrounds. A rich conversation ensued on the topics

  7. Topical Review: Integrating Findings on Direct Observation of Family Communication in Studies Comparing Pediatric Chronic Illness and Typically Developing Samples.

    PubMed

    Murphy, Lexa K; Murray, Caitlin B; Compas, Bruce E

    2017-01-01

    To review research on observed family communication in families with children with chronic illnesses compared with families with healthy, typically developing children, and to integrate findings utilizing a unifying family communication framework. Topical review of studies that have directly observed family communication in pediatric populations and included a typically developing comparison group. Initial findings from 14 studies with diverse approaches to quantifying observed family communication suggest that families with children with chronic illnesses may demonstrate lower levels of warm and structured communication and higher levels of hostile/intrusive and withdrawn communication compared with families with healthy, typically developing children. An integrative framework of family communication may be used in future studies that examine the occurrence, correlates, and mechanisms of family communication in pediatric populations.

  8. 21 CFR 172.395 - Xylitol.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES PERMITTED FOR DIRECT ADDITION TO FOOD FOR HUMAN CONSUMPTION Special Dietary and Nutritional Additives § 172.395 Xylitol. Xylitol may be safely used in foods for special...

  9. The effectiveness of xylitol in a school-based cluster-randomized clinical trial.

    PubMed

    Lee, Wonik; Spiekerman, Charles; Heima, Masahiro; Eggertsson, Hafsteinn; Ferretti, Gerald; Milgrom, Peter; Nelson, Suchitra

    2015-01-01

    The purpose of this double-blind, cluster-randomized clinical trial was to examine the effects of xylitol gummy bear snacks on dental caries progression in primary and permanent teeth of inner-city school children. A total of 562 children aged 5-6 years were recruited from five elementary schools in East Cleveland, Ohio. Children were randomized by classroom to receive xylitol (7.8 g/day) or placebo (inulin fiber 20 g/day) gummy bears. Gummy bears were given three times per day for the 9-month kindergarten year within a supervised school environment. Children in both groups also received oral health education, toothbrush and fluoridated toothpaste, topical fluoride varnish treatment and dental sealants. The numbers of new decayed, missing, and filled surfaces for primary teeth (dmfs) and permanent teeth (DMFS) from baseline to the middle of 2nd grade (exit exam) were compared between the treatment (xylitol/placebo) groups using an optimally-weighted permutation test for cluster-randomized data. The mean new d(3-6)mfs at the exit exam was 5.0 ± 7.6 and 4.0 ± 6.5 for the xylitol and placebo group, respectively. Similarly, the mean new D(3-6)MFS was 0.38 ± 0.88 and 0.48 ± 1.39 for the xylitol and placebo group, respectively. The adjusted mean difference between the two groups was not statistically significant: new d(3-6)mfs: mean 0.4, 95% CI -0.25, 0.8), and new D(3-6)MFS: mean 0.16, 95% CI -0.16, 0.43. Xylitol consumption did not have additional benefit beyond other preventive measures. Caries progression in the permanent teeth of both groups was minimal, suggesting that other simultaneous prevention modalities may have masked the possible beneficial effects of xylitol in this trial. © 2014 S. Karger AG, Basel.

  10. Xylitol chewing gum and dental caries.

    PubMed

    Tanzer, J M

    1995-02-01

    There is an extensive peer-reviewed literature on xylitol chewing gum as it pertains to effects on tooth decay in human subjects, on human dental plaque reduction, on inhibition of dental plaque acid production, on inhibition of the growth and metabolism of the mutans group of streptococci which are the prime causative agents of tooth decay, on reduction of tooth decay in experimental animals, and on xylitol's reported contribution to the remineralisation of teeth. The literature not only supports the conclusion that xylitol is non-cariogenic but it is now strongly suggestive that xylitol is caries inhibitory, that is, anti-cariogenic in human subjects, and it supplies reasonable mechanistic explanation(s).

  11. Comparison of topical oxybuprocaine and intravenous fentanyl in pediatric strabismus surgery

    PubMed Central

    Yousafzai, Ibrahim; Zahoor, Abdul; Andrey, Butrov; Ahmad, Nauman

    2017-01-01

    Purpose: To compare the outcomes such as postoperative nausea/vomiting, analgesic requirements, and hospital stay following the use of topical oxybuprocaine hydrochloride 0.4% or intravenous (IV) fentanyl in children undergoing strabismus surgery. Methods: This was a prospective cohort study. Children operated under general anesthesia for strabismus were given topical oxybuprocaine hydrochloride 0.4% (Group T) and IV fentanyl (Group F) before surgery. The episodes of nausea/vomiting, pain score, requirement of additional analgesia during postoperative period, and duration of hospital stay were compared in two groups. Results: There were 47 children in Group T and 59 children in Group F. The median pain score in two groups were 2.38 (25% quartile; 2.0) and 3.00 (25% quartile; 3.00), respectively. The difference was significant (K W P < 0.03). The episodes of nausea/vomiting in two groups were in 2 and 6 children in Group T and Group F, respectively. The median hospital stay of children of Group T and Group F were 242 and 285 min, respectively. The difference was not statistically significant (P = 0.22). Conclusions: Using intraoperative topical oxybuprocaine drops, one can achieve better analgesic outcomes and reduce risk of nausea and vomiting compared to intravenous opioid analgesics and therefore, the hospital stay could also be marginally reduced. PMID:28217057

  12. Comparison of topical oxybuprocaine and intravenous fentanyl in pediatric strabismus surgery.

    PubMed

    Yousafzai, Ibrahim; Zahoor, Abdul; Andrey, Butrov; Ahmad, Nauman

    2017-01-01

    To compare the outcomes such as postoperative nausea/vomiting, analgesic requirements, and hospital stay following the use of topical oxybuprocaine hydrochloride 0.4% or intravenous (IV) fentanyl in children undergoing strabismus surgery. This was a prospective cohort study. Children operated under general anesthesia for strabismus were given topical oxybuprocaine hydrochloride 0.4% (Group T) and IV fentanyl (Group F) before surgery. The episodes of nausea/vomiting, pain score, requirement of additional analgesia during postoperative period, and duration of hospital stay were compared in two groups. There were 47 children in Group T and 59 children in Group F. The median pain score in two groups were 2.38 (25% quartile; 2.0) and 3.00 (25% quartile; 3.00), respectively. The difference was significant (K W P < 0.03). The episodes of nausea/vomiting in two groups were in 2 and 6 children in Group T and Group F, respectively. The median hospital stay of children of Group T and Group F were 242 and 285 min, respectively. The difference was not statistically significant ( P = 0.22). Using intraoperative topical oxybuprocaine drops, one can achieve better analgesic outcomes and reduce risk of nausea and vomiting compared to intravenous opioid analgesics and therefore, the hospital stay could also be marginally reduced.

  13. Successful treatment of pediatric nail psoriasis with periodic pustular eruption using topical indigo naturalis oil extract.

    PubMed

    Liang, Chung-Yu; Lin, Tung-Yi; Lin, Yin-Ku

    2013-01-01

    Psoriasis of the nail greatly affects quality of life because of the difficulty in achieving long-lasting remission. Pustular psoriasis of the nail apparatus is characterized by the formation of sterile pustules, starting on one or two fingers or less often on the toes, and spontaneous improvement has rarely been observed. This case presents a girl with refractory nail psoriasis accompanied by periodic pustular eruption that responded well to topical treatment with indigo naturalis oil extract drops, achieving a remission of longer than 1 year. © 2012 Wiley Periodicals, Inc.

  14. [Clinical application of mass spectrometry in the pediatric field: current topics].

    PubMed

    Yamaguchi, Seiji

    2013-09-01

    Mass spectrometry, including tandem mass spectrometry (MS/MS) and gas chromatography-mass spectrometry (GC/MS), is becoming prominent in the diagnosis of metabolic disorders in the pediatric field. It enables biochemical diagnosis of metabolic disorders from the metabolic profiles obtained by MS/MS and/or GC/MS. In neonatal mass screening for inherited metabolic disease (IMD) using MS/MS, amino acids and acylcarnitines on dried blood spots are analyzed. The target diseases include amino acidemia, urea cycle disorder, organic acidemia, and fatty acid oxidation disorder. In the MS/MS screening, organic acid analysis using GC/MS is required for differential and/or definite diagnosis of the IMDs. GC/MS data processing, however, is difficult, and metabolic diagnosis often requires the necessary skills and expertize. We developed an automated system of GC/MS data processing and autodiagnosis, and the biochemical diagnosis using GC/MS became markedly easier and user-friendly. Mass spectrometric techniques will expand from research laboratories to clinical laboratories in the near future.

  15. Analysis of metabolisms and transports of xylitol using xylose- and xylitol-assimilating Saccharomyces cerevisiae.

    PubMed

    Tani, Tatsunori; Taguchi, Hisataka; Akamatsu, Takashi

    2017-05-01

    To clarify the relationship between NAD(P) + /NAD(P)H redox balances and the metabolisms of xylose or xylitol as carbon sources, we analyzed aerobic and anaerobic batch cultures of recombinant Saccharomyces cerevisiae in a complex medium containing 20 g/L xylose or 20 g/L xylitol at pH 5.0 and 30°C. The TDH3p-GAL2 or gal80Δ strain completely consumed the xylose within 24 h and aerobically consumed 92-100% of the xylitol within 96 h, but anaerobically consumed only 20% of the xylitol within 96 h. Cells of both strains grew well in aerobic culture. The addition of acetaldehyde (an effective oxidizer of NADH) increased the xylitol consumption by the anaerobically cultured strain. These results indicate that in anaerobic culture, NAD + generated in the NAD(P)H-dependent xylose reductase reaction was likely needed in the NAD + -dependent xylitol dehydrogenase reaction, whereas in aerobic culture, the NAD + generated by oxidation of NADH in the mitochondria is required in the xylitol dehydrogenase reaction. The role of Gal2 and Fps1 in importing xylitol into the cytosol and exporting it from the cells was analyzed by examining the xylitol consumption in aerobic culture and the export of xylitol metabolized from xylose in anaerobic culture, respectively. The xylitol consumptions of gal80Δ gal2Δ and gal80Δ gal2Δ fps1Δ strains were reduced by 81% and 88% respectively, relative to the gal80Δ strain. The maximum xylitol concentration accumulated by the gal80Δ, gal80Δ gal2Δ, and gal80Δ gal2Δ fps1Δ strains was 7.25 g/L, 5.30 g/L, and 4.27 g/L respectively, indicating that Gal2 and Fps1 transport xylitol both inward and outward. Copyright © 2017 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  16. Antifungal Activity of Lactobacillus sp. Bacteria in the Presence of Xylitol and Galactosyl-Xylitol.

    PubMed

    Lipińska, Lidia; Klewicki, Robert; Klewicka, Elżbieta; Kołodziejczyk, Krzysztof; Sójka, Michał; Nowak, Adriana

    2016-01-01

    Lactic acid fermentation is a natural method of antimicrobial food protection. Antagonistic activity of Lactobacillus sp. bacteria, taking part in this process, is directed mainly against the same or other microorganisms. In this work we determine the impact of the presence of xylitol and galactosyl-xylitol on the antagonistic activity of 60 Lactobacillus sp. strains against indicator molds (Alternaria alternata, Alternaria brassicicola, Aspergillus niger, Fusarium latenicum, Geotrichum candidum, and Mucor hiemalis) and yeasts (Candida vini). We used double-layer method to select antifungal strains of Lactobacillus bacteria and poisoned medium method to confirm their fungistatic properties. Additionally, we examined the inhibition of Alternaria brassicicola by Lactobacillus paracasei ŁOCK 0921 cultivated with xylitol or galactosyl-xylitol directly on wild cherries. The presence of xylitol and its galactosyl derivative led to increase of spectrum of antifungal activity in most of the studied plant-associated lactobacilli strains. However, no single strain exhibited activity against all the indicator microorganisms. The antifungal activity of Lactobacillus bacteria against molds varied considerably and depended on both the indicator strain and the composition of the medium. The presence of xylitol and galactosyl-xylitol in the growth medium is correlated with the antifungal activity of the studied Lactobacillus sp. bacteria against selected indicator molds.

  17. Antifungal Activity of Lactobacillus sp. Bacteria in the Presence of Xylitol and Galactosyl-Xylitol

    PubMed Central

    Lipińska, Lidia; Klewicki, Robert; Klewicka, Elżbieta; Kołodziejczyk, Krzysztof; Sójka, Michał; Nowak, Adriana

    2016-01-01

    Lactic acid fermentation is a natural method of antimicrobial food protection. Antagonistic activity of Lactobacillus sp. bacteria, taking part in this process, is directed mainly against the same or other microorganisms. In this work we determine the impact of the presence of xylitol and galactosyl-xylitol on the antagonistic activity of 60 Lactobacillus sp. strains against indicator molds (Alternaria alternata, Alternaria brassicicola, Aspergillus niger, Fusarium latenicum, Geotrichum candidum, and Mucor hiemalis) and yeasts (Candida vini). We used double-layer method to select antifungal strains of Lactobacillus bacteria and poisoned medium method to confirm their fungistatic properties. Additionally, we examined the inhibition of Alternaria brassicicola by Lactobacillus paracasei ŁOCK 0921 cultivated with xylitol or galactosyl-xylitol directly on wild cherries. The presence of xylitol and its galactosyl derivative led to increase of spectrum of antifungal activity in most of the studied plant-associated lactobacilli strains. However, no single strain exhibited activity against all the indicator microorganisms. The antifungal activity of Lactobacillus bacteria against molds varied considerably and depended on both the indicator strain and the composition of the medium. The presence of xylitol and galactosyl-xylitol in the growth medium is correlated with the antifungal activity of the studied Lactobacillus sp. bacteria against selected indicator molds. PMID:27294124

  18. The in vitro mucolytic effect of xylitol and dornase alfa on chronic rhinosinusitis mucus.

    PubMed

    Hardcastle, Tim; Jain, Ravi; Radcliff, Fiona; Waldvogel-Thurlow, Sharon; Zoing, Melissa; Biswas, Kristi; Douglas, Richard

    2017-09-01

    The overproduction and stagnation of purulent mucus impair mucociliary clearance and exacerbate the symptoms of chronic rhinosinusitis (CRS). There is a clinical need for effective topical mucolytic agents to facilitate removal of mucus and improve postoperative outcomes. The effects of xylitol (5%) and dornase alfa (1 mg/mL) on mucus and mucus crusts were investigated. Viscoelasticity and viscosity of wet mucus derived from 30 CRS patients was measured with a plate rheometer. Postoperative dried mucus crust dissolution was measured by examining peripheral transparency, central transparency, and border definition of treated crust samples from 17 CRS patients. Xylitol and dornase alfa reduced wet mucus viscoelasticity at a frequency of 0.1 Hz significantly more than the saline control. Treatments also produced significantly lower viscosities than saline at a shear rate of 10 and 100 seconds -1 . Xylitol and dornase alfa significantly decreased mucus crust border definition relative to saline. Xylitol and dornase alfa may be efficacious mucolytics, encouraging the breakdown of postoperative mucus crusts and the reduction of viscoelasticity and viscosity of wet mucus. In vivo study is required to evaluate the potential of these agents in treating recalcitrant CRS. © 2017 ARS-AAOA, LLC.

  19. Protective Effect of Dietary Xylitol on Influenza A Virus Infection

    PubMed Central

    Yin, Sun Young; Kim, Hyoung Jin; Kim, Hong-Jin

    2014-01-01

    Xylitol has been used as a substitute for sugar to prevent cavity-causing bacteria, and most studies have focused on its benefits in dental care. Meanwhile, the constituents of red ginseng (RG) are known to be effective in ameliorating the symptoms of influenza virus infection when they are administered orally for 14 days. In this study, we investigated the effect of dietary xylitol on influenza A virus infection (H1N1). We designed regimens containing various fractions of RG (RGs: whole extract, water soluble fraction, saponin and polysaccharide) and xylitol, and combination of xylitol with the RG fractions. Mice received the various combinations orally for 5 days prior to lethal influenza A virus infection. Almost all the mice died post challenge when xylitol or RGs were administered separately. Survival was markedly enhanced when xylitol was administered along with RGs, pointing to a synergistic effect. The effect of xylitol plus RG fractions increased with increasing dose of xylitol. Moreover, dietary xylitol along with the RG water soluble fraction significantly reduced lung virus titers after infection. Therefore, we suggest that dietary xylitol is effective in ameliorating influenza-induced symptoms when it is administered with RG fractions, and this protective effect of xylitol should be considered in relation to other diseases. PMID:24392148

  20. Xylitol gum and maternal transmission of mutans streptococci.

    PubMed

    Nakai, Y; Shinga-Ishihara, C; Kaji, M; Moriya, K; Murakami-Yamanaka, K; Takimura, M

    2010-01-01

    An important caries prevention strategy for children includes measures to interfere with transmission of mutans streptococci (MS). This study confirmed the effectiveness of maternal early exposure to xylitol chewing gum on mother-child transmission of MS. After screening, 107 pregnant women with high salivary MS were randomized into two groups: xylitol gum (Xylitol; n = 56) and no gum (Control; n = 51) groups. Maternal chewing started at the sixth month of pregnancy and terminated 13 months later in the Xylitol group. Outcome measures were the presence of MS in saliva or plaque of the children until age 24 months. The Xylitol-group children were significantly less likely to show MS colonization than Control-group children aged 9-24 months. The Control-group children acquired MS 8.8 months earlier than those in the Xylitol group, suggesting that maternal xylitol gum chewing in Japan shows beneficial effects similar to those demonstrated in Nordic countries.

  1. Effect of solvent on crystallization behavior of xylitol

    NASA Astrophysics Data System (ADS)

    Hao, Hongxun; Hou, Baohong; Wang, Jing-Kang; Lin, Guangyu

    2006-04-01

    Effect of organic solvents content on crystallization behavior of xylitol was studied. Solubility and crystallization kinetics of xylitol in methanol-water system were experimentally determined. It was found that the solubility of xylitol at various methanol content all increases with increase of temperature. But it decreases when increasing methanol content at constant temperature. Based on the theory of population balance, the nucleation and growth rates of xylitol in methanol-water mixed solvents were calculated by moments method. From a series of experimental population density data of xylitol gotten from a batch-operated crystallizer, parameters of crystal nucleation and growth rate equations at different methanol content were got by the method of nonlinear least-squares. By analyzing, it was found that the content of methanol had an apparent effect on nucleation and growth rate of xylitol. At constant temperature, the nucleation and growth rate of xylitol all decrease with increase of methanol content.

  2. Products based on olive oil, betaine, and xylitol in the post-radiotherapy xerostomia.

    PubMed

    Martín, Margarita; Marín, Alicia; López, Mario; Liñán, Olga; Alvarenga, Felipe; Büchser, David; Cerezo, Laura

    2017-01-01

    The objective of this study was determining if the use of products based in olive oil, betaine and xylitol are efficacious to decrease the impact of the dry mouth in the quality of life of the patients with xerostomia due to radiotherapy treatment. Following therapeutic irradiation of the head and neck, patients with profound xerostomia have complaints associated with oral dryness, speech, and taste. There is no strong evidence that any topical therapy is effective for relieving the symptom of dry mouth. 40 patients who had been treated with radiotherapy for head and neck carcinoma and reported symptoms of dry mouth were included in the study. A xerostomia-related quality of life questionnaire, visual analogue scale questionnaire for subjective assessment of salivary dysfunction and salivary flow were reported before and 15 days after the use of topical products based on olive oil, betaina and xylitol. The four primary quality of life areas demonstrated significantly greater improvement after the use of topical products and all eight VAS items had favourable changes. The reduction of symptoms was statistically significant in 7 of the 8 items. After the use of the products, there were improvements in salivary flow in 45%. The use of products based on olive oil, betaine and xylitol, shaped like collutory, toothpaste, gel and spray significantly improved most symptoms and the quality of life limitations produced by dry mouth in patients treated with radiotherapy.

  3. Pediatrics

    NASA Technical Reports Server (NTRS)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  4. Evaluation of cotton stalk hydrolysate for xylitol production.

    PubMed

    Sapcı, Burcu; Akpinar, Ozlem; Bolukbasi, Ufuk; Yilmaz, Levent

    2016-07-03

    Cotton stalk is a widely distributed and abundant lignocellulosic waste found in Turkey. Because of its rich xylose content, it can be a promising source for the production of xylitol. Xylitol can be produced by chemical or biotechnological methods. Because the biotechnological method is a simple process with great substrate specificity and low energy requirements, it is more of an economic alternative for the xylitol production. This study aimed to use cotton stalk for the production of xylitol with Candida tropicalis Kuen 1022. For this purpose, the combined effects of different oxygen concentration, inoculum level and substrate concentration were investigated to obtain high xylitol yield and volumetric xylitol production rate. Candida tropicalis Kuen 1022 afforded different concentrations of xylitol depending on xylose concentration, inoculum level, and oxygen concentration. The optimum xylose, yeast concentration, and airflow rate for cotton stalk hydrolysate were found as 10.41 g L(-1), 0.99 g L(-1), and 1.02 vvm, respectively, and under these conditions, xylitol yield and volumetric xylitol production rate were obtained as 36% and 0.06 g L(-1) hr(-1), respectively. The results of this study show that cotton stalk can serve as a potential renewable source for the production of xylitol.

  5. Xylitol Chewing Gums on the Market: Do They Prevent Caries?

    PubMed

    Alanzi, Abrar; Soderling, Eva; Varghese, Anisha; Honkala, Eino

    To measure the xylitol content in sugar-free chewing gums available on the market in Gulf Cooperation Council (GCC) countries in the Middle East, in order to identify those products that can provide the recommended daily dose of xylitol for caries prevention (6-7 g). Acid production from chewing gums was also measured in vitro and in vivo. Twenty-one chewing gums containing xylitol were identified and collected from the GCC market (Kuwait, Bahrain, Qatar, Saudi Arabia, UAE and Oman). Xylitol was extracted and its concentration was analysed using a special enzymatic kit. The pH of extracts was measured during 30-min incubation with Streptococcus mutans. Changes in saliva and plaque pH were noted in four subjects after the consumption of highly concentrated xylitol gums. The xylitol content in grams was clearly mentioned only on one product's label. Twelve products stated the percentage of xylitol (3.5% to 35%). The rest did not specify the amount. The mean measured weight of one piece of gum was 1.67 ± 0.38 g. The mean measured xylitol content/piece was 0.33 ± 0.21 g. Xylitol content was < 0.3 g/ piece in 9 products, 0.3-0.5 g in 7 and > 0.5 g in 5 products. None of the highly concentrated xylitol gums showed a pH drop in vitro or in vivo. One chewing gum, containing xylitol and glucose, resulted in a low pH level (< 5.5) when tested in vitro. The majority of xylitol chewing gums sold on the GCC market do not provide the consumers with the recommended daily dose of xylitol for caries prevention. Clear, accurate labeling is recommended.

  6. 21 CFR 172.395 - Xylitol.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 3 2014-04-01 2014-04-01 false Xylitol. 172.395 Section 172.395 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD ADDITIVES PERMITTED FOR DIRECT ADDITION TO FOOD FOR HUMAN CONSUMPTION Special Dietary and Nutritional Additives § 172...

  7. Preliminary safety assessment of C-8 xylitol monoester and xylitol phosphate esters.

    PubMed

    Silveira, J E P S; Pereda, M C V; Nogueira, C; Dieamant, G; Cesar, C K M; Assanome, K M; Silva, M S; Torello, C O; Queiroz, M L S; Eberlin, S

    2016-02-01

    Most of the cosmetic compounds with preservative properties available in the market pose some risks concerning safety, such as the possibility of causing sensitization. Due to the fact that there are few options, the proper development of new molecules with this purpose is needed. Xylitol is a natural sugar, and the antimicrobial properties of xylitol-derived compounds have already been described in the literature. C-8 xylitol monoester and xylitol phosphate esters may be useful for the development of skincare products. As an initial screen for safety of chemicals, the combination of in silico methods and in vitro testing can aid in prioritizing resources in toxicological investigations while reducing the ethical and monetary costs that are related to animal and human testing. This study was designed to evaluate the safety of C-8 xylitol monoester and xylitol phosphate esters regarding carcinogenicity, mutagenicity, skin and eye irritation/corrosion and sensitization through alternative methods. For the initial safety assessment, quantitative structure-activity relationship methodology was used. The prediction of the parameters carcinogenicity/mutagenicity, skin and eye irritation/corrosion and sensitization was generated from the chemical structure. The analysis also comprised physical-chemical properties, Cramer rules, threshold of toxicological concern and Michael reaction. In silico results of candidate molecules were compared to 19 compounds with preservative properties that are available in the market. Additionally, in vitro tests (Ames test for mutagenicity, cytotoxicity and phototoxicity tests and hen's egg test--chorioallantoic membrane for irritation) were performed to complement the evaluation. In silico evaluation of both molecules presented no structural alerts related to eye and skin irritation, corrosion and sensitization, but some alerts for micronucleus and carcinogenicity were detected. However, by comparison, C-8 xylitol monoester, xylitol

  8. Enhanced xylitol production: Expression of xylitol dehydrogenase from Gluconobacter oxydans and mixed culture of resting cell.

    PubMed

    Qi, Xiang-Hui; Zhu, Jing-Fei; Yun, Jun-Hua; Lin, Jing; Qi, Yi-Lin; Guo, Qi; Xu, Hong

    2016-09-01

    Xylitol has numerous applications in food and pharmaceutical industry, and it can be biosynthesized by microorganisms. In the present study, xdh gene, encoding xylitol dehydrogenase (XDH), was cloned from the genome of Gluconobacter oxydans CGMCC 1.49 and overexpressed in Escherichia coli BL21. Sequence analysis revealed that XDH has a TGXXGXXG NAD(H)-binding motif and a YXXXK active site motif, and belongs to the short-chain dehydrogenase/reductase family. And then, the enzymatic properties and kinetic parameter of purified recombinant XDH were investigated. Subsequently, transformations of xylitol from d-xylulose and d-arabitol, respectively, were studied through mixed culture of resting cells of G. oxydans wild-type strain and recombinant strain BL21-xdh. We obtained 28.80 g/L xylitol by mixed culture from 30 g/L d-xylulose in 28 h. The production was increased by more than three times as compared with that of wild-type strain. Furthermore, 25.10 g/L xylitol was produced by the mixed culture from 30 g/L d-arabitol in 30 h with a yield of 0.837 g/g, and the max volumetric productivity of 0.990 g/L h was obtained at 22 h. These contrast to the fact that wild-type strain G. oxydans only produced 8.10 g/L xylitol in 30 h with a yield of 0.270 g/g. To our knowledge, these values are the highest among the reported yields and productivity efficiencies of xylitol from d-arabitol with engineering strains. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  9. Effects of xylitol on xylitol-sensitive versus xylitol-resistant Streptococcus mutans strains in a three-species in vitro biofilm.

    PubMed

    Marttinen, Aino M; Ruas-Madiedo, Patricia; Hidalgo-Cantabrana, Claudio; Saari, Markku A; Ihalin, Riikka A; Söderling, Eva M

    2012-09-01

    We studied the effects of xylitol on biofilms containing xylitol-resistant (Xr) and xylitol-sensitive (Xs) Streptococcus mutans, Actinomyces naeslundii and S. sanguinis. The biofilms were grown for 8 and 24 h on hydroxyapatite discs. The viable microorganisms were determined by plate culturing techniques and fluorescence in situ hybridization (FISH) was performed using a S. mutans-specific probe. Extracellular cell-bound polysaccharides (EPS) were determined by spectrofluorometry from single-species S. mutans biofilms. In the presence of 5 % xylitol, the counts of the Xs S. mutans decreased tenfold in the young (8 h) biofilm (p < 0.05) but no effect was seen in the mature (24 h) biofilm. No decrease was observed for the Xr strains, and FISH confirmed these results. No differences were detected in the EPS production of the Xs S. mutans grown with or without xylitol, nor between Xr and Xs S. mutans strains. Thus, it seems that xylitol did not affect the EPS synthesis of the S. mutans strains. Since the Xr S. mutans strains, not inhibited by xylitol, showed no xylitol-induced decrease in the biofilms, we conclude that growth inhibition could be responsible for the decrease of the counts of the Xs S. mutans strains in the clinically relevant young biofilms.

  10. The in vitro effect of xylitol on chronic rhinosinusitis biofilms.

    PubMed

    Jain, R; Lee, T; Hardcastle, T; Biswas, K; Radcliff, F; Douglas, R

    2016-12-01

    Biofilms have been implicated in chronic rhinosinusitis (CRS) and may explain the limited efficacy of antibiotics. There is a need to find more effective, non-antibiotic based therapies for CRS. This study examines the effects of xylitol on CRS biofilms and planktonic bacteria. Crystal violet assay and spectrophotometry were used to quantify the effects of xylitol (5% and 10% solutions) against Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus. The disruption of established biofilms, inhibition of biofilm formation and effects on planktonic bacteria growth were investigated and compared to saline and no treatment. Xylitol 5% and 10% significantly reduced biofilm biomass (S. epidermidis), inhibited biofilm formation (S. aureus and P. aeruginosa) and reduced growth of planktonic bacteria (S. epidermidis, S. aureus, and P. aeruginosa). Xylitol 5% inhibited formation of S. epidermidis biofilms more effectively than xylitol 10%. Xylitol 10% reduced S. epidermidis planktonic bacteria more effectively than xylitol 5%. Saline, xylitol 5% and 10% disrupted established biofilms of S. aureus when compared with no treatment. No solution was effective against established P. aeruginosa biofilm. Xylitol has variable activity against biofilms and planktonic bacteria in vitro and may have therapeutic efficacy in the management of CRS.

  11. Optimization of fed-batch fermentation for xylitol production by Candida tropicalis.

    PubMed

    Kim, J-H; Han, K-C; Koh, Y-H; Ryu, Y-W; Seo, J-H

    2002-07-01

    Xylitol, a functional sweetener, was produced from xylose by biological conversion using Candida tropicalis ATCC 13803. Based on a two-substrate fermentation using glucose for cell growth and xylose for xylitol production, fed-batch fermentations were undertaken to increase the final xylitol concentration. The effects of xylose and xylitol on xylitol production rate were studied to determine the optimum concentrations for fed-batch fermentation. Xylose concentration in the medium (100 g l(-1)) and less than 200 g l(-1) total xylose plus xylitol concentration were determined as optimum for maximum xylitol production rate and xylitol yield. Increasing the concentrations of xylose and xylitol decreased the rate and yield of xylitol production and the specific cell growth rate, probably because of an increase in osmotic stress that would interfere with xylose transport, xylitol flux to secretion to cell metabolism. The feeding rate of xylose solution during the fed-batch mode of operation was determined by using the mass balance equations and kinetic parameters involved in the equations in order to increase final xylitol concentration without affecting xylitol and productivity. The optimized fed-batch fermentation resulted in 187 g l(-1) xylitol concentration, 0.75 g xylitol g xylose(-1) xylitol yield and 3.9 g xylitol l(-1) h(-1) volumetric productivity.

  12. Research Findings on Xylitol and the Development of Xylitol Vehicles to Address Public Health Needs

    PubMed Central

    Milgrom, P.; Ly, K.A.; Rothen, M.

    2013-01-01

    Xylitol has been demonstrated to be a safe and effective tooth decay preventive agent when used habitually. Nevertheless, its application has been limited by absence of formulations that demand minimal adherence and are acceptable and safe in settings where chewing gum may not be allowed. A substantial literature suggests that a minimum of five to six grams and three exposures per day from chewing gum or candies are needed for a clinical effect. At the same time there is conflicting evidence in the literature from toothpaste studies suggesting that lower-doses and less frequent exposures might be effective. The growing use of xylitol as a sweetener in low amounts in foods and other consumables is, simultaneously, increasing the overall exposure of the public to xylitol and may have additive benefits. PMID:19710081

  13. Xylitol prevents NEFA-induced insulin resistance in rats

    PubMed Central

    Kishore, P.; Kehlenbrink, S.; Hu, M.; Zhang, K.; Gutierrez-Juarez, R.; Koppaka, S.; El-Maghrabi, M. R.

    2013-01-01

    Aims/hypothesis Increased NEFA levels, characteristic of type 2 diabetes mellitus, contribute to skeletal muscle insulin resistance. While NEFA-induced insulin resistance was formerly attributed to decreased glycolysis, it is likely that glucose transport is the rate-limiting defect. Recently, the plant-derived sugar alcohol xylitol has been shown to have favourable metabolic effects in various animal models. Furthermore, its derivative xylulose 5-phosphate may prevent NEFA-induced suppression of glycolysis. We therefore examined whether and how xylitol might prevent NEFA-induced insulin resistance. Methods We examined the ability of xylitol to prevent NEFA-induced insulin resistance. Sustained ~1.5-fold elevations in NEFA levels were induced with Intralipid/heparin infusions during 5 h euglycaemic–hyperinsulinaemic clamp studies in 24 conscious non-diabetic Sprague-Dawley rats, with or without infusion of xylitol. Results Intralipid infusion reduced peripheral glucose uptake by ~25%, predominantly through suppression of glycogen synthesis. Co-infusion of xylitol prevented the NEFA-induced decreases in both glucose uptake and glycogen synthesis. Although glycolysis was increased by xylitol infusion alone, there was minimal NEFA-induced suppression of glycolysis, which was not affected by co-infusion of xylitol. Conclusions/interpretation We conclude that xylitol prevented NEFA-induced insulin resistance, with favourable effects on glycogen synthesis accompanying the improved insulin-mediated glucose uptake. This suggests that this pentose sweetener has beneficial insulin-sensitising effects. PMID:22460760

  14. Production of xylitol from D-xylose by Debaryomyces hansenii

    SciTech Connect

    Dominguez, J.M.; Gong, Cheng S.; Tsao, G.T.

    1997-12-31

    Xylitol, a naturally occurring five-carbon sugar alcohol, can be produced from D-xylose through microbial hydrogenation. Xylitol has found increasing use in the food industries, especially in confectionary. It is the only so-called {open_quotes}second-generation polyol sweeteners{close_quotes} that is allowed to have the specific health claims in some world markets. In this study, the effect of cell density on the xylitol production by the yeast Debaryomyces hansenii NRRL Y-7426 from D-xylose under microaerobic conditions was examined. The rate of xylitol production increased with increasing yeast cell density to 3 g/L. Beyond this amount there was no increase in the xylitol production withmore » increasing cell density. The optimal pH range for xylitol production was between 4.5 and 5.5. The optimal temperature was between 28 and 37{degrees}C, and the optimal shaking speed was 300 rpm. The rate of xylitol production increased linearly with increasing initial xylose concentration. A high concentration of xylose (279 g/L) was converted rapidly and efficiently to produce xylitol with a product concentration of 221 g/L was reached after 48 h of incubation under optimum conditions. 18 refs., 5 figs.« less

  15. [The cariogenicity of xylitol in the animal experiment].

    PubMed

    Karle, E J

    1977-01-01

    After programmed feeding of rats in a six and eight-week long conventional experiment with increasing concentrations of xylitol, compared to sorbitol, fructose and saccharose, the non-cariogenic nature of xylitol was confirmed. The increasing amounts of xylitol after sorbitol in chocolate diets (up to 30 g/day/rat) led to serious dilatation of the cecum and to changes in the mucosa of cecum and colon when sorbitol was given. Examination of plaques of the germ-free rats monoassociated with S. mutans showed that xylitol had no bacteriostatic effect on this type of germ. Since xylitol is not broken down by these germs with acid being formed, careis did not continue to extend.

  16. Microbial production of xylitol from xylose and L-arabinose: conversion of L-arabitol to xylitol using bacterial oxidoreductases

    USDA-ARS?s Scientific Manuscript database

    Microbial production of xylitol, using hemicellulosic biomass such as agricultural residues, is becoming more attractive for reducing its manufacturing cost. L-arabitol is a particular problem to xylitol production from hemicellulosic hydrolyzates that contain both xylose and L-arabinose because it...

  17. Synergistic inhibition of Streptococcal biofilm by ribose and xylitol.

    PubMed

    Lee, Heon-Jin; Kim, Se Chul; Kim, Jinkyung; Do, Aejin; Han, Se Yeong; Lee, Bhumgey David; Lee, Hyun Ho; Lee, Min Chan; Lee, So Hui; Oh, Taejun; Park, Sangbin; Hong, Su-Hyung

    2015-02-01

    Streptococcus mutans and Streptococcus sobrinus are the major causative agents of human dental caries. Therefore, the removal or inhibition of these streptococcal biofilms is essential for dental caries prevention. In the present study, we evaluated the effects of ribose treatment alone or in combination with xylitol on streptococcal biofilm formation for both species. Furthermore, we examined the expression of genes responsible for dextran-dependent aggregation (DDAG). In addition, we investigated whether ribose affects the biofilm formation of xylitol-insensitive streptococci, which results from long-term exposure to xylitol. The viability of streptococci biofilms formed in a 24-well polystyrene plate was quantified by fluorescent staining with the LIVE/DEAD bacterial viability and counting kit, which was followed by fluorescence activated cell sorting analysis. The effects of ribose and/or xylitol on the mRNA expression of DDAG-responsible genes, gbpC and dblB, was evaluated by RT-qPCR. Our data showed that ribose and other pentose molecules significantly inhibited streptococcal biofilm formation and the expression of DDAG-responsible genes. In addition, co-treatment with ribose and xylitol decreased streptococcal biofilm formation to a further extent than ribose or xylitol treatment alone in both streptococcal species. Furthermore, ribose attenuated the increase of xylitol-insensitive streptococcal biofilm, which results in the reduced difference of biofilm formation between S. mutans that are sensitive and insensitive to xylitol. These data suggest that pentose may be used as an additive for teeth-protective materials or in sweets. Furthermore, ribose co-treatment with xylitol might help to increase the anti-cariogenic efficacy of xylitol. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Possible mechanisms for the cariostatic effect of xylitol.

    PubMed

    Mäkinen, K K

    1976-01-01

    Xylitol appears to be the only known cariostatic natural carbohydrate which meets most of the desiderata for a sweetener in the human diet. Possible mechanisms for this cariostatic action can be derived from a consideration of the factors which may be operating at a molecular and microbiological level. These include: a) Molecular size and e.g. the short, open-chain structure and absence of reducing groups b) Absence or relative lack in most oral microorganisms of xylitol-binding factors in dental plaque c) Lack of bacterial genes coding for xylitol-utilizing enzymes or of inducible or de-repressible genes for this purpose d) Inhibition of enzymes involved in cariogenesis (competitive in case of some isomerases) e) Enzyme specificity requirements f) Higher osmotic pressure exerted by xylitol as compared to hexoses and disaccharides g) Ability of xylitol to produce a favourable electrolyte concentration in the saliva without lowering plaque pH h) Ability of xylitol to increase the secretion and activity of salivary lactoperoxidase and certain other (muco) proteins. Xylitol may enhance the adsorption of glycoproteins on the tooth surfaces and strengthen the acquired pellicle.

  19. Acute Hepatic Failure in a Dog after Xylitol Ingestion.

    PubMed

    Schmid, Renee D; Hovda, Lynn R

    2016-06-01

    Xylitol is a five-carbon sugar alcohol produced from natural resources frequently used as a sugar substitute for humans. We report the development and successful treatment of acute hepatic failure and coagulopathy in a dog after xylitol ingestion. A 9-year-old 4.95 kg (10.9 lb) neutered male Chihuahua was evaluated at a veterinary clinic for vomiting after ingesting 224 g (45 g/kg, 20.5 g/lb) of granulated xylitol. Hypoglycemia developed within 1-2 h, elevated liver values, suggesting the development of acute hepatic failure, within 12 h and coagulopathy less than 24 h after ingestion. Treatment included maropitant, intravenous dextrose, phytonadione, metronidazole, and fresh frozen plasma. N-acetylcysteine (NAC) and S-adensoyl-L-methionine (SAMe) provided hepatic detoxification and support. The dog survived and liver values returned to normal within 1 month post ingestion. No adverse effects to hepatic function have been identified 2 years after acute xylitol toxicity. This paper is one of the few reports of successful management of a dog with hypoglycemia, hepatic failure, and coagulopathy caused by xylitol toxicity. To date, this is the highest published xylitol dose survived by a dog, as well as the only reported case that documents laboratory changes throughout the course of toxicity and includes normal hepatic indices for 7 months following xylitol toxicity. The rapidly expanding use of xylitol in a variety of products intended for human consumption has led to a rise in xylitol toxicity cases reported in dogs, and clinicians should be aware that more dogs may potentially be exposed and develop similar manifestations.

  20. Potential Allergens in Disposable Diaper Wipes, Topical Diaper Preparations, and Disposable Diapers: Under-recognized Etiology of Pediatric Perineal Dermatitis.

    PubMed

    Yu, JiaDe; Treat, James; Chaney, Keri; Brod, Bruce

    2016-01-01

    Allergic contact dermatitis in young children may be an under-recognized cause of perineal dermatitis. The diapered infant skin is uniquely susceptible to allergic contact dermatitis because of more permeable neonatal skin, a moist environment, frequent contact with irritants and resultant skin barrier breakdown, and exposure to topical products such as diaper wipes, diaper preparations, and disposable diapers. To our knowledge, potential allergens in these products have not been thoroughly catalogued or studied. We explore and review potential allergenic ingredients in diaper wipes, topical diaper preparations, and disposable diapers. We analyzed 63 diaper wipes, 41 topical diaper preparations, and the 3 top selling diaper brands available from two of the largest retailers in the United States. Each potential allergen is discussed, and epidemiologic studies of rates of sensitization to potential allergens in children are also reported. Botanical extracts, including members of the Compositae family, were the most commonly represented potential allergen in both diaper wipes and topical preparations. Other potential allergens identified with high frequency include α-tocopherol, fragrances, propylene glycol, parabens, iodopropynyl butylcarbamate, and lanolin. Frequent culprits such as formaldehyde releasers and methylchloroisothiazolinone/methylisothiazolinone were not prevalent in our analyzed products.

  1. Bioconversion of lignocellulosic biomass to xylitol: An overview.

    PubMed

    Venkateswar Rao, Linga; Goli, Jyosthna Khanna; Gentela, Jahnavi; Koti, Sravanthi

    2016-08-01

    Lignocellulosic wastes include agricultural and forest residues which are most promising alternative energy sources and serve as potential low cost raw materials that can be exploited to produce xylitol. The strong physical and chemical construction of lignocelluloses is a major constraint for the recovery of xylose. The large scale production of xylitol is attained by nickel catalyzed chemical process that is based on xylose hydrogenation, that requires purified xylose as raw substrate and the process requires high temperature and pressure that remains to be cost intensive and energy consuming. Therefore, there is a necessity to develop an integrated process for biotechnological conversion of lignocelluloses to xylitol and make the process economical. The present review confers about the pretreatment strategies that facilitate cellulose and hemicellulose acquiescent for hydrolysis. There is also an emphasis on various detoxification and fermentation methodologies including genetic engineering strategies for the efficient conversion of xylose to xylitol. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Microencapsulation of xylitol by double emulsion followed by complex coacervation.

    PubMed

    Santos, Milla G; Bozza, Fernanda T; Thomazini, Marcelo; Favaro-Trindade, Carmen S

    2015-03-15

    The objective of this study was to produce and characterise xylitol microcapsules for use in foods, in order to prolong the sweetness and cooling effect provided by this ingredient. Complex coacervation was employed as the microencapsulation method. A preliminary double emulsion step was performed due to the hydrophilicity of xylitol. The microcapsules obtained were characterised in terms of particle size and morphology (optical, confocal and scanning electron microscopy), solubility, sorption isotherms, FTIR, encapsulation efficiency and release study. The microcapsules of xylitol showed desirable characteristics for use in foods, such as a particle size below 109 μm, low solubility and complete encapsulation of the core by the wall material. The encapsulation efficiency ranged from 31% to 71%, being higher in treatments with higher concentrations of polymers. Release of over 70% of the microencapsulated xylitol in artificial saliva occurred within 20 min. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Xylitol Syrup for the Prevention of Acute Otitis Media

    PubMed Central

    Corwin, Michael J.; Vezina, Richard M.; Pelton, Steven I.; Feldman, Henry A.; Coyne-Beasley, Tamera; Mitchell, Allen A.

    2014-01-01

    BACKGROUND: Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions for US children. Xylitol, a naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as a gum or syrup, but a more convenient dosing regimen is needed for widespread adoption. METHODS: We designed a pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at a dose of 5 g 3 times per day could reduce the occurrence of clinically diagnosed AOM among otitis-prone children 6 months through 5 years of age. RESULTS: A total of 326 subjects were enrolled, with 160 allocated to xylitol and 166 to placebo. In the primary analysis of time to first clinically diagnosed AOM episode, the hazard ratio for xylitol versus placebo recipients was 0.88 (95% confidence interval [CI] 0.61 to 1.3). In secondary analyses, the incidence of AOM was 0.53 episodes per 90 days in the xylitol group versus 0.59 in the placebo group (difference 0.06; 95% CI –0.25 to 0.13); total antibiotic use was 6.8 days per 90 days in the xylitol group versus 6.4 in the placebo group (difference 0.4; 95% CI –1.8 to 2.7). The lack of effectiveness was not explained by nonadherence to treatment, as the hazard ratio for those taking nearly all assigned xylitol compared with those taking none was 0.93 (95% CI 0.56 to 1.57). CONCLUSIONS: Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitis-prone children. PMID:24394686

  4. Bronchoscopic assessment of airway retention time of aerosolized xylitol

    PubMed Central

    Durairaj, Lakshmi; Neelakantan, Srividya; Launspach, Janice; Watt, Janet L; Allaman, Margaret M; Kearney, William R; Veng-Pedersen, Peter; Zabner, Joseph

    2006-01-01

    Background Human airway surface liquid (ASL) has abundant antimicrobial peptides whose potency increases as the salt concentration decreases. Xylitol is a 5-carbon sugar that has the ability to lower ASL salt concentration, potentially enhancing innate immunity. Xylitol was detected for 8 hours in the ASL after application in airway epithelium in vitro. We tested the airway retention time of aerosolized iso-osmotic xylitol in healthy volunteers. Methods After a screening spirometry, volunteers received 10 ml of nebulized 5% xylitol. Bronchoscopy was done at 20 minutes (n = 6), 90 minutes (n = 6), and 3 hours (n = 5) after nebulization and ASL was collected using microsampling probes, followed by bronchoalveolar lavage (BAL). Xylitol concentration was measured by nuclear magnetic resonance spectroscopy and corrected for dilution using urea concentration. Results All subjects tolerated nebulization and bronchoscopy well. Mean ASL volume recovered from the probes was 49 ± 23 μl. The mean ASL xylitol concentration at 20, 90, and 180 minutes was 1.6 ± 1.9 μg/μl, 0.6 ± 0.6 μg/μl, and 0.1 ± 0.1 μg/μl, respectively. Corresponding BAL concentration corrected for dilution was consistently lower at all time points. The terminal half-life of aerosolized xylitol obtained by the probes was 45 minutes with a mean residence time of 65 minutes in ASL. Corresponding BAL values were 36 and 50 minutes, respectively. Conclusion After a single dose nebulization, xylitol was detected in ASL for 3 hours, which was shorter than our in vitro measurement. The microsampling probe performed superior to BAL when sampling bronchial ASL. PMID:16483382

  5. Xylitol production by a Pichia stipitis D-xylulokinase mutant

    Treesearch

    Yong-Su Jin; Jose Cruz; Thomas W. Jeffries

    2005-01-01

    Xylitol production by Pichia stipitis FPL-YS30, a xyl3-Ä1 mutant that metabolizes xylose using an alternative metabolic pathway, was investigated under aerobic and oxygen-limited culture conditions. Under both culture conditions, FPL-YS30 (xyl3-Ä1) produced a negligible amount of ethanol and converted xylose mainly into xylitol with comparable yields (0.30 and 0.27 g...

  6. The yeast Scheffersomyces amazonensis is an efficient xylitol producer.

    PubMed

    Cadete, Raquel M; Melo-Cheab, Monaliza A; Viana, Adriana L; Oliveira, Evelyn S; Fonseca, César; Rosa, Carlos A

    2016-12-01

    This study assessed the efficiency of Scheffersomyces amazonensis UFMG-CM-Y493 T , cultured in xylose-supplemented medium (YPX) and rice hull hydrolysate (RHH), to convert xylose to xylitol under moderate and severe oxygen limitation. The highest xylitol yields of 0.75 and 1.04 g g -1 in YPX and RHH, respectively, were obtained under severe oxygen limitation. However, volumetric productivity in RHH was ninefold decrease than that in YPX medium. The xylose reductase (XR) and xylitol dehydrogenase (XDH) activities in the YPX cultures were strictly dependent on NADPH and NAD + respectively, and were approximately 10% higher under severe oxygen limitation than under moderate oxygen limitation. This higher xylitol production observed under severe oxygen limitation can be attributed to the higher XR activity and shortage of the NAD + needed by XDH. These results suggest that Sc. amazonensis UFMG-CM-Y493 T is one of the greatest xylitol producers described to date and reveal its potential use in the biotechnological production of xylitol.

  7. Lipase-catalyzed synthesis of xylitol monoesters: solvent engineering approach.

    PubMed

    Castillo, E; Pezzotti, F; Navarro, A; López-Munguía, A

    2003-05-08

    A solvent engineering strategy was applied to the lipase-catalyzed synthesis of xylitol-oleic acid monoesters. The different esterification degrees for this polyhydroxylated molecule were examined in different organic solvent mixtures. In this context, conditions for high selectivity towards monooleoyl xylitol synthesis were enhanced from 6 mol% in pure n-hexane to 73 mol% in 2-methyl-2-propanol/dimethylsulfoxide (DMSO) 80:20 (v/v). On the contrary, the highest production of di- and trioleoyl xylitol, corresponding to 94 mol%, was achieved in n-hexane. Changes in polarity of the reaction medium and in the molecular interactions between solvents and reactants were correlated with the activity coefficients of products. Based on experimental results and calculated thermodynamic activities, the effect of different binary mixtures of solvents on the selective production of xylitol esters is reported. From this analysis, it is concluded that in the more polar conditions (100% dimethylsulfoxide (DMSO)), the synthesis of xylitol monoesters is favored. However, these conditions are unfavorable in terms of enzyme stability. As an alternative, binary mixtures of solvents were proposed. Each mixture of solvents was characterized in terms of the quantitative polarity parameter E(T)(30) and related with the activity coefficients of xylitol esters. To our knowledge, the characterization of solvent mixtures in terms of this polarity parameter and its relationship with the selectivity of the process has not been previously reported.

  8. Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis.

    PubMed

    Hilerowicz, Yuval; Koren, Amir; Mashiah, Jacob; Katz, Oren; Sprecher, Eli; Artzi, Ofir

    2018-05-01

    Leishmaniasis is a protozoan zoonotic parasitic infection with cutaneous, mucocutaneous, and visceral manifestations. Israel is endemic for cutaneous leishmaniasis, which is a self-limited disease but is associated with scarring, which is often a source of psychological and social burden for patients. Scars can be especially devastating for children and teenagers. A wide range of physical and medical approaches is used to treat cutaneous leishmaniasis, among which intralesional injections of sodium stibogluconate rank among the most frequently used. Unfortunately, despite being effective, this therapeutic modality can be very painful. Fractional ablative laser creates a controlled mesh-like pattern of tissue ablation in the skin that promotes dermal remodeling and collagen production while at the same time facilitating enhanced delivery of topically applied medications. Patients were treated with fractional ablative carbon dioxide laser followed by immediate topical application of sodium stibogluconate. All children were diagnosed with cutaneous leishmaniasis prior to treatment initiation.. Ten children were treated. One leishmania tropica-positive girl failed to respond. The other nine patients achieved clinical cure and demonstrated good to excellent final cosmesis. Self-rated patient satisfaction and tolerance were high No adverse effects were observed or reported during treatment. Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application appears to be a safe and promising treatment for cutaneous leishmaniasis infection in children. Future controlled studies are required to validate these findings and compare this technique with traditional approaches. © 2018 Wiley Periodicals, Inc.

  9. Formation of xylitol and xylitol-5-phosphate and its impact on growth of d-xylose-utilizing Corynebacterium glutamicum strains.

    PubMed

    Radek, Andreas; Müller, Moritz-Fabian; Gätgens, Jochem; Eggeling, Lothar; Krumbach, Karin; Marienhagen, Jan; Noack, Stephan

    2016-08-10

    Wild-type Corynebacterium glutamicum has no endogenous metabolic activity for utilizing the lignocellulosic pentose d-xylose for cell growth. Therefore, two different engineering approaches have been pursued resulting in platform strains harbouring a functional version of either the Isomerase (ISO) or the Weimberg (WMB) pathway for d-xylose assimilation. In a previous study we found for C. glutamicum WMB by-product formation of xylitol during growth on d-xylose and speculated that the observed lower growth rates are due to the growth inhibiting effect of this compound. Based on a detailed phenotyping of the ISO, WMB and the wild-type strain of C. glutamicum, we here show that this organism has a natural capability to synthesize xylitol from d-xylose under aerobic cultivation conditions. We furthermore observed the intracellular accumulation of xylitol-5-phosphate as a result of the intracellular phosphorylation of xylitol, which was particularly pronounced in the C. glutamicum ISO strain. Interestingly, low amounts of supplemented xylitol strongly inhibit growth of this strain on d-xylose, d-glucose and d-arabitol. These findings demonstrate that xylitol is a suitable substrate of the endogenous xylulokinase (XK, encoded by xylB) and its overexpression in the ISO strain leads to a significant phosphorylation of xylitol in C. glutamicum. Therefore, in order to circumvent cytotoxicity by xylitol-5-phosphate, the WMB pathway represents an interesting alternative route for engineering C. glutamicum towards efficient d-xylose utilization. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Antisolvent precipitation of novel xylitol-additive crystals to engineer tablets with improved pharmaceutical performance.

    PubMed

    Kaialy, Waseem; Maniruzzaman, Mohammad; Shojaee, Saeed; Nokhodchi, Ali

    2014-12-30

    The purpose of this work was to develop stable xylitol particles with modified physical properties, improved compactibility and enhanced pharmaceutical performance without altering polymorphic form of xylitol. Xylitol was crystallized using antisolvent crystallization technique in the presence of various hydrophilic polymer additives, i.e., polyethylene glycol (PEG), polyvinylpyrrolidone (PVP) and polyvinyl alcohol (PVA) at a range of concentrations. The crystallization process did not influence the stable polymorphic form or true density of xylitol. However, botryoidal-shaped crystallized xylitols demonstrated different particle morphologies and lower powder bulk and tap densities in comparison to subangular-shaped commercial xylitol. Xylitol crystallized without additive and xylitol crystallized in the presence of PVP or PVA demonstrated significant improvement in hardness of directly compressed tablets; however, such improvement was observed to lesser extent for xylitol crystallized in the presence of PEG. Crystallized xylitols produced enhanced dissolution profiles for indomethacin in comparison to original xylitol. The influence of additive concentration on tablet hardness was dependent on the type of additive, whereas an increased concentration of all additives provided an improvement in the dissolution behavior of indomethacin. Antisolvent crystallization using judiciously selected type and concentration of additive can be a potential approach to prepare xylitol powders with promising physicomechanical and pharmaceutical properties. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Extent and quality of systematic review evidence related to minimum intervention in dentistry: essential oils, powered toothbrushes, triclosan, xylitol.

    PubMed

    Mickenautsch, Steffen; Yengopal, Veerasamy

    2011-08-01

    To investigate extent and quality of current systematic review evidence regarding: powered toothbrushes, triclosan toothpaste, essential oil mouthwashes, xylitol chewing gum. Five databases were searched for systematic reviews until 13 November 2010. relevant to topic, systematic review according to title and/or abstract, published in English. Article exclusion criteria were based on QUOROM recommendations for the reporting of systematic review methods. Systematic review quality was judged using the AMSTAR tool. All trials included by reviews were assessed for selection bias. 119 articles were found, of which 11 systematic reviews were included. Of these, six were excluded and five accepted: one for triclosan toothpaste; one for xylitol chewing gum; two for powered toothbrushes; one for essential oil mouthwashes. AMSTAR scores: triclosan toothpaste 7; powered toothbrushes 9 and 11; xylitol chewing gum 9; essential oil mouthwashes 8. In total, 75 (out of 76) reviewed trials were identified. In-depth assessment showed a high risk of selection bias for all trials. The extent of available systematic review evidence is low. Although the few identified systematic reviews could be rated as of medium and high quality, the validity of their conclusions needs to be treated with caution, owing to high risk of selection bias in the reviewed trials. High quality randomised control trials are needed in order to provide convincing evidence regarding true clinical efficacy. © 2011 FDI World Dental Federation.

  12. Effects of xylitol as a sugar substitute on diabetes-related parameters in nondiabetic rats.

    PubMed

    Islam, Md Shahidul

    2011-05-01

    Abstract The present study was examined the effects of xylitol feeding on diabetes-associated parameters in nondiabetic rats. Seven-week-old male Sprague-Dawley rats were randomly divided into three groups: control (five rats), sucrose (six rats), and xylitol (six rats). Animal had free access to a commercial rat pellet diet, and ad libitum water, 10% sucrose solution, and 10% xylitol solution were supplied to the control, sucrose, and xylitol groups, respectively. After 3 weeks of feeding of experimental diets, food intakes were significantly (P<.05) lower in the sucrose and xylitol groups compared with the control group. Drink intake was significantly higher in the sucrose group but significantly lower in the xylitol group compared with the control group. Body weight gain was significantly lower in the xylitol group compared with the sucrose group. Weekly nonfasting blood glucose was significantly increased, but fasting blood glucose was significantly decreased, in the sucrose group compared with the control and xylitol groups. Significantly better glucose tolerance was observed in the xylitol group compared with the control and sucrose groups. Serum insulin and fructosamine concentrations were not significantly influenced by the feeding of xylitol or sucrose. Relative liver weight and liver glycogen were significantly increased in the xylitol group compared with the sucrose group, whereas no difference was observed between the xylitol and control groups. Serum total cholesterol and low-density lipoprotein-cholesterol were significantly decreased in the sucrose and xylitol groups, and serum triglyceride of the xylitol group, but not the sucrose group, was significantly increased compared with the control group. Data of this study suggest that xylitol can be a better sweetener than sucrose to maintain diabetes-related parameters at a physiologically safer and stable condition.

  13. Xylitol production in immobilized cultures: a recent review.

    PubMed

    Pérez-Bibbins, Belinda; Torrado-Agrasar, Ana; Salgado, José Manuel; Mussatto, Solange I; Domínguez, José Manuel

    2016-08-01

    Xylitol is a pentahydroxy sugar alcohol coming from xylose with many applications in the food and pharmaceutical industries as a low caloric sweetener suitable for diabetics and as an active ingredient in several biomedical applications. The microbial bioproduction of xylitol from natural xylose coming from lignocellulosic materials appears a sustainable and a promising alternative to chemical synthesis, which works at stronger reaction conditions and generates undesirable co-products which must be removed. There are several reviews that study the metabolic pathways in wild and transformed xylitol producing yeasts and the culture conditions that enhance xylitol accumulation, which are mainly related to the need of microaerobiose for the best producing wild yeasts. Nevertheless, there are relatively few studies focusing on the engineering aspects related to scalable systems and bioreactors that could result in a final industrial stage. This review explores recent advances on xylitol production using immobilized systems, which have been proposed to facilitate the reuse of the biocatalyst for extended periods and the main types of bioreactors available assayed for this purpose.

  14. Streptococcus mutans: Fructose Transport, Xylitol Resistance, and Virulence

    PubMed Central

    Tanzer, J.M.; Thompson, A.; Wen, Z.T.; Burne, R.A.

    2008-01-01

    Streptococcus mutans, the primary etiological agent of human dental caries, possesses at least two fructose phosphotransferase systems (PTSs), encoded by fruI and fruCD. fruI is also responsible for xylitol transport. We hypothesized that fructose and xylitol transport systems do not affect virulence. Thus, colonization and cariogenicity of fruI− and fruCD− single and double mutants, their WT (UA159), and xylitol resistance (Xr) of S. mutans were studied in rats fed a high-sucrose diet. A sucrose phosphorylase (gtfA−) mutant and a reference strain (NCTC-10449S) were additional controls. Recoveries of fruI mutant from the teeth were decreased, unlike those for the other strains. The fruCD mutation was associated with a slight loss of cariogenicity on enamel, whereas mutation of fruI was associated with a loss of cariogenicity in dentin. These results also suggest why xylitol inhibition of caries is paradoxically associated with spontaneous emergence of so-called Xr S. mutans in habitual human xylitol users. PMID:16567561

  15. Effectiveness of Xylitol in Reducing Dental Caries in Children.

    PubMed

    Marghalani, Abdullah A; Guinto, Emilie; Phan, Minhthu; Dhar, Vineet; Tinanoff, Norman

    2017-03-15

    The purpose of this study was to evaluate the effectiveness of xylitol in reducing dental caries in children compared to no treatment, a placebo, or preventive strategies. MEDLINE via PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 1, 1995 through Sept. 26, 2016 for randomized and controlled trials on children consuming xylitol for at least 12 months. The primary endpoint was caries reduction measured by mean decayed, missing, and filled primary and permanent surfaces/ teeth (dmfs/t, DMFS/T, respectively). The I2 and chi-square test for heterogeneity were used to detect trial heterogeneity. Meta-analyses were performed and quality was evaluated using GRADE profiler software. Analysis of five randomized controlled trials (RCTs) showed that xylitol had a small effect on reducing dental caries (standardized mean difference [SMD] equals -0.24; 95 percent confidence interval [CI] equals -0.48 to 0.01; P = 0.06) with a very low quality of evidence and considerable heterogeneity. Studies with higher xylitol doses (greater than four grams per day) demonstrated a medium caries reduction (SMD equals -0.54; 95 percent CI equals -1.14 to 0.05; P = 0.07), with these studies also having considerable heterogeneity and very low quality of evidence. The present systematic review examining the effectiveness of xylitol on caries incidence in children showed a small effect size in randomized controlled trials and a very low quality of evidence that makes preventive action of xylitol uncertain.

  16. Microbial xylitol production from corn cobs using Candida magnoliae.

    PubMed

    Tada, Kiyoshi; Horiuchi, Jun-Ichi; Kanno, Tohru; Kobayashi, Masayoshi

    2004-01-01

    Microbial production of xylitol from corn cobs using Candida magnoliae was experimentally investigated. Approximately 25 g-xylose/l solution was obtained from 100 g-corn cobs/l solution by hydrolysis using 1.0% sulfuric acid at 121 degrees C for 60 min. To remove inhibitors from the hydrolysates, charcoal pellets were found to be effective in selectively removing the inhibitors from the hydrolysates without affecting xylose concentration. C. magnoliae was successfully cultivated using the treated corn cob hydrolysate, resulting in the production of 18.7 g-xylitol/l from 25 g-xylose/l within 36 h.

  17. Utilization of xylitol dehydrogenase in a combined microbial/enzymatic process for production of xylitol from D-glucose.

    PubMed

    Mayer, Gerhard; Kulbe, Klaus D; Nidetzky, Bernd

    2002-01-01

    The production of xylitol from D-glucose occurs through a three-step process in which D-arabitol and D-xylulose are formed as the first and second intermediate product, respectively, and both are obtained via microbial bioconversion reactions. Catalytic hydrogenation of D-xylulose yields xylitol; however, it is contaminated with D-arabitol. The aim of this study was to increase the stereoselectivity of the D-xylulose reduction step by using enzymatic catalysis. Recombinant xylitol dehydrogenase from the yeast Galactocandida mastotermitis was employed to catalyze xylitol formation from D-xylulose in an NADH-dependent reaction, and coenzyme regeneration was achieved by means of formate dehydrogenase-catalyzed oxidation of formate into carbon dioxide. The xylitol yield from D-xylulose was close to 100%. Optimal productivity was found for initial coenzyme concentrations of between 0.5 and 0.75 mM. In the presence of 0.30 M (45 g/L) D-xylulose and 2000 U/L of both dehydrogenases, exhaustive substrate turnover was achieved typically in a 4-h reaction time. The enzymes were recovered after the reaction in yields of approx 90% by means of ultrafiltration and could be reused for up to six cycles of D-xylulose reduction. The advantages of incorporating the enzyme-catalyzed step in a process for producing xylitol from D-glucose are discussed, and strategies for downstream processing are proposed by which the observed coenzyme turnover number of approx 600 could be increased significantly.

  18. Production of ethanol and xylitol from corn cobs by yeasts.

    PubMed

    Latif, F; Rajoka, M I

    2001-03-01

    Saccharomyces cerevisiae and Candida tropicalis were used separately and as co-culture for simultaneous saccharification and fermentation (SSF) of 5-20% (w/v) dry corn cobs. A maximal ethanol concentration of 27, 23, 21 g/l (w/v) from 200 g/l (w/v) dry corn cobs was obtained by S. cerevisiae, C. tropicalis and the co-culture, respectively, after 96 h of fermentation. However, theoretical yields of 82%, 71% and 63% were observed from 50 g/l dry corn cobs for the above cultures, respectively. Maximal xylitol concentration of 21, 20 and 15 g/l from 200 g/l (w/v) dry corn cobs was obtained by C. tropicalis, co-culture, and S. cerevisiae, respectively. Maximum theoretical yields of 79.0%, 77.0% and 58% were observed from 50 g/l of corn cobs, respectively. The volumetric productivities for ethanol and xylitol increased with the increase in substrate concentration, whereas, yield decreased. Glycerol and acetic acid were formed as minor by-products. S. cerevisiae and C. tropicalis resulted in better product yields (0.42 and 0.36 g/g) for ethanol and (0.52 and 0.71 g/g) for xylitol, respectively, whereas, the co-culture showed moderate level of ethanol (0.32 g/g) and almost maximal levels of xylitol (0.69 g/g).

  19. Xylitol as a prophylaxis for acute otitis media: systematic review.

    PubMed

    Danhauer, Jeffrey L; Johnson, Carole E; Corbin, Nicole E; Bruccheri, Kaitlyn G

    2010-10-01

    A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects.

  20. A surrogate method for comparison analysis of salivary concentrations of Xylitol-containing products

    PubMed Central

    Riedy, Christine A; Milgrom, Peter; Ly, Kiet A; Rothen, Marilynn; Mueller, Gregory; Hagstrom, Mary K; Tolentino, Ernie; Zhou, Lingmei; Roberts, Marilyn C

    2008-01-01

    Background Xylitol chewing gum has been shown to reduce Streptococcus mutans levels and decay. Two studies examined the presence and time course of salivary xylitol concentrations delivered via xylitol-containing pellet gum and compared them to other xylitol-containing products. Methods A within-subjects design was used for both studies. Study 1, adults (N = 15) received three xylitol-containing products (pellet gum (2.6 g), gummy bears (2.6 g), and commercially available stick gum (Koolerz, 3.0 g)); Study 2, a second group of adults (N = 15) received three xylitol-containing products (pellet gum, gummy bears, and a 33% xylitol syrup (2.67 g). For both studies subjects consumed one xylitol product per visit with a 7-day washout between each product. A standardized protocol was followed for each product visit. Product order was randomly determined at the initial visit. Saliva samples (0.5 mL to 1.0 mL) were collected at baseline and up to 10 time points (~16 min in length) after product consumption initiated. Concentration of xylitol in saliva samples was analyzed using high-performance liquid chromatography. Area under the curve (AUC) for determining the average xylitol concentration in saliva over the total sampling period was calculated for each product. Results In both studies all three xylitol products (Study 1: pellet gum, gummy bears, and stick gum; Study 2: pellet gum, gummy bears, and syrup) had similar time curves with two xylitol concentration peaks during the sampling period. Study 1 had its highest mean peaks at the 4 min sampling point while Study 2 had its highest mean peaks between 13 to 16 minutes. Salivary xylitol levels returned to baseline at about 18 minutes for all forms tested. Additionally, for both studies the total AUC for the xylitol products were similar compared to the pellet gum (Study 1: pellet gum – 51.3 μg.min/mL, gummy bears – 59.6 μg.min/mL, and stick gum – 46.4 μg.min/mL; Study 2: pellet gum – 63.0 μg.min/mL, gummy

  1. Xylitol induces cell death in lung cancer A549 cells by autophagy.

    PubMed

    Park, Eunjoo; Park, Mi Hee; Na, Hee Sam; Chung, Jin

    2015-05-01

    Xylitol is a widely used anti-caries agent that has anti-inflammatory effects. We have evaluated the potential of xylitol in cancer treatment. It's effects on cell proliferation and cytotoxicity were measured by MTT assay and LDH assay. Cell morphology and autophagy were examined by immunostaining and immunoblotting. Xylitol inhibited cell proliferation in a dose-dependent manner in these cancer cells: A549, Caki, NCI-H23, HCT-15, HL-60, K562, and SK MEL-2. The IC50 of xylitol in human gingival fibroblast cells was higher than in cancer cells, indicating that it is more specific for cancer cells. Moreover, xylitol induced autophagy in A549 cells that was inhibited by 3-methyladenine, an autophagy inhibitor. These results indicate that xylitol has potential in therapy against lung cancer by inhibiting cell proliferation and inducing autophagy of A549 cells.

  2. Production of xylitol from corn cob hydrolysate through acid and enzymatic hydrolysis by yeast

    NASA Astrophysics Data System (ADS)

    Mardawati, Efri; Andoyo, R.; Syukra, K. A.; Kresnowati, MTAP; Bindar, Y.

    2018-03-01

    The abundance of corn production in Indonesia offers the potential for its application as the raw material for biorefinery process. The hemicellulose content in corn cobs can be considered to be used as a raw material for xylitol production. The purpose of this research was to study the effect of hydrolysis methods for xylitol production and the effect of the hydrolyzed corn cobs to produce xylitol through fermentation. Hydrolysis methods that would be evaluated were acid and enzymatic hydrolysis. The result showed that the xylitol yield of fermented solution using enzymatic hydrolysates was 0.216 g-xylitol/g-xylose, which was higher than the one that used acid hydrolysates, which was 0.100 g-xylitol/g-xylose. Moreover, the specific growth rate of biomass in fermentation using enzymatic hydrolysates was also higher than the one that used acid hydrolysates, 0.039/h compared to 0.0056/h.

  3. Cell Adhesion Modification of Streptococcus viridians in the Presence of Xylitol

    NASA Astrophysics Data System (ADS)

    Esmacher, Jason; Vidakovich, Blair; Giangrande, Michael; Hoffmann, Peter

    2012-10-01

    There is scientific documentation that those who chew gum sweetened by the sugar alcohol xylitol report a dramatically lower incident of both dental caries and otitis media compared to those who chew conventional gum sweetened by sucrose. An explanation contends that xylitol interferes with the ability of Streptococcus viridian (SV) to form biofilms which is a necessary precursor to the bacteria's ability to damage human tissues. We have used atomic force microscopy to study the cell wall/fimbria properties at the nanonewton level in both the presence and absence of xylitol. The first set of measurements used varying concentrations of xylitol incorporated within the incubation medium. The second used non-xylitol grown bacteria, the xylitol was added externally at various concentrations. Our study suggests that growing SV with xylitol reduces their ability to adhere together. Additionally, externally added xylitol showed grouping of cell adhesion to a relatively narrow nanonewton spread that is concentration dependent. Measurement of the adhesion properties of the bacterial cell wall have found that there is a dramatic increase in the cell wall's firmness which simultaneously accompanied a decrease in its ability to support adhesion, even at very low concentrations of xylitol.

  4. Involvement of TRPV1 and AQP2 in hypertonic stress by xylitol in odontoblast cells.

    PubMed

    Tokuda, M; Fujisawa, M; Miyashita, K; Kawakami, Y; Morimoto-Yamashita, Y; Torii, M

    2015-02-01

    To examine the responses of mouse odontoblast-lineage cell line (OLC) cultures to xylitol-induced hypertonic stress. OLCs were treated with xylitol, sucrose, sorbitol, mannitol, arabinose and lyxose. Cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium assay. The expression of transient receptor potential vanilloids (TRPV) 1, 3 and 4 was detected using a reverse transcriptase-polymerase chain reaction (RT-PCR) assay. The expression of aquaporin (AQP) 2 was detected using immunofluorescence and Western blotting analysis. The expression of interleukin-6 (IL-6) under xylitol-induced hypertonic stress was assessed using an enzyme-linked immunosorbent assay (ELISA). Small interfering ribonucleic acid (siRNA) for AQP-2 was used to inhibition assay. Xylitol-induced hypertonic stress did not decrease OLC viability, unlike the other sugars tested. OLCs expressed TRPV1, 3 and 4 as well as AQP2. Xylitol inhibited lipopolysaccharide (LPS)-induced IL-6 expression after 3 h of hypertonic stress. TRPV1 mRNA expression was upregulated by xylitol. Costimulation with HgCl2 (AQP inhibitor) and Ruthenium red (TRPV1 inhibitor) decreased cell viability with xylitol stimulation. OLCs treated with siRNA against TRPV1 exhibited decreased cell viability with xylitol stimulation. OLCs have high-cell viability under xylitol-induced hypertonic stress, which may be associated with TRPV1 and AQP2 expressions.

  5. Effects of short-term xylitol gum chewing on the oral microbiome.

    PubMed

    Söderling, Eva; ElSalhy, Mohamed; Honkala, Eino; Fontana, Margherita; Flannagan, Susan; Eckert, George; Kokaras, Alexis; Paster, Bruce; Tolvanen, Mimmi; Honkala, Sisko

    2015-03-01

    The aim of this study was to determine the effects of short-term xylitol gum chewing on the salivary microbiota of children. The study was a randomised, controlled, double-blind trial. Healthy children used xylitol chewing gum (xylitol group, n = 35) or sorbitol chewing gum (control group, n = 38) for 5 weeks. The daily dose of xylitol/sorbitol was approximately 6 g/day. At baseline and at the end of the test period, unstimulated and paraffin-stimulated saliva were collected. The microbial composition of the saliva was assessed using human oral microbe identification microarray (HOMIM). Mutans streptococci (MS) were plate cultured. As judged by HOMIM results, no xylitol-induced changes in the salivary microbiota took place in the xylitol group. In the control group, Veillonella atypica showed a significant decrease (p = 0.0001). The xylitol gum chewing decreased viable counts of MS in both stimulated (p = 0.006) and unstimulated (p = 0.002) saliva, but similar effects were also seen in the control group. The use of xylitol gum decreased MS, in general, but did not change the salivary microbial composition. Short-term consumption of xylitol had no impact on the composition of the salivary microbiota, but resulted in a decrease in the levels of MS.

  6. By passing microbial resistance: xylitol controls microorganisms growth by means of its anti-adherence property.

    PubMed

    Ferreira, Aline S; Silva-Paes-Leme, Annelisa F; Raposo, Nádia R B; da Silva, Sílvio S

    2015-01-01

    Xylitol is an important polyalcohol suitable for use in odontological, medical and pharmaceutical products and as an additive in food. The first studies on the efficacy of xylitol in the control and treatment of infections started in the late 1970s and it is still applied for this purpose, with safety and very little contribution to resistance. Xylitol seems to act against microorganisms exerting an anti-adherence effect. Some research studies have demonstrated its action against Gram-positive and Gram-negative bacteria and yeasts. However, a clear explanation of how xylitol is effective has not been completely established yet. Some evidence shows that xylitol acts on gene expression, down-regulating the ones which are involved in the microorganisms' virulence, such as capsule formation. Another possible clarification is that xylitol blocks lectin-like receptors. The most important aspect is that, over time, xylitol bypasses microbial resistance and succeeds in controlling infection, either alone or combined with another compound. In this review, the effect of xylitol in inhibiting the growth of a different microorganism is described, focusing on studies in which such an anti-adherent property was highlighted. This is the first mini-review to describe xylitol as an anti-adherent compound and take into consideration how it exerts such action.

  7. Calorimetric and relaxation properties of xylitol-water mixtures

    NASA Astrophysics Data System (ADS)

    Elamin, Khalid; Sjöström, Johan; Jansson, Helén; Swenson, Jan

    2012-03-01

    We present the first broadband dielectric spectroscopy (BDS) and differential scanning calorimetry study of supercooled xylitol-water mixtures in the whole concentration range and in wide frequency (10-2-106 Hz) and temperature (120-365 K) ranges. The calorimetric glass transition, Tg, decreases from 247 K for pure xylitol to about 181 K at a water concentration of approximately 37 wt. %. At water concentrations in the range 29-35 wt. % a plentiful calorimetric behaviour is observed. In addition to the glass transition, almost simultaneous crystallization and melting events occurring around 230-240 K. At higher water concentrations ice is formed during cooling and the glass transition temperature increases to a steady value of about 200 K for all higher water concentrations. This Tg corresponds to an unfrozen xylitol-water solution containing 20 wt. % water. In addition to the true glass transition we also observed a glass transition-like feature at 220 K for all the ice containing samples. However, this feature is more likely due to ice dissolution [A. Inaba and O. Andersson, Thermochim. Acta, 461, 44 (2007)]. In the case of the BDS measurements the presence of water clearly has an effect on both the cooperative α-relaxation and the secondary β-relaxation. The α-relaxation shows a non-Arrhenius temperature dependence and becomes faster with increasing concentration of water. The fragility of the solutions, determined by the temperature dependence of the α-relaxation close to the dynamic glass transition, decreases with increasing water content up to about 26 wt. % water, where ice starts to form. This decrease in fragility with increasing water content is most likely caused by the increasing density of hydrogen bonds, forming a network-like structure in the deeply supercooled regime. The intensity of the secondary β-relaxation of xylitol decreases noticeably already at a water content of 2 wt. %, and at a water content above 5 wt. % it has been replaced by a

  8. The effect of xylitol on dental caries and oral flora

    PubMed Central

    Nayak, Prathibha Anand; Nayak, Ullal Anand; Khandelwal, Vishal

    2014-01-01

    Dental caries, the most chronic disease affecting mankind, has been in the limelight with regard to its prevention and treatment. Professional clinical management of caries has been very successful in cases of different severities of disease manifestations. However, tertiary management of this disease has been gaining attention, with numerous methods and agents emerging on a daily basis. Higher intake of nutritive sweeteners can result in higher energy intake and lower diet quality and thereby predispose an individual to conditions like obesity, cardiovascular disorders, and type 2 diabetes mellitus. Non-nutritive sweeteners have gained popularity as they are sweeter and are required in substantially lesser quantities. Xylitol, a five-carbon sugar polyol, has been found to be promising in reducing dental caries disease and also reversing the process of early caries. This paper throws light on the role and effects of various forms of xylitol on dental caries and oral hygiene status of an individual. PMID:25422590

  9. Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro.

    PubMed

    Cardoso, C A B; de Castilho, A R F; Salomão, P M A; Costa, E N; Magalhães, A C; Buzalaf, M A R

    2014-11-01

    Analyse the effect of varnishes containing xylitol alone or combined with fluoride on the remineralization of artificial enamel caries lesions in vitro. Bovine enamel specimens were randomly allocated to 7 groups (n=15/group). Artificial caries lesions were produced by immersion in 30 mL of lactic acid buffer containing 3mM CaCl2·2H2O, 3mM KH2PO4, 6 μM tetraetil metil diphosphanate (pH 5.0) for 6 days. The enamel blocks were treated with the following varnishes: 10% xylitol; 20% xylitol; 10% xylitol plus F (5% NaF); 20% xylitol plus F (5% NaF); Duofluorid™ (6% NaF, 2.71% F+6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6h. The blocks were subjected to pH-cycles (demineralization-2h/remineralization-22 h during 8 days) and enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analysed by ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). Enamel surface remineralization was significantly increased by Duraphat™, 10% xylitol plus F and 20% xylitol plus F formulations, while significant subsurface mineral remineralization could be seen only for enamel treated with Duraphat™, Duofluorid™ and 20% xylitol formulations. 20% xylitol varnishes seem to be promising alternatives to increase remineralization of artificial caries lesions. effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in vitro, which should be confirmed by in situ and clinical studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Evaluation of sorghum straw hemicellulosic hydrolysate for biotechnological production of xylitol by Candida guilliermondii

    PubMed Central

    Sene, L.; Arruda, P.V.; Oliveira, S.M.M.; Felipe, M.G.A.

    2011-01-01

    A preliminary study on xylitol production by Candida guilliermondii in sorghum straw hemicellulosic hydrolysate was performed. Hydrolysate had high xylose content and inhibitors concentrations did not exceed the commonly found values in other hemicellulosic hydrolysates. The highest xylitol yield (0.44 g/g) and productivity (0.19 g/Lh) were verified after 72 hours. PMID:24031733

  11. The effects of xylitol and sorbitol on lysozyme- and peroxidase-related enzymatic and candidacidal activities.

    PubMed

    Kim, Bum-Soo; Chang, Ji-Youn; Kim, Yoon-Young; Kho, Hong-Seop

    2015-07-01

    To investigate whether xylitol and sorbitol affect enzymatic and candidacidal activities of lysozyme, the peroxidase system, and the glucose oxidase-mediated peroxidase system. Xylitol and sorbitol were added to hen egg-white lysozyme, bovine lactoperoxidase, glucose oxidase-mediated peroxidase, and whole saliva in solution and on hydroxyapatite surfaces. The enzymatic activities of lysozyme, peroxidase, and glucose oxidase-mediated peroxidase were determined by the turbidimetric method, the NbsSCN assay, and production of oxidized o-dianisidine, respectively. Candidacidal activities were determined by comparing colony forming units using Candida albicans ATCC strains 10231, 11006, and 18804. While xylitol and sorbitol did not affect the enzymatic activity of hen egg-white lysozyme both in solution and on hydroxyapatite surfaces, they did inhibit the enzymatic activity of salivary lysozyme significantly in solution, but not on the surfaces. Xylitol and sorbitol enhanced the enzymatic activities of both bovine lactoperoxidase and salivary peroxidase significantly in a dose-dependent manner in solution, but not on the surfaces. Sorbitol, but not xylitol, inhibited the enzymatic activity of glucose oxidase-mediated peroxidase significantly. Both xylitol and sorbitol did not affect candidacidal activities of hen egg-white lysozyme, the bovine lactoperoxidase system, or the glucose oxidase-mediated bovine lactoperoxidase system. Xylitol and sorbitol inhibited salivary lysozyme activity, but enhanced both bovine lactoperoxidase and salivary peroxidase activities significantly in solution. Xylitol and sorbitol did not augment lysozyme- and peroxidase-related candidacidal activities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. 75 FR 8920 - Grant of Authority for Subzone Status; Danisco USA, Inc., Sweeteners Division (Xylitol, Xylose...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ... Status; Danisco USA, Inc., Sweeteners Division (Xylitol, Xylose, Galactose and Mannose); Thomson, IL...., Sweeteners Division, located in Thomson, Illinois, (FTZ Docket 4-2009, filed 2/4/2009); Whereas, notice... xylitol, xylose, galactose and mannose at the facility of Danisco USA, Inc., Sweeteners Division, located...

  13. Xylitol: a review on bioproduction, application, health benefits, and related safety issues.

    PubMed

    Ur-Rehman, Salim; Mushtaq, Zarina; Zahoor, Tahir; Jamil, Amir; Murtaza, Mian Anjum

    2015-01-01

    Xylitol is a pentahydroxy sugar-alcohol which exists in a very low quantity in fruits and vegetables (plums, strawberries, cauliflower, and pumpkin). On commercial scale, xylitol can be produced by chemical and biotechnological processes. Chemical production is costly and extensive in purification steps. However, biotechnological method utilizes agricultural and forestry wastes which offer the possibilities of economic production of xylitol by reducing required energy. The precursor xylose is produced from agricultural biomass by chemical and enzymatic hydrolysis and can be converted to xylitol primarily by yeast strain. Hydrolysis under acidic condition is the more commonly used practice influenced by various process parameters. Various fermentation process inhibitors are produced during chemical hydrolysis that reduce xylitol production, a detoxification step is, therefore, necessary. Biotechnological xylitol production is an integral process of microbial species belonging to Candida genus which is influenced by various process parameters such as pH, temperature, time, nitrogen source, and yeast extract level. Xylitol has application and potential for food and pharmaceutical industries. It is a functional sweetener as it has prebiotic effects which can reduce blood glucose, triglyceride, and cholesterol level. This review describes recent research developments related to bioproduction of xylitol from agricultural wastes, application, health, and safety issues.

  14. Eosinophilic Esophagitis: MedlinePlus Health Topic

    MedlinePlus

    ... Esophagitis (EoE) (American Academy of Allergy, Asthma, and Immunology) Also in Spanish Latest News Eosinophilic Esophagitis May ... Pediatric and Adolescent Patients (American College of Gastroenterology) Topic Image Related Health Topics Eosinophilic Disorders Esophagus Disorders ...

  15. Effects of Consuming Xylitol on Gut Microbiota and Lipid Metabolism in Mice.

    PubMed

    Uebanso, Takashi; Kano, Saki; Yoshimoto, Ayumi; Naito, Chisato; Shimohata, Takaaki; Mawatari, Kazuaki; Takahashi, Akira

    2017-07-14

    The sugar alcohol xylitol inhibits the growth of some bacterial species including Streptococcus mutans . It is used as a food additive to prevent caries. We previously showed that 1.5-4.0 g/kg body weight/day xylitol as part of a high-fat diet (HFD) improved lipid metabolism in rats. However, the effects of lower daily doses of dietary xylitol on gut microbiota and lipid metabolism are unclear. We examined the effect of 40 and 200 mg/kg body weight/day xylitol intake on gut microbiota and lipid metabolism in mice. Bacterial compositions were characterized by denaturing gradient gel electrophoresis and targeted real-time PCR. Luminal metabolites were determined by capillary electrophoresis electrospray ionization time-of-flight mass spectrometry. Plasma lipid parameters and glucose tolerance were examined. Dietary supplementation with low- or medium-dose xylitol (40 or 194 mg/kg body weight/day, respectively) significantly altered the fecal microbiota composition in mice. Relative to mice not fed xylitol, the addition of medium-dose xylitol to a regular and HFD in experimental mice reduced the abundance of fecal Bacteroidetes phylum and the genus Barnesiella , whereas the abundance of Firmicutes phylum and the genus Prevotella was increased in mice fed an HFD with medium-dose dietary xylitol. Body composition, hepatic and serum lipid parameters, oral glucose tolerance, and luminal metabolites were unaffected by xylitol consumption. In mice, 40 and 194 mg/kg body weight/day xylitol in the diet induced gradual changes in gut microbiota but not in lipid metabolism.

  16. Isolation and characterization of xylitol-assimilating mutants of recombinant Saccharomyces cerevisiae.

    PubMed

    Tani, Tatsunori; Taguchi, Hisataka; Fujimori, Kazuhiro E; Sahara, Takehiko; Ohgiya, Satoru; Kamagata, Yoichi; Akamatsu, Takashi

    2016-10-01

    To clarify the mechanisms of xylitol utilization, three xylitol-assimilating mutants were isolated from recombinant Saccharomyces cerevisiae strains showing highly efficient xylose-utilization. The nucleotide sequences of the mutant genomes were analyzed and compared with those of the wild-type strains and the mutation sites were identified. gal80 mutations were common to all the mutants, and recessive to the wild-type allele. Hence we constructed a gal80Δ mutant and confirmed that the gal80Δ mutant showed a xylitol-assimilation phenotype. When the constructed gal80Δ mutant was crossed with the three isolated mutants, all diploid hybrids showed xylitol assimilation, indicating that the mutations were all located in the GAL80. We analyzed the role of the galactose permease Gal2, controlled by the regulatory protein Gal80, in assimilating xylitol. A gal2Δ gal80Δ double mutant did not show xylitol assimilation, whereas expression of GAL2 under the control of the TDH3 promoter in the GAL80 strain did result in assimilation. These data indicate that Gal2 was needed for xylitol assimilation in the wild-type strain. When the gal80 mutant with an initial cell concentration of A660 = 20 was used for batch fermentation in a complex medium containing 20 g/L xylose or 20 g/L xylitol at pH 5.0 and 30°C under oxygen limitation, the gal80 mutant consumed 100% of the xylose within 12 h, but <30% of the xylitol within 100 h, indicating that xylose reductase is required for xylitol consumption in oxygen-limited conditions. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  17. Effects of Consuming Xylitol on Gut Microbiota and Lipid Metabolism in Mice

    PubMed Central

    Uebanso, Takashi; Kano, Saki; Yoshimoto, Ayumi; Naito, Chisato; Shimohata, Takaaki; Takahashi, Akira

    2017-01-01

    The sugar alcohol xylitol inhibits the growth of some bacterial species including Streptococcus mutans. It is used as a food additive to prevent caries. We previously showed that 1.5–4.0 g/kg body weight/day xylitol as part of a high-fat diet (HFD) improved lipid metabolism in rats. However, the effects of lower daily doses of dietary xylitol on gut microbiota and lipid metabolism are unclear. We examined the effect of 40 and 200 mg/kg body weight/day xylitol intake on gut microbiota and lipid metabolism in mice. Bacterial compositions were characterized by denaturing gradient gel electrophoresis and targeted real-time PCR. Luminal metabolites were determined by capillary electrophoresis electrospray ionization time-of-flight mass spectrometry. Plasma lipid parameters and glucose tolerance were examined. Dietary supplementation with low- or medium-dose xylitol (40 or 194 mg/kg body weight/day, respectively) significantly altered the fecal microbiota composition in mice. Relative to mice not fed xylitol, the addition of medium-dose xylitol to a regular and HFD in experimental mice reduced the abundance of fecal Bacteroidetes phylum and the genus Barnesiella, whereas the abundance of Firmicutes phylum and the genus Prevotella was increased in mice fed an HFD with medium-dose dietary xylitol. Body composition, hepatic and serum lipid parameters, oral glucose tolerance, and luminal metabolites were unaffected by xylitol consumption. In mice, 40 and 194 mg/kg body weight/day xylitol in the diet induced gradual changes in gut microbiota but not in lipid metabolism. PMID:28708089

  18. Origin of Xylitol in Chewing Gum: A Compound-Specific Isotope Technique for the Differentiation of Corn- and Wood-Based Xylitol by LC-IRMS.

    PubMed

    Köster, Daniel; Wolbert, Jens-Benjamin; Schulte, Marcel S; Jochmann, Maik A; Schmidt, Torsten C

    2018-02-28

    The sugar replacement compound xylitol has gained increasing attention because of its use in many commercial food products, dental-hygiene articles, and pharmaceuticals. It can be classified by the origin of the raw material used for its production. The traditional "birch xylitol" is considered a premium product, in contrast to xylitol produced from agriculture byproducts such as corn husks or sugar-cane straw. Bulk stable-isotope analysis (BSIA) and compound-specific stable-isotope analysis (CSIA) by liquid-chromatography isotope-ratio mass spectrometry (LC-IRMS) of chewing-gum extracts were used to determine the δ 13 C isotope signatures for xylitol. These were applied to elucidate the original plant type the xylitol was produced from on the basis of differences in isotope-fractionation processes of photosynthetic CO 2 fixation. For the LC-IRMS analysis, an organic-solvent-free extraction protocol and HPLC method for the separation of xylitol from different artificial sweeteners and sugar-replacement compounds was successfully developed and applied to the analysis of 21 samples of chewing gum, from which 18 could be clearly related to the raw-material plant class.

  19. Parent Refusal of Topical Fluoride for Their Children: Clinical Strategies and Future Research Priorities to Improve Evidence-Based Pediatric Dental Practice.

    PubMed

    Chi, Donald L

    2017-07-01

    A growing number of parents are refusing topical fluoride for their children during preventive dental and medical visits. This nascent clinical and public health problem warrants attention from dental professionals and the scientific community. Clinical and community-based strategies are available to improve fluoride-related communications with parents and the public. In terms of future research priorities, there is a need to develop screening tools to identify parents who are likely to refuse topical fluoride and diagnostic instruments to uncover the reasons for topical fluoride refusal. This knowledge will lead to evidence-based strategies that can be widely disseminated into clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Furfural and glucose can enhance conversion of xylose to xylitol by Candida magnoliae TISTR 5663.

    PubMed

    Wannawilai, Siwaporn; Lee, Wen-Chien; Chisti, Yusuf; Sirisansaneeyakul, Sarote

    2017-01-10

    Xylitol production from xylose by the yeast Candida magnoliae TISTR 5663 was enhanced by supplementing the fermentation medium with furfural (300mg/L) and glucose (3g/L with an initial mass ratio of glucose to xylose of 1:10) together under oxygen limiting conditions. In the presence of furfural and glucose, the final concentration of xylitol was unaffected relative to control cultures but the xylitol yield on xylose increased by about 5%. Supplementation of the culture medium with glucose alone at an initial concentration of 3g/L, stimulated the volumetric and specific rates of xylose consumption and the rate of xylitol production from xylose. In a culture medium containing 30g/L xylose, 300mg/L furfural and 3g/L glucose, the volumetric production rate of xylitol was 1.04g/L h and the specific production rate was 0.169g/g h. In the absence of furfural and glucose, the volumetric production rate of xylitol was ∼35% lower and the specific production rate was nearly 30% lower. In view of these results, xylose-containing lignocellulosic hydrolysates contaminated with furfural can be effectively used for producing xylitol by fermentation so long as the glucose-to-xylose mass ratio in the hydrolysate does not exceed 1:10 and the furfural concentration is ≤300mg/L. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Detoxification of Corncob Acid Hydrolysate with SAA Pretreatment and Xylitol Production by Immobilized Candida tropicalis

    PubMed Central

    Deng, Li-Hong; Tang, Yong; Liu, Yun

    2014-01-01

    Xylitol fermentation production from corncob acid hydrolysate has become an attractive and promising process. However, corncob acid hydrolysate cannot be directly used as fermentation substrate owing to various inhibitors. In this work, soaking in aqueous ammonia (SAA) pretreatment was employed to reduce the inhibitors in acid hydrolysate. After detoxification, the corncob acid hydrolysate was fermented by immobilized Candida tropicalis cell to produce xylitol. Results revealed that SAA pretreatment showed high delignification and efficient removal of acetyl group compounds without effect on cellulose and xylan content. Acetic acid was completely removed, and the content of phenolic compounds was reduced by 80%. Furthermore, kinetic behaviors of xylitol production by immobilized C. tropicalis cell were elucidated from corncob acid hydrolysate detoxified with SAA pretreatment and two-step adsorption method, respectively. The immobilized C. tropicalis cell showed higher productivity efficiency using the corncob acid hydrolysate as fermentation substrate after detoxification with SAA pretreatment than by two-step adsorption method in the five successive batch fermentation rounds. After the fifth round fermentation, about 60 g xylitol/L fermentation substrate was obtained for SAA pretreatment detoxification, while about 30 g xylitol/L fermentation substrate was obtained for two-step adsorption detoxification. PMID:25133211

  2. Xylitol Affects the Intestinal Microbiota and Metabolism of Daidzein in Adult Male Mice

    PubMed Central

    Tamura, Motoi; Hoshi, Chigusa; Hori, Sachiko

    2013-01-01

    This study examined the effects of xylitol on mouse intestinal microbiota and urinary isoflavonoids. Xylitol is classified as a sugar alcohol and used as a food additive. The intestinal microbiota seems to play an important role in isoflavone metabolism. Xylitol feeding appears to affect the gut microbiota. We hypothesized that dietary xylitol changes intestinal microbiota and, therefore, the metabolism of isoflavonoids in mice. Male mice were randomly divided into two groups: those fed a 0.05% daidzein with 5% xylitol diet (XD group) and those fed a 0.05% daidzein-containing control diet (CD group) for 28 days. Plasma total cholesterol concentrations were significantly lower in the XD group than in the CD group (p < 0.05). Urinary amounts of equol were significantly higher in the XD group than in the CD group (p < 0.05). The fecal lipid contents (% dry weight) were significantly greater in the XD group than in the CD group (p < 0.01). The cecal microbiota differed between the two dietary groups. The occupation ratios of Bacteroides were significantly greater in the CD than in the XD group (p < 0.05). This study suggests that xylitol has the potential to affect the metabolism of daidzein by altering the metabolic activity of the intestinal microbiota and/or gut environment. Given that equol affects bone health, dietary xylitol plus isoflavonoids may exert a favorable effect on bone health. PMID:24336061

  3. Improving xylitol production at elevated temperature with engineered Kluyveromyces marxianus through over-expressing transporters.

    PubMed

    Zhang, Jia; Zhang, Biao; Wang, Dongmei; Gao, Xiaolian; Hong, Jiong

    2015-01-01

    Three transporter genes including Kluyveromyces marxianus aquaglyceroporin gene (KmFPS1), Candida intermedia glucose/xylose facilitator gene (CiGXF1) or glucose/xylose symporter gene (CiGXS1) were over-expressed in K. marxianus YZJ017 to improve xylitol production at elevated temperatures. The xylitol production of YZJ074 that harbored CiGXF1 was improved to 147.62g/L in Erlenmeyer flask at 42°C. In fermenter, 99.29 and 149.60g/L xylitol were produced from 99.55 and 151.91g/L xylose with productivity of 4.14 and 3.40g/L/h respectively at 42°C. Even at 45°C, YZJ074 could produce 101.30g/L xylitol from 101.41g/L xylose with productivity of 2.81g/L/h. Using fed-batch fermentation through repeatedly adding non-sterilized substrate directly, YZJ074 could produce 312.05g/L xylitol which is the highest yield reported to date. The engineered strains YZJ074 which can produce xylitol at elevated temperatures is an excellent foundation for xylitol bioconversion. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Xylitol-supplemented nutrition enhances bacterial killing and prolongs survival of rats in experimental pneumococcal sepsis

    PubMed Central

    Renko, Marjo; Valkonen, Päivi; Tapiainen, Terhi; Kontiokari, Tero; Mattila, Pauli; Knuuttila, Matti; Svanberg, Martti; Leinonen, Maija; Karttunen, Riitta; Uhari, Matti

    2008-01-01

    Background Xylitol has antiadhesive effects on Streptococcus pneumoniae and inhibits its growth, and has also been found to be effective in preventing acute otitis media and has been used in intensive care as a valuable source of energy. Results We evaluated the oxidative burst of neutrophils in rats fed with and without xylitol. The mean increase in the percentage of activated neutrophils from the baseline was higher in the xylitol-exposed group than in the control group (58.1% vs 51.4%, P = 0.03 for the difference) and the mean induced increase in the median strength of the burst per neutrophil was similarly higher in the xylitol group (159.6 vs 140.3, P = 0.04). In two pneumococcal sepsis experiments rats were fed either a basal powder diet (control group) or the same diet supplemented with 10% or 20% xylitol and infected with an intraperitoneal inoculation of S. pneumoniae after two weeks. The mean survival time was 48 hours in the xylitol groups and 34 hours in the control groups (P < 0.001 in log rank test). Conclusion Xylitol has beneficial effects on both the oxidative killing of bacteria in neutrophilic leucocytes and on the survival of rats with experimental pneumococcal sepsis. PMID:18334022

  5. Xylitol affects the intestinal microbiota and metabolism of daidzein in adult male mice.

    PubMed

    Tamura, Motoi; Hoshi, Chigusa; Hori, Sachiko

    2013-12-10

    This study examined the effects of xylitol on mouse intestinal microbiota and urinary isoflavonoids. Xylitol is classified as a sugar alcohol and used as a food additive. The intestinal microbiota seems to play an important role in isoflavone metabolism. Xylitol feeding appears to affect the gut microbiota. We hypothesized that dietary xylitol changes intestinal microbiota and, therefore, the metabolism of isoflavonoids in mice. Male mice were randomly divided into two groups: those fed a 0.05% daidzein with 5% xylitol diet (XD group) and those fed a 0.05% daidzein-containing control diet (CD group) for 28 days. Plasma total cholesterol concentrations were significantly lower in the XD group than in the CD group (p < 0.05). Urinary amounts of equol were significantly higher in the XD group than in the CD group (p < 0.05). The fecal lipid contents (% dry weight) were significantly greater in the XD group than in the CD group (p < 0.01). The cecal microbiota differed between the two dietary groups. The occupation ratios of Bacteroides were significantly greater in the CD than in the XD group (p < 0.05). This study suggests that xylitol has the potential to affect the metabolism of daidzein by altering the metabolic activity of the intestinal microbiota and/or gut environment. Given that equol affects bone health, dietary xylitol plus isoflavonoids may exert a favorable effect on bone health.

  6. Xylitol production by genetically modified industrial strain of Saccharomyces cerevisiae using glycerol as co-substrate.

    PubMed

    Kogje, Anushree B; Ghosalkar, Anand

    2017-06-01

    Xylitol is commercially used in chewing gum and dental care products as a low calorie sweetener having medicinal properties. Industrial yeast strain of S. cerevisiae was genetically modified to overexpress an endogenous aldose reductase gene GRE3 and a xylose transporter gene SUT1 for the production of xylitol. The recombinant strain (XP-RTK) carried the expression cassettes of both the genes and the G418 resistance marker cassette KanMX integrated into the genome of S. cerevisiae. Short segments from the 5' and 3' delta regions of the Ty1 retrotransposons were used as homology regions for integration of the cassettes. Xylitol production by the industrial recombinant strain was evaluated using hemicellulosic hydrolysate of the corn cob with glucose as the cosubstrate. The recombinant strain XP-RTK showed significantly higher xylitol productivity (212 mg L -1  h -1 ) over the control strain XP (81 mg L -1  h -1 ). Glucose was successfully replaced by glycerol as a co-substrate for xylitol production by S. cerevisiae. Strain XP-RTK showed the highest xylitol productivity of 318.6 mg L -1  h -1 and titre of 47 g L -1 of xylitol at 12 g L -1 initial DCW using glycerol as cosubstrate. The amount of glycerol consumed per amount of xylitol produced (0.47 mol mol -1 ) was significantly lower than glucose (23.7 mol mol -1 ). Fermentation strategies such as cell recycle and use of the industrial nitrogen sources were demonstrated using hemicellulosic hydrolysate for xylitol production.

  7. Efficient production of xylitol from hemicellulosic hydrolysate using engineered Escherichia coli.

    PubMed

    Su, Buli; Wu, Mianbin; Zhang, Zhe; Lin, Jianping; Yang, Lirong

    2015-09-01

    A metabolically engineered Escherichia coli has been constructed for the production of xylitol, one of the top 12 platform chemicals from agricultural sources identified by the US Department of Energy. An optimal plasmid was constructed to express xylose reductase from Neurospora crassa with almost no inclusion bodies at relatively high temperature. The phosphoenolpyruvate-dependent glucose phosphotransferase system (ptsG) was disrupted to eliminate catabolite repression and allow simultaneous uptake of glucose and xylose. The native pathway for D-xylose catabolism in E. coli W3110 was blocked by deleting the xylose isomerase (xylA) and xylulose kinase (xylB) genes. The putative pathway for xylitol phosphorylation was also blocked by disrupting the phosphoenolpyruvate-dependent fructose phosphotransferase system (ptsF). The xylitol producing recombinant E. coli allowed production of 172.4 g L(-1) xylitol after 110 h of fed-batch cultivation with an average productivity of 1.57 g L(-1) h(-1). The molar yield of xylitol to glucose reached approximately 2.2 (mol xylitol mol(-1) glucose). Furthermore, the recombinant strain also produced about 150 g L(-1) xylitol from hemicellulosic sugars in modified M9 minimal medium and the overall productivity was 1.40 g L(-1) h(-1), representing the highest xylitol concentration and productivity reported to date from hemicellulosic sugars using bacteria. Thus, this engineered E. coli is a candidate for the development of efficient industrial-scale production of xylitol from hemicellulosic hydrolysate. Copyright © 2015 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.

  8. Engineering of Corynebacterium glutamicum for xylitol production from lignocellulosic pentose sugars.

    PubMed

    Dhar, Kiran S; Wendisch, Volker F; Nampoothiri, Kesavan Madhavan

    2016-07-20

    Xylitol is a non-fermentable sugar alcohol used as sweetener. Corynebacterium glutamicum ATCC13032 was metabolically engineered for xylitol production from the lignocellulosic pentose sugars xylose and arabinose. Direct conversion of xylose to xylitol was achieved through the heterologous expression of NAD(P)H-dependent xylose reductase (xr) gene from Rhodotorula mucilaginosa. Xylitol synthesis from arabinose was attained through polycistronic expression of l-arabinose isomerase (araA), d-psicose 3 epimerase (dpe) and l-xylulose reductase (lxr) genes from Escherichia coli, Agrobacterium tumefaciens and Mycobacterium smegmatis, respectively. Expression of xr and the synthetic araA-dpe-lxr operon under the control of IPTG-inducible Ptac promoter enabled production of xylitol from both xylose and arabinose in the mineral (CGXII) medium with glucose as carbon source. Additional expression of a pentose transporter (araTF) gene enhanced xylitol production by about four-fold compared to the parent strain. The constructed strain Cg-ax3 produced 6.7±0.4g/L of xylitol in batch fermentations and 31±0.5g/L of xylitol in fed-batch fermentations with a specific productivity of 0.28±0.05g/g cdw/h. The strain Cg-ax3 was also validated for xylitol production from pentose rich, acid pre-treated liquor of sorghum stover (SAPL) and the results were comparable in both SAPL (27±0.3g/L) and mineral medium (31±0.5g/L). Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Milk Sweetened with Xylitol: A Proof-of-Principle Caries Prevention Randomized Clinical Trial.

    PubMed

    Chi, Donald L; Zegarra, Graciela; Vasquez Huerta, Elsa C; Castillo, Jorge L; Milgrom, Peter; Roberts, Marilyn C; Cabrera-Matta, Ailin R; Merino, Ana P

    2016-09-15

    To evaluate the efficacy of xylitol-sweetened milk as a caries-preventive strategy. In this nine-month prospective proof-of-principle trial, Peruvian schoolchildren were randomized to one of five different milk groups: (1) eight g of xylitol per 200 mL milk once per day; (2) four g of xylitol per 100 mL milk twice per day; (3) eight g of sorbitol per 200 mL milk once per day; (4) four g of sorbitol per 100 mL milk twice per day; or (5) eight g of sucrose per 200 mL milk once per day. The primary outcome was plaque mutans streptococci (MS) at nine months. A secondary outcome was caries incidence. We hypothesized that children in the xylitol groups would have a greater MS decline and lower caries incidence. One hundred fifty-three children were randomized in the intent-to-treat analyses. Children receiving xylitol had a greater decline in MS than children receiving sucrose (P=0.02) but were not different from children receiving sorbitol (P=0.07). Dental caries incidence for xylitol once per day or twice per day was 5.3±3.4 and 4.3±4.0 surfaces, respectively, compared to sorbitol once per day, sorbitol twice per day, or sucrose (4.1±2.8, 3.7±4.2, and 3.2±3.4 surfaces, respectively). There were no differences in caries incidence between xylitol and sucrose (rate ratio [RR] = 1.51; 95 percent confidence interval [CI] = 0.88, 2.59; P=0.13) or between xylitol and sorbitol (RR = 1.28; 95 percent CI = 0.90, 1.83; P=0.16). Xylitol-sweetened milk significantly reduced mutans streptococci levels compared to sucrose-sweetened milk, but differences in caries incidence were not detected.

  10. Milk sweetened with xylitol: a proof-of-principle caries prevention randomized clinical trial

    PubMed Central

    Chi, Donald L.; Zegarra, Graciela; Vasquez Huerta, Elsa C.; Castillo, Jorge L.; Milgrom, Peter; Roberts, Marilyn C.; Cabrera Matta, Ailin R.; Mancl, Lloyd; Merino, Ana P.

    2016-01-01

    Purpose To evaluate the efficacy of xylitol-sweetened milk as a caries preventive strategy. Methods In this nine-month prospective proof-of-principle trial, 153 Peruvian school children Peru were randomized to a milk group: 8g xylitol/200mL milk once/day, 4g xylitol/100mL milk twice/day, 8g sorbitol/200mL milk once/day, 4g sorbitol/100mL milk twice/day, or 8g sucrose/200mL milk once/day. The primary outcome was plaque mutans streptococci (MS) at nine-months. A secondary outcome was tooth decay incidence. We hypothesized children in the xylitol groups would have a greater MS decline and lower tooth decay incidence. Results One-hundred-thirty-five children were included in the intent-to-treat analyses. Children receiving xylitol had a greater reduction in MS than sucrose (P=0.02) but were not different from sorbitol (P=0.07). Tooth decay incidence for xylitol once/day or twice/day was 5.3±3.4 and 4.3±4.0 surfaces, respectively, compared to sorbitol once/day, sorbitol twice/day, or sucrose (4.1±2.8,3.7±4.2, and 3.2±3.4 surfaces, respectively). There were no differences in tooth decay incidence between xylitol and sucrose (Rate Ratio [RR]=1.51;95% confidence interval [CI]=0.88,2.59;P=0.13) or between xylitol and sorbitol (RR=1.28;95% CI=0.90,1.83;P=0.16). Conclusion Xylitol-sweetened milk significantly reduced MS levels compared to sucrose-sweetened milk, but we were unable to detect differences in caries incidence. ISRCTN34705772. PMID:28327266

  11. Raman Spectroscopy of Xylitol Uptake and Metabolism in Gram-Positive and Gram-Negative Bacteria▿

    PubMed Central

    Palchaudhuri, Sunil; Rehse, Steven J.; Hamasha, Khozima; Syed, Talha; Kurtovic, Eldar; Kurtovic, Emir; Stenger, James

    2011-01-01

    Visible-wavelength Raman spectroscopy was used to investigate the uptake and metabolism of the five-carbon sugar alcohol xylitol by Gram-positive viridans group streptococcus and the two extensively used strains of Gram-negative Escherichia coli, E. coli C and E. coli K-12. E. coli C, but not E. coli K-12, contains a complete xylitol operon, and the viridans group streptococcus contains an incomplete xylitol operon used to metabolize the xylitol. Raman spectra from xylitol-exposed viridans group streptococcus exhibited significant changes that persisted even in progeny grown from the xylitol-exposed mother cells in a xylitol-free medium for 24 h. This behavior was not observed in the E. coli K-12. In both viridans group streptococcus and the E. coli C derivative HF4714, the metabolic intermediates are stably formed to create an anomaly in bacterial normal survival. The uptake of xylitol by Gram-positive and Gram-negative pathogens occurs even in the presence of other high-calorie sugars, and its stable integration within the bacterial cell wall may discontinue bacterial multiplication. This could be a contributing factor for the known efficacy of xylitol when taken as a prophylactic measure to prevent or reduce occurrences of persistent infection. Specifically, these bacteria are causative agents for several important diseases of children such as pneumonia, otitis media, meningitis, and dental caries. If properly explored, such an inexpensive and harmless sugar-alcohol, alone or used in conjunction with fluoride, would pave the way to an alternative preventive therapy for these childhood diseases when the causative pathogens have become resistant to modern medicines such as antibiotics and vaccine immunotherapy. PMID:21037297

  12. Social pediatrics: weaving horizontal and vertical threads through pediatric residency.

    PubMed

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle

    2017-01-13

    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  13. Cell surface engineering of Saccharomyces cerevisiae combined with membrane separation technology for xylitol production from rice straw hydrolysate.

    PubMed

    Guirimand, Gregory; Sasaki, Kengo; Inokuma, Kentaro; Bamba, Takahiro; Hasunuma, Tomohisa; Kondo, Akihiko

    2016-04-01

    Xylitol, a value-added polyol deriving from D-xylose, is widely used in both the food and pharmaceutical industries. Despite extensive studies aiming to streamline the production of xylitol, the manufacturing cost of this product remains high while demand is constantly growing worldwide. Biotechnological production of xylitol from lignocellulosic waste may constitute an advantageous and sustainable option to address this issue. However, to date, there have been few reports of biomass conversion to xylitol. In the present study, xylitol was directly produced from rice straw hydrolysate using a recombinant Saccharomyces cerevisiae YPH499 strain expressing cytosolic xylose reductase (XR), along with β-glucosidase (BGL), xylosidase (XYL), and xylanase (XYN) enzymes (co-)displayed on the cell surface; xylitol production by this strain did not require addition of any commercial enzymes. All of these enzymes contributed to the consolidated bioprocessing (CBP) of the lignocellulosic hydrolysate to xylitol to produce 5.8 g/L xylitol with 79.5 % of theoretical yield from xylose contained in the biomass. Furthermore, nanofiltration of the rice straw hydrolysate provided removal of fermentation inhibitors while simultaneously increasing sugar concentrations, facilitating high concentration xylitol production (37.9 g/L) in the CBP. This study is the first report (to our knowledge) of the combination of cell surface engineering approach and membrane separation technology for xylitol production, which could be extended to further industrial applications.

  14. The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a randomized, double-blind, clinical trial.

    PubMed

    Evangelista, Mara Therese Padilla; Abad-Casintahan, Flordeliz; Lopez-Villafuerte, Lillian

    2014-01-01

    Atopic dermatitis (AD) is a chronic skin disease characterized by defects in the epidermal barrier function and cutaneous inflammation, in which transepidermal water loss (TEWL) is increased and the ability of the stratum corneum to hold water is impaired, causing decreased skin capacitance and hydration. This study investigated the effects of topical virgin coconut oil (VCO) and mineral oil, respectively, on SCORAD (SCORing of Atopic Dermatitis) index values, TEWL, and skin capacitance in pediatric patients with mild to moderate AD, using a randomized controlled trial design in which participants and investigators were blinded to the treatments allocated. Patients were evaluated at baseline, and at 2, 4, and 8 weeks. A total of 117 patients were included in the analysis. Mean SCORAD indices decreased from baseline by 68.23% in the VCO group and by 38.13% in the mineral oil group (P < 0.001). In the VCO group, 47% (28/59) of patients achieved moderate improvement and 46% (27/59) showed an excellent response. In the mineral oil group, 34% (20/58) of patients showed moderate improvement and 19% (11/58) achieved excellent improvement. The VCO group achieved a post-treatment mean TEWL of 7.09 from a baseline mean of 26.68, whereas the mineral oil group demonstrated baseline and post-treatment TEWL values of 24.12 and 13.55, respectively. In the VCO group, post-treatment skin capacitance rose to 42.3 from a baseline mean of 32.0, whereas that in the mineral oil group increased to 37.49 from a baseline mean of 31.31. Thus, among pediatric patients with mild to moderate AD, topical application of VCO for eight weeks was superior to that of mineral oil based on clinical (SCORAD) and instrumental (TEWL, skin capacitance) assessments. © 2013 The International Society of Dermatology.

  15. The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia.

    PubMed

    Ivani, Giorgio; Suresh, Santhanam; Ecoffey, Claude; Bosenberg, Adrian; Lonnqvist, Per-Anne; Krane, Elliot; Veyckemans, Francis; Polaner, David M; Van de Velde, Marc; Neal, Joseph M

    2015-01-01

    Some topics in the clinical management of regional anesthesia in children remain controversial. To evaluate and come to a consensus regarding some of these topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a joint committee practice advisory on pediatric regional anesthesia (PRA). Representatives from both ASRA and ESRA comprised the joint committee practice advisory on PRA. Evidence-based recommendations were based on a systematic search of the literature. In cases where no literature was available, expert opinion was elicited. Experts selected controversial topics in PRA. The performance of PRA under general anesthesia or deep sedation is associated with acceptable safety and should be viewed as the standard of care (Evidence B2 and Evidence B3). Because of the difficulty interpreting a negative test dose, the use of test dosing should remain discretionary (Evidence B4). The use of either air-loss of resistance or saline-loss of resistance techniques is supported by expert opinion, but the literature supporting one technique over the other is sparse and controversial; when used appropriately, each technique may be safely used in children. There are no current evidence-based data that the use of RA increases the risk for acute compartment syndrome or delays its diagnosis in children. High-level evidence is not yet available for the topics evaluated, and most recommendations are based on Evidence B studies. The ESRA/ASRA recommendations intend to provide guidance for the safe practice of regional anesthesia in children.

  16. Optimized Production of Xylitol from Xylose Using a Hyper-Acidophilic Candida tropicalis.

    PubMed

    Tamburini, Elena; Costa, Stefania; Marchetti, Maria Gabriella; Pedrini, Paola

    2015-08-19

    The yeast Candida tropicalis DSM 7524 produces xylitol, a natural, low-calorie sweetener, by fermentation of xylose. In order to increase xylitol production rate during the submerged fermentation process, some parameters-substrate (xylose) concentration, pH, aeration rate, temperature and fermentation strategy-have been optimized. The maximum xylitol yield reached at 60-80 g/L initial xylose concentration, pH 5.5 at 37 °C was 83.66% (w/w) on consumed xylose in microaerophilic conditions (kLa = 2·h(-1)). Scaling up on 3 L fermenter, with a fed-batch strategy, the best xylitol yield was 86.84% (w/w), against a 90% of theoretical yield. The hyper-acidophilic behaviour of C. tropicalis makes this strain particularly promising for industrial application, due to the possibility to work in non-sterile conditions.

  17. Optimized Production of Xylitol from Xylose Using a Hyper-Acidophilic Candida tropicalis

    PubMed Central

    Tamburini, Elena; Costa, Stefania; Marchetti, Maria Gabriella; Pedrini, Paola

    2015-01-01

    The yeast Candida tropicalis DSM 7524 produces xylitol, a natural, low-calorie sweetener, by fermentation of xylose. In order to increase xylitol production rate during the submerged fermentation process, some parameters-substrate (xylose) concentration, pH, aeration rate, temperature and fermentation strategy-have been optimized. The maximum xylitol yield reached at 60–80 g/L initial xylose concentration, pH 5.5 at 37 °C was 83.66% (w/w) on consumed xylose in microaerophilic conditions (kLa = 2·h−1). Scaling up on 3 L fermenter, with a fed-batch strategy, the best xylitol yield was 86.84% (w/w), against a 90% of theoretical yield. The hyper-acidophilic behaviour of C. tropicalis makes this strain particularly promising for industrial application, due to the possibility to work in non-sterile conditions. PMID:26295411

  18. Dielectric relaxation and hydrogen bonding interaction in xylitol-water mixtures using time domain reflectometry

    NASA Astrophysics Data System (ADS)

    Rander, D. N.; Joshi, Y. S.; Kanse, K. S.; Kumbharkhane, A. C.

    2016-01-01

    The measurements of complex dielectric permittivity of xylitol-water mixtures have been carried out in the frequency range of 10 MHz-30 GHz using a time domain reflectometry technique. Measurements have been done at six temperatures from 0 to 25 °C and at different weight fractions of xylitol (0 < W X ≤ 0.7) in water. There are different models to explain the dielectric relaxation behaviour of binary mixtures, such as Debye, Cole-Cole or Cole-Davidson model. We have observed that the dielectric relaxation behaviour of binary mixtures of xylitol-water can be well described by Cole-Davidson model having an asymmetric distribution of relaxation times. The dielectric parameters such as static dielectric constant and relaxation time for the mixtures have been evaluated. The molecular interaction between xylitol and water molecules is discussed using the Kirkwood correlation factor ( g eff ) and thermodynamic parameter.

  19. Challenges and prospects of xylitol production with whole cell bio-catalysis: A review.

    PubMed

    Dasgupta, Diptarka; Bandhu, Sheetal; Adhikari, Dilip K; Ghosh, Debashish

    2017-04-01

    Xylitol, as an alternative low calorie sweetener is well accepted in formulations of various confectioneries and healthcare products. Worldwide it is industrially produced by catalytic hydrogenation of pure d-xylose solution under high temperature and pressure. Biotechnological xylitol production is a potentially attractive replacement for chemical process, as it occurs under much milder process conditions and can be based on sugar mixtures derived from low-cost industrial and agri-waste. However, microbial fermentation route of xylitol production is not so far practiced industrially. This review highlights the challenges and prospects of biotechnological xylitol production considering possible genetic modifications of fermenting microorganisms and various aspects of industrial bioprocessing and product downstreaming. Copyright © 2017 Elsevier GmbH. All rights reserved.

  20. Developing Public Health Interventions with Xylitol for the US and US-Associated Territories and States

    PubMed Central

    Milgrom, Peter; Rothen, Marilynn; Milgrom, Linda

    2006-01-01

    Summary This paper examines how the limited exposure of the professional dental community in the United States to the potential caries reduction benefits of xylitol, and the absence of vehicles for xylitol that could be recommended in private practice settings or applied in public health programs, has retarded xylitol’s adoption. Few papers appeared in the English language literature prior to the last two decades but now a greater number are appearing. Current work at the University of Washington has led to a series of randomized controlled trials more clearly establishing dosing and frequency guidelines and increased interest in use of xylitol products for caries prevention. Steps to develop effective alternative vehicles for the delivery of xylitol particularly useful for young children and institutional settings in America, and their bioequivalency, are explored. PMID:17369871

  1. Influence of sucrose and xylitol on an early Streptococcus mutans biofilm in a dental simulator.

    PubMed

    Salli, K M; Forssten, S D; Lahtinen, S J; Ouwehand, A C

    2016-10-01

    In vitro methods to study dental biofilms are useful in finding ways to support a healthy microbial balance in the oral cavity. The effects of sucrose, xylitol, and their combination on three strains of Streptococcus mutans and one strain of Streptococcus sobrinus were studied using a dental simulator. A simulator was used to mimic the oral cavity environment. It provided a continuous-flow system using artificial saliva (AS), constant temperature, mixing, and hydroxyapatite (HA) surface in which the influence of xylitol was studied. The quantities of planktonic and adhered bacteria were measured by real-time qPCR. Compared against the untreated AS, adding 1% sucrose increased the bacterial colonization of HA (p<0.0001) whereas 2% xylitol decreased it (p<0.05), with the exception of clinical S. mutans isolate 117. The combination of xylitol and sucrose decreased the bacterial quantities within the AS and the colonization on the HA by clinical S. mutans isolate 2366 was reduced (p<0.05). Increasing the concentration (2%-5%) of xylitol caused a reduction in bacterial counts even in the presence of sucrose. The continuous-culture biofilm model showed that within a young biofilm, sucrose significantly promotes whereas xylitol reduces bacterial colonization and proliferation. The results indicate that xylitol affects the ability of certain S. mutans strains to adhere to the HA. Clinical studies have also shown that xylitol consumption decreases caries incidence and reduces the amount of plaque. This study contributes to the understanding of the mechanism behind these clinical observations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Effect of white tea and xylitol on structure and properties of demineralized enamel and jawbone

    NASA Astrophysics Data System (ADS)

    Auerkari, EI; Kiranahayu, R.; Emerita, D.; Sumariningsih, P.; Sarita, D.; Adiwirya, MS; Suhartono, AW

    2018-05-01

    White tea and xylitol have been suggested as potential agents to combat dental caries and osteoporosis through enhanced remineralization. This investigation aimed to determine the effects of exposure to white tea with and without xylitol on the structure, composition and hardness of demineralized human dental enamel. For control, samples of untreated and demineralized enamel and samples of untreated rat jawbone were subjected to similar measurements. For demineralization, the enamel samples were immersed for two days at 50°C in an acetate solution (pH 4.0). All samples were then soaked for two weeks at 37°C in a solution containing three different concentrations of white tea, xylitol or both, and an optional addition of the remineralization ingredients including Ca, P and F. For enamel samples without preceding demineralization and without added remineralization ingredients, the results showed highest mean hardness after immersion in a solution containing both white tea and xylitol, practically independently of their applied concentration level. However, for demineralized enamel samples with added remineralization ingredients, the resulting mean hardness was also dependent on concentration of white tea and xylitol. With sufficient concentration, hardness was again higher for combined white tea and xylitol than for either of these used alone.

  3. Effect of Xylitol on Growth of Streptococcus pneumoniae in the Presence of Fructose and Sorbitol

    PubMed Central

    Tapiainen, Terhi; Kontiokari, Tero; Sammalkivi, Laura; Ikäheimo, Irma; Koskela, Markku; Uhari, Matti

    2001-01-01

    Xylitol is effective in preventing acute otitis media by inhibiting the growth of Streptococcus pneumoniae. To clarify this inhibition we used fructose, which is known to block similar growth inhibition observed in Streptococcus mutans. In addition, we evaluated the efficacy of sorbitol in inhibiting the growth of pneumococci, as sorbitol is widely used for indications similar to those for which xylitol is used. The addition of 5% xylitol to the growth medium resulted in marked growth inhibition, an effect which was totally eliminated in the presence of 1, 2.5, or 5% fructose but not in the presence of 1 or 5% glucose, 1% galactose, or 1% sucrose. This finding implies that xylitol-induced inhibition of pneumococcal growth is mediated via the fructose phosphotransferase system in a way similar to that in which mutans group streptococcal growth is inhibited. The addition of sorbitol at concentrations of 1, 2.5, or 5% to the growth medium did not affect the growth of pneumococci and neither inhibited nor enhanced the xylitol-induced growth impairment. Thus, it seems that xylitol is the only commercially used sugar substitute proven to have an antimicrobial effect on pneumococci. PMID:11120960

  4. Dual utilization of NADPH and NADH cofactors enhances xylitol production in engineered Saccharomyces cerevisiae.

    PubMed

    Jo, Jung-Hyun; Oh, Sun-Young; Lee, Hyeun-Soo; Park, Yong-Cheol; Seo, Jin-Ho

    2015-12-01

    Xylitol, a natural sweetener, can be produced by hydrogenation of xylose in hemicelluloses. In microbial processes, utilization of only NADPH cofactor limited commercialization of xylitol biosynthesis. To overcome this drawback, Saccharomyces cerevisiae D452-2 was engineered to express two types of xylose reductase (XR) with either NADPH-dependence or NADH-preference. Engineered S. cerevisiae DWM expressing both the XRs exhibited higher xylitol productivity than the yeast strain expressing NADPH-dependent XR only (DWW) in both batch and glucose-limited fed-batch cultures. Furthermore, the coexpression of S. cerevisiae ZWF1 and ACS1 genes in the DWM strain increased intracellular concentrations of NADPH and NADH and improved maximum xylitol productivity by 17%, relative to that for the DWM strain. Finally, the optimized fed-batch fermentation of S. cerevisiae DWM-ZWF1-ACS1 resulted in 196.2 g/L xylitol concentration, 4.27 g/L h productivity and almost the theoretical yield. Expression of the two types of XR utilizing both NADPH and NADH is a promising strategy to meet the industrial demands for microbial xylitol production. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Ameliorating Effect of Dietary Xylitol on Human Respiratory Syncytial Virus (hRSV) Infection.

    PubMed

    Xu, Mei Ling; Wi, Ga Ram; Kim, Hyoung Jin; Kim, Hong-Jin

    2016-01-01

    Human respiratory syncytial virus (hRSV) is the most common cause of bronchiolitis and pneumonia in infants. The lack of proper prophylactics and therapeutics for controlling hRSV infection has been of great concern worldwide. Xylitol is a well-known sugar substitute and its effect against bacteria in the oral cavity is well known. However, little is known of its effect on viral infections. In this study, the effect of dietary xylitol on hRSV infection was investigated in a mouse model for the first time. Mice received xylitol for 14 d prior to virus challenge and for a further 3 d post challenge. Significantly larger reductions in lung virus titers were observed in the mice receiving xylitol than in the controls receiving phosphate-buffered saline (PBS). In addition, fewer CD3(+) and CD3(+)CD8(+) lymphocytes, whose numbers reflect inflammatory status, were recruited in the mice receiving xylitol. These results indicate that dietary xylitol can ameliorate hRSV infections and reduce inflammation-associated immune responses to hRSV infection.

  6. Xylitol gummy bear snacks: a school-based randomized clinical trial

    PubMed Central

    Ly, Kiet A; Riedy, Christine A; Milgrom, Peter; Rothen, Marilynn; Roberts, Marilyn C; Zhou, Lingmei

    2008-01-01

    Background Habitual consumption of xylitol reduces mutans streptococci (MS) levels but the effect on Lactobacillus spp. is less clear. Reduction is dependent on daily dose and frequency of consumption. For xylitol to be successfully used in prevention programs to reduce MS and prevent caries, effective xylitol delivery methods must be identified. This study examines the response of MS, specifically S. mutans/sobrinus and Lactobacillus spp., levels to xylitol delivered via gummy bears at optimal exposures. Methods Children, first to fifth grade (n = 154), from two elementary schools in rural Washington State, USA, were randomized to xylitol 15.6 g/day (X16, n = 53) or 11.7 g/day (X12, n = 49), or maltitol 44.7 g/day (M45, n = 52). Gummy bear snacks were pre-packaged in unit-doses, labeled with ID numbers, and distributed three times/day during school hours. No snacks were sent home. Plaque was sampled at baseline and six weeks and cultured on modified Mitis Salivarius agar for S. mutans/sobrinus and Rogosa SL agar for Lactobacillus spp. enumeration. Results There were no differences in S. mutans/sobrinus and Lactobacillus spp. levels in plaque between the groups at baseline. At six weeks, log10 S. mutans/sobrinus levels showed significant reductions for all groups (p = 0.0001): X16 = 1.13 (SD = 1.65); X12 = 0.89 (SD = 1.11); M45 = 0.91 (SD = 1.46). Reductions were not statistically different between groups. Results for Lactobacillus spp. were mixed. Group X16 and M45 showed 0.31 (SD = 2.35), and 0.52 (SD = 2.41) log10 reductions, respectively, while X12 showed a 0.11 (SD = 2.26) log10 increase. These changes were not significant. Post-study discussions with school staff indicated that it is feasible to implement an in-classroom gummy bear snack program. Parents are accepting and children willing to consume gummy bear snacks daily. Conclusion Reductions in S. mutans/sobrinus levels were observed after six weeks of gummy bear snack consumption containing xylitol at 11

  7. Retrospective evaluation of xylitol ingestion in dogs: 192 cases (2007-2012).

    PubMed

    DuHadway, Meghan R; Sharp, Claire R; Meyers, Katherine E; Koenigshof, Amy M

    2015-01-01

    To summarize the signalment, clinical signs, prevalence of decreased blood glucose concentration (BG), prevalence of increased liver values, treatment, and outcome in dogs known to have ingested xylitol. Retrospective study from December 2007 to February 2012 SETTING: Three university teaching hospitals. One hundred ninety-two client-owned dogs with known or suspected xylitol ingestion. None. The median ingested xylitol dose was 0.32 g/kg (range 0.03-3.64 g/kg). Clinical signs were present in 39 (20%) dogs on presentation to the veterinary teaching hospitals. The most common clinical sign was vomiting (n = 25), followed by lethargy (12). The median duration of clinical signs prior to presentation was 93 minutes (range 0-5,040 minutes). Dogs that developed clinical signs ingested a significantly higher dose of xylitol than those that were asymptomatic. Thirty dogs became hypoglycemic (BG ≤ 3.3 mmol/L [60 mg/dL]) at some time point during their hospitalization. When evaluating all dogs, there was a significant difference between the initial and lowest BGs. Thirty dogs had increased alanine aminotransferase activity or total serum bilirubin concentration. Dogs with increases in alanine aminotransferase activity or total serum bilirubin concentration had a significantly lower nadir BG. All dogs survived to discharge and 158 were known to be alive at 28 days. The rest were lost to follow up. The prognosis for dogs evaluated by a veterinarian that ingest lower doses of xylitol and do not develop liver failure is excellent. Dogs ingesting xylitol should be hospitalized and monitored for variations in BG, because BG drops in most dogs following presentation. Additional studies are needed in dogs ingesting higher doses of xylitol before correlations between dose and the development of clinical signs or liver failure can be established. Treatment and prognosis for these dogs warrants further investigation. © Veterinary Emergency and Critical Care Society 2015.

  8. Metabolic activity of Streptococcus mutans biofilms and gene expression during exposure to xylitol and sucrose.

    PubMed

    Decker, Eva-Maria; Klein, Christian; Schwindt, Dimitri; von Ohle, Christiane

    2014-12-01

    The objective of the study was to analyse Streptococcus mutans biofilms grown under different dietary conditions by using multifaceted methodological approaches to gain deeper insight into the cariogenic impact of carbohydrates. S. mutans biofilms were generated during a period of 24 h in the following media: Schaedler broth as a control medium containing endogenous glucose, Schaedler broth with an additional 5% sucrose, and Schaedler broth supplemented with 1% xylitol. The confocal laser scanning microscopy (CLSM)-based analyses of the microbial vitality, respiratory activity (5-cyano-2,3-ditolyl tetrazolium chloride, CTC) and production of extracellular polysaccharides (EPS) were performed separately in the inner, middle and outer biofilm layers. In addition to the microbiological sample testing, the glucose/sucrose consumption of the biofilm bacteria was quantified, and the expression of glucosyltransferases and other biofilm-associated genes was investigated. Xylitol exposure did not inhibit the viability of S. mutans biofilms, as monitored by the following experimental parameters: culture growth, vitality, CTC activity and EPS production. However, xylitol exposure caused a difference in gene expression compared to the control. GtfC was upregulated only in the presence of xylitol. Under xylitol exposure, gtfB was upregulated by a factor of 6, while under sucrose exposure, it was upregulated by a factor of three. Compared with glucose and xylitol, sucrose increased cell vitality in all biofilm layers. In all nutrient media, the intrinsic glucose was almost completely consumed by the cells of the S. mutans biofilm within 24 h. After 24 h of biofilm formation, the multiparametric measurements showed that xylitol in the presence of glucose caused predominantly genotypic differences but did not induce metabolic differences compared to the control. Thus, the availability of dietary carbohydrates in either a pure or combined form seems to affect the

  9. Metabolic activity of Streptococcus mutans biofilms and gene expression during exposure to xylitol and sucrose

    PubMed Central

    Decker, Eva-Maria; Klein, Christian; Schwindt, Dimitri; von Ohle, Christiane

    2014-01-01

    The objective of the study was to analyse Streptococcus mutans biofilms grown under different dietary conditions by using multifaceted methodological approaches to gain deeper insight into the cariogenic impact of carbohydrates. S. mutans biofilms were generated during a period of 24 h in the following media: Schaedler broth as a control medium containing endogenous glucose, Schaedler broth with an additional 5% sucrose, and Schaedler broth supplemented with 1% xylitol. The confocal laser scanning microscopy (CLSM)-based analyses of the microbial vitality, respiratory activity (5-cyano-2,3-ditolyl tetrazolium chloride, CTC) and production of extracellular polysaccharides (EPS) were performed separately in the inner, middle and outer biofilm layers. In addition to the microbiological sample testing, the glucose/sucrose consumption of the biofilm bacteria was quantified, and the expression of glucosyltransferases and other biofilm-associated genes was investigated. Xylitol exposure did not inhibit the viability of S. mutans biofilms, as monitored by the following experimental parameters: culture growth, vitality, CTC activity and EPS production. However, xylitol exposure caused a difference in gene expression compared to the control. GtfC was upregulated only in the presence of xylitol. Under xylitol exposure, gtfB was upregulated by a factor of 6, while under sucrose exposure, it was upregulated by a factor of three. Compared with glucose and xylitol, sucrose increased cell vitality in all biofilm layers. In all nutrient media, the intrinsic glucose was almost completely consumed by the cells of the S. mutans biofilm within 24 h. After 24 h of biofilm formation, the multiparametric measurements showed that xylitol in the presence of glucose caused predominantly genotypic differences but did not induce metabolic differences compared to the control. Thus, the availability of dietary carbohydrates in either a pure or combined form seems to affect the

  10. Effect of xylitol on cariogenic and beneficial oral streptococci: a randomized, double-blind crossover trial

    PubMed Central

    Bahador, A; Lesan, S; Kashi, N

    2012-01-01

    Background/purpose Although habitual consumption of xylitol reduces cariogenic streptococci levels, its effect on beneficial oral streptococci is less clear. The main aim of the study is to investigate the effect of short-term xylitol consumption on the oral beneficial streptococci level of saliva, Streptococcus sanguinis and S. mitis. Material and Methods Twenty four volunteers with a median age of 23.7 years (range: 20-28) harboring Streptococcus mutans, S. sobrinus, S. sanguinis and S. mitis participated in the randomized, double-blind, cross-over study. The experimental chewing gum (1.5 g/pellet) contained 70% xylitol w/w while the control gum contained 63% sorbitol w/w. Saliva samples were collected before and after two three-week test periods with a four-week washout interval. Colony-forming units (CFU)/ml were enumerated for the estimation of S. mutans levels on Mitis Salivarius-Mutans valinomycin (MS-MUTV), S. sobrinus on Mitis Salivarius-Sobrinus (MS-SOB), S. sanguinis on Modified Medium 10-Sucrose (MM10-S) and S. mitis on Mitis Salivarius Agar with Tellurite (MSAT) media. Results The S. mutans and S. sobrinus counts of the saliva samples decreased significantly (p = 0.01 and p = 0.011, respectively) in the xylitol gum group but not in the sorbitol gum group. The salivary S. sanguinis and S. mitis counts did not decrease in both xylitol and sorbitol gum groups. Conclusions Based on the findings of this study, xylitol consumption reduced S. mutans and S. sobrinus counts in saliva but appeared not to effect numbers of S. sanguinis and S. mitis in saliva. So, habitual consumption of xylitol reduces cariogenic streptococci levels without any effect on beneficial sterptococci for the oral cavity. PMID:22973473

  11. Novel endophytic yeast Rhodotorula mucilaginosa strain PTD3 I: production of xylitol and ethanol.

    PubMed

    Bura, Renata; Vajzovic, Azra; Doty, Sharon L

    2012-07-01

    An endophytic yeast, Rhodotorula mucilaginosa strain PTD3, that was isolated from stems of hybrid poplar was found to be capable of production of xylitol from xylose, of ethanol from glucose, galactose, and mannose, and of arabitol from arabinose. The utilization of 30 g/L of each of the five sugars during fermentation by PTD3 was studied in liquid batch cultures. Glucose-acclimated PTD3 produced enhanced yields of xylitol (67% of theoretical yield) from xylose and of ethanol (84, 86, and 94% of theoretical yield, respectively) from glucose, galactose, and mannose. Additionally, this yeast was capable of metabolizing high concentrations of mixed sugars (150 g/L), with high yields of xylitol (61% of theoretical yield) and ethanol (83% of theoretical yield). A 1:1 glucose:xylose ratio with 30 g/L of each during double sugar fermentation did not affect PTD3's ability to produce high yields of xylitol (65% of theoretical yield) and ethanol (92% of theoretical yield). Surprisingly, the highest yields of xylitol (76% of theoretical yield) and ethanol (100% of theoretical yield) were observed during fermentation of sugars present in the lignocellulosic hydrolysate obtained after steam pretreatment of a mixture of hybrid poplar and Douglas fir. PTD3 demonstrated an exceptional ability to ferment the hydrolysate, overcome hexose repression of xylose utilization with a short lag period of 10 h, and tolerate sugar degradation products. In direct comparison, PTD3 had higher xylitol yields from the mixed sugar hydrolysate compared with the widely studied and used xylitol producer Candida guilliermondii.

  12. Xylitol improves pancreatic islets morphology to ameliorate type 2 diabetes in rats: a dose response study.

    PubMed

    Rahman, Md Atiar; Islam, Md Shahdiul

    2014-07-01

    Xylitol has been reported as a potential antidiabetic sweetener in a number of recent studies; however, the most effective dietary dose and organ-specific effects are still unclear. Six-week-old male Sprague-Dawley rats were randomly divided into 5 groups: normal control (NC), diabetic control (DBC), diabetic xylitol 2.5% (DXL2.5), diabetic xylitol 5.0% (DXL5), and diabetic xylitol 10.0% (DXL10). Diabetes was induced only in the animals in DBC and DXL groups and considered diabetic when their nonfasting blood glucose level was >300 mg/dL. The DXL groups were fed with 2.5%, 5.0%, and 10% xylitol solution, whereas the NC and DBC groups were supplied with normal drinking water. After 4-wk intervention, body weight, food and fluid intake, blood glucose, serum fructosamine, liver glycogen, serum alanine transaminase, aspartate transaminase, lactate dehydrogenase, creatine kinase, uric acid, creatinine, and most serum lipids were significantly decreased, and serum insulin concentration, glucose tolerance ability, and pancreatic islets morphology were significantly improved in the DXL10 group compared to the DBC group. The data of this study suggest that 10% xylitol has the better antidiabetic effects compared to 2.5% and 5.0% and it can be used as an excellent antidiabetic sweetener and food supplement in antidiabetic foods. Xylitol is widely used as a potential anticariogenic and sweetening agent in a number of oral care and food products when many of its health benefits are still unknown. Due to its similar sweetening power but lower calorific value (2.5 compared with 4 kcal) and lower glycemic index (13 compared with 65) compared to sucrose, recently it has been widely used as a sugar substitute particularly by overweight, obese, and diabetic patients in order to reduce their calorie intake from sucrose. However, the potential antidiabetic effects of xylitol have been discovered recently. The results of this study confirmed the effective dietary dose of xylitol for

  13. Metabolomic Effects of Xylitol and Fluoride on Plaque Biofilm in Vivo

    PubMed Central

    Takahashi, N.; Washio, J.

    2011-01-01

    Dental caries is initiated by demineralization of the tooth surface through acid production from sugar by plaque biofilm. Fluoride and xylitol have been used worldwide as caries-preventive reagents, based on in vitro-proven inhibitory mechanisms on bacterial acid production. We attempted to confirm the inhibitory mechanisms of fluoride and xylitol in vivo by performing metabolome analysis on the central carbon metabolism in supragingival plaque using the combination of capillary electrophoresis and a time-of-flight mass spectrometer. Fluoride (225 and 900 ppm F−) inhibited lactate production from 10% glucose by 34% and 46%, respectively, along with the increase in 3-phosphoglycerate and the decrease in phosphoenolpyruvate in the EMP pathway in supragingival plaque. These results confirmed that fluoride inhibited bacterial enolase in the EMP pathway and subsequently repressed acid production in vivo. In contrast, 10% xylitol had no effect on acid production and the metabolome profile in supragingival plaque, although xylitol 5-phosphate was produced. These results suggest that xylitol is not an inhibitor of plaque acid production but rather a non-fermentative sugar alcohol. Metabolome analyses of plaque biofilm can be applied for monitoring the efficacy of dietary components and medicines for plaque biofilm, leading to the development of effective plaque control. PMID:21940519

  14. Metabolomic effects of xylitol and fluoride on plaque biofilm in vivo.

    PubMed

    Takahashi, N; Washio, J

    2011-12-01

    Dental caries is initiated by demineralization of the tooth surface through acid production from sugar by plaque biofilm. Fluoride and xylitol have been used worldwide as caries-preventive reagents, based on in vitro-proven inhibitory mechanisms on bacterial acid production. We attempted to confirm the inhibitory mechanisms of fluoride and xylitol in vivo by performing metabolome analysis on the central carbon metabolism in supragingival plaque using the combination of capillary electrophoresis and a time-of-flight mass spectrometer. Fluoride (225 and 900 ppm F(-)) inhibited lactate production from 10% glucose by 34% and 46%, respectively, along with the increase in 3-phosphoglycerate and the decrease in phosphoenolpyruvate in the EMP pathway in supragingival plaque. These results confirmed that fluoride inhibited bacterial enolase in the EMP pathway and subsequently repressed acid production in vivo. In contrast, 10% xylitol had no effect on acid production and the metabolome profile in supragingival plaque, although xylitol 5-phosphate was produced. These results suggest that xylitol is not an inhibitor of plaque acid production but rather a non-fermentative sugar alcohol. Metabolome analyses of plaque biofilm can be applied for monitoring the efficacy of dietary components and medicines for plaque biofilm, leading to the development of effective plaque control.

  15. Effect of Furfural, Vanillin and Syringaldehyde on Candida guilliermondii Growth and Xylitol Biosynthesis

    NASA Astrophysics Data System (ADS)

    Kelly, Christine; Jones, Opal; Barnhart, Christopher; Lajoie, Curtis

    Xylitol is a five-carbon sugar alcohol with established commercial use as an alternative sweetener and can be produced from hemicellulose hydrolysate. However, there are difficulties with microbiological growth and xylitol biosynthesis on hydrolysate because of the inhibitors formed from hydrolysis of hemicellulose. This research focused on the effect of furfural, vanillin, and syringaldehyde on growth of Candida guilliermondii and xylitol accumulation from xylose in a semi-synthetic medium in microwell plate and bioreactor cultivations. All three compounds reduced specific growth rate, increased lag time, and reduced xylitol production rate. In general, increasing concentration of inhibitor increased the severity of inhibition, except in the case of 0.5 g vanillin per liter, which resulted in a faster late batch phase growth rate and increased biomass yield. At concentrations of 1 g/1 or higher, furfural was the least inhibitory to growth, followed by syringaldehyde. Vanillin most severely reduced specific growth rate. All three inhibitors reduced xylitol production rate approximately to the same degree.

  16. Results from the Xylitol for Adult Caries Trial (X-ACT)

    PubMed Central

    Bader, James D.; Vollmer, William M.; Shugars, Daniel A.; Gilbert, Gregg H.; Amaechi, Bennett T.; Brown, John P.; Laws, Reesa L.; Funkhouser, Kimberly A.; Makhija, Sonia K.; Ritter, André V.; Leo, Michael C.

    2013-01-01

    Background Although caries is prevalent in adults, few preventive therapies have been tested in adult populations. This randomized clinical trial evaluated the effectiveness of xylitol lozenges in preventing caries in elevated caries-risk adults. Methods X-ACT was a three-site placebo-controlled randomized trial. Participants (n=691) ages 21–80 consumed five 1.0 g xylitol or placebo lozenges daily for 33 months. Clinical examinations occurred at baseline, 12, 24 and 33 months. Results Xylitol lozenges reduced the caries increment 11%. This reduction, which represented less than one-third of a surface per year, was not statistically significant. There was no indication of a dose-response effect. Conclusions Daily use of xylitol lozenges did not result in a statistically or clinically significant reduction in 33-month caries increment among elevated caries-risk adults. Clinical Implications These results suggest that xylitol used as a supplement in adults does not significantly reduce their caries experience. PMID:23283923

  17. Effect of furfural, vanillin and syringaldehyde on Candida guilliermondii growth and xylitol biosynthesis.

    PubMed

    Kelly, Christine; Jones, Opal; Barnhart, Christopher; Lajoie, Curtis

    2008-03-01

    Xylitol is a five-carbon sugar alcohol with established commercial use as an alternative sweetener and can be produced from hemicellulose hydrolysate. However, there are difficulties with microbiological growth and xylitol biosynthesis on hydrolysate because of the inhibitors formed from hydrolysis of hemicellulose. This research focused on the effect of furfural, vanillin, and syringaldehyde on growth of Candida guilliermondii and xylitol accumulation from xylose in a semi-synthetic medium in microwell plate and bioreactor cultivations. All three compounds reduced specific growth rate, increased lag time, and reduced xylitol production rate. In general, increasing concentration of inhibitor increased the severity of inhibition, except in the case of 0.5 g vanillin per liter, which resulted in a faster late batch phase growth rate and increased biomass yield. At concentrations of 1 g/l or higher, furfural was the least inhibitory to growth, followed by syringaldehyde. Vanillin most severely reduced specific growth rate. All three inhibitors reduced xylitol production rate approximately to the same degree.

  18. Is mother-child transmission a possible vehicle for xylitol prophylaxis in acute otitis media?

    PubMed

    Danhauer, Jeffrey L; Kelly, Allison; Johnson, Carole E

    2011-10-01

    Xylitol can be a prophylaxis for acute otitis media (AOM), especially when administered via chewing gum, but that vehicle has limitations for children. This review sought evidence for links of mother-child transmission of bacteria and as a vehicle for xylitol as a prophylaxis for dental caries and its translation to AOM in infants and young children. Qualitative systematic review. Combining output from 43 search strings used earlier and submitting 20 new strings to PubMed resulted in 14 studies (six were excluded; eight were included). Included studies had to be published in English-language, peer-reviewed journals; involve mothers using xylitol; and assess bacteria or caries in their children. Evaluation forms were completed for search, retrieval, and quality assessment of included studies. The studies showed that mothers' chewing xylitol gum was a prophylaxis against bacteria and caries in their children. A mother-child transmission model was presented as a possible vehicle for use in comprehensive prevention programs for AOM. Potential for xylitol use to prevent AOM warrants further study. A mother-child model may apply to AOM for transmission of bacteria and as a prophylaxis, but alternative vehicles like nasal sprays should be investigated for ease of use and effectiveness.

  19. Xylitol dehydrogenase from Candida tropicalis: molecular cloning of the gene and structural analysis of the protein.

    PubMed

    Lima, Luanne Helena Augusto; Pinheiro, Cristiano Guimarães do Amaral; de Moraes, Lídia Maria Pepe; de Freitas, Sonia Maria; Torres, Fernando Araripe Gonçalves

    2006-12-01

    Yeasts can metabolize xylose by the action of two key enzymes: xylose reductase and xylitol dehydrogenase. In this work, we present data concerning the cloning of the XYL2 gene encoding xylitol dehydrogenase from the yeast Candida tropicalis. The gene is present as a single copy in the genome and is controlled at the transcriptional level by the presence of the inducer xylose. XYL2 was functionally tested by heterologous expression in Saccharomyces cerevisiae to develop a yeast strain capable of producing ethanol from xylose. Structural analysis of C. tropicalis xylitol dehydrogenase, Xyl2, suggests that it is a member of the medium-chain dehydrogenase (MDR) family. This is supported by the presence of the amino acid signature [GHE]xx[G]xxxxx[G]xx[V] in its primary sequence and a typical alcohol dehydrogenase Rossmann fold pattern composed by NAD(+) and zinc ion binding domains.

  20. Microbial and Bioconversion Production of D-xylitol and Its Detection and Application

    PubMed Central

    Chen, Xi; Jiang, Zi-Hua; Chen, Sanfeng; Qin, Wensheng

    2010-01-01

    D-Xylitol is found in low content as a natural constituent of many fruits and vegetables. It is a five-carbon sugar polyol and has been used as a food additive and sweetening agent to replace sucrose, especially for non-insulin dependent diabetics. It has multiple beneficial health effects, such as the prevention of dental caries, and acute otitis media. In industry, it has been produced by chemical reduction of D-xylose mainly from photosynthetic biomass hydrolysates. As an alternative method of chemical reduction, biosynthesis of D-xylitol has been focused on the metabolically engineered Saccharomyces cerevisiae and Candida strains. In order to detect D-xylitol in the production processes, several detection methods have been established, such as gas chromatography (GC)-based methods, high performance liquid chromatography (HPLC)-based methods, LC-MS methods, and capillary electrophoresis methods (CE). The advantages and disadvantages of these methods are compared in this review. PMID:21179590

  1. The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing

    NASA Astrophysics Data System (ADS)

    Zabner, Joseph; Seiler, Michael P.; Launspach, Janice L.; Karp, Philip H.; Kearney, William R.; Look, Dwight C.; Smith, Jeffrey J.; Welsh, Michael J.

    2000-10-01

    The thin layer of airway surface liquid (ASL) contains antimicrobial substances that kill the small numbers of bacteria that are constantly being deposited in the lungs. An increase in ASL salt concentration inhibits the activity of airway antimicrobial factors and may partially explain the pathogenesis of cystic fibrosis (CF). We tested the hypothesis that an osmolyte with a low transepithelial permeability may lower the ASL salt concentration, thereby enhancing innate immunity. We found that the five-carbon sugar xylitol has a low transepithelial permeability, is poorly metabolized by several bacteria, and can lower the ASL salt concentration in both CF and non-CF airway epithelia in vitro. Furthermore, in a double-blind, randomized, crossover study, xylitol sprayed for 4 days into each nostril of normal volunteers significantly decreased the number of nasal coagulase-negative Staphylococcus compared with saline control. Xylitol may be of value in decreasing ASL salt concentration and enhancing the innate antimicrobial defense at the airway surface.

  2. Practical Considerations in Pediatric Surgery

    PubMed Central

    Louis, Matthew R.; Meaike, Jesse D.; Chamata, Edward; Hollier, Larry H.

    2016-01-01

    The care of pediatric patients requires special considerations that are often not addressed in the literature. Relatively straightforward tasks such as clinical evaluation, antibiotic use, splinting, wound closure, and care of simple burns become complicated in the pediatric population for several reasons. The authors seek to demystify some of these topics using the senior author's years of clinical experience treating pediatric patients by giving practical advice and general considerations when treating children. PMID:27895539

  3. Sugarcane straw as a feedstock for xylitol production by Candida guilliermondii FTI 20037.

    PubMed

    Hernández-Pérez, Andrés Felipe; de Arruda, Priscila Vaz; Felipe, Maria das Graças de Almeida

    2016-01-01

    Sugarcane straw has become an available lignocellulosic biomass since the progressive introduction of the non-burning harvest in Brazil. Besides keeping this biomass in the field, it can be used as a feedstock in thermochemical or biochemical conversion processes. This makes feasible its incorporation in a biorefinery, whose economic profitability could be supported by integrated production of low-value biofuels and high-value chemicals, e.g., xylitol, which has important industrial and clinical applications. Herein, biotechnological production of xylitol is presented as a possible route for the valorization of sugarcane straw and its incorporation in a biorefinery. Nutritional supplementation of the sugarcane straw hemicellulosic hydrolyzate as a function of initial oxygen availability was studied in batch fermentation of Candida guilliermondii FTI 20037. The nutritional supplementation conditions evaluated were: no supplementation; supplementation with (NH4)2SO4, and full supplementation with (NH4)2SO4, rice bran extract and CaCl2·2H2O. Experiments were performed at pH 5.5, 30°C, 200rpm, for 48h in 125mL Erlenmeyer flasks containing either 25 or 50mL of medium in order to vary initial oxygen availability. Without supplementation, complete consumption of glucose and partial consumption of xylose were observed. In this condition the maximum xylitol yield (0.67gg(-1)) was obtained under reduced initial oxygen availability. Nutritional supplementation increased xylose consumption and xylitol production by up to 200% and 240%, respectively. The maximum xylitol volumetric productivity (0.34gL(-1)h(-1)) was reached at full supplementation and increased initial oxygen availability. The results demonstrated a combined effect of nutritional supplementation and initial oxygen availability on xylitol production from sugarcane straw hemicellulosic hydrolyzate. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  4. Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in situ.

    PubMed

    Cardoso, C A B; Cassiano, L P S; Costa, E N; Souza-E-Silva, C M; Magalhães, A C; Grizzo, L T; Caldana, M L; Bastos, J R M; Buzalaf, M A R

    2016-07-01

    Analyze the effect of varnishes containing xylitol compared to commercial fluoridated varnishes on the remineralization of artificial enamel caries lesions in situ. Twenty subjects took part in this crossover, double-blind study performed in four phases of 5days each. Each subject worn palatal appliances containing four predemineralized bovine enamel specimens. Artificial caries lesions were produced by immersion in 30ml of lactic acid buffer containing 3mM CaCl2·2H2O, 3mM KH2PO4, 6μM tetraetil metil diphosphanate (pH 5.0) for 6days. The specimens in each subject were treated once with the following varnishes: 20% xylitol (experimental); Duofluorid™ (6% NaF, 6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6h. Fifteen subjects were able to finish all phases. The enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analyzed by Friedmann and Dunn's tests test (p<0.05). Enamel surface remineralization was significantly increased by Duraphat™, Duofluorid™ and 20% xylitol formulations. Significant subsurface mineral remineralization could also be seen for the experimental and commercial varnishes, except for Duraphat™, when the parameter "lesion depth" was considered. 20% xylitol varnish seem to be a promising alternative to increase surface and subsurface remineralization of artificial caries lesions in situ. effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in situ, which should be confirmed by clinical studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Crystal structure of glucose isomerase in complex with xylitol inhibitor in one metal binding mode.

    PubMed

    Bae, Ji-Eun; Kim, In Jung; Nam, Ki Hyun

    2017-11-04

    Glucose isomerase (GI) is an intramolecular oxidoreductase that interconverts aldoses and ketoses. These characteristics are widely used in the food, detergent, and pharmaceutical industries. In order to obtain an efficient GI, identification of novel GI genes and substrate binding/inhibition have been studied. Xylitol is a well-known inhibitor of GI. In Streptomyces rubiginosus, two crystal structures have been reported for GI in complex with xylitol inhibitor. However, a structural comparison showed that xylitol can have variable conformation at the substrate binding site, e.g., a nonspecific binding mode. In this study, we report the crystal structure of S. rubiginosus GI in a complex with xylitol and glycerol. Our crystal structure showed one metal binding mode in GI, which we presumed to represent the inactive form of the GI. The metal ion was found only at the M1 site, which was involved in substrate binding, and was not present at the M2 site, which was involved in catalytic function. The O 2 and O 4 atoms of xylitol molecules contributed to the stable octahedral coordination of the metal in M1. Although there was no metal at the M2 site, no large conformational change was observed for the conserved residues coordinating M2. Our structural analysis showed that the metal at the M2 site was not important when a xylitol inhibitor was bound to the M1 site in GI. Thus, these findings provided important information for elucidation or engineering of GI functions. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Effect of xylitol versus sorbitol: a quantitative systematic review of clinical trials.

    PubMed

    Mickenautsch, Steffen; Yengopal, Veerasamy

    2012-08-01

    This study aimed to appraise, within the context of tooth caries, the current clinical evidence and its risk for bias regarding the effects of xylitol in comparison with sorbitol. Databases were searched for clinical trials to 19 March 2011. Inclusion criteria required studies to: test a caries-related primary outcome; compare the effects of xylitol with those of sorbitol; describe a clinical trial with two or more arms, and utilise a prospective study design. Articles were excluded if they did not report computable data or did not follow up test and control groups in the same way. Individual dichotomous and continuous datasets were extracted from accepted articles. Selection and performance/detection bias were assessed. Sensitivity analysis was used to investigate attrition bias. Egger's regression and funnel plotting were used to investigate risk for publication bias. Nine articles were identified. Of these, eight were accepted and one was excluded. Ten continuous and eight dichotomous datasets were extracted. Because of high clinical heterogeneity, no meta-analysis was performed. Most of the datasets favoured xylitol, but this was not consistent. The accepted trials may be limited by selection bias. Results of the sensitivity analysis indicate a high risk for attrition bias. The funnel plot and Egger's regression results suggest a low publication bias risk. External fluoride exposure and stimulated saliva flow may have confounded the measured anticariogenic effect of xylitol. The evidence identified in support of xylitol over sorbitol is contradictory, is at high risk for selection and attrition bias and may be limited by confounder effects. Future high-quality randomised controlled trials are needed to show whether xylitol has a greater anticariogenic effect than sorbitol. © 2012 FDI World Dental Federation.

  7. Fluorouracil Topical

    MedlinePlus

    ... caused by years of too much exposure to sunlight). Fluorouracil cream and topical solution are also used ... plan to avoid unnecessary or prolonged exposure to sunlight and UV light (such as tanning booths) and ...

  8. Ciclopirox Topical

    MedlinePlus

    ... Use the applicator brush attached to the bottle cap to apply ciclopirox topical solution evenly to all ... can reach these areas. Wipe off the bottle cap and neck and replace the cap tightly on ...

  9. Xylitol-containing products for preventing dental caries in children and adults.

    PubMed

    Riley, Philip; Moore, Deborah; Ahmed, Farooq; Sharif, Mohammad O; Worthington, Helen V

    2015-03-26

    Dental caries is a highly prevalent chronic disease which affects the majority of people. It has been postulated that the consumption of xylitol could help to prevent caries. The evidence on the effects of xylitol products is not clear and therefore it is important to summarise the available evidence to determine its effectiveness and safety. To assess the effects of different xylitol-containing products for the prevention of dental caries in children and adults. We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 14 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 7), MEDLINE via OVID (1946 to 14 August 2014), EMBASE via OVID (1980 to 14 August 2014), CINAHL via EBSCO (1980 to 14 August 2014), Web of Science Conference Proceedings (1990 to 14 August 2014), Proquest Dissertations and Theses (1861 to 14 August 2014). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We included randomised controlled trials assessing the effects of xylitol products on dental caries in children and adults. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We attempted to contact study authors for missing data or clarification where feasible. For continuous outcomes, we used means and standard deviations to obtain the mean difference and 95% confidence interval (CI). We used the continuous data to calculate prevented fractions (PF) and 95% CIs to summarise the percentage reduction in caries. For dichotomous outcomes, we reported risk ratios (RR) and 95% CIs. As there were less than four studies included in the meta-analysis, we used a fixed-effect model. We planned

  10. Pediatric Injury

    MedlinePlus

    ... injuries (or traumas) are quite diverse in their origins, severity, and effects on children. One way to ... cdc.gov/safechild American Academy of Pediatrics. (2008). Management of pediatric trauma. Pediatrics, 121 , 849–854. How ...

  11. Aggregatibacter actinomycetemcomitans-Induced AIM2 Inflammasome Activation Is Suppressed by Xylitol in Differentiated THP-1 Macrophages.

    PubMed

    Kim, Seyeon; Park, Mi Hee; Song, Yu Ri; Na, Hee Sam; Chung, Jin

    2016-06-01

    Aggressive periodontitis is characterized by rapid destruction of periodontal tissue caused by Aggregatibacter actinomycetemcomitans. Interleukin (IL)-1β is a proinflammatory cytokine, and its production is tightly regulated by inflammasome activation. Xylitol, an anticaries agent, is anti-inflammatory, but its effect on inflammasome activation has not been researched. This study investigates the effect of xylitol on inflammasome activation induced by A. actinomycetemcomitans. The differentiated THP-1 macrophages were stimulated by A. actinomycetemcomitans with or without xylitol and the expressions of IL-1β and inflammasome components were detected by real time PCR, ELISA, confocal microscopy and Immunoblot analysis. The effects of xylitol on the adhesion and invasion of A. actinomycetemcomitans to cells were measured by viable cell count. A. actinomycetemcomitans increased pro IL-1β synthesis and IL-1β secretion in a multiplicity of infection- and time-dependent manner. A. actinomycetemcomitans also stimulated caspase-1 activation. Among inflammasome components, apoptosis-associated speck-like protein containing a CARD (ASC) and absent in melanoma 2 (AIM2) proteins were upregulated by A. actinomycetemcomitans infection. When cells were pretreated with xylitol, proIL-1β and IL-1β production by A. actinomycetemcomitans infection was significantly decreased. Xylitol also inhibited ASC and AIM2 proteins and formation of ASC puncta. Furthermore, xylitol suppressed internalization of A. actinomycetemcomitans into differentiated THP-1 macrophages without affecting viability of A. actinomycetemcomitans within cells. A. actinomycetemcomitans induced IL-1β production and AIM2 inflammasome activation. Xylitol inhibited these effects, possibly by suppressing internalization of A. actinomycetemcomitans into cells. Thus, this study proposes a mechanism for IL-1β production via inflammasome activation and discusses a possible use for xylitol in periodontal inflammation

  12. Xylitol, an Anticaries Agent, Exhibits Potent Inhibition of Inflammatory Responses in Human THP-1-Derived Macrophages Infected With Porphyromonas gingivalis

    PubMed Central

    Park, Eunjoo; Na, Hee Sam; Kim, Sheon Min; Wallet, Shannon; Cha, Seunghee; Chung, Jin

    2016-01-01

    Background Xylitol is a well-known anticaries agent and has been used for the prevention and treatment of dental caries. In this study, the anti-inflammatory effects of xylitol are evaluated for possible use in the prevention and treatment of periodontal infections. Methods Cytokine expression was stimulated in THP-1 (human monocyte cell line)-derived macrophages by live Porphyromonas gingivalis, and enzyme-linked immunosorbent assay and a commercial multiplex assay kit were used to determine the effects of xylitol on live P. gingivalis–induced production of cytokine. The effects of xylitol on phagocytosis and the production of nitric oxide were determined using phagocytosis assay, viable cell count, and Griess reagent. The effects of xylitol on P. gingivalis adhesion were determined by immunostaining, and costimulatory molecule expression was examined by flow cytometry. Results Live P. gingivalis infection increased the production of representative proinflammatory cytokines, such as tumor necrosis factor-α and interleukin (IL)-1β, in a multiplicity of infection– and time-dependent manner. Live P. gingivalis also enhanced the release of cytokines and chemokines, such as IL-12 p40, eotaxin, interferon γ–induced protein 10, monocyte chemotactic protein-1, and macrophage inflammatory protein-1. The pretreatment of xylitol significantly inhibited the P. gingivalis– induced cytokines production and nitric oxide production. In addition, xylitol inhibited the attachment of live P. gingivalis on THP-1-derived macrophages. Furthermore, xylitol exerted anti-phagocytic activity against both Escherichia coli and P. gingivalis. Conclusion These findings suggest that xylitol acts as an antiinflammatory agent in THP-1-derived macrophages infected with live P. gingivalis, which supports its use in periodontitis. PMID:24592909

  13. Xylitol, an anticaries agent, exhibits potent inhibition of inflammatory responses in human THP-1-derived macrophages infected with Porphyromonas gingivalis.

    PubMed

    Park, Eunjoo; Na, Hee Sam; Kim, Sheon Min; Wallet, Shannon; Cha, Seunghee; Chung, Jin

    2014-06-01

    Xylitol is a well-known anticaries agent and has been used for the prevention and treatment of dental caries. In this study, the anti-inflammatory effects of xylitol are evaluated for possible use in the prevention and treatment of periodontal infections. Cytokine expression was stimulated in THP-1 (human monocyte cell line)-derived macrophages by live Porphyromonas gingivalis, and enzyme-linked immunosorbent assay and a commercial multiplex assay kit were used to determine the effects of xylitol on live P. gingivalis-induced production of cytokine. The effects of xylitol on phagocytosis and the production of nitric oxide were determined using phagocytosis assay, viable cell count, and Griess reagent. The effects of xylitol on P. gingivalis adhesion were determined by immunostaining, and costimulatory molecule expression was examined by flow cytometry. Live P. gingivalis infection increased the production of representative proinflammatory cytokines, such as tumor necrosis factor-α and interleukin (IL)-1β, in a multiplicity of infection- and time-dependent manner. Live P. gingivalis also enhanced the release of cytokines and chemokines, such as IL-12 p40, eotaxin, interferon γ-induced protein 10, monocyte chemotactic protein-1, and macrophage inflammatory protein-1. The pretreatment of xylitol significantly inhibited the P. gingivalis-induced cytokines production and nitric oxide production. In addition, xylitol inhibited the attachment of live P. gingivalis on THP-1-derived macrophages. Furthermore, xylitol exerted antiphagocytic activity against both Escherichia coli and P. gingivalis. These findings suggest that xylitol acts as an anti-inflammatory agent in THP-1-derived macrophages infected with live P. gingivalis, which supports its use in periodontitis.

  14. The Efficacy of Xylitol, Xylitol-Probiotic and Fluoride Dentifrices in Plaque Reduction and Gingival Inflammation in Children: A Randomised Controlled Clinical Trial.

    PubMed

    Arat Maden, Eda; Altun, Ceyhan; Açikel, Cengizhan

    The present prospective, randomised, placebo-controlled, clinical trial was designed to evaluate the clinical effects of a commercially available dentifrice containing fluoride, xylitol or xylitol-probiotic on the decrease of plaque and gingival inflammation in children between 13 and 15 years of age. Forty-eight adolescents were randomly grouped into three groups of n = 16 each: study group A received xylitol (Xyliwhite) toothpaste; study group B received xylitol-probiotic (Periobiotic) toothpaste; and the control group C received fluoride (Colgate Max Fresh) toothpaste. The subjects were instructed to use the dentifrice determined and a modified Bass brushing technique twice a day for two minutes over a 6-week perioed. Clinical evaluation was performed using a gingival index and a plaque index at baseline and at the end of the 6-week period. From day 0 to 42, reductions in the plaque index were statistically significant in all groups, Colgate Max Fresh, PerioBiotic and Xyliwhite (p-values 0.001, 0.001 and 0.035, respectively), but reductions in the gingival index were statistically significant only in the Colgate Max Fresh and PerioBiotic groups (both with p = 0.001), not in the Xyliwhite group (p = 0.116). PerioBiotic toothpaste was found to be better than Xyliwhite and Colgate Max Fresh toothpastes at reducing plaque and gingival scores. However, statistically significant differences with PerioBiotic and Colgate Max Fresh toothpaste were not observed. It was concluded that PerioBiotic was an all-round dentifrice that produced a significant reduction in both gingivitis and plaque.

  15. Xylitol synthesis mutant of xylose-utilizing zymomonas for ethanol production

    DOEpatents

    Viitanen, Paul V.; Chou, Yat-Chen; McCutchen, Carol M.; Zhang, Min

    2010-06-22

    A strain of xylose-utilizing Zymomonas was engineered with a genetic modification to the glucose-fructose oxidoreductase gene resulting in reduced expression of GFOR enzyme activity. The engineered strain exhibits reduced production of xylitol, a detrimental by-product of xylose metabolism. It also consumes more xylose and produces more ethanol during mixed sugar fermentation under process-relevant conditions.

  16. The Role of Xylitol Gum Chewing in Restoring Postoperative Bowel Activity After Cesarean Section.

    PubMed

    Lee, Jian Tao; Hsieh, Mei-Hui; Cheng, Po-Jen; Lin, Jr-Rung

    2016-03-01

    The goal of this study was to evaluate the effects of xylitol gum chewing on gastrointestinal recovery after cesarean section. Women who underwent cesarean section (N = 120) were randomly allocated into Group A (xylitol gum), Group B (nonxylitol gum), or the control group (no chewing gum). Every 2 hr post-cesarean section and until first flatus, Groups A and B received two pellets of chewing gum and were asked to chew for 15 min. The times to first bowel sounds, first flatus, and first defecation were then compared among the three groups. Group A had the shortest mean time to first bowel sounds (6.9 ± 1.7 hr), followed by Group B (8 ± 1.6 hr) and the control group (12.8 ± 2.5 hr; one-way analysis of variance, p < .001; Scheffe's post hoc comparisons, p < .05). The gum-chewing groups demonstrated a faster return of flatus than the control group did (p < .001), but the time to flatus did not differ significantly between the gum-chewing groups. Additionally, the differences in the time to first defecation were not significant. After cesarean section, chewing gum increased participants' return of bowel activity, as measured by the appearance of bowel sounds and the passage of flatus. In this context, xylitol-containing gum may be superior to xylitol-free gum. © The Author(s) 2015.

  17. Kinetic behavior of Candida guilliermondii yeast during xylitol production from Brewer's spent grain hemicellulosic hydrolysate.

    PubMed

    Mussatto, Solange I; Dragone, Giuliano; Roberto, Inês C

    2005-01-01

    Brewer's spent grain, the main byproduct of breweries, was hydrolyzed with dilute sulfuric acid to produce a hemicellulosic hydrolysate (containing xylose as the main sugar). The obtained hydrolysate was used as cultivation medium by Candidaguilliermondii yeast in the raw form (containing 20 g/L xylose) and after concentration (85 g/L xylose), and the kinetic behavior of the yeast during xylitol production was evaluated in both media. Assays in semisynthetic media were also performed to compare the yeast performance in media without toxic compounds. According to the results, the kinetic behavior of the yeast cultivated in raw hydrolysate was as effective as in semisynthetic medium containing 20 g/L xylose. However, in concentrated hydrolysate medium, the xylitol production efficiency was 30.6% and 42.6% lower than in raw hydrolysate and semisynthetic medium containing 85 g/L xylose, respectively. In other words, the xylose-to-xylitol bioconversion from hydrolysate medium was strongly affected when the initial xylose concentration was increased; however, similar behavior did not occur from semisynthetic media. The lowest efficiency of xylitol production from concentrated hydrolysate can be attributed to the high concentration of toxic compounds present in this medium, resulting from the hydrolysate concentration process.

  18. Microbial Production of Xylitol from L-arabinose by Metabolically Engineered Escherichia coli

    USDA-ARS?s Scientific Manuscript database

    An Escherichia coli strain, ZUC99(pATX210), which can produce xylitol from L-arabinose at a high yield has been created by introducing a new bioconversion pathway into cells. This pathway consists of three enzymes: L-arabinose isomerase, which converts L-arabinose to L-ribulose; D-psicose 3-epimer...

  19. Biochemical conversion of sugarcane straw hemicellulosic hydrolyzate supplemented with co-substrates for xylitol production.

    PubMed

    Hernández-Pérez, A F; Costa, I A L; Silva, D D V; Dussán, K J; Villela, T R; Canettieri, E V; Carvalho, J A; Soares Neto, T G; Felipe, M G A

    2016-01-01

    Biotechnological production of xylitol is an attractive route to add value to a sugarcane biorefinery, through utilization of the hemicellulosic fraction of sugarcane straw, whose availability is increasing in Brazil. Herein, supplementation of the sugarcane straw hemicellulosic hydrolyzate (xylose 57gL(-1)) with maltose, sucrose, cellobiose or glycerol was proposed, and their effect as co-substrates on xylitol production by Candida guilliermondii FTI 20037 was studied. Sucrose (10gL(-1)) and glycerol (0.7gL(-1)) supplementation led to significant increase of 8.88% and 6.86% on xylose uptake rate (1.11gL(-1)h(-1) and 1.09gL(-1)), respectively, but only with sucrose, significant increments of 12.88% and 8.69% on final xylitol concentration (36.11gL(-1)) and volumetric productivity (0.75gL(-1)h(-1)), respectively, were achieved. Based on these results, utilization of complex sources of sucrose, derived from agro-industries, as nutritional supplementation for xylitol production can be proposed as a strategy for improving the yeast performance and reducing the cost of this bioprocess by replacing more expensive nutrients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Xylitol production from DEO hydrolysate of corn stover by Pichia stipitis YS-30

    Treesearch

    Rita C.L.B. Rodrigues; William R. Kenealy; Thomas W. Jeffries

    2011-01-01

    Corn stover that had been treated with vapor-phase diethyl oxalate released a mixture of mono-and oligosaccharides consisting mainly of xylose and glucose. Following overliming and neutralization, a D-xylulokinase mutant of Pichia stipitis, FPL-YS30 (xyl3 -Ä1), converted the stover hydrolysate into xylitol. This research examined the effects of phosphoric or gluconic...

  1. Microbial Production of Xylitol from L-arabinose by Metabolically Engineered Escherichia coli

    USDA-ARS?s Scientific Manuscript database

    Xylitol is used commercially as a natural sweetener in some food products such as chewing gum, soft drinks, and confectionery. It is currently produced by chemical reduction of D-xylose derived from plant materials, mainly hemicellulosic hydrolysates from birch trees. Expanding the substrate range...

  2. Ethanol production using xylitol synthesis mutant of xylose-utilizing zymomonas

    DOEpatents

    Viitanen, Paul V.; McCutchen, Carol M.; Emptage, Mark; Caimi, Perry G.; Zhang, Min; Chou, Yat-Chen

    2010-06-22

    Production of ethanol using a strain of xylose-utilizing Zymomonas with a genetic modification of the glucose-fructose oxidoreductase gene was found to be improved due to greatly reduced production of xylitol, a detrimental by-product of xylose metabolism synthesized during fermentation.

  3. Pediatric Uveitis.

    PubMed

    Chan, Nicole Shu-Wen; Choi, Jessy; Cheung, Chui Ming Gemmy

    2018-01-01

    Pediatric uveitis differs from adult-onset uveitis and is a topic of special interest because of its diagnostic and therapeutic challenges. Children with uveitis are often asymptomatic and the uveitis is often chronic, persistent, recurrent, and resistant to conventional treatment. Anterior uveitis is the most common type of uveitis in children; the prevalence of intermediate, posterior, and panuveitis varies geographically and among ethnic groups. Regarding etiology, most cases of pediatric uveitis are idiopathic but can be due to systemic inflammatory disorders, infections, or a manifestation of masquerade syndrome. Ocular complications include cataracts, hypotony or glaucoma, band keratopathy, synechiae formation, macular edema, optic disc edema, choroidal neovascular membranes, and retinal detachment. These complications are often severe, leading to irreversible structural damage and significant visual disability due to delayed presentation and diagnosis, persistent chronic inflammation from suboptimal treatment, topical and systemic corticosteroid dependence, and delayed initiation of systemic disease‒modifying agents. Treatment for noninfectious uveitis is a stepwise approach starting with corticosteroids. Immunomodulatory therapy should be initiated in cases where quiescence cannot be achieved without steroid dependence. Patients should be monitored regularly for complications of uveitis along with systemic and ocular adverse effects from treatments. The goals are to achieve steroid-free durable remission, to reduce the risk of sight-threatening complications from the uncontrolled ocular inflammation, and to avoid the impact of lifelong burden of visual loss on the child and their family. Multidisciplinary management will ensure holistic care of affected children and improve the support for their families. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

  4. Improved NADPH supply for xylitol production by engineered Escherichia coli with glycolytic mutations.

    PubMed

    Chin, Jonathan W; Cirino, Patrick C

    2011-01-01

    Escherichia coli engineered to uptake xylose while metabolizing glucose was previously shown to produce high levels of xylitol from a mixture of glucose and xylose when expressing NADPH-dependent xylose reductase from Candida boidinii (CbXR) (Cirino et al., Biotechnol Bioeng. 2006;95:1167-1176). We then described the effects of deletions of key metabolic pathways (e.g., Embden-Meyerhof-Parnas and pentose phosphate pathway) and reactions (e.g., transhydrogenase and NADH dehydrogenase) on resting-cell xylitol yield (Y RPG: moles of xylitol produced per mole of glucose consumed) (Chin et al., Biotechnol Bioeng. 2009;102:209-220). These prior results demonstrated the importance of direct NADPH supply by NADP+-utilizing enzymes in central metabolism for driving heterologous NADPH-dependent reactions. This study describes strain modifications that improve coupling between glucose catabolism (oxidation) and xylose reduction using two fundamentally different strategies. We first examined the effects of deleting the phosphofructokinase (pfk) gene(s) on growth-uncoupled xylitol production and found that deleting both pfkA and sthA (encoding the E. coli-soluble transhydrogenase) improved the xylitol Y RPG from 3.4 ± 0.6 to 5.4 ± 0.4. The second strategy focused on coupling aerobic growth on glucose to xylitol production by deleting pgi (encoding phosphoglucose isomerase) and sthA. Impaired growth due to imbalanced NADPH metabolism (Sauer et al., J Biol Chem. 2004;279:6613-6619) was alleviated upon expressing CbXR, resulting in xylitol production similar to that of the growth-uncoupled precursor strains but with much less acetate secretion and more efficient utilization of glucose. Intracellular nicotinamide cofactor levels were also quantified, and the magnitude of the change in the NADPH/NADP+ ratio measured from cells consuming glucose in the absence vs. presence of xylose showed a strong correlation to the resulting Y RPG. Copyright © 2011 American Institute of Chemical

  5. Xylitol for preventing acute otitis media in children up to 12 years of age.

    PubMed

    Azarpazhooh, Amir; Lawrence, Herenia P; Shah, Prakeshkumar S

    2016-08-03

    Acute otitis media (AOM) is the most common bacterial infection among young children in the United States. There are limitations and concerns over its treatment with antibiotics and surgery and so effective preventative measures are attractive. A potential preventative measure is xylitol, a natural sugar substitute that reduces the risk of dental decay. Xylitol can reduce the adherence of Streptococcus pneumoniae (S pneumoniae) and Haemophilus influenzae (H influenzae) to nasopharyngeal cells in vitro. This is an update of a review first published in 2011. To assess the efficacy and safety of xylitol to prevent AOM in children aged up to 12 years. We searched CENTRAL (to Issue 12, 2015), MEDLINE (1950 to January 2016), Embase (1974 to January 2016), CINAHL (1981 to January 2016), LILACS (1982 to January 2016), Web of Science (2011 to January 2016) and International Pharmaceutical Abstracts (2000 to January 2016). Randomised controlled trials (RCTs) or quasi-RCTs of children aged 12 years or younger where xylitol supplementation was compared with placebo or no treatment to prevent AOM. Two review authors independently selected trials from search results, assessed and rated study quality and extracted relevant data for inclusion in the review. We contacted trial authors to request missing data. We noted data on any adverse events of xylitol. We extracted data on relevant outcomes and estimated the effect size by calculating risk ratio (RR), risk difference (RD) and associated 95% confidence intervals (CI). We identified five clinical trials that involved 3405 children for inclusion. For this 2016 update, we identified one new trial for inclusion. This trial was systematically reviewed but due to several sources of heterogeneity, was not included in the meta-analysis. The remaining four trials were of adequate methodological quality. In three RCTs that involved a total of 1826 healthy Finnish children attending daycare, there is moderate quality evidence that

  6. Cluster-randomized xylitol toothpaste trial for early childhood caries prevention.

    PubMed

    Chi, Donald L; Tut, Ohnmar; Milgrom, Peter

    2014-01-01

    The purpose of this study was to assess the efficacy of supervised tooth-brushing with xylitol toothpaste to prevent early childhood caries (ECC) and reduce mutans streptococci. In this cluster-randomized efficacy trial, 196 four- to five-year-old children in four Head Start classrooms in the Marshall Islands were randomly assigned to supervised toothbrushing with 1,400 ppm/31 percent fluoride xylitol or 1,450 ppm fluoride sorbitol toothpaste. We hypothesized that there would be no difference in efficacy between the two types of toothpaste. The primary outcome was the surface-level primary molar caries increment (d(2-3)mfs) after six months. A single examiner was blinded to classroom assignments. Two classrooms were assigned to the fluoride-xylitol group (85 children), and two classrooms were assigned to the fluoride-sorbitol group (83 children). The child-level analyses accounted for clustering. There was no difference between the two groups in baseline or end-of-trial mean d(2-3)mfs. The mean d(2-3)mfs increment was greater in the fluoride-xylitol group compared to the fluoride-sorbitol group (2.5 and 1.4 d(2-3)mfs, respectively), but the difference was not significant (95% confidence interval: -0.17, 2.37; P=.07). No adverse effects were reported. After six months, brushing with a low-strength xylitol/fluoride tooth-paste is no more efficacious in reducing ECC than a fluoride-only toothpaste in a high caries-risk child population.

  7. Cluster-randomized xylitol toothpaste trial for early childhood caries prevention

    PubMed Central

    Chi, Donald L.; Tut, Ohnmar K.; Milgrom, Peter

    2013-01-01

    Purpose We assessed the efficacy of supervised toothbrushing with xylitol toothpaste to prevent early childhood caries (ECC) and to reduce mutans streptococci (MS). Methods In this cluster-randomized efficacy trial, 4 Head Start classrooms in the Marshall Islands were randomly assigned to supervised toothbrushing with 1,400ppm/31% fluoride-xylitol (Epic Dental, Provo, UT) or 1,450ppm fluoride-sorbitol toothpaste (Colgate-Palmolive, New York, NY) (N=196 children, ages 4–5 yrs). We hypothesized no difference in efficacy between the two types of toothpaste. The primary outcome was primary molar d2-3mfs increment after 6 mos. A single examiner was blinded to classroom assignments. Two classrooms were assigned to the fluoride-xylitol group (85 children) and 2 classrooms to the fluoride-sorbitol group (83 children). The child-level analyses accounted for clustering. Results There was no difference between the two groups in baseline or end-of-trial mean d2-3mfs. The mean d2-3mfs increment was greater in the fluoride-xylitol group compared to the fluoride-sorbitol group (2.5 and 1.4 d2-3mfs, respectively), but the difference was not significant (95% CI:−0.17, 2.37;P=0.07). No adverse effects were reported. Conclusion After 6 mos, brushing with a low strength xylitol/fluoride toothpaste is no more efficacious in reducing ECC than a fluoride only toothpaste in a high caries risk child population. PMID:24709430

  8. Electrochemical oxidation and electroanalytical determination of xylitol at a boron-doped diamond electrode.

    PubMed

    Lourenço, Anabel S; Sanches, Fátima A C; Magalhães, Renata R; Costa, Daniel J E; Ribeiro, Williame F; Bichinho, Kátia M; Salazar-Banda, Giancarlo R; Araújo, Mário C U

    2014-02-01

    Xylitol is a reduced sugar with anticariogenic properties used by insulin-dependent diabetics, and which has attracted great attention of the pharmaceutical, cosmetics, food and dental industries. The detection of xylitol in different matrices is generally based on separation techniques. Alternatively, in this paper, the application of a boron-doped diamond (BDD) electrode allied to differing voltammetric techniques is presented to study the electrochemical behavior of xylitol, and to develop an analytical methodology for its determination in mouthwash. Xylitol undergoes two oxidation steps in an irreversible diffusion-controlled process (D=5.05 × 10(-5)cm(2)s(-1)). Differential pulse voltammetry studies revealed that the oxidation mechanism for peaks P1 (3.4 ≤ pH ≤ 8.0), and P2 (6.0 ≤ pH ≤ 9.0) involves transfer of 1H(+)/1e(-), and 1e(-) alone, respectively. The oxidation process P1 is mediated by the (•)OH generated at the BDD hydrogen-terminated surface. The maximum peak current was obtained at a pH of 7.0, and the electroanalytical method developed, (employing square wave voltammetry) yielded low detection (1.3 × 10(-6) mol L(-1)), and quantification (4.5 × 10(-6) mol L(-1)) limits, associated with good levels of repeatability (4.7%), and reproducibility (5.3%); thus demonstrating the viability of the methodology for detection of xylitol in biological samples containing low concentrations. © 2013 Elsevier B.V. All rights reserved.

  9. Probiotic capsules and xylitol chewing gum to manage symptoms of pharyngitis: a randomized controlled factorial trial

    PubMed Central

    Little, Paul; Stuart, Beth; Wingrove, Zoe; Mullee, Mark; Thomas, Tammy; Johnson, Sophie; Leydon, Gerry; Richards-Hall, Samantha; Williamson, Ian; Yao, Lily; Zhu, Shihua; Moore, Michael

    2017-01-01

    BACKGROUND: Reducing the use of antibiotics for upper respiratory tract infections is needed to limit the global threat of antibiotic resistance. We estimated the effectiveness of probiotics and xylitol for the management of pharyngitis. METHODS: In this parallel-group factorial randomized controlled trial, participants in primary care (aged 3 years or older) with pharyngitis underwent randomization by nurses who provided sequential intervention packs. Pack contents for 3 kinds of material and advice were previously determined by computer-generated random numbers: no chewing gum, xylitol-based chewing gum (15% xylitol; 5 pieces daily) and sorbitol gum (5 pieces daily). Half of each group were also randomly assigned to receive either probiotic capsules (containing 24 × 109 colony-forming units of lactobacilli and bifidobacteria) or placebo. The primary outcome was mean self-reported severity of sore throat and difficulty swallowing (scale 0–6) in the first 3 days. We used multiple imputation to avoid the assumption that data were missing completely at random. RESULTS: A total of 1009 individuals consented, 934 completed the baseline assessment, and 689 provided complete data for the primary outcome. Probiotics were not effective in reducing the severity of symptoms: mean severity scores 2.75 with no probiotic and 2.78 with probiotic (adjusted difference −0.001, 95% confidence interval [CI] −0.24 to 0.24). Chewing gum was also ineffective: mean severity scores 2.73 without gum, 2.72 with sorbitol gum (adjusted difference 0.07, 95% CI −0.23 to 0.37) and 2.73 with xylitol gum (adjusted difference 0.01, 95% CI −0.29 to 0.30). None of the secondary outcomes differed significantly between groups, and no harms were reported. INTERPRETATION: Neither probiotics nor advice to chew xylitol-based chewing gum was effective for managing pharyngitis. Trial registration: ISRCTN, no. ISRCTN51472596 PMID:29255098

  10. Probiotic capsules and xylitol chewing gum to manage symptoms of pharyngitis: a randomized controlled factorial trial.

    PubMed

    Little, Paul; Stuart, Beth; Wingrove, Zoe; Mullee, Mark; Thomas, Tammy; Johnson, Sophie; Leydon, Gerry; Richards-Hall, Samantha; Williamson, Ian; Yao, Lily; Zhu, Shihua; Moore, Michael

    2017-12-18

    Reducing the use of antibiotics for upper respiratory tract infections is needed to limit the global threat of antibiotic resistance. We estimated the effectiveness of probiotics and xylitol for the management of pharyngitis. In this parallel-group factorial randomized controlled trial, participants in primary care (aged 3 years or older) with pharyngitis underwent randomization by nurses who provided sequential intervention packs. Pack contents for 3 kinds of material and advice were previously determined by computer-generated random numbers: no chewing gum, xylitol-based chewing gum (15% xylitol; 5 pieces daily) and sorbitol gum (5 pieces daily). Half of each group were also randomly assigned to receive either probiotic capsules (containing 24 × 10 9 colony-forming units of lactobacilli and bifidobacteria) or placebo. The primary outcome was mean self-reported severity of sore throat and difficulty swallowing (scale 0-6) in the first 3 days. We used multiple imputation to avoid the assumption that data were missing completely at random. A total of 1009 individuals consented, 934 completed the baseline assessment, and 689 provided complete data for the primary outcome. Probiotics were not effective in reducing the severity of symptoms: mean severity scores 2.75 with no probiotic and 2.78 with probiotic (adjusted difference -0.001, 95% confidence interval [CI] -0.24 to 0.24). Chewing gum was also ineffective: mean severity scores 2.73 without gum, 2.72 with sorbitol gum (adjusted difference 0.07, 95% CI -0.23 to 0.37) and 2.73 with xylitol gum (adjusted difference 0.01, 95% CI -0.29 to 0.30). None of the secondary outcomes differed significantly between groups, and no harms were reported. Neither probiotics nor advice to chew xylitol-based chewing gum was effective for managing pharyngitis. Trial registration: ISRCTN, no. ISRCTN51472596. © 2017 Joule Inc. or its licensors.

  11. Simultaneous catalytic conversion of cellulose and corncob xylan under temperature programming for enhanced sorbitol and xylitol production.

    PubMed

    Ribeiro, Lucília Sousa; Órfão, José J de Melo; Pereira, Manuel Fernando Ribeiro

    2017-11-01

    Sorbitol and xylitol yields can be improved by converting cellulose and xylan simultaneously, due to a synergetic effect between both substrates. Furthermore, both yields can be greatly enhanced by simply adjusting the reaction conditions regarding the optimum for the production of each product, since xylitol (from xylan) and sorbitol (from cellulose) yields are maximized when the reaction is carried out at 170 and 205°C, respectively. Therefore, the combination of a simultaneous conversion of cellulose and xylan with a two-step temperature approach, which consists in the variation of the reaction temperature from 170 to 205°C after 2h, showed to be a good strategy for maximizing the production of sorbitol and xylitol directly from mixture of cellulose and xylan. Using this new and environmentally friendly approach, yields of sorbitol and xylitol of 75 and 77%, respectively, were obtained after 6h of reaction. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Effects of Locally Applied Glycerol and Xylitol on the Hydration, Barrier Function and Morphological Parameters of the Skin.

    PubMed

    Korponyai, Csilla; Szél, Edit; Behány, Zoltán; Varga, Erika; Mohos, Gábor; Dura, Ágnes; Dikstein, Shabtay; Kemény, Lajos; Erős, Gábor

    2017-02-08

    Glycerol and xylitol hydrate the skin and improve its barrier function over a short period. We studied the effects of glycerol and xylitol on the physiological properties and morphology of the skin after longer-term application. Twelve volunteers with dry skin were examined. Three areas on the arms were determined. Area 1 served as untreated control. The vehicle was applied to area 2, while area 3 was treated twice daily with a formulation containing glycerol (5%) and xylitol (5%) for 14 days. Transepidermal water loss (TEWL), hydration and biomechanical properties of the skin were monitored. Biopsies were taken for routine histology and immunohistochemistry for filaggrin and matrix metalloproteinase-1 (MMP-1). The polyols increased the skin hydration and protein quantity of filaggrin, elevated the interdigitation index, decreased the TEWL and improved the biomechanical properties of the skin, but did not change the protein expression of MMP-1. A combination of glycerol and xylitol can be useful additional therapy for dry skin.

  13. Effects of water on the primary and secondary relaxation of xylitol and sorbitol: Implication on the origin of the Johari-Goldstein relaxation

    NASA Astrophysics Data System (ADS)

    Psurek, T.; Maslanka, S.; Paluch, M.; Nozaki, R.; Ngai, K. L.

    2004-07-01

    Dielectric spectroscopy was employed to study the effects of water on the primary α -relaxation and the secondary β -relaxation of xylitol. The measurements were made on anhydrous xylitol and mixtures of xylitol with water with three different water concentrations over a temperature range from 173K to 293K . The α -relaxation speeds up with increasing concentration of water in xylitol, whereas the rate of the β -relaxation is essentially unchanged. Some systematic differences in the behavior of α -relaxation for anhydrous xylitol and the mixtures were observed. Our findings confirm all the observations of Nozaki [R. Nozaki, H. Zenitani, A. Minoguchi, and K. Kitai, J. Non-Cryst. Solids 307, 349 (2002)] in sorbitol/water mixtures. Effects of water on both the α - and β -relaxation dynamics in xylitol and sorbitol are explained by using the coupling model.

  14. Construction of plasmid-free Escherichia coli for the production of arabitol-free xylitol from corncob hemicellulosic hydrolysate.

    PubMed

    Su, Buli; Zhang, Zhe; Wu, Mianbin; Lin, Jianping; Yang, Lirong

    2016-05-26

    High costs and low production efficiency are a serious constraint to bio-based xylitol production. For industrial-scale production of xylitol, a plasmid-free Escherichia coli for arabitol-free xylitol production from corncob hemicellulosic hydrolysate has been constructed. Instead of being plasmid and inducer dependent, this strain relied on multiple-copy integration of xylose reductase (XR) genes into the chromosome, where their expression was controlled by the constitutive promoter P43. In addition, to minimize the flux from L-arabinose to arabitol, two strategies including low XR total activity and high selectivity of XR has been adopted. Arabitol was significantly decreased using plasmid-free strain which had lower XR total activity and an eight point-mutations of XR with a 27-fold lower enzyme activity toward L-arabinose was achieved. The plasmid-free strain in conjunction with this mutant XR can completely eliminate arabitol formation in xylitol production. In fed-batch fermentation, this plasmid-free strain produced 143.8 g L(-1) xylitol at 1.84 g L(-1) h(-1) from corncob hemicellulosic hydrolysate. From these results, we conclude that this route by plasmid-free E. coli has potential to become a commercially viable process for xylitol production.

  15. Construction of plasmid-free Escherichia coli for the production of arabitol-free xylitol from corncob hemicellulosic hydrolysate

    PubMed Central

    Su, Buli; Zhang, Zhe; Wu, Mianbin; Lin, Jianping; Yang, Lirong

    2016-01-01

    High costs and low production efficiency are a serious constraint to bio-based xylitol production. For industrial-scale production of xylitol, a plasmid-free Escherichia coli for arabitol-free xylitol production from corncob hemicellulosic hydrolysate has been constructed. Instead of being plasmid and inducer dependent, this strain relied on multiple-copy integration of xylose reductase (XR) genes into the chromosome, where their expression was controlled by the constitutive promoter P43. In addition, to minimize the flux from L-arabinose to arabitol, two strategies including low XR total activity and high selectivity of XR has been adopted. Arabitol was significantly decreased using plasmid-free strain which had lower XR total activity and an eight point-mutations of XR with a 27-fold lower enzyme activity toward L-arabinose was achieved. The plasmid-free strain in conjunction with this mutant XR can completely eliminate arabitol formation in xylitol production. In fed-batch fermentation, this plasmid-free strain produced 143.8 g L−1 xylitol at 1.84 g L−1 h−1 from corncob hemicellulosic hydrolysate. From these results, we conclude that this route by plasmid-free E. coli has potential to become a commercially viable process for xylitol production. PMID:27225023

  16. Novel endophytic yeast Rhodotorula mucilaginosa strain PTD3 II: production of xylitol and ethanol in the presence of inhibitors.

    PubMed

    Vajzovic, Azra; Bura, Renata; Kohlmeier, Kevin; Doty, Sharon L

    2012-10-01

    A systematic study was conducted characterizing the effect of furfural, 5-hydroxymethylfurfural (5-HMF), and acetic acid concentration on the production of xylitol and ethanol by a novel endophytic yeast, Rhodotorula mucilaginosa strain PTD3. The influence of different inhibitor concentrations on the growth and fermentation abilities of PTD3 cultivated in synthetic nutrient media containing 30 g/l xylose or glucose were measured during liquid batch cultures. Concentrations of up to 5 g/l of furfural stimulated production of xylitol to 77 % of theoretical yield (10 % higher compared to the control) by PTD3. Xylitol yields produced by this yeast were not affected in the presence of 5-HMF at concentrations of up to 3 g/l. At higher concentrations of furfural and 5-HMF, xylitol and ethanol yields were negatively affected. The higher the concentration of acetic acid present in a media, the higher the ethanol yield approaching 99 % of theoretical yield (15 % higher compared to the control) was produced by the yeast. At all concentrations of acetic acid tested, xylitol yield was lowered. PTD3 was capable of metabolizing concentrations of 5, 15, and 5 g/l of furfural, 5-HMF, and acetic acid, respectively. This yeast would be a potent candidate for the bioconversion of lignocellulosic sugars to biochemicals given that in the presence of low concentrations of inhibitors, its xylitol and ethanol yields are stimulated, and it is capable of metabolizing pretreatment degradation products.

  17. Direct and efficient xylitol production from xylan by Saccharomyces cerevisiae through transcriptional level and fermentation processing optimizations.

    PubMed

    Li, Zhe; Qu, Hongnan; Li, Chun; Zhou, Xiaohong

    2013-12-01

    In this study, four engineered Saccharomyces cerevisiae carrying xylanase, β-xylosidase and xylose reductase genes by different transcriptional regulations were constructed to directly convert xylan to xylitol. According to the results, the high-copy number plasmid required a rigid selection for promoter characteristics, on the contrast, the selection of promoters could be more flexible for low-copy number plasmid. For cell growth and xylitol production, glucose and galactose were found more efficient than other sugars. The semi-aerobic condition and feeding of co-substrates were taken to improve the yield of xylitol. It was found that the strain containing high-copy number plasmid had the highest xylitol yield, but it was sensitive to the change of fermentation. However, the strain carrying low-copy number plasmid was more adaptable to different processes. By optimization of the transcriptional regulation and fermentation processes, the xylitol concentration could be increased of 1.7 folds and the yield was 0.71 g xylitol/g xylan. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Will parents participate in and comply with programs and regimens using xylitol for preventing acute otitis media in their children?

    PubMed

    Danhauer, Jeffrey L; Johnson, Carole E; Baker, Jason A; Ryu, Jung A; Smith, Rachel A; Umeda, Claire J

    2015-04-01

    Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen of xylitol for preventing AOM in their preschool- and kindergarten-aged children. An Internet questionnaire was designed and administered to parents of young children in preschool and kindergarten settings. Most parents were unaware of xylitol's use for AOM and would not likely comply with regimens for preventing AOM in their children; however, parents having previous knowledge of xylitol and whose children had a history of AOM would be more likely to do so. Generally, most of these parents did not know about xylitol and probably would not use it to prevent ear infections. Unfortunately, these results parallel earlier findings for teachers and schools, which present obstacles for establishing ear infection prevention programs using similar protocols for young children. The results showed that considerable education and age-appropriate vehicles for administering xylitol are needed before establishing AOM prevention programs in schools and/or at home.

  19. Pediatric Psoriasis Comorbidity Screening Guidelines.

    PubMed

    Osier, Emily; Wang, Audrey S; Tollefson, Megha M; Cordoro, Kelly M; Daniels, Stephen R; Eichenfield, Andrew; Gelfand, Joel M; Gottlieb, Alice B; Kimball, Alexa B; Lebwohl, Mark; Mehta, Nehal N; Paller, Amy S; Schwimmer, Jeffrey B; Styne, Dennis M; Van Voorhees, Abby S; Tom, Wynnis L; Eichenfield, Lawrence F

    2017-07-01

    Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence. A literature review was performed using PubMed from January 1999 through December 2015. Limiting the search to human studies published in English and removing reviews and editorials produced 153 relevant manuscripts. An expert panel in psoriasis, pediatric dermatology, pediatric rheumatology, pediatric gastroenterology, pediatric endocrinology, and adult and pediatric cardiology used the patient-centered Strength of Recommendation Taxonomy (SORT) method to evaluate and grade the quality of evidence. Because of the limited number of pediatric studies published on these topics, the strength of the panel's recommendations is classified as SORT level C expert consensus recommendations. The majority of recommendations coincide with those endorsed by the American Academy of Pediatrics for the general pediatric patient but with added attention to signs and symptoms of arthritis, depression, and anxiety. The panel also identified key areas for further investigation. Patients with pediatric psoriasis should receive routine screening and identification of risk factors for associated comorbidities. These guidelines are relevant for all health care providers caring for patients with pediatric psoriasis, including primary care clinicians, dermatologists, and pediatric specialists. Because these are the first pediatric guidelines, re-review and refinement will be necessary as studies further detail, and possibly

  20. Xylitol lozenges were not effective in overall dental caries prevention in adults.

    PubMed

    Fontana, Margherita; Gonzalez-Cabezas, Carlos

    2013-09-01

    Results from the xylitol for adult caries trial (X-ACT). Bader JD, Vollmer WM, Shugars DA, Gilbert GH, Amaechi BT, Brown JP, Laws RL, Kunkhouser KA, Makhija SK, Ritter AV, Leo MC. JADA 2013; 144(1): 21-30. Margherita Fontana, DDS, PhD, Carlos Gonzalez-Cabezas, DDS, MSD, PhD PURPOSE/QUESTION: Among an adult population at risk of dental caries, does the use of five 1 g xylitol lozenges per day over 33 months reduce the experience of cavitated caries lesions? Government: National Institute of Dental and Craniofacial Research Multicenter, double blind, placebo-controlled, randomized clinical trial Level 1: Good quality, patient-oriented evidence B: Limited quality patient-oriented evidence. Published by Mosby, Inc.

  1. Production of Xylitol from D-Xylose by Overexpression of Xylose Reductase in Osmotolerant Yeast Candida glycerinogenes WL2002-5.

    PubMed

    Zhang, Cheng; Zong, Hong; Zhuge, Bin; Lu, Xinyao; Fang, Huiying; Zhuge, Jian

    2015-07-01

    Efficient bioconversion of D-xylose into various biochemicals is critical for the developing lignocelluloses application. In this study, we compared D-xylose utilization in Candida glycerinogenes WL2002-5 transformants expressing xylose reductase (XYL1) in D-xylose metabolism. C. glycerinogenes WL2002-5 expressing XYL1 from Schefferomyces stipitis can produce xylitol. Xylitol production by the recombinant strains was evaluated using a xylitol fermentation medium with glucose as a co-substrate. As glucose was found to be an insufficient co-substrate, various carbon sources were screened for efficient cofactor regeneration, and glycerol was found to be the best co-substrate. The effects of glycerol on the xylitol production rate by a xylose reductase gene (XYL1)-overexpressed mutant of C. glycerinogenes WL2002-5 were investigated. The XYL1-overexpressed mutant produced xylitol from D-xylose using glycerol as a co-substrate for cell growth and NAD (P) H regeneration: 100 g/L D-xylose was completely converted into xylitol when at least 20 g/L glycerol was used as a co-substrate. XYL1 overexpressed mutant grown on glycerol as co-substrate accumulated 2.1-fold increased xylitol concentration over those cells grown on glucose as co-substrate. XYL1 overexpressed mutant produced xylitol with a volumetric productivity of 0.83 g/L/h, and a xylitol yield of 98 % xylose. Recombinant yeast strains obtained in this study are promising candidates for xylitol production. This is the first report of XYL1 gene overexpression of C. glycerinogenes WL2002-5 for enhancing the efficiency of xylitol production.

  2. Myocarditis - pediatric

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  3. Effect of Probiotic Yogurt and Xylitol-Containing Chewing Gums on Salivary S Mutans Count.

    PubMed

    Ghasemi, Elnaz; Mazaheri, Romina; Tahmourespour, Arezoo

    In addition to improving gastrointestinal health and intestinal microflora, probiotic bacteria have been recently suggested to decrease cariogenic agents in the oral cavity. The aim of this study was to investigate the effects of probiotic yogurt and xylitol-containing chewing gums on reducing salivary Streptococcus mutans levels. This randomized clinical trial recruited 50 female students with over 10 5 colony forming units S. mutans per milliliter of their saliva. The participants were randomly allocated to two equal groups to receive either probiotic yogurt containing Lactobacillus acidophilus ATCC 4356 andBifidobacteriumbifidum ATCC 29521 (200 g daily) or xylitol-containing chewing gums (two gums three times daily after each meal; total xylitol content: 5.58 g daily) for three weeks. At baseline and one day, two weeks, and four weeks after the interventions, saliva samples were cultured on mitis-salivarius-bacitracin agar and salivary S. mutans counts were determined. Data were analyzed with independent t-tests, analysis of variance, and Fisher's least significant difference test. In both groups, S. mutans counts on the first day, second week, and fourth weeks after the intervention were significantly lower than baseline values (P < 0.05). The greatest level of reduction in both groups was observed in the second week after the intervention. Moreover, although the reduction was greater in probiotic yogurt consumers, the difference between the two groups was not statistically significant. Probiotic yogurt and xylitol-containing chewing gums seem to be as effective in reduction of salivary S. mutans levels. Their constant long-term consumption is thus recommended to prevent caries.

  4. Determination of glutathione in apoptotic SMMC-7221 cells induced by xylitol selenite using capillary electrophoresis.

    PubMed

    Wu, Xue; Cao, Yu; Zhang, Jian; Lei, Ming; Deng, Xiaojie; Zahid, Kashif Rafiq; Liu, Yanli; Liu, Ke; Yang, Jihong; Xiong, Guomei; Yao, Hanchao; Qi, Chao

    2016-05-01

    To determine the glutathione (GSH) content in a human hepatoma cell line (SMMC-7221) treated with xylitol/selenite, providing a part of an investigation of its anti-cancer mechanisms. The nuclei of SMMC-7221 cells were stained with Hoechst 33258 in an apoptosis assay, and their morphology subsequently changed from circular to crescent shape. The calibration curve (r(2) = 0.992) was established, and GSH content markedly decreased after treated with 0.5 and 1 mg xylitol/selenite l(-1) for 12, 36 and 60 h (12 h: from 95.57 ± 19.57 to 29.09 ± 7.74 and 24.27 ± 11.15; 36 h: from 70.73 ± 11.35 to 19.54 ± 6.39 and 9.35 ± 6.69; 60 h: from 72.63 ± 16.94 to 7.432 ± 3.84 and 0). The depletion rate of GSH was more related to the concentration of xylitol/selenite than the treatment time (from 69.95 ± 1.87 to 100 % vs. 0.22 ± 0.2 to 100 %). Xylitol/selenite is a promising anti-cancer drug to induce apoptosis in SMMC-7221 cells. It may regulate the apoptosis through the co-action of multiple mechanisms related to GSH depletion.

  5. Pediatric caregiver involvement in the assessment of physicians.

    PubMed

    Moreau, Katherine A; Pound, Catherine M; Eady, Kaylee

    2015-08-01

    Given the growth and benefits of consumerist and family-centred approaches to pediatric health care, there is a need to involve pediatric caregivers in the assessment of their children's physicians. We present interconnected questions that are important to address in order to facilitate pediatric caregiver involvement in the assessment of their children's physicians. Pediatric caregivers can be valuable assessors of physicians' non-technical skills. It is important to conduct additional research on caregiver involvement in assessment activities and create a reflective discourse on this topic. To ensure that pediatric caregivers' assessments of physicians are formally recognized and advantageous, it is important to understand: (a) what pediatric caregivers can assess; (b) what assessment tools exist for pediatric caregivers; (c) how to create appropriate assessment tools for pediatric caregivers; (d) how to collect pediatric caregivers' assessments; (e) how to increase the legitimacy, use, and effectiveness of pediatric caregivers' assessments; and (f) the consequences of pediatric caregiver assessment.

  6. Gut hormone secretion, gastric emptying, and glycemic responses to erythritol and xylitol in lean and obese subjects.

    PubMed

    Wölnerhanssen, Bettina K; Cajacob, Lucian; Keller, Nino; Doody, Alison; Rehfeld, Jens F; Drewe, Juergen; Peterli, Ralph; Beglinger, Christoph; Meyer-Gerspach, Anne Christin

    2016-06-01

    With the increasing prevalence of obesity and a possible association with increasing sucrose consumption, nonnutritive sweeteners are gaining popularity. Given that some studies indicate that artificial sweeteners might have adverse effects, alternative solutions are sought. Xylitol and erythritol have been known for a long time and their beneficial effects on caries prevention and potential health benefits in diabetic patients have been demonstrated in several studies. Glucagon-like peptide-1 (GLP-1) and cholecystokinin (CCK) are released from the gut in response to food intake, promote satiation, reduce gastric emptying (GE), and modulate glucose homeostasis. Although glucose ingestion stimulates sweet taste receptors in the gut and leads to incretin and gastrointestinal hormone release, the effects of xylitol and erythritol have not been well studied. Ten lean and 10 obese volunteers were given 75 g of glucose, 50 g of xylitol, or 75 g of erythritol in 300 ml of water or placebo (water) by a nasogastric tube. We examined plasma glucose, insulin, active GLP-1, CCK, and GE with a [(13)C]sodium acetate breath test and assessed subjective feelings of satiation. Xylitol and erythritol led to a marked increase in CCK and GLP-1, whereas insulin and plasma glucose were not (erythritol) or only slightly (xylitol) affected. Both xylitol and erythritol induced a significant retardation in GE. Subjective feelings of appetite were not significantly different after carbohydrate intake compared with placebo. In conclusion, acute ingestion of erythritol and xylitol stimulates gut hormone release and slows down gastric emptying, whereas there is no or only little effect on insulin release. Copyright © 2016 the American Physiological Society.

  7. Effects of xylitol on carbohydrate digesting enzymes activity, intestinal glucose absorption and muscle glucose uptake: a multi-mode study.

    PubMed

    Chukwuma, Chika Ifeanyi; Islam, Md Shahidul

    2015-03-01

    The present study investigated the possible mechanism(s) behind the effects of xylitol on carbohydrate digesting enzymes activity, muscle glucose uptake and intestinal glucose absorption using in vitro, ex vivo and in vivo experimental models. The effects of increasing concentrations of xylitol (2.5%-40% or 164.31 mM-2628.99 mM) on alpha amylase and alpha glucosidase activity in vitro and intestinal glucose absorption and muscle glucose uptake were investigated under ex vivo conditions. Additionally, the effects of an oral bolus dose of xylitol (1 g per kg BW) on gastric emptying and intestinal glucose absorption and digesta transit in the different segments of the intestinal tract were investigated in normal and type 2 diabetic rats at 1 hour after dose administration, when phenol red was used as a recovery marker. Xylitol exhibited concentration-dependent inhibition of alpha amylase (IC₅₀ = 1364.04 mM) and alpha glucosidase (IC₅₀ = 1127.52 mM) activity in vitro and small intestinal glucose absorption under ex vivo condition. Xylitol also increased dose dependent muscle glucose uptake with and without insulin, although the uptake was not significantly affected by the addition of insulin. Oral single bolus dose of xylitol significantly delayed gastric emptying, inhibited intestinal glucose absorption but increased the intestinal digesta transit rate in both normal and diabetic rats compared to their respective controls. The data of this study suggest that xylitol reduces intestinal glucose absorption via inhibiting major carbohydrate digesting enzymes, slowing gastric emptying and fastening the intestinal transit rate, but increases muscle glucose uptake in normal and type 2 diabetic rats.

  8. Viscoelastic and Functional Properties of Cod-Bone Gelatin in the Presence of Xylitol and Stevioside

    NASA Astrophysics Data System (ADS)

    Nian, Linyu; Cao, Ailing; Wang, Jing; Tian, Hongyu; Liu, Yongguo; Gong, Lingxiao; Cai, Luyun; Wang, Yuhao

    2018-05-01

    The physical, rheological, structural and functional properties of cod bone gelatin (CBG) with various concentrations (0, 2, 4, 6, 10 and 15%) of low-calorie sweeteners (xylitol (X) and stevioside (S)) to form gels were investigated. The gel strength of CBGX increased with increased xylitol due presumably to hydrogen bonds between xylitol and gelatin, but with CBGS the highest gel strength occurred when S concentration was 4%. Viscosity of CBGS samples were higher than CBGX due to S’s high molecular mass. The viscoelasticity (G' and G″), foaming capacity and fat binding capacity of CBGX were higher while foam stability was lower. The emulsion activity and emulsion stability of CBGX were a little lower than CBGS at the same concentration. The structure of X is linear making it easier to form a dense three-dimensional network structure, while the complex cyclic structure of S had more difficulty forming a network structure with cod bone gelatin. Therefore, X may be a better choice for sweetening gelatin gels.

  9. Effect of pressure on the α relaxation in glycerol and xylitol

    NASA Astrophysics Data System (ADS)

    Paluch, M.; Casalini, R.; Hensel-Bielowka, S.; Roland, C. M.

    2002-06-01

    The effect of pressure on the dielectric relaxation of two polyhydroxy alcohols is examined by analysis of existing data on glycerol, together with new measurements on xylitol. The fragility, or Tg-normalized temperature dependence, changes with pressure for low pressures, but becomes invariant above 1 GPa. When compared at temperatures for which the α-relaxation times are equal, there is no effect of pressure (<1 GPa) on the shape of the α dispersion at higher temperatures. However, nearer Tg, pressure broadens the α peak, consistent with the expected correlation of fragility with the breadth of the relaxation function. We also observe that the α-relaxation peaks for both glycerol and xylitol show an excess intensity at higher frequencies. For xylitol, unlike for glycerol, at lower temperatures this wing disjoins to form a separate peak. For both glass formers, elevated pressure causes the excess wing to become more separated from the peak maximum; that is, the properties of the primary and excess intensities are not correlated. This implies that the excess wing in glycerol is also a distinct secondary process, although it cannot be resolved from the primary peak.

  10. Levorotatory carbohydrates and xylitol subdue Streptococcus mutans and Candida albicans adhesion and biofilm formation.

    PubMed

    Brambilla, Eugenio; Ionescu, Andrei C; Cazzaniga, Gloria; Ottobelli, Marco; Samaranayake, Lakshman P

    2016-05-01

    Dietary carbohydrates and polyols affect the microbial colonization of oral surfaces by modulating adhesion and biofilm formation. The aim of this study was to evaluate the influence of a select group of l-carbohydrates and polyols on either Streptococcus mutans or Candida albicans adhesion and biofilm formation in vitro. S. mutans or C. albicans suspensions were inoculated on polystyrene substrata in the presence of Tryptic soy broth containing 5% of the following compounds: d-glucose, d-mannose, l-glucose, l-mannose, d- and l-glucose (raceme), d- and l-mannose (raceme), l-glucose and l-mannose, sorbitol, mannitol, and xylitol. Microbial adhesion (2 h) and biofilm formation (24 h) were evaluated using MTT-test and Scanning Electron Microscopy (SEM). Xylitol and l-carbohydrates induced the lowest adhesion and biofilm formation in both the tested species, while sorbitol and mannitol did not promote C. albicans biofilm formation. Higher adhesion and biofilm formation was noted in both organisms in the presence of d-carbohydrates relative to their l-carbohydrate counterparts. These results elucidate, hitherto undescribed, interactions of the individually tested strains with l- and d-carbohydrates, and how they impact fungal and bacterial colonization. In translational terms, our data raise the possibility of using l-form of carbohydrates and xylitol for dietary control of oral plaque biofilms. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Optimal experimental condition for hemicellulosic hydrolyzate treatment with activated charcoal for xylitol production.

    PubMed

    Mussatto, Solange I; Roberto, Inês C

    2004-01-01

    Rice straw was hydrolyzed into a mixture of sugars using diluted H(2)SO(4). During hydrolysis, a variety of inhibitors was also produced, including acetic acid, furfural, hydroxymethylfurfural, and lignin degradation products (several aromatic and phenolic compounds). To reduce the toxic compounds concentration in the hydrolyzate and to improve the xylitol yield and volumetric productivity, rice straw hemicellulosic hydrolyzate was treated with activated charcoal under different pH values, stirring rates, contact times, and temperatures, employing a 2(4) full-factorial design. Fermentative assays were conducted with treated hydrolyzates containing 90 g/L xylose. The results indicated that temperature, pH, and stirring rate strongly influenced the hydrolyzate treatment, temperature and pH interfering with all of the responses analyzed (removal of color and lignin degradation products, xylitol yield factor, and volumetric productivity). The combination of pH 2.0, 150 rpm, 45 degrees C, and 60 min was considered an optimal condition, providing significant removal rates of color (48.9%) and lignin degradation products (25.8%), as well as a xylitol production of 66 g/L, a volumetric productivity of 0.57 g/L.h, and a yield factor of 0.72 g/g.

  12. Evaluation of the Simultaneous Production of Xylitol and Ethanol from Sisal Fiber

    PubMed Central

    Damião Xavier, Franklin; Santos Bezerra, Gustavo; Florentino Melo Santos, Sharline; Sousa Conrado Oliveira, Líbia; Luiz Honorato Silva, Flávio; Joice Oliveira Silva, Aleir; Maria Conceição, Marta

    2018-01-01

    Recent years have seen an increase in the use of lignocellulosic materials in the development of bioproducts. Because sisal fiber is a low cost raw material and is readily available, this work aimed to evaluate its hemicellulose fraction for the simultaneous production of xylitol and ethanol. The sisal fiber presented a higher hemicellulose content than other frequently-employed biomasses, such as sugarcane bagasse. A pretreatment with dilute acid and low temperatures was conducted in order to obtain the hemicellulose fraction. The highest xylose contents (0.132 g·g−1 of sisal fiber) were obtained at 120 °C with 2.5% (v/v) of sulfuric acid. The yeast Candida tropicalis CCT 1516 was used in the fermentation. In the sisal fiber hemicellulose hydrolysate, the maximum production of xylitol (0.32 g·g−1) and of ethanol (0.27 g·g−1) was achieved in 60 h. Thus, sisal fiber presents as a potential biomass for the production of ethanol and xylitol, creating value with the use of hemicellulosic liquor without detoxification and without the additional steps of alkaline pretreatment. PMID:29320469

  13. Viscoelastic and Functional Properties of Cod-Bone Gelatin in the Presence of Xylitol and Stevioside.

    PubMed

    Nian, Linyu; Cao, Ailing; Wang, Jing; Tian, Hongyu; Liu, Yongguo; Gong, Lingxiao; Cai, Luyun; Wang, Yuhao

    2018-01-01

    The physical, rheological, structural and functional properties of cod bone gelatin (CBG) with various concentrations (0, 2, 4, 6, 10, and 15%) of low-calorie sweeteners [xylitol (X) and stevioside (S)] to form gels were investigated. The gel strength of CBGX increased with increased xylitol due presumably to hydrogen bonds between xylitol and gelatin, but with CBGS the highest gel strength occurred when S concentration was 4%. Viscosity of CBGS samples were higher than CBGX due to S's high molecular mass. The viscoelasticity (G' and G''), foaming capacity and fat binding capacity of CBGX were higher while foam stability was lower. The emulsion activity and emulsion stability of CBGX were a little lower than CBGS at the same concentration. The structure of X is linear making it easier to form a dense three-dimensional network structure, while the complex cyclic structure of S had more difficulty forming a network structure with cod bone gelatin. Therefore, X may be a better choice for sweetening gelatin gels.

  14. Linear response of mutans streptococci to increasing frequency of xylitol chewing gum use: a randomized controlled trial [ISRCTN43479664

    PubMed Central

    Ly, Kiet A; Milgrom, Peter; Roberts, Marilyn C; Yamaguchi, David K; Rothen, Marilynn; Mueller, Greg

    2006-01-01

    Background Xylitol is a naturally occurring sugar substitute that has been shown to reduce the level of mutans streptococci in plaque and saliva and to reduce tooth decay. It has been suggested that the degree of reduction is dependent on both the amount and the frequency of xylitol consumption. For xylitol to be successfully and cost-effectively used in public health prevention strategies dosing and frequency guidelines should be established. This study determined the reduction in mutans streptococci levels in plaque and unstimulated saliva to increasing frequency of xylitol gum use at a fixed total daily dose of 10.32 g over five weeks. Methods Participants (n = 132) were randomized to either active groups (10.32 g xylitol/day) or a placebo control (9.828 g sorbitol and 0.7 g maltitol/day). All groups chewed 12 pieces of gum per day. The control group chewed 4 times/day and active groups chewed xylitol gum at a frequency of 2 times/day, 3 times/day, or 4 times/day. The 12 gum pieces were evenly divided into the frequency assigned to each group. Plaque and unstimulated saliva samples were taken at baseline and five-weeks and were cultured on modified Mitis Salivarius agar for mutans streptococci enumeration. Results There were no significant differences in mutans streptococci level among the groups at baseline. At five-weeks, mutans streptococci levels in plaque and unstimulated saliva showed a linear reduction with increasing frequency of xylitol chewing gum use at the constant daily dose. Although the difference observed for the group that chewed xylitol 2 times/day was consistent with the linear model, the difference was not significant. Conclusion There was a linear reduction in mutans streptococci levels in plaque and saliva with increasing frequency of xylitol gum use at a constant daily dose. Reduction at a consumption frequency of 2 times per day was small and consistent with the linear-response line but was not statistically significant. PMID:16556326

  15. Linear response of mutans streptococci to increasing frequency of xylitol chewing gum use: a randomized controlled trial [ISRCTN43479664].

    PubMed

    Ly, Kiet A; Milgrom, Peter; Roberts, Marilyn C; Yamaguchi, David K; Rothen, Marilynn; Mueller, Greg

    2006-03-24

    Xylitol is a naturally occurring sugar substitute that has been shown to reduce the level of mutans streptococci in plaque and saliva and to reduce tooth decay. It has been suggested that the degree of reduction is dependent on both the amount and the frequency of xylitol consumption. For xylitol to be successfully and cost-effectively used in public health prevention strategies dosing and frequency guidelines should be established. This study determined the reduction in mutans streptococci levels in plaque and unstimulated saliva to increasing frequency of xylitol gum use at a fixed total daily dose of 10.32 g over five weeks. Participants (n = 132) were randomized to either active groups (10.32 g xylitol/day) or a placebo control (9.828 g sorbitol and 0.7 g maltitol/day). All groups chewed 12 pieces of gum per day. The control group chewed 4 times/day and active groups chewed xylitol gum at a frequency of 2 times/day, 3 times/day, or 4 times/day. The 12 gum pieces were evenly divided into the frequency assigned to each group. Plaque and unstimulated saliva samples were taken at baseline and five-weeks and were cultured on modified Mitis Salivarius agar for mutans streptococci enumeration. There were no significant differences in mutans streptococci level among the groups at baseline. At five-weeks, mutans streptococci levels in plaque and unstimulated saliva showed a linear reduction with increasing frequency of xylitol chewing gum use at the constant daily dose. Although the difference observed for the group that chewed xylitol 2 times/day was consistent with the linear model, the difference was not significant. There was a linear reduction in mutans streptococci levels in plaque and saliva with increasing frequency of xylitol gum use at a constant daily dose. Reduction at a consumption frequency of 2 times per day was small and consistent with the linear-response line but was not statistically significant.

  16. Continuous co-production of ethanol and xylitol from rice straw hydrolysate in a membrane bioreactor.

    PubMed

    Zahed, Omid; Jouzani, Gholamreza Salehi; Abbasalizadeh, Saeed; Khodaiyan, Faramarz; Tabatabaei, Meisam

    2016-05-01

    The present study was set to develop a robust and economic biorefinery process for continuous co-production of ethanol and xylitol from rice straw in a membrane bioreactor. Acid pretreatment, enzymatic hydrolysis, detoxification, yeast strains selection, single and co-culture batch fermentation, and finally continuous co-fermentation were optimized. The combination of diluted acid pretreatment (3.5 %) and enzymatic conversion (1:10 enzyme (63 floating-point unit (FPU)/mL)/biomass ratio) resulted in the maximum sugar yield (81 % conversion). By concentrating the hydrolysates, sugars level increased by threefold while that of furfural reduced by 50 % (0.56 to 0.28 g/L). Combined application of active carbon and resin led to complete removal of furfural, hydroxyl methyl furfural, and acetic acid. The strains Saccharomyces cerevisiae NCIM 3090 with 66.4 g/L ethanol production and Candida tropicalis NCIM 3119 with 9.9 g/L xylitol production were selected. The maximum concentrations of ethanol and xylitol in the single cultures were recorded at 31.5 g/L (0.42 g/g yield) and 26.5 g/L (0.58 g/g yield), respectively. In the batch co-culture system, the ethanol and xylitol productions were 33.4 g/L (0.44 g/g yield) and 25.1 g/L (0.55 g/g yield), respectively. The maximum ethanol and xylitol volumetric productivity values in the batch co-culture system were 65 and 58 % after 25 and 60 h, but were improved in the continuous co-culture mode and reached 80 % (55 g/L) and 68 % (31 g/L) at the dilution rate of 0.03 L per hour, respectively. Hence, the continuous co-production strategy developed in this study could be recommended for producing value-added products from this hugely generated lignocellulosic waste.

  17. Production of xylitol by a Coniochaeta ligniaria strain tolerant of inhibitors and defective in growth on xylose.

    PubMed

    Nichols, Nancy N; Saha, Badal C

    2016-05-01

    In conversion of biomass to fuels or chemicals, inhibitory compounds arising from physical-chemical pretreatment of the feedstock can interfere with fermentation of the sugars to product. Fungal strain Coniochaeta ligniaria NRRL30616 metabolizes the furan aldehydes furfural and 5-hydroxymethylfurfural, as well as a number of aromatic and aliphatic acids and aldehydes. Use of NRRL30616 to condition biomass sugars by metabolizing the inhibitors improves their fermentability. Wild-type C. ligniaria has the ability to grow on xylose as sole source of carbon and energy, with no accumulation of xylitol. Mutants of C. ligniaria unable to grow on xylose were constructed. Xylose reductase and xylitol dehydrogenase activities were reduced by approximately two thirds in mutant C8100. The mutant retained ability to metabolize inhibitors in biomass hydrolysates. Although C. ligniaria C8100 did not grow on xylose, the strain converted a portion of xylose to xylitol, producing 0.59 g xylitol/g xylose in rich medium and 0.48 g xylitol/g xylose in corn stover dilute acid hydrolysate. 2016 American Institute of Chemical Engineers Biotechnol. Prog., 2016 © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:606-612, 2016. © 2016 American Institute of Chemical Engineers.

  18. Benzoate-induced stress enhances xylitol yield in aerobic fed-batch culture of Candida mogii TISTR 5892.

    PubMed

    Wannawilai, Siwaporn; Sirisansaneeyakul, Sarote; Chisti, Yusuf

    2015-01-20

    Production of the natural sweetener xylitol from xylose via the yeast Candida mogii TISTR 5892 was compared with and without the growth inhibitor sodium benzoate in the culture medium. Sodium benzoate proved to be an uncompetitive inhibitor in relatively poorly oxygenated shake flask aerobic cultures. In a better controlled aerobic environment of a bioreactor, the role of sodium benzoate could equally well be described as competitive, uncompetitive or noncompetitive inhibitor of growth. In intermittent fed-batch fermentations under highly aerobic conditions, the presence of sodium benzoate at 0.15gL(-1) clearly enhanced the xylitol titer relative to the control culture without the sodium benzoate. The final xylitol concentration and the average xylitol yield on xylose were nearly 50gL(-1) and 0.57gg(-1), respectively, in the presence of sodium benzoate. Both these values were substantially higher than reported for the same fermentation under microaerobic conditions. Therefore, a fed-batch aerobic fermentation in the presence of sodium benzoate is promising for xylitol production using C. mogii. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. XYLITOL IMPROVES ANTI-OXIDATIVE DEFENSE SYSTEM IN SERUM, LIVER, HEART, KIDNEY AND PANCREAS OF NORMAL AND TYPE 2 DIABETES MODEL OF RATS.

    PubMed

    Chukwuma, Chika Ifeanyi; Islam, Shahidul

    2017-05-01

    The present study investigated the anti-oxidative effects of xylitol both in vitro and in vivo in normal and type 2 diabetes (T2D) rat model. Free radical scavenging and ferric reducing potentials of different concentrations of xylitol were investigated in vitro. For in vivo study, six weeks old male Sprague-Dawley rats were divided into four groups, namely: Normal Control (NC), Diabetic Control (DBC), Normal Xylitol (NXYL) and Diabetic Xylitol (DXYL). T2D was induced in the DBC and DXYL groups. After the confirmation of diabetes, a 10% xylitol solution was supplied instead of drinking water to NXYL and DXYL, while normal drinking water was supplied to NC and DBC ad libitum. After five weeks intervention period, the animals were sacri- ficed and thiobarbituric acid reactive substances (TBARS) and reduced glutathione (GSH) concentrations as well as superoxide dismutase, catalase glutathione reductase and glutathione peroxidase activities were determined in the liver, heart, kidney, pancreatic tissues and serum samples. Xylitol exhibited significant (p < 0.05) in vitro nitric oxide and hydroxyl radical scavenging and ferric reducing activities. In vivo study revealed significant (p < 0.05) reduction in TBARS concentrations in the xylitol consuming groups compared to their respective controls. Significant (p < 0.05) increase in GSH levels and antioxidant enzyme activities were observed in analyzed tissues and serum of xylitol-fed animals compared to their respective controls. Results of this study indicate that xylitol has strong anti-oxidative potential against T2D-associated oxidative stress. Hence, xylitol can be used as a potential supplement in diabetic foods and food products.

  20. Anticipatory guidance topics: are more better?

    PubMed

    Barkin, Shari L; Scheindlin, Benjamin; Brown, Caroline; Ip, Edward; Finch, Stacia; Wasserman, Richard C

    2005-01-01

    Anticipatory guidance is a cornerstone of primary care pediatrics. Despite the fact that retention of information is essential for later action, data are lacking on what parents recall immediately after the visit and 1 month later and how the total number of topics discussed affects this outcome. Parents and practitioners completed postvisit surveys of anticipatory guidance topics discussed during health-maintenance visits for children ages 2-11. Postvisit and 1 month later, parental recall was compared with provider report of topics discussed. We examined the relationship between parental recall and the total number of topics discussed. Families with children ages 2-11 years from across the United States participated in this study (N = 861). Providers reported discussing the topics of nutrition, car restraints, dental care, and reading aloud most often (72%- 93%). Concordance between parent and provider was high for all topics (72%-90%). Immediately postvisit, parents reported 6.33 (SD 2.9) as the mean number of topics discussed while providers reported 6.9 (SD 2.7) as the mean number of topics discussed. However, parental recall decreased significantly with more topics (> or =9) discussed. The same trend existed 1 month later. Providers and parents have good agreement about topics discussed or not discussed during a well-child visit; however, parental recall dwindles with increasing numbers of topics discussed. Rethinking well-child care to limit the total number of topics discussed is warranted.

  1. Investigation of Water Absorption and Diffusion in Microparticles Containing Xylitol to Provide a Cooling Effect by Thermal Analysis

    NASA Astrophysics Data System (ADS)

    Salaün, F.; Bedek, G.; Devaux, E.; Dupont, D.; Deranton, D.

    2009-08-01

    Polyurethane microparticles containing xylitol as a sweat sensor system were prepared by interfacial polymerization. The structural and thermal properties of the resultant microparticles were studied. The surface morphology and chemical structure of microparticles were investigated using an optical microscope (OM) and a Fourier-transform infrared spectroscope (FTIR), respectively. The thermal properties of samples were investigated by thermogravimetric analysis (TGA) and by differential scanning calorimetry (DSC). Thus, two types of microparticles were synthesized by varying the percentage of monomers introduced. The obtained morphology is directly related to the synthesis conditions. DSC analysis indicated that the mass content of crystalline xylitol was up to 63.8 %, which resulted in a high enthalpy of dilution of 127.7 J · g-1. Furthermore, the water release rate monitored by TGA analysis was found to be faster from the microparticles than from raw xylitol. Thus, the microparticles could be applied for thermal energy storage and moisture sensor enhancement.

  2. Monitoring the recrystallisation of amorphous xylitol using Raman spectroscopy and wide-angle X-ray scattering.

    PubMed

    Palomäki, Emmi; Ahvenainen, Patrik; Ehlers, Henrik; Svedström, Kirsi; Huotari, Simo; Yliruusi, Jouko

    2016-07-11

    In this paper we present a fast model system for monitoring the recrystallization of quench-cooled amorphous xylitol using Raman spectroscopy and wide-angle X-ray scattering. The use of these two methods enables comparison between surface and bulk crystallization. Non-ordered mesoporous silica micro-particles were added to the system in order to alter the rate of crystallization of the amorphous xylitol. Raman measurements showed that adding silica to the system increased the rate of surface crystallization, while X-ray measurements showed that the rate of bulk crystallization decreased. Using this model system it is possible to measure fast changes, which occur in minutes or within a few hours. Raman-spectroscopy and wide-angle X-ray scattering were found to be complementary techniques when assessing surface and bulk crystallization of amorphous xylitol. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Effect of selected aldehydes found in the corncob hemicellulose hydrolysate on the growth and xylitol fermentation of Candida tropicalis.

    PubMed

    Wang, Le; Tang, Pingwah; Fan, Xiaoguang; Yuan, Qipeng

    2013-01-01

    The effects of four aldehydes (furfural, 5-hydroxymethylfurfural, vanillin and syringaldehyde), which were found in the corncob hemicellulose hydrolysate, on the growth and xylitol fermentation of Candida tropicalis were investigated. The results showed that vanillin was the most toxic aldehyde for the xylitol fermentation, followed by syringaldehyde, furfural and 5-hydroxymethylfurfural. Moreover, the binary combination tests revealed that furfural amplified the toxicity of other aldehydes and the toxicities of other binary combinations without furfural were simply additive. Based on the fermentation experiments, it was demonstrated that the inhibition of aldehydes could be alleviated by prolonging the fermentation incubation, increasing the initial cell concentration, enhancing the initial pH value and minimizing the furfural levels in the hydrolysate evaporation process. The strategies that we proposed to suppress the inhibitory effects of the aldehydes successfully avoided the complicated and costly detoxifications. Our findings could be potentially adopted for the industrial xylitol fermentation from hydrolysates. © 2013 American Institute of Chemical Engineers.

  4. Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults.

    PubMed

    Brown, John P; Amaechi, Bennett T; Bader, James D; Gilbert, Gregg H; Makhija, Sonia K; Lozano-Pineda, Juanita; Leo, Michael C; Chen, Chuhe; Vollmer, William M

    2014-06-01

    To better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency. As part of the Xylitol for Adult Caries Trial (X-ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21-80, with complete data for four dental examinations, were selected from the 691 randomized into the 3-year trial, conducted at three sites. Acceptable inter- and intra-examiner reliability before and during the trial was quantified using the kappa statistic. The mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full-scale, placebo-controlled, multisite, randomized, double-blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. ClinicalTrials.Gov NCT00393055. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Visual scoring of non-cavitated caries lesions and clinical trial efficiency, testing xylitol in caries active adults

    PubMed Central

    Brown, JP; Amaechi, BT; Bader, JD; Gilbert, GH; Makhija, SK; Lozano-Pineda, J; Leo, MC; Chuhe, C; Vollmer, WM

    2013-01-01

    Objectives To better understand the effectiveness of xylitol in caries prevention in adults, and to attempt improved clinical trial efficiency. Methods As part of the Xylitol for Adult Caries Trial (X-ACT), non-cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 grams/day of xylitol, consumed by dissolving in the mouth five 1 gram lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21–80, with complete data for four dental examinations were selected from the 691 randomized into the three year trial, conducted at three sites. Acceptable inter and intra examiner reliability before and during the trial was quantified using the kappa statistic. Results The mean annualized non-cavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically non-significant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. Conclusions There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non-cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non-cavitated lesion assessment in this full scale, placebo controlled, multi site, randomized, double blinded clinical trial in adults experiencing dental caries, did not achieve added trial efficiency or demonstrate practical benefit of xylitol. Trial Registration ClinicalTrials.Gov NCT00393055 PMID:24205951

  6. Anti-irritant and anti-inflammatory effects of glycerol and xylitol in sodium lauryl sulphate-induced acute irritation.

    PubMed

    Szél, E; Polyánka, H; Szabó, K; Hartmann, P; Degovics, D; Balázs, B; Németh, I B; Korponyai, C; Csányi, E; Kaszaki, J; Dikstein, S; Nagy, K; Kemény, L; Erős, G

    2015-12-01

    Glycerol is known to possess anti-irritant and hydrating properties and previous studies suggested that xylitol may also have similar effects. Our aim was to study whether different concentrations of these polyols restore skin barrier function and soothe inflammation in sodium lauryl sulphate (SLS)-induced acute irritation. The experiments were performed on male SKH-1 hairless mice. The skin of the dorsal region was exposed to SLS (5%) for 3 h alone or together with 5% or 10% of glycerol respectively. Further two groups received xylitol solutions (8.26% and 16.52% respectively) using the same osmolarities, which were equivalent to those of the glycerol treatments. The control group was treated with purified water. Transepidermal water loss (TEWL) and skin hydration were determined. Microcirculatory parameters of inflammation were observed by means of intravital videomicroscopy (IVM). Furthermore, accumulation of neutrophil granulocytes and lymphocytes, the expression of inflammatory cytokines and SLS penetration were assessed, as well. Treatment with the 10% of glycerol and both concentrations of xylitol inhibited the SLS-induced elevation of TEWL and moderated the irritant-induced increase in dermal blood flow and in the number of leucocyte-endothelial interactions. All concentrations of the applied polyols improved hydration and prevented the accumulation of lymphocytes near the treatment site. At the mRNA level, neither glycerol nor xylitol influenced the expression of interleukin-1 alpha. However, expression of interleukin-1 beta was significantly decreased by the 10% glycerol treatment, while expression of tumour necrosis factor-alpha decreased upon the same treatment, as well as in response to xylitol. Higher polyol treatments decreased the SLS penetration to the deeper layers of the stratum corneum. Both of the analysed polyols exert considerable anti-irritant and anti-inflammatory properties, but the effective concentration of xylitol is lower than that of

  7. Pediatric Sepsis.

    PubMed

    Prusakowski, Melanie K; Chen, Audrey P

    2017-02-01

    Pediatric sepsis is distinct from adult sepsis in its definitions, clinical presentations, and management. Recognition of pediatric sepsis is complicated by the various pediatric-specific comorbidities that contribute to its mortality and the age- and development-specific vital sign and clinical parameters that obscure its recognition. This article outlines the clinical presentation and management of sepsis in neonates, infants, and children, and highlights some key populations who require specialized care. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Comparing the xylose reductase/xylitol dehydrogenase and xylose isomerase pathways in arabinose and xylose fermenting Saccharomyces cerevisiae strains

    PubMed Central

    Bettiga, Maurizio; Hahn-Hägerdal, Bärbel; Gorwa-Grauslund, Marie F

    2008-01-01

    Background Ethanolic fermentation of lignocellulosic biomass is a sustainable option for the production of bioethanol. This process would greatly benefit from recombinant Saccharomyces cerevisiae strains also able to ferment, besides the hexose sugar fraction, the pentose sugars, arabinose and xylose. Different pathways can be introduced in S. cerevisiae to provide arabinose and xylose utilisation. In this study, the bacterial arabinose isomerase pathway was combined with two different xylose utilisation pathways: the xylose reductase/xylitol dehydrogenase and xylose isomerase pathways, respectively, in genetically identical strains. The strains were compared with respect to aerobic growth in arabinose and xylose batch culture and in anaerobic batch fermentation of a mixture of glucose, arabinose and xylose. Results The specific aerobic arabinose growth rate was identical, 0.03 h-1, for the xylose reductase/xylitol dehydrogenase and xylose isomerase strain. The xylose reductase/xylitol dehydrogenase strain displayed higher aerobic growth rate on xylose, 0.14 h-1, and higher specific xylose consumption rate in anaerobic batch fermentation, 0.09 g (g cells)-1 h-1 than the xylose isomerase strain, which only reached 0.03 h-1 and 0.02 g (g cells)-1h-1, respectively. Whereas the xylose reductase/xylitol dehydrogenase strain produced higher ethanol yield on total sugars, 0.23 g g-1 compared with 0.18 g g-1 for the xylose isomerase strain, the xylose isomerase strain achieved higher ethanol yield on consumed sugars, 0.41 g g-1 compared with 0.32 g g-1 for the xylose reductase/xylitol dehydrogenase strain. Anaerobic fermentation of a mixture of glucose, arabinose and xylose resulted in higher final ethanol concentration, 14.7 g l-1 for the xylose reductase/xylitol dehydrogenase strain compared with 11.8 g l-1 for the xylose isomerase strain, and in higher specific ethanol productivity, 0.024 g (g cells)-1 h-1 compared with 0.01 g (g cells)-1 h-1 for the xylose reductase/xylitol

  9. Pediatric emergencies.

    PubMed

    Ryan, Erin

    2015-03-01

    It is important that pediatric critical care nurses possess a thorough understanding of their patient and be able to provide exceptional care, especially during emergent situations in the operating room. This care is accomplished by assessing the pediatric patient, dosing medications accurately and effectively, and performing effective Pediatric Advanced Life Support. Pediatric patients present with unique anatomy, physiology, and pathophysiology. Emergencies are reviewed according to organ system, with a focus on definition, presentation, pathophysiology, management, and special considerations. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Metabolic responses in Candida tropicalis to complex inhibitors during xylitol bioconversion.

    PubMed

    Wang, Shizeng; Li, Hao; Fan, Xiaoguang; Zhang, Jingkun; Tang, Pingwah; Yuan, Qipeng

    2015-09-01

    During xylitol fermentation, Candida tropicalis is often inhibited by inhibitors in hemicellulose hydrolysate. The mechanisms involved in the metabolic responses to inhibitor stress and the resistances to inhibitors are still not clear. To understand the inhibition mechanisms and the metabolic responses to inhibitors, a GC/MS-based metabolomics approach was performed on C. tropicalis treated with and without complex inhibitors (CI, including furfural, phenol and acetic acid). Partial least squares discriminant analysis was used to determine the metabolic variability between CI-treated groups and control groups, and 25 metabolites were identified as possible entities responsible for the discrimination caused by inhibitors. We found that xylose uptake rate and xylitol oxidation rate were promoted by CI treatment. Metabolomics analysis showed that the flux from xylulose to pentose phosphate pathway increased, and tricarboxylic acid cycle was disturbed by CI. Moreover, the changes in levels of 1,3-propanediol, trehalose, saturated fatty acids and amino acids showed different mechanisms involved in metabolic responses to inhibitor stress. The increase of 1,3-propanediol was considered to be correlated with regulating redox balance and osmoregulation. The increase of trehalose might play a role in protein stabilization and cellular membranes protection. Saturated fatty acids could cause the decrease of membrane fluidity and make the plasma membrane rigid to maintain the integrity of plasma membrane. The deeper understanding of the inhibition mechanisms and the metabolic responses to inhibitors will provide us with more information on the metabolism regulation during xylitol bioconversion and the construction of industrial strains with inhibitor tolerance for better utilization of bioresource. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Optimization of CDT-1 and XYL1 Expression for Balanced Co-Production of Ethanol and Xylitol from Cellobiose and Xylose by Engineered Saccharomyces cerevisiae

    PubMed Central

    Zha, Jian; Li, Bing-Zhi; Shen, Ming-Hua; Hu, Meng-Long; Song, Hao; Yuan, Ying-Jin

    2013-01-01

    Production of ethanol and xylitol from lignocellulosic hydrolysates is an alternative to the traditional production of ethanol in utilizing biomass. However, the conversion efficiency of xylose to xylitol is restricted by glucose repression, causing a low xylitol titer. To this end, we cloned genes CDT-1 (encoding a cellodextrin transporter) and gh1-1 (encoding an intracellular β-glucosidase) from Neurospora crassa and XYL1 (encoding a xylose reductase that converts xylose into xylitol) from Scheffersomyces stipitis into Saccharomyces cerevisiae, enabling simultaneous production of ethanol and xylitol from a mixture of cellobiose and xylose (main components of lignocellulosic hydrolysates). We further optimized the expression levels of CDT-1 and XYL1 by manipulating their promoters and copy-numbers, and constructed an engineered S. cerevisiae strain (carrying one copy of PGK1p-CDT1 and two copies of TDH3p-XYL1), which showed an 85.7% increase in xylitol production from the mixture of cellobiose and xylose than that from the mixture of glucose and xylose. Thus, we achieved a balanced co-fermentation of cellobiose (0.165 g/L/h) and xylose (0.162 g/L/h) at similar rates to co-produce ethanol (0.36 g/g) and xylitol (1.00 g/g). PMID:23844185

  12. Role of polyols (erythritol, xylitol and sorbitol) on the structural stabilization of collagen

    NASA Astrophysics Data System (ADS)

    Usha, R.; Raman, S. Sundar; Subramanian, V.; Ramasami, T.

    2006-10-01

    The effect of erythritol, xylitol and sorbitol on monomeric collagen solution was evaluated with melting temperature, fluorescence studies, conformational stability and binding energy. The emission intensity and the melting temperature increase as the chain length of polyols increases. Circular dichroism (CD) results indicate the possibility of aggregation of collagen in the presence of polyols. The interaction between collagen and polyols were calculated using binding energy, RMS deviation with collagen like models. Molecular mechanics calculations suggest that polyols bind well with collagen models, that have serine in the X position. The stability of collagen decreases as the number of carbon atoms present in the polyols increases.

  13. Ultrasonic speed, densities and viscosities of xylitol in water and in aqueous tyrosine and phenylalanine solutions at different temperatures

    NASA Astrophysics Data System (ADS)

    Ali, A.; Bidhuri, P.; Uzair, S.

    2014-07-01

    Ultrasonic speed u, densities ρ and viscosities η of xylitol in water and in 0.001 m aqueous l-tyrosine (Tyr) and l-phenylalanine (Phe) have been measured at different temperatures. From the density and ultrasonic speed measurements apparent molar isentropic compression κ_{φ}, apparent molar isentropic compressions at infinite dilution κ_{{S,φ}}0 , experimental slope S K , hydration number n H , transfer partial molar isentropic compressibility Δ_{tr} κ_{{S,φ}}0 of xylitol from water to aqueous Tyr and Phe have been obtained. From the viscosity data, B-coefficient and B-coefficient of transfer Δ tr B of xylitol from water to aqueous Phe and Tyr at different temperatures have also been estimated. Gibbs free energies of activation of viscous flow per mole of solvent Δ μ 1 0# and per mole of solute Δ μ 2 0# have been calculated by using Feakins transition state theory for the studied systems. The calculated parameters have been interpreted in terms of solute-solute and solute-solvent interactions and hydration behavior of xylitol.

  14. Changing flux of xylose metabolites by altering expression of xylose reductase and xylitol dehydrogenase in recombinant Saccharomyces cerevisiae

    Treesearch

    Yong-Su Jin; Thomas W. Jeffries

    2003-01-01

    We changed the fluxes of xylose metabolites in recombinant Saccharomyces cerevisiae by manipulating expression of Pichia stipitis genes(XYL1 and XYL2) coding for xylose reductase (XR) and xylitol dehydrogenase (XDH), respectively. XYL1 copy number was kept constant by integrating it into the chromosome. Copy numbers of XYL2 were varied either by integrating XYL2 into...

  15. 3,6-Anhydro-l-galactose, a rare sugar from agar, a new anticariogenic sugar to replace xylitol.

    PubMed

    Yun, Eun Ju; Lee, Ah Reum; Kim, Jung Hyun; Cho, Kyung Mun; Kim, Kyoung Heon

    2017-04-15

    The significance for anticariogenic sugar substitutes is growing due to increasing demands for dietary sugars and rising concerns of dental caries. Xylitol is widely used as an anticariogenic sugar substitute, but the inhibitory effects of xylitol on Streptococcus mutans, the main cause of tooth decay, are exhibited only at high concentrations. Here, the inhibitory effects of 3,6-anhydro-l-galactose (AHG), a rare sugar from red macroalgae, were evaluated on S. mutans, in comparison with those of xylitol. In the presence of 5g/l of AHG, the growth of S. mutans was retarded. At 10g/l of AHG, the growth and acid production by S. mutans were completely inhibited. However, in the presence of xylitol, at a much higher concentration (i.e., 40g/l), the growth of S. mutans still occurred. These results suggest that AHG can be used as a new anticariogenic sugar substitute for preventing dental caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Will Parents Participate in and Comply with Programs and Regimens Using Xylitol for Preventing Acute Otitis Media in Their Children?

    ERIC Educational Resources Information Center

    Danhauer, Jeffrey L.; Johnson, Carole E.; Baker, Jason A.; Ryu, Jung A.; Smith, Rachel A.; Umeda, Claire J.

    2015-01-01

    Purpose: Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen…

  17. Modeling and simulation of xylitol production in bioreactor by Debaryomyces nepalensis NCYC 3413 using unstructured and artificial neural network models.

    PubMed

    Pappu, J Sharon Mano; Gummadi, Sathyanarayana N

    2016-11-01

    This study examines the use of unstructured kinetic model and artificial neural networks as predictive tools for xylitol production by Debaryomyces nepalensis NCYC 3413 in bioreactor. An unstructured kinetic model was proposed in order to assess the influence of pH (4, 5 and 6), temperature (25°C, 30°C and 35°C) and volumetric oxygen transfer coefficient kLa (0.14h(-1), 0.28h(-1) and 0.56h(-1)) on growth and xylitol production. A feed-forward back-propagation artificial neural network (ANN) has been developed to investigate the effect of process condition on xylitol production. ANN configuration of 6-10-3 layers was selected and trained with 339 experimental data points from bioreactor studies. Results showed that simulation and prediction accuracy of ANN was apparently higher when compared to unstructured mechanistic model under varying operational conditions. ANN was found to be an efficient data-driven tool to predict the optimal harvest time in xylitol production. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Management of pediatric uveitis

    PubMed Central

    Wentworth, Bailey A.; Freitas-Neto, Clovis A.

    2014-01-01

    Pediatric uveitis is a topic of special interest not only because of the unique diagnostic and therapeutic challenges but also because of the lifetime burden of vision loss if the problem is not adequately treated, as well as the economic and psychological toll on the family. Often, uveitis in children is discovered as part of a routine eye exam; this silent, insidious inflammation can be difficult to treat and can lead to further complications if not handled skillfully. Corticosteroids have long been the mainstay of therapy; however, the significant associated side effects mandate a corticosteroid-sparing therapeutic regimen in pursuit of remission. In this review, we cover the therapeutic options for pediatric uveitis, specifically focusing on the most common non-infectious varieties, juvenile idiopathic arthritis-associated uveitis and pars planitis. PMID:24991418

  19. Aging of the Johari-Goldstein relaxation in the glass-forming liquids sorbitol and xylitol

    NASA Astrophysics Data System (ADS)

    Yardimci, Hasan; Leheny, Robert L.

    2006-06-01

    Employing frequency-dependent dielectric susceptibility we characterize the aging in two supercooled liquids, sorbitol and xylitol, below their calorimetric glass transition temperatures. In addition to the alpha relaxation that tracks the structural dynamics, the susceptibility of both liquids possesses a secondary Johari-Goldstein relaxation at higher frequencies. Following a quench through the glass transition, the susceptibility slowly approaches the equilibrium behavior. For both liquids, the magnitude of the Johari-Goldstein relaxation displays a dependence on the time since the quench, or aging time, that is quantitatively very similar to the age dependence of the alpha peak frequency. The Johari-Goldstein relaxation time remains constant during aging for sorbitol while it decreases slightly with age for xylitol. Hence, one cannot sensibly assign a fictive temperature to the Johari-Goldstein relaxation. This behavior contrasts with that of liquids lacking distinct Johari-Goldstein peaks for which the excess wing of the alpha peak tracks the main part of the peak during aging, enabling the assignment of a single fictive temperature to the entire spectrum. The aging behavior of the Johari-Goldstein relaxation time further calls into question the possibility that the relaxation time possesses stronger temperature dependence in equilibrium than is observed in the out-of-equilibrium state below the glass transition.

  20. Individual and interaction effects of vanillin and syringaldehyde on the xylitol formation by Candida guilliermondii.

    PubMed

    Cortez, Daniela Vieira; Roberto, Inês Conceição

    2010-03-01

    The effect of lignin degradation products liberated during chemical hydrolysis of lignocellulosic materials on xylose-to-xylitol bioconversion by Candida guilliermondii FTI 20037 was studied. Two aromatic aldehydes (vanillin and syringaldehyde) were selected as model compounds. A two-level factorial design was employed to evaluate the effects of pH (5.5-7.0), cell concentration (1.0-3.0 g l(-1)), vanillin concentration (0-2.0 g l(-1)) and syringaldehyde concentration (0-2.0 g l(-1)) on this bioprocess. The results showed that in the presence of vanillin or syringaldehyde (up to 2.0 g l(-1)) the cell growth was inhibited to different degrees with a complete inhibition of the yeast growth when the mixture of both (at 2.0 g l(-1) each) was added to the fermentation medium. The xylitol yield was not significantly influenced by vanillin, but was strongly reduced by syringaldehyde, which showed a more pronounced inhibitor effect at pH 7.0. The yeast was also able to convert vanillin and syringaldehyde to the corresponding aromatic acids or alcohols and their formation was dependent of the experimental conditions employed. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  1. Xylitol production from xylose mother liquor: a novel strategy that combines the use of recombinant Bacillus subtilis and Candida maltosa

    PubMed Central

    2011-01-01

    Background Xylose mother liquor has high concentrations of xylose (35%-40%) as well as other sugars such as L-arabinose (10%-15%), galactose (8%-10%), glucose (8%-10%), and other minor sugars. Due to the complexity of this mother liquor, further isolation of xylose by simple method is not possible. In China, more than 50,000 metric tons of xylose mother liquor was produced in 2009, and the management of sugars like xylose that present in the low-cost liquor is a problem. Results We designed a novel strategy in which Bacillus subtilis and Candida maltosa were combined and used to convert xylose in this mother liquor to xylitol, a product of higher value. First, the xylose mother liquor was detoxified with the yeast C. maltosa to remove furfural and 5-hydromethylfurfural (HMF), which are inhibitors of B. subtilis growth. The glucose present in the mother liquor was also depleted by this yeast, which was an added advantage because glucose causes carbon catabolite repression in B. subtilis. This detoxification treatment resulted in an inhibitor-free mother liquor, and the C. maltosa cells could be reused as biocatalysts at a later stage to reduce xylose to xylitol. In the second step, a recombinant B. subtilis strain with a disrupted xylose isomerase gene was constructed. The detoxified xylose mother liquor was used as the medium for recombinant B. subtilis cultivation, and this led to L-arabinose depletion and xylose enrichment of the medium. In the third step, the xylose was further reduced to xylitol by C. maltosa cells, and crystallized xylitol was obtained from this yeast transformation medium. C. maltosa transformation of the xylose-enriched medium resulted in xylitol with 4.25 g L-1·h-1 volumetric productivity and 0.85 g xylitol/g xylose specific productivity. Conclusion In this study, we developed a biological method for the purification of xylose from xylose mother liquor and subsequent preparation of xylitol by C. maltosa-mediated biohydrogenation of xylose

  2. Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations.

    PubMed

    Rudmik, Luke; Hoy, Monica; Schlosser, Rodney J; Harvey, Richard J; Welch, Kevin C; Lund, Valerie; Smith, Timothy L

    2013-04-01

    Topical therapies have become an integral component in the management plan for chronic rhinosinusitis (CRS). Several topical therapy strategies have been evaluated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence-based approach for the utilization of topical therapies in the management of CRS. A systematic review of the literature was performed and the guidelines for development of an evidence-based review with recommendations were followed. Study inclusion criteria were: adult population >18 years old; chronic rhinosinusitis (CRS) based on published diagnostic criteria; and clearly defined primary clinical end-point. We focused on reporting higher-quality studies (level 2b or higher), but reported on lower-level studies if the topic contained insufficient evidence. We excluded drug-eluting spacer and stent therapy from this review. This review identified and evaluated the literature on 5 topical therapy strategies for CRS: saline irrigation, topical steroid, topical antibiotic, topical antifungal, and topical alternatives (surfactant, manuka honey, and xylitol irrigations). Based on the available evidence, sinonasal saline irrigation and standard topical nasal steroid therapy are recommended in the topical treatment of CRS. Nonstandard (off-label) topical sinonasal steroid therapies can be an option for managing CRS. The evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using nebulized and spray techniques in routine cases of CRS. There is insufficient clinical research to provide recommendations for alternative therapies or topical antibiotic therapy delivered using other delivery methods (eg, irrigations). © 2013 ARS-AAOA, LLC.

  3. Simulation-based medical education in pediatrics.

    PubMed

    Lopreiato, Joseph O; Sawyer, Taylor

    2015-01-01

    The use of simulation-based medical education (SBME) in pediatrics has grown rapidly over the past 2 decades and is expected to continue to grow. Similar to other instructional formats used in medical education, SBME is an instructional methodology that facilitates learning. Successful use of SBME in pediatrics requires attention to basic educational principles, including the incorporation of clear learning objectives. To facilitate learning during simulation the psychological safety of the participants must be ensured, and when done correctly, SBME is a powerful tool to enhance patient safety in pediatrics. Here we provide an overview of SBME in pediatrics and review key topics in the field. We first review the tools of the trade and examine various types of simulators used in pediatric SBME, including human patient simulators, task trainers, standardized patients, and virtual reality simulation. Then we explore several uses of simulation that have been shown to lead to effective learning, including curriculum integration, feedback and debriefing, deliberate practice, mastery learning, and range of difficulty and clinical variation. Examples of how these practices have been successfully used in pediatrics are provided. Finally, we discuss the future of pediatric SBME. As a community, pediatric simulation educators and researchers have been a leading force in the advancement of simulation in medicine. As the use of SBME in pediatrics expands, we hope this perspective will serve as a guide for those interested in improving the state of pediatric SBME. Published by Elsevier Inc.

  4. Comparative evaluation of the effects of xylitol and sugar-free chewing gums on salivary and dental plaque pH in children.

    PubMed

    Kumar, Shikhar; Sogi, Suma H P; Indushekar, K R

    2013-01-01

    This research paper primarily focuses on the importance of use of xylitol among school children. The purpose of this paper is to evaluate the salivary and dental plaque pH changes after consumption of sugared and sugar-free (xylitol) chewing gums in children. A total of 30 school children were selected for this study and were divided into two equal groups and given both chewing gums for the experiment. Children consuming the sugar-free (xylitol) chewing gum showed a marked increase in the pH of saliva and plaque when compared to their counterpart. All these values had a significant difference of P ≤ 0.0001. Xylitol is a safe all-natural sweetener which helps to reduce tooth decay. It plays a unique role in preventive strategies for better health.

  5. Pediatric cataract

    PubMed Central

    Khokhar, Sudarshan Kumar; Pillay, Ganesh; Dhull, Chirakshi; Agarwal, Esha; Mahabir, Manish; Aggarwal, Pulak

    2017-01-01

    Pediatric cataract is a leading cause of childhood blindness. Untreated cataracts in children lead to tremendous social, economical, and emotional burden to the child, family, and society. Blindness related to pediatric cataract can be treated with early identification and appropriate management. Most cases are diagnosed on routine screening whereas some may be diagnosed after the parents have noticed leukocoria or strabismus. Etiology of pediatric cataract is varied and diagnosis of specific etiology aids in prognostication and effective management. Pediatric cataract surgery has evolved over years, and with improving knowledge of myopic shift and axial length growth, outcomes of these patients have become more predictable. Favorable outcomes depend not only on effective surgery, but also on meticulous postoperative care and visual rehabilitation. Hence, it is the combined effort of parents, surgeons, anesthesiologists, pediatricians, and optometrists that can make all the difference. PMID:29208814

  6. Pediatric Specialists

    MedlinePlus

    ... this site from a secured browser on the server. Please enable scripts and reload this page. Turn ... for Referral to Pediatric Surgical Specialists Sports Medicine Professionals What is a Child Abuse Pediatrician? What is ...

  7. Pediatric Asthma

    MedlinePlus

    ... Asthma (Pediatric) Find a Doctor Appointments & Questions Patient Education & Support Visiting Us Tests & Procedures Ways to Give National Jewish Health ... Programs Health Information Doctors & Departments Clinical Research & ... Training Contact Us Make a Donation Make an Appointment Patient Portal ...

  8. Pediatric MS

    MedlinePlus

    ... Disease T Cells d What Causes MS? Disproved Theories Viruses Clusters d Who Gets MS? Pediatric MS ... Community at MSconnection.org Join a Local Support Group Peer Connections: One-on-One Edward M. Dowd ...

  9. Pediatric Terminology

    Cancer.gov

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  10. Pediatric Anthropometry

    NASA Astrophysics Data System (ADS)

    Klinich, Kathleen D.; Reed, Matthew P.

    Anthropometry is the measurement of human size, shape, and physical capabilities. Most pediatric anthropometry data are gathered to describe child growth patterns, but data on body size, mass distribution, range of motion, and posture are used to develop crash test dummies and computational models of child occupants. Pediatric anthropometry data are also used to determine child restraint dimensions, so they will accommodate the applicable population of child occupants.

  11. Pediatric Ureteroscopy.

    PubMed

    Ost, Michael C; Fox, Patrick J

    2018-05-01

    In recent years, the incidence of nephrolithiasis in the pediatric population appears to be increasing. 1 This has placed a new emphasis on surgical management of stones in children. In the past, extracorporeal shockwave lithotripsy was the preferred management technique for stones in children. 2 More recently, though, advances in endoscopy have allowed ureteroscopy to be adapted to the pediatric population and this approach has become more frequently utilized not just for lower ureteral calculi but also for proximal ureteral and renal stones.

  12. EFFECTS OF SHORT-TERM USE OF XYLITOL CHEWING GUM AND MOLTITOL ORAL SPRAY ON SALIVARY STREPTOCOCCUS MUTANS AND ORAL PLAQUE.

    PubMed

    Mitrakul, Kemthong; Srisatjaluk, Ratchapin; Vongsawan, Kutkao; Teerawongpairoj, Chayanid; Choongphong, Nachata; Panich, Tathata; Kaewvimonrat, Pravee

    2017-03-01

    The purpose of this study was to investigate the short-term effects of xylitol chewing gum and maltitol spray on the concentration of salivary mutans streptococci (MS) and on the plaque index. Eighty-one second, third and fourth year dental and dental assistant students with a salivary MS concentration > 103 CFU/ml cultured on mitis salivarius bacitracin (MSB) agar were included in the study. The age range of subjects was 18-23 years. The participants were divided into 3 groups: control, xylitol chewing gum and maltitol spray groups. Each subject brushed their teeth with fluoridated toothpaste (1,000 ppm). Each subject in the xylitol chewing gum group was told to chew 2 pieces, 6 times a day (total xylitol dose=7.3 g/day) for 4 weeks. Each subject in the maltitol spray group was told to spray one puff twice daily (morning and evening) for 4 weeks. A dental examination and saliva samples to determine the salivary MS concentration were collected at baseline and at 2 and 4 weeks after experiment initiation. The nonparametric Mann–Whitney U test was used to analyze differences among groups. The mean ages in the control, xylitol chewing gum and maltitol spray groups were 22±1, 20±1 and 20±1 years, respectively. The mean MS concentrations at the beginning of the study and after 2 weeks in the control, and xylitol chewing gum and moltitol oral spray groups were not significantly different from each other. There was a significantly lower MS concentration in the moltitol oral spray group than in the control group by 4 weeks (p=0.045) but no significant difference between the control group and the xylitol gum group by 4 weeks. There were no significant differences in the mean plaque index at baseline among the control group, the xylitol chewing gum group and the moltitol oral spray group. The plaque index was significantly lower in the xylitol chewing gum group than the control group (p=0.003) at 2 weeks but not 4 weeks. There was no significant difference in the mean

  13. Pediatric Sepsis

    PubMed Central

    Mathias, Brittany; Mira, Juan; Larson, Shawn D.

    2016-01-01

    Purpose of Review Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72,000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. Recent Findings The definition of pediatric sepsis is currently in a state of evolution and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated. Summary Current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become commonplace. PMID:26983000

  14. Pediatric sepsis.

    PubMed

    Mathias, Brittany; Mira, Juan C; Larson, Shawn D

    2016-06-01

    Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72 000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. The definition of pediatric sepsis is currently in a state of evolution, and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated. The current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become a commonplace.

  15. Teaching pediatric laboratory medicine to pathology residents.

    PubMed

    Pysher, Theodore J; Bach, Philip R; Geaghan, Sharon M; Hamilton, Marilyn S; Laposata, Michael; Lockitch, Gillian; Brugnara, Carlo; Coffin, Cheryl M; Pasquali, Marzia; Rinaldo, Piero; Roberts, William L; Rutledge, Joe C; Ashwood, Edward R; Blaylock, Robert C; Campos, Joseph M; Goldsmith, Barbara; Jones, Patricia M; Lim, Megan; Meikle, A Wayne; Perkins, Sherrie L; Perry, Deborah A; Petti, Cathy A; Rogers, Beverly B; Steele, Paul E; Weiss, Ronald L; Woods, Gail

    2006-07-01

    Laboratory data are essential to the medical care of fetuses, infants, children, and adolescents. However, the performance and interpretation of laboratory tests on specimens from these patients, which may constitute a significant component of the workload in general hospitals and integrated health care systems as well as specialized perinatal or pediatric centers, present unique challenges to the clinical pathologist and the laboratory. Therefore, pathology residents should receive training in pediatric laboratory medicine. Children's Health Improvement through Laboratory Diagnostics, a group of pathologists and laboratory scientists with interest and expertise in pediatric laboratory medicine, convened a task force to develop a list of curriculum topics, key resources, and training experiences in pediatric laboratory medicine for trainees in anatomic and clinical pathology or straight clinical pathology residency programs and in pediatric pathology fellowship programs. Based on the experiences of 11 training programs, we have compiled a comprehensive list of pediatric topics in the areas of clinical chemistry, endocrinology, hematology, urinalysis, coagulation medicine, transfusion medicine, immunology, microbiology and virology, biochemical genetics, cytogenetics and molecular diagnostics, point of care testing, and laboratory management. This report also includes recommendations for training experiences and a list of key texts and other resources in pediatric laboratory medicine. Clinical pathologists should be trained to meet the laboratory medicine needs of pediatric patients and to assist the clinicians caring for these patients with the selection and interpretation of laboratory studies. This review helps program directors tailor their curricula to more effectively provide this training.

  16. Virtual Pediatric Hospital

    MedlinePlus

    ... Assistant™ Last revised on February 22, 2017 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  17. Pediatric sleep apnea

    MedlinePlus

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  18. Topical brinzolamide for foveal schisis in juvenile retinoschisis.

    PubMed

    Yang, Francine P; Willyasti, Katharina; Leo, Seo Wei

    2013-04-01

    We describe a case series of 4 consecutive patients diagnosed with X-linked retinoschisis seen at a pediatric ophthalmology clinic during a 3-year period. All patients were treated with topical brinzolamide; 3 patients experienced significantly decreased severity of macular cysts on OCT in at least one eye. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  19. Milia en plaque of the nose: report of a case and successful treatment with topical tretinoin.

    PubMed

    Nambudiri, Vinod E; Habib, Nancy; Arndt, Kenneth A; Kane, Kay S

    2014-05-01

    Milia are benign, superficial keratinaceous cysts that present as fine, small white papules. Milia en plaque is a rare, challenging-to-treat variant most often seen in the posterior auricular region. A total of 9 cases of milia en plaque have been reported in the pediatric literature to date. We report a case of milia en plaque of the nose in a 7-year-old boy, a novel site of involvement in the pediatric population, and successful treatment with the use of topical tretinoin. Topical retinoids offer an effective treatment option for the management of milia en plaque in the pediatric population. Copyright © 2014 by the American Academy of Pediatrics.

  20. D-Xylose fermentation, xylitol production and xylanase activities by seven new species of Sugiyamaella.

    PubMed

    Sena, Letícia M F; Morais, Camila G; Lopes, Mariana R; Santos, Renata O; Uetanabaro, Ana P T; Morais, Paula B; Vital, Marcos J S; de Morais, Marcos A; Lachance, Marc-André; Rosa, Carlos A

    2017-01-01

    Sixteen yeast isolates identified as belonging to the genus Sugiyamaella were studied in relation to D-xylose fermentation, xylitol production, and xylanase activities. The yeasts were recovered from rotting wood and sugarcane bagasse samples in different Brazilian regions. Sequence analyses of the internal transcribed spacer (ITS) region and the D1/D2 domains of large subunit rRNA gene showed that these isolates belong to seven new species. The species are described here as Sugiyamaella ayubii f.a., sp. nov. (UFMG-CM-Y607 T  = CBS 14108 T ), Sugiyamaella bahiana f.a., sp. nov. (UFMG-CM-Y304 T  = CBS 13474 T ), Sugiyamaella bonitensis f.a., sp. nov. (UFMG-CM-Y608 T  = CBS 14270 T ), Sugiyamaella carassensis f.a., sp. nov. (UFMG-CM-Y606 T  = CBS 14107 T ), Sugiyamaella ligni f.a., sp. nov. (UFMG-CM-Y295 T  = CBS 13482 T ), Sugiyamaella valenteae f.a., sp. nov. (UFMG-CM-Y609 T  = CBS 14109 T ) and Sugiyamaella xylolytica f.a., sp. nov. (UFMG-CM-Y348 T  = CBS 13493 T ). Strains of the described species S. boreocaroliniensis, S. lignohabitans, S. novakii and S. xylanicola, isolated from rotting wood of Brazilian ecosystems, were also compared for traits relevant to xylose metabolism. S. valenteae sp. nov., S. xylolytica sp. nov., S. bahiana sp. nov., S. bonitensis sp. nov., S. boreocarolinensis, S. lignohabitans and S. xylanicola were able to ferment D-xylose to ethanol. Xylitol production was observed for all Sugiyamaella species studied, except for S. ayubii sp. nov. All species studied showed xylanolytic activity, with S. xylanicola, S. lignohabitans and S. valenteae sp. nov. having the highest values. Our results suggest these Sugiyamaella species have good potential for biotechnological applications.

  1. Engineering a synthetic anaerobic respiration for reduction of xylose to xylitol using NADH output of glucose catabolism by Escherichia coli AI21.

    PubMed

    Iverson, Andrew; Garza, Erin; Manow, Ryan; Wang, Jinhua; Gao, Yuanyuan; Grayburn, Scott; Zhou, Shengde

    2016-04-16

    Anaerobic rather than aerobic fermentation is preferred for conversion of biomass derived sugars to high value redox-neutral and reduced commodities. This will likely result in a higher yield of substrate to product conversion and decrease production cost since substrate often accounts for a significant portion of the overall cost. To this goal, metabolic pathway engineering has been used to optimize substrate carbon flow to target products. This approach works well for the production of redox neutral products such as lactic acid from redox neutral sugars using the reducing power NADH (nicotinamide adenine dinucleotide, reduced) generated from glycolysis (2 NADH per glucose equivalent). Nevertheless, greater than two NADH per glucose catabolized is needed for the production of reduced products (such as xylitol) from redox neutral sugars by anaerobic fermentation. The Escherichia coli strain AI05 (ΔfrdBC ΔldhA ΔackA Δ(focA-pflB) ΔadhE ΔptsG ΔpdhR::pflBp 6-(aceEF-lpd)), previously engineered for reduction of xylose to xylitol using reducing power (NADH equivalent) of glucose catabolism, was further engineered by 1) deleting xylAB operon (encoding for xylose isomerase and xylulokinase) to prevent xylose from entering the pentose phosphate pathway; 2) anaerobically expressing the sdhCDAB-sucABCD operon (encoding for succinate dehydrogenase, α-ketoglutarate dehydrogenase and succinyl-CoA synthetase) to enable an anaerobically functional tricarboxcylic acid cycle with a theoretical 10 NAD(P)H equivalent per glucose catabolized. These reducing equivalents can be oxidized by synthetic respiration via xylose reduction, producing xylitol. The resulting strain, AI21 (pAI02), achieved a 96 % xylose to xylitol conversion, with a yield of 6 xylitol per glucose catabolized (molar yield of xylitol per glucose consumed (YRPG) = 6). This represents a 33 % improvement in xylose to xylitol conversion, and a 63 % increase in xylitol yield per glucose catabolized over

  2. Pediatric sepsis

    PubMed Central

    Randolph, Adrienne G; McCulloh, Russell J

    2014-01-01

    Sepsis is the leading cause of death in children worldwide. Although the diagnosis and management of sepsis in infants and children is largely influenced by studies done in adults, there are important considerations relevant for pediatrics. This article highlights pediatric-specific issues related to the definition of sepsis and its epidemiology and management. We review how the capacity of the immune system to respond to infection develops over early life. We also bring attention to primary immune deficiencies that should be considered in children recurrently infected with specific types of organisms. The management of pediatric sepsis must be tailored to the child’s age and immune capacity, and to the site, severity, and source of the infection. It is important for clinicians to be aware of infection-related syndromes that primarily affect children. Although children in developed countries are more likely to survive severe infections than adults, many survivors have chronic health impairments. PMID:24225404

  3. Cardiopulmonary bypass for pediatric cardiac surgery.

    PubMed

    Hirata, Yasutaka

    2018-02-01

    The management of cardiopulmonary bypass for pediatric cardiac surgery is more challenging than that in adults due to the smaller size, immaturity, and complexity of the anatomy in children. Despite major improvements in cardiopulmonary bypass, there remain many subjects of debate. This review article discusses the physiology of cardiopulmonary bypass for pediatric and congenital heart surgery, including topics related to hemodilution, hypothermia, acid-base strategies, inflammatory response, and myocardial protection.

  4. Pediatric keratoplasty.

    PubMed

    Vanathi, M; Panda, Anita; Vengayil, Sujith; Chaudhuri, Zia; Dada, Tanuj

    2009-01-01

    Penetrating keratoplasty in children is a highly challenging and demanding procedure associated with a high risk of graft failure or failure of amblyopia therapy in clear grafts. Nonetheless, keratoplasty remains the surgery of choice for the management of pediatric corneal stromal opacities or edema. Allograft rejection, graft infection, corneal neovascularization, glaucoma, trauma to the anterior segment, vitreous pathology, and additional surgical interventions, especially those related to glaucoma management, are important risk factors. Successful penetrating keratoplasty in children requires careful preoperative evaluation and selection of patients follow-up by well-motivated parents, an expert corneal transplant surgeon, and a devoted pediatric ophthalmologist.

  5. Ethics and the pediatric surgeon.

    PubMed

    Fallat, Mary E; Caniano, Donna A; Fecteau, Annie H

    2007-01-01

    Care of infants and children with life-impairing or life-threatening congenital and acquired disorders often raises ethical concerns for pediatric surgeons. The purpose of this survey was to determine the level of interest in clinical ethics and how respondents would manage ethical dilemmas within several clinical case scenarios. A 12-item validated questionnaire developed by the Ethics and Advocacy Committee was provided for the American Pediatric Surgical Association (APSA; www.eapsa.org) members on the organizational website. General categories of questions included informed consent, patient privacy, and what constitutes research. The survey was completed by 235 of the 825 APSA members; a response rate of 28.4%. The majority (62%) were in academic practice, 22% had additional education or an advanced degree in ethics, and 11% were members of a hospital ethics committee. There was a clear majority response for seven questions. Topics generating the most controversy included the impact of consent by minors, decision making in the neurologically devastated child, what constitutes research in pediatric surgery, the use of interpreters for consent, and patient privacy. Respondents chose a well-referenced manuscript as the preferred modality for ethics education of the APSA members. Pediatric surgeons have a general interest in clinical ethics as it relates to the care of their patients. An important mission of the Ethics and Advocacy Committee can be to provide education that gives guidance and knowledge to the members of APSA on timely topics in surgical ethics.

  6. Deoxycholate-hydrogels: novel drug carrier systems for topical use.

    PubMed

    Valenta, C; Nowack, E; Bernkop-Schnürch, A

    1999-08-05

    Na-deoxycholate (Na-DOC) forms a viscous thixotropic gel when in contact with excess buffer systems. The resulting gels have been tested as novel drug carrier systems for topical use. The influence of differing amounts of mannitol, glycerol and xylitol on the viscous modulus (G"/Pa) was evaluated by oscillatory measurements. Na-DOC (0.5%) in phosphate buffered saline (PBS) with 5% mannitol was chosen as an optimised formulation, taking into account viscosity, distribution and appearance. The release rate of the model drug rutin through an artificial membrane was higher than those from hydroxyethylcellulose- (HEC) and sodium polyacrylate (NaC934)-gels; permeation through excised rat skin was also highest for the Na-DOC systems. The results indicate that Na-DOC significantly increases the membrane permeability. The microbial stability was in the same range as HEC- and NaC934-gels, making a preservation necessary. Na-DOC-gels are novel low molecular weight, multifunctional drug carriers, which also act as penetration enhancers. Their thixotropy is an additional advantage for better application to large skin areas, nasal, vaginal and buccal membranes. Therefore, Na-DOC-gels can be considered promising, alternative drug carrier systems for topical pharmaceutical as well as cosmetic use.

  7. Fermentation Kinetics for Xylitol Production by a Pichia stipitis d-Xylulokinase Mutant Previously Grown in Spent Sulfite Liquor

    NASA Astrophysics Data System (ADS)

    Rodrigues, Rita C. L. B.; Lu, Chenfeng; Lin, Bernice; Jeffries, Thomas W.

    Spent sulfite pulping liquor (SSL) contains lignin, which is present as lignosulfonate, and hemicelluloses that are present as hydrolyzed carbohydrates. To reduce the biological oxygen demand of SSL associated with dissolved sugars, we studied the capacity of Pichia stipitis FPL-YS30 (xyl3Δ) to convert these sugars into useful products. FPL-YS30 produces a negligible amount of ethanol while converting xylose into xylitol. This work describes the xylose fermentation kinetics of yeast strain P.stipitis FPL-YS30. Yeast was grown in rich medium supplemented with different carbon sources: glucose, xylose, or ammonia-base SSL. The SSL and glucose-acclimatized cells showed similar maximum specific growth rates (0.146 h-1). The highest xylose consumption at the beginning of the fermentation process occurred using cells precultivated in xylose, which showed relatively high specific activity of glucose-6-phosphate dehydrogenase (EC 1.1.1.49). However, the maximum specific rates of xylose consumption (0.19 gxylose/gcel h) and xylitol production (0.059 gxylitol/gcel h) were obtained with cells acclimatized in glucose, in which the ratio between xylose reductase (EC 1.1.1.21) and xylitol dehydrogenase (EC 1.1.1.9) was kept at higher level (0.82). In this case, xylitol production (31.6 g/l) was 19 and 8% higher than in SSL and xylose-acclimatized cells, respectively. Maximum glycerol (6.26 g/l) and arabitol (0.206 g/l) production were obtained using SSL and xylose-acclimatized cells, respectively. The medium composition used for the yeast precultivation directly reflected their xylose fermentation performance. The SSL could be used as a carbon source for cell production. However, the inoculum condition to obtain a high cell concentration in SSL needs to be optimized.

  8. Streptococcus mutans forms xylitol-resistant biofilm on excess adhesive flash in novel ex-vivo orthodontic bracket model.

    PubMed

    Ho, Cindy S F; Ming, Yue; Foong, Kelvin W C; Rosa, Vinicius; Thuyen, Truong; Seneviratne, Chaminda J

    2017-04-01

    During orthodontic bonding procedures, excess adhesive is invariably left on the tooth surface at the interface between the bracket and the enamel junction; it is called excess adhesive flash (EAF). We comparatively evaluated the biofilm formation of Streptococcus mutans on EAF produced by 2 adhesives and examined the therapeutic efficacy of xylitol on S mutans formed on EAF. First, we investigated the biofilm formation of S mutans on 3 orthodontic bracket types: stainless steel preadjusted edgewise, ceramic preadjusted edgewise, and stainless steel self-ligating. Subsequently, tooth-colored Transbond XT (3M Unitek, Monrovia, Calif) and green Grengloo (Ormco, Glendora, Calif) adhesives were used for bonding ceramic brackets to extracted teeth. S mutans biofilms on EAF produced by the adhesives were studied using the crystal violet assay and scanning electron microscopy. Surface roughness and surface energy of the EAF were examined. The therapeutic efficacies of different concentrations of xylitol were tested on S mutans biofilms. Significantly higher biofilms were formed on the ceramic preadjusted edgewise brackets (P = 0.003). Transbond XT had significantly higher S mutans biofilms compared with Grengloo surfaces (P = 0.007). There was no significant difference in surface roughness between Transbond XT and Grengloo surfaces (P >0.05). Surface energy of Transbond XT had a considerably smaller contact angle than did Grengloo, suggesting that Transbond XT is a more hydrophilic material. Xylitol at low concentrations had no significant effect on the reduction of S mutans biofilms on orthodontic adhesives (P = 0.016). Transbond XT orthodontic adhesive resulted in more S mutans biofilm compared with Grengloo adhesive on ceramic brackets. Surface energy seemed to play a more important role than surface roughness for the formation of S mutans biofilm on EAF. Xylitol does not appear to have a therapeutic effect on mature S mutans biofilm. Copyright © 2017 American

  9. Regulatory Information By Topic

    EPA Pesticide Factsheets

    EPA develops and enforces regulations that span many environmental topics, from acid rain reduction to wetlands restoration. Each topic listed below may include related laws and regulations, compliance enforcement information, policies guidance

  10. Pediatric Dermatology

    PubMed Central

    McMahon, Patrick

    2017-01-01

    Skin changes are common in children. Common concerns are birthmarks (e.g., hemangiomas and port wine stains), atopic and contact dermatitis, acne, and alopecia areata. The authors review advances in common and not so common skin changes in pediatric patients. PMID:28360970

  11. Pediatric Trichotillomania

    PubMed Central

    Harrison, Julie P.; Franklin, Martin E.

    2012-01-01

    Trichotillomania (TTM) is an impulse control disorder characterized by chronic hair-pulling, distress, and impairment. Although the negative effects of TTM are documented and often readily evident, there remains a paucity of psychopathology and treatment research on this disorder, particularly in pediatric populations. In an effort to improve assessment of pediatric TTM, several TTM-specific instruments for youth have now been developed to reliably identify symptoms and examine related phenomenology. Instrument development has now yielded instruments to evaluate TTM and related symptoms in the context of clinical trials of youth, and the first randomized controlled trial of any treatment for pediatric TTM was recently published. Using the initial pediatric TTM studies as building blocks, future research is now needed to create a stronger body of knowledge about the relative and combined efficacy of potential interventions for TTM in youth, as well as to examine the effects of TTM phenomenology and comorbidity on treatment outcome. Dissemination efforts must also be heightened for this knowledge to best reach these vulnerable populations. PMID:22437627

  12. Ethanol and xylitol production by fermentation of acid hydrolysate from olive pruning with Candida tropicalis NBRC 0618.

    PubMed

    Mateo, Soledad; Puentes, Juan G; Moya, Alberto J; Sánchez, Sebastián

    2015-08-01

    Olive tree pruning biomass has been pretreated with pressurized steam, hydrolysed with hydrochloric acid, conditioned and afterwards fermented using the non-traditional yeast Candida tropicalis NBRC 0618. The main aim of this study was to analyse the influence of acid concentration on the hydrolysis process and its effect on the subsequent fermentation to produce ethanol and xylitol. From the results, it could be deduced that both total sugars and d-glucose recovery were enhanced by increasing the acid concentration tested; almost the whole hemicellulose fraction was hydrolysed when 3.77% was used. It has been observed a sequential production first of ethanol, from d-glucose, and then xylitol from d-xylose. The overall ethanol and xylitol yields ranged from 0.27 to 0.38kgkg(-1), and 0.12 to 0.23kgkg(-1) respectively, reaching the highest values in the fermentation of the hydrolysates obtained with hydrochloric acid 2.61% and 1.11%, respectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Production of xylitol and bio-detoxification of cocoa pod husk hemicellulose hydrolysate by Candida boidinii XM02G

    PubMed Central

    2018-01-01

    The use of cocoa pod husk hemicellulose hydrolysate (CPHHH) was evaluated for the production of xylitol by Candida boidinii XM02G yeast isolated from soil of cocoa-growing areas and decaying bark, as an alternative means of reusing this type of waste. Xylitol was obtained in concentrations of 11.34 g.L-1, corresponding to a yield (Yp/s) of 0.52 g.g-1 with a fermentation efficiency (ε) of 56.6%. The yeast was tolerant to inhibitor compounds present in CPHHH without detoxification in different concentration factors, and was able to tolerate phenolic compounds at approximately 6 g.L-1. The yeast was also able to metabolize more than 99% (p/v) of furfural and hydroxymethylfurfural present in the non-detoxified CPHHH without extension of the cell-growth lag phase, showing the potential of this microorganism for the production of xylitol. The fermentation of cocoa pod husk hydrolysates appears to provide an alternative use which may reduce the impact generated by incorrect disposal of this waste. PMID:29641547

  14. Lignocellulosic sugar management for xylitol and ethanol fermentation with multiple cell recycling by Kluyveromyces marxianus IIPE453.

    PubMed

    Dasgupta, Diptarka; Ghosh, Debashish; Bandhu, Sheetal; Adhikari, Dilip K

    2017-07-01

    Optimum utilization of fermentable sugars from lignocellulosic biomass to deliver multiple products under biorefinery concept has been reported in this work. Alcohol fermentation has been carried out with multiple cell recycling of Kluyveromyces marxianus IIPE453. The yeast utilized xylose-rich fraction from acid and steam treated biomass for cell generation and xylitol production with an average yield of 0.315±0.01g/g while the entire glucose rich saccharified fraction had been fermented to ethanol with high productivity of 0.9±0.08g/L/h. A detailed insight into its genome illustrated the strain's complete set of genes associated with sugar transport and metabolism for high-temperature fermentation. A set flocculation proteins were identified that aided in high cell recovery in successive fermentation cycles to achieve alcohols with high productivity. We have brought biomass derived sugars, yeast cell biomass generation, and ethanol and xylitol fermentation in one platform and validated the overall material balance. 2kg sugarcane bagasse yielded 193.4g yeast cell, and with multiple times cell recycling generated 125.56g xylitol and 289.2g ethanol (366mL). Copyright © 2017 Elsevier GmbH. All rights reserved.

  15. Enhanced anticaries efficacy of a 0.243% sodium fluoride/10% xylitol/silica dentifrice: 3-year clinical results.

    PubMed

    Sintes, J L; Escalante, C; Stewart, B; McCool, J J; Garcia, L; Volpe, A R; Triol, C

    1995-10-01

    To evaluate the efficacy of a sodium fluoride (NaF)/silica/xylitol dentifrice compared with that of a positive control NaF/silica dentifrice on caries increments in school children over a 3-year period in an area without an optimal level of fluoride in the drinking water (mean level <0.1 ppm). A 3-year, double-blind clinical caries study was conducted in 2,630 children initially aged 8-10 years at 17 schools in the San Jose, Costa Rica metropolitan area. Clinical dental examinations were performed at participating schools utilizing portable dental equipment. Caries evaluations employed conventional tactile/visual methodology consisting of artificial light, dental mirrors and single-edge #23 explorers. Children accepted into the study were stratified by age and sex into two balanced groups within each school, and randomly assigned to use either a positive control dentifrice containing 0.243% NaF/silica or a test dentifrice containing 0.234% NaF/silica/10% xylitol. Children were instructed to brush with the assigned dentifrice twice daily. Caries evaluations were conducted at baseline, 2 years, and 3 years. After 3 years, subjects using the 0.234% NaF/silica/10% xylitol dentifrice had statistically significantly reduced decayed/filled surfaces (DFS; -12.3% reduction; P < or = 0.001) and decayed/filled buccal and lingual surfaces (DFS-BL; -10.5% reduction; P < or = 0/01).

  16. Pediatric Oncology Branch - training- resident electives | Center for Cancer Research

    Cancer.gov

    Resident Electives Select pediatric residents may be approved for a 4-week elective rotation at the Pediatric Oncology Branch. This rotation emphasizes the important connection between research and patient care in pediatric oncology. The resident is supervised directly by the Branch’s attending physician and clinical fellows. Residents attend daily in-patient and out-patient rounds, multiple weekly Branch conferences, and are expected to research relevant topics and present a 30-minute talk toward the end of their rotation.

  17. Freshman Health Topics

    ERIC Educational Resources Information Center

    Hovde, Karen

    2011-01-01

    This article examines a cluster of health topics that are frequently selected by students in lower division classes. Topics address issues relating to addictive substances, including alcohol and tobacco, eating disorders, obesity, and dieting. Analysis of the topics examines their interrelationships and organization in the reference literature.…

  18. Citation classics in pediatric orthopaedics.

    PubMed

    Varghese, Ranjit A; Dhawale, Arjun A; Zavaglia, Bogard C; Slobogean, Bronwyn L; Mulpuri, Kishore

    2013-09-01

    The purpose of this study was to identify the clinical pediatric orthopaedic articles with at least 100 citations published in all orthopaedic journals and to examine their characteristics. All journals dedicated to orthopaedics and its subspecialties were selected from the Journal Citation Report 2001 under the subject category "orthopedics." Articles cited 100 times or more were identified using the database of the Science Citation Index Expanded (SCI-EXPANDED, 1900 to present). The articles were ranked in a comprehensive list. Two authors independently reviewed the full text of each article and applied the inclusion and exclusion criteria to the list of articles. The 2 lists were then compared. All disagreements were resolved by consensus with input from the senior author. The final list of pediatric orthopaedic articles was then compiled. There were a total of 49 journals under the search category "orthopedics." Five journals were excluded as they were non-English journals. The remaining 44 journals were screened for articles with at least 100 citations. A total of 135 clinical pediatric orthopaedic articles cited at least 100 times were included. The most cited article was cited 692 times. The mean number of citations per article was 159 (95% confidence interval, 145-173). All the articles were published between 1949 and 2001, with 1980 and 1989 producing the most citation classics (34). The majority (90) originated from the United States, followed by the United Kingdom (12) and Canada (11). Scoliosis/kyphosis was the most common topic with 26 papers. The second most common subject was hip disorders (24). Therapeutic studies were the most common study type (71). Ninety-seven papers were assigned a 4 for level of evidence. The list of citation classics in pediatric orthopaedic articles is useful for several reasons. It identifies important contributions to the field of pediatric orthopaedics and their originators; it facilitates the understanding and discourse

  19. 75 FR 47819 - Workshop on Optimizing Clinical Trial Design for the Development of Pediatric Cardiovascular Devices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ...] Workshop on Optimizing Clinical Trial Design for the Development of Pediatric Cardiovascular Devices AGENCY... (AAP), the American College of Cardiology (ACC), and the Society for Cardiovascular Angiography and... Development of Pediatric Cardiovascular Devices.'' The topic to be discussed is pediatric cardiovascular...

  20. Xylitol as a potential co-crystal co-former for enhancing dissolution rate of felodipine: preparation and evaluation of sublingual tablets.

    PubMed

    Arafa, Mona F; El-Gizawy, Sanaa A; Osman, Mohamed A; El Maghraby, Gamal M

    2018-06-01

    Dissolution enhancement is a promising strategy for improving drug bioavailability. Co-crystallization of drugs with inert material can help in this direction. The benefit will become even greater if the inert material can form co-crystal while maintaining its main function as excipient. Accordingly, the objective of the current study was to investigate xylitol as a potential co-crystal co-former for felodipine with the goal of preparing felodipine sublingual tablets. Co-crystallization was achieved by wet co-grinding of the crystals deposited from methanolic solutions containing felodipine with increasing molar ratios of xylitol (1:1, 1:2 and 1:3). The developed co-crystals were characterized using Fourier transform infrared spectroscopy (FTIR), X-ray diffractometry (XRD), differential scanning calorimetry (DSC) and scanning electron microscopy (SEM) before monitoring drug dissolution. These results reflected the development of new crystalline species depending on the relative proportions of felodipine and xylitol with complete co-crystallization of felodipine being achieved in the presence of double its molar concentration of xylitol. This co-crystal formulation was compressed into sublingual tablet with ultrashort disintegration time with subsequent fast dissolution. Co-crystal formation was associated with enhanced dissolution with the optimum formulation producing the fastest dissolution rate. In conclusion, xylitol can be considered as a co-crystal co-former for enhanced dissolution rate of drugs.

  1. Effect of maternal use of chewing gums containing xylitol on transmission of mutans streptococci in children: a meta-analysis of randomized controlled trials.

    PubMed

    Lin, Hsi-Kuei; Fang, Chia-En; Huang, Mao-Suan; Cheng, Hsin-Chung; Huang, Tsai-Wei; Chang, Hui-Ting; Tam, Ka-Wai

    2016-01-01

    Mutans streptococci (MS) are the major causative bacteria involved in human dental decay. Habitual consumption of xylitol has been proved to reduce MS levels in saliva and plaque. To evaluate the effect of the maternal use of xylitol gum on MS reduction in infants. A structured literature review and meta-analysis. A random effects model was used to assess the relative risks of the incidence of MS in the saliva or plaque of children who were 6, 9, 12, 18, and 24 months old. We reviewed 11 RCTs derived from 5 research teams that included 601 mothers. Our results indicated that the incidence of MS in the saliva or plaque of the infants was significantly reduced in the xylitol group (risk ratio: 0.54; 95% confidence interval: 0.39-0.73, at 12-18 months) and (risk ratio: 0.56; 95% confidence interval: 0.40-0.79, at 36 months) compared with the control groups. The long-term effect of maternal xylitol gum exposure on their children's dental caries was controversial. Habitual xylitol consumption by mothers with high MS levels was associated with a significant reduction in the mother-child transmission of salivary MS. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Improvement on D-xylose to Xylitol Biotransformation by Candida guilliermondii Using Cells Permeabilized with Triton X-100 and Selected Process Conditions.

    PubMed

    Cortez, Daniela Vieira; Mussatto, Solange I; Roberto, Inês Conceição

    2016-11-01

    Cells of Candida guilliermondii permeabilized with Triton X-100 were able to efficiently produce xylitol from a medium composed only by D-xylose and MgCl 2 ·6H 2 O in potassium phosphate buffer, at 35 °C and pH 6.5. Under these conditions, the results were similar to those obtained when cofactor and co-substrate or nutrients were added to the medium (about 95 % D-xylose was assimilated producing 42 g/L of xylitol, corresponding to 0.80 g/g yield and 2.65 g/L h volumetric productivity). Furthermore, the permeabilized cells kept the D-xylose assimilation in about 90 % and the xylitol production in approx. 40 g/L during three bioconversion cycles of 16 h each. These values are highly relevant when compared to others reported in the literature using enzyme technology and fermentative process, thereby demonstrating the effectiveness of the proposed method. The present study reveals that the use of permeabilized cells is an interesting alternative to obtain high xylitol productivity using low cost medium formulation. This approach may allow the future development of xylitol production from xylose present in lignocellulosic biomass, with additional potential for implementation in biorefinery strategies.

  3. Xylitol production by yeasts isolated from rotting wood in the Galápagos Islands, Ecuador, and description of Cyberlindnera galapagoensis f.a., sp. nov.

    PubMed

    Guamán-Burneo, Maria C; Dussán, Kelly J; Cadete, Raquel M; Cheab, Monaliza A M; Portero, Patricia; Carvajal-Barriga, Enrique J; da Silva, Sílvio S; Rosa, Carlos A

    2015-10-01

    This study evaluated D-xylose-assimilating yeasts that are associated with rotting wood from the Galápagos Archipelago, Ecuador, for xylitol production from hemicellulose hydrolysates. A total of 140 yeast strains were isolated. Yeasts related to the clades Yamadazyma, Kazachstania, Kurtzmaniella, Lodderomyces, Metschnikowia and Saturnispora were predominant. In culture assays using sugarcane bagasse hemicellulose hydrolysate, Candida tropicalis CLQCA-24SC-125 showed the highest xylitol production, yield and productivity (27.1 g L(-1) xylitol, Y p/s (xyl) = 0.67 g g(-1), Qp = 0.38 g L(-1). A new species of Cyberlindnera, strain CLQCA-24SC-025, was responsible for the second highest xylitol production (24 g L(-1), Y p/s (xyl) = 0.64 g g(-1), Qp = 0.33 g L(-1) h(-1)) on sugarcane hydrolysate. The new xylitol-producing species Cyberlindnera galapagoensis f.a., sp. nov., is proposed to accommodate the strain CLQCA-24SC-025(T) (=UFMG-CM-Y517(T); CBS 13997(T)). The MycoBank number is MB 812171.

  4. Improved Xylitol Production from D-Arabitol by Enhancing the Coenzyme Regeneration Efficiency of the Pentose Phosphate Pathway in Gluconobacter oxydans.

    PubMed

    Li, Sha; Zhang, Jinliang; Xu, Hong; Feng, Xiaohai

    2016-02-10

    Gluconobacter oxydans is used to produce xylitol from D-arabitol. This study aims to improve xylitol production by increasing the coenzyme regeneration efficiency of the pentose phosphate pathway in G. oxydans. Glucose-6-phosphate dehydrogenase (G6PDH) and 6-phosphogluconate dehydrogenase (6PGDH) were overexpressed in G. oxydans. Real-time PCR and enzyme activity assays revealed that G6PDH/6PGDH activity and coenzyme regeneration efficiency increased in the recombinant G. oxydans strains. Approximately 29.3 g/L xylitol was obtained, with a yield of 73.2%, from 40 g/L d-arabitol in the batch biotransformation with the G. oxydans PZ strain. Moreover, the xylitol productivity (0.62 g/L/h) was 3.26-fold of the wild type strain (0.19 g/L/h). In repetitive batch biotransformation, the G. oxydans PZ cells were used for five cycles without incurring a significant loss in productivity. These results indicate that the recombinant G. oxydans PZ strain is economically feasible for xylitol production in industrial bioconversion.

  5. Simultaneous fermentation of glucose and xylose at elevated temperatures co-produces ethanol and xylitol through overexpression of a xylose-specific transporter in engineered Kluyveromyces marxianus.

    PubMed

    Zhang, Biao; Zhang, Jia; Wang, Dongmei; Han, Ruixiang; Ding, Rui; Gao, Xiaolian; Sun, Lianhong; Hong, Jiong

    2016-09-01

    Engineered Kluyveromyces marxianus strains were constructed through over-expression of various transporters for simultaneous co-fermentation of glucose and xylose. The glucose was converted into ethanol, whereas xylose was converted into xylitol which has higher value than ethanol. Over-expressing xylose-specific transporter ScGAL2-N376F mutant enabled yeast to co-ferment glucose and xylose and the co-fermentation ability was obviously improved through increasing ScGAL2-N376F expression. The production of glycerol was blocked and acetate production was reduced by disrupting gene KmGPD1. The obtained K. marxianus YZJ119 utilized 120g/L glucose and 60g/L xylose simultaneously and produced 50.10g/L ethanol and 55.88g/L xylitol at 42°C. The yield of xylitol from consumed xylose was over 98% (0.99g/g). Through simultaneous saccharification and co-fermentation at 42°C, YZJ119 produced a maximal concentration of 44.58g/L ethanol and 32.03g/L xylitol or 29.82g/L ethanol and 31.72g/L xylitol, respectively, from detoxified or non-detoxified diluted acid pretreated corncob. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Effects of xylitol on blood glucose, glucose tolerance, serum insulin and lipid profile in a type 2 diabetes model of rats.

    PubMed

    Islam, Md Shahidul; Indrajit, Mitesh

    2012-01-01

    The present study was conducted to examine the antidiabetic effects of xylitol in a type 2 diabetes rat model. Six-week-old male Sprague-Dawley rats were randomly divided into 3 groups: normal control (NC), diabetic control (DBC) and xylitol (XYL). Diabetes was induced only in the DBC and XYL animal groups by feeding them a 10% fructose solution for 2 weeks followed by an injection (i.p.) of streptozotocin (40 mg/kg body weight). One week after the streptozotocin injection, the animals with a nonfasting blood glucose level of >300 mg/dl were considered to be diabetic. The XYL group was fed further with a 10% xylitol solution, whereas the NC and DBC groups were supplied with normal drinking water. After 5 weeks of intervention, food and fluid intake, body weight, blood glucose, serum fructosamine and most of the serum lipids were significantly decreased, and serum insulin concentration and glucose tolerance ability was significantly increased in the XYL group compared to the DBC group. Liver weight, liver glycogen and serum triglycerides were not influenced by feeding with xylitol. The data of this study suggest that xylitol can be used not only as a sugar substitute but also as a supplement to antidiabetic food and other food products. Copyright © 2012 S. Karger AG, Basel.

  7. Mortality of the House Fly (Diptera: Muscidae) After Exposure to Combinations of Beauveria bassiana (Hypocreales: Clavicipitaceae) With the Polyol Sweeteners Erythritol and Xylitol.

    PubMed

    Burgess, Edwin R; Johnson, Dana M; Geden, Christopher J

    2018-06-01

    Documented resistance to traditional insecticides in the house fly, Musca domestica L. (Diptera: Muscidae), has expedited a need for alternative forms of control. One such method is the use of biological control organisms, such as the entomopathogenic fungus, Beauveria bassiana (Balsamo - Crivelli) Vuillemin (Hypocreales: Clavicipitaceae). Administering B. bassiana with a calorically rich phagostimulant such as sucrose may have the unintended effect of increasing fly vitality and thus reproduction before mortality sets in. Therefore, finding a phagostimulant with lower caloric value that can replace sucrose is valuable. Here B. bassiana was combined with the sweeteners erythritol and xylitol as potential low-calorie substitutes for sucrose. Female flies consumed as much xylitol alone as they did sucrose alone, but less erythritol than both. After 24 h of exposure, B. bassiana administered at 1 mg in erythritol and in sucrose were equally effective at reducing survival and better than xylitol. B. bassiana administered at 10 mg worked equally well at reducing survival in all three sweeteners. When exposed to 10 mg of B. bassiana in sweetener for 1 h, sucrose reduced survival more than in erythritol or xylitol, but mortality was still in excess of 97% after 8 d in all three sweeteners. Each sweetener mixed with B. bassiana worked as well in an environment with additional food sources and stimuli as they did in an environment lacking these additions. Erythritol and xylitol appear to be strong candidates to replace sucrose in baits formulated around B. bassiana.

  8. Complementary and alternative medicine for pediatric otitis media.

    PubMed

    Levi, Jessica R; Brody, Robert M; McKee-Cole, Katie; Pribitkin, Edmund; O'Reilly, Robert

    2013-06-01

    To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain

  9. Topical treatment of psoriasis.

    PubMed

    Laws, Philip M; Young, Helen S

    2010-08-01

    The majority of patients with psoriasis can be safely and effectively treated with topical therapy alone, either under the supervision of a family physician or dermatologist. For those requiring systemic agents, topical therapies can provide additional benefit. Optimal use of topical therapy requires an awareness of the range and efficacy of all products. The review covers the efficacy and role of topical therapies including emollients, corticosteroids, vitamin D analogs, calcineurin inhibitors, dithranol, coal tar, retinoids, keratolyics and combination therapy. The report was prepared following a PubMed and Embase literature search up to April 2010. The paper provides a broad review of the relevant topical therapeutic options available in routine clinical practice for the management of psoriasis and a recommendation for selection of treatment. Topical therapies used appropriately provide a safe and effective option for the management of psoriasis. An awareness of the available products and their efficacy is key to treatment selection and patient satisfaction.

  10. Comparison of nasal hyperosmolar xylitol and xylometazoline solutions on quality of life in patients with inferior turbinate hypertrophy secondary to nonallergic rhinitis.

    PubMed

    Cingi, Cemal; Birdane, Leman; Ural, Ahmet; Oghan, Fatih; Bal, Cengiz

    2014-06-01

    The purpose of this study was to objectively determine and compare the efficacy and effectiveness of xylitol solution (Xlear Nasal Sprey®) compared with xylometazoline and physiological saline with respect to quality of life (QoL) in patients with nasal congestion. A prospective, randomized study was performed in 42 patients who had nasal obstruction and hypertrophied turbinate mucosa that was refractory to medical treatment. The study population was randomized into 3 groups according to the application of xylometazoline, physiological saline, and xylitol hyperosmolar solution. The efficacy of treatment was evaluated objectively (4-phase rhinomanometry) and subjectively (visual analogue scale VAS.) before and after the application of the nasal solutions. QoL was evaluated by means of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). VAS scores and 4-phase rhinomanometry scores were better in the group treated with xylometazoline compared to those treated with xylitol or saline. The xylitol procedure yielded better results than the saline procedure, but differences were not statistically significant in both objective and subjective evaluation methods. For overall QoL, there was a significant improvement from baseline for the xylometazoline and xylitol groups. However, the improvement in the xylometazoline group was significantly greater than that obtained in the xylitol group. Xlear Nasal Spray® is an effective modality in the treatment of nasal congestion and has positive effect on the QoL of patients. Further studies are needed in order to plan an ongoing treatment of Xlear Nasal Sprey® at certain intervals for continuous relief of symptoms and a better and longstanding QoL. © 2014 ARS-AAOA, LLC.

  11. Overexpression of D-Xylose Reductase (xyl1) Gene and Antisense Inhibition of D-Xylulokinase (xyiH) Gene Increase Xylitol Production in Trichoderma reesei

    PubMed Central

    Hong, Yuanyuan; Dashtban, Mehdi; Kepka, Greg; Chen, Sanfeng; Qin, Wensheng

    2014-01-01

    T. reesei is an efficient cellulase producer and biomass degrader. To improve xylitol production in Trichoderma reesei strains by genetic engineering, two approaches were used in this study. First, the presumptive D-xylulokinase gene in T. reesei (xyiH), which has high homology to known fungi D-xylulokinase genes, was silenced by transformation of T. reesei QM9414 strain with an antisense construct to create strain S6-2-2. The expression of the xyiH gene in the transformed strain S6-2-2 decreased at the mRNA level, and D-xylulokinase activity decreased after 48 h of incubation. This led to an increase in xylitol production from undetectable levels in wild-type T. reesei QM9414 to 8.6 mM in S6-2-2. The T. reesei Δxdh is a xylose dehydrogenase knockout strain with increased xylitol production compared to the wild-type T. reesei QM9414 (22.8 mM versus undetectable). The copy number of the xylose reductase gene (xyl1) in T. reesei Δxdh strain was increased by genetic engineering to create a new strain Δ9-5-1. The Δ9-5-1 strain showed a higher xyl1 expression and a higher yield of xylose reductase, and xylitol production was increased from 22.8 mM to 24.8 mM. Two novel strains S6-2-2 and Δ9-5-1 are capable of producing higher yields of xylitol. T. reesei has great potential in the industrial production of xylitol. PMID:25013760

  12. Antimicrobial evaluation of new metallic complexes with xylitol active against P. aeruginosa and C. albicans: MIC determination, post-agent effect and Zn-uptake.

    PubMed

    Santi, E; Facchin, G; Faccio, R; Barroso, R P; Costa-Filho, A J; Borthagaray, G; Torre, M H

    2016-02-01

    Xylitol (xylH5) is metabolized via the pentose pathway in humans, but it is unsuitable as an energy source for many microorganisms where it produces a xylitol-induced growth inhibition and disturbance in protein synthesis. For this reason, xylitol is used in the prophylaxis of several infections. In the search of better antimicrobial agents, new copper and zinc complexes with xylitol were synthesized and characterized by analytical and spectrosco pic methods: Na2[Cu3(xylH−4)2]·NaCl·4.5H2O (Cu-xyl) and [Zn4(xylH−4)2(H2O)2]·NaCl·3H2O (Zn-xyl). Both copper and zinc complexes presented higher MIC against Pseudomona aeruginosa than the free xylitol while two different behaviors were found against Candida albicans depending on the complex. The growth curves showed that Cu-xyl presented lower activity than the free ligand during all the studied period. In the case of Znxyl the growth curves showed that the inhibition of the microorganism growth in the first stage was equivalent to that of xylitol but in the second stage (after 18 h) Zn-xyl inhibited more. Besides, the PAE (post agent effect)obtained for Zn-xyl and xyl showed that the recovery from the damage of microbial cells had a delay of 14 and 13 h respectively. This behavior could be useful in prophylaxis treatments for infectious diseases where it is important that the antimicrobial effect lasts longer. With the aim to understand the microbiological activities the analysis of the particle size, lipophilicity and Zn uptake was performed.

  13. Salicylic Acid Topical

    MedlinePlus

    ... stinging in the area where you applied topical salicylic acid Some side effects can be serious. If you experience any of ... of the eyes, face, lips, or tongue Topical salicylic acid may cause other side effects. Call your doctor if you have any unusual ...

  14. Pediatric fibromyalgia.

    PubMed

    Buskila, Dan

    2009-05-01

    Fibromyalgia is an idiopathic chronic pain syndrome defined by widespread nonarticular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, nonrefreshing sleep, irritable bowel, and more. Central nervous system sensitization is a major pathophysiologic aspect of fibromyalgia; in addition, various external stimuli such as trauma and stress may contribute to development of the syndrome. Fibromyalgia is most common in midlife, but may be seen at any age. This article reviews the epidemiology, clinical characteristics, etiology, management, and outcome of pediatric fibromyalgia.

  15. Pediatric dysphagia.

    PubMed

    Kakodkar, Kedar; Schroeder, James W

    2013-08-01

    Feeding and swallowing disorders in the pediatric population are becoming more common, particularly in infants born prematurely and in children with chronic medical conditions. The normal swallowing mechanism is divided into 4 stages: the preparatory, the oral, the pharyngeal, and the esophageal phases. Feeding disorders have multiple causes: medical, nutritional, behavioral, psychological, and environmental factors can all contribute. Pathologic conditions involving any of the anatomic sites associated with the phases of swallowing can negatively impact the coordination of these phases and lead to symptoms of dysphagia and feeding intolerance. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. 2015 Pediatric Research Priorities in Prehospital Care.

    PubMed

    Browne, Lorin R; Shah, Manish I; Studnek, Jonathan R; Farrell, Brittany M; Mattrisch, Linda M; Reynolds, Stacy; Ostermayer, Daniel G; Brousseau, David C; Lerner, E Brooke

    2016-01-01

    Pediatric prehospital research has been limited, but work in this area is starting to increase particularly with the growth of pediatric-specific research endeavors. Given the increased interest in pediatric prehospital research, there is a need to identify specific research priorities that incorporate the perspective of prehospital providers and other emergency medical services (EMS) stakeholders. To develop a list of specific research priorities that is relevant, specific, and important to the practice of pediatric prehospital care. Three independent committees of EMS providers and researchers were recruited. Each committee developed a list of research topics. These topics were collated and used to initiate a modified Delphi process for developing consensus on a list of research priorities. Participants were the committee members. Topics approved by 80% were retained as research priorities. Topics that were rejected by more than 50% were eliminated. The remaining topics were modified and included on subsequent surveys. Each survey allowed respondents to add additional topics. The surveys were continued until all topics were either successfully retained or rejected and no new topics were suggested. Fifty topics were identified by the three independent committees. These topics were included on the initial electronic survey. There were 5 subsequent surveys. At the completion of the final survey a total of 29 research priorities were identified. These research priorities covered the following study areas: airway management, asthma, cardiac arrest, pain, patient-family interaction, resource utilization, seizure, sepsis, spinal immobilization, toxicology, trauma, training and competency, and vascular access. The research priorities were very specific. For example, under airway the priorities were: "identify the optimal device for effectively managing the airway in the prehospital setting" and "identify the optimal airway management device for specific disease processes

  17. Cellulolytic enzyme expression and simultaneous conversion of lignocellulosic sugars into ethanol and xylitol by a new Candida tropicalis strain.

    PubMed

    Mattam, Anu Jose; Kuila, Arindam; Suralikerimath, Niranjan; Choudary, Nettem; Rao, Peddy V C; Velankar, Harshad Ravindra

    2016-01-01

    Lignocellulosic ethanol production involves major steps such as thermochemical pretreatment of biomass, enzymatic hydrolysis of pre-treated biomass and the fermentation of released sugars into ethanol. At least two different organisms are conventionally utilized for producing cellulolytic enzymes and for ethanol production through fermentation, whereas in the present study a single yeast isolate with the capacity to simultaneously produce cellulases and xylanases and ferment the released sugars into ethanol and xylitol has been described. A yeast strain isolated from soil samples and identified as Candida tropicalis MTCC 25057 expressed cellulases and xylanases over a wide range of temperatures (32 and 42 °C) and in the presence of different cellulosic substrates [carboxymethylcellulose and wheat straw (WS)]. The studies indicated that the cultivation of yeast at 42 °C in pre-treated hydrolysate containing 0.5 % WS resulted in proportional expression of cellulases (exoglucanases and endoglucanases) at concentrations of 114.1 and 97.8 U g(-1) ds, respectively. A high xylanase activity (689.3 U g(-1) ds) was also exhibited by the yeast under similar growth conditions. Maximum expression of cellulolytic enzymes by the yeast occurred within 24 h of incubation. Of the sugars released from biomass after pretreatment, 49 g L(-1) xylose was aerobically converted into 15.8 g L(-1) of xylitol. In addition, 25.4 g L(-1) glucose released after the enzymatic hydrolysis of biomass was fermented by the same yeast to obtain an ethanol titer of 7.3 g L(-1). During the present study, a new strain of C. tropicalis was isolated and found to have potential for consolidated bioprocessing (CBP) applications. The strain could grow in a wide range of process conditions (temperature, pH) and in the presence of lignocellulosic inhibitors such as furfural, HMF and acetic acid. The new yeast produced cellulolytic enzymes over a wide temperature range and in the presence of

  18. 'Hot Topics' in Astrophysics

    NASA Technical Reports Server (NTRS)

    Maran, Stephen P.

    2000-01-01

    Three current topics in astrophysics are described here on the occasion of the joint meeting of the American Association of Physics Teachers and the American Astronomical Society (Jan. 7-11, 2001, San Diego, Calif.). Many equally exciting topics--ranging from the dozens of newly discovered planets of sunlike stars to evidence suggesting that the expansion of the universe is accelerating--could have been chosen. The topics discussed are: (1) the habitability of Mars, (2) black holes, galaxy bulges, and the X-ray background, and (3) the greatest explosions since the Big Bang.

  19. Methodological and Ethical Issues in Pediatric Medication Safety Research.

    PubMed

    Carpenter, Delesha; Gonzalez, Daniel; Retsch-Bogart, George; Sleath, Betsy; Wilfond, Benjamin

    2017-09-01

    In May 2016, the Eshelman School of Pharmacy at The University of North Carolina at Chapel Hill convened the PharmSci conference to address the topic of "methodological and ethical issues in pediatric medication safety research." A multidisciplinary group of experts representing a diverse array of perspectives, including those of the US Food and Drug Administration, children's hospitals, and academia, identified important considerations for pediatric medication safety research and opportunities to advance the field. This executive summary describes current challenges that clinicians and researchers encounter related to pediatric medication safety research and identifies innovative and ethically sound methodologies to address these challenges to improve children's health. This article addresses 5 areas: (1) pediatric drug development and drug trials; (2) conducting comparative effectiveness research in pediatric populations; (3) child and parent engagement on study teams; (4) improving communication with children and parents; and (5) assessing child-reported outcomes and adverse drug events. Copyright © 2017 by the American Academy of Pediatrics.

  20. Diclofenac Topical (osteoarthritis pain)

    MedlinePlus

    ... gel (Voltaren) is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining ... Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a ...

  1. Topical Therapies in Psoriasis

    PubMed Central

    Torsekar, R.; Gautam, Manjyot M.

    2017-01-01

    Topical therapy as monotherapy is useful in psoriasis patients with mild disease. Topical agents are also used as adjuvant for moderate-to-severe disease who are being concurrently treated with either ultraviolet light or systemic medications. Emollients are useful adjuncts to the treatment of psoriasis. Use of older topical agents such as anthralin and coal tar has declined over the years. However, they are cheaper and can still be used for the treatment of difficult psoriasis refractory to conventional treatment. Salicylic acid can be used in combination with other topical therapies such as topical corticosteroids (TCS) and calcineurin inhibitors for the treatment of thick limited plaques to increase the absorption of the latter into the psoriatic plaques. Low- to mid-potent TCS are used in facial/flexural psoriasis and high potent over palmoplantar/thick psoriasis lesions. The addition of noncorticosteroid treatment can also facilitate the avoidance of long-term daily TCS. Tacrolimus and pimecrolimus can be used for the treatment of facial and intertriginous psoriasis. Tazarotene is indicated for stable plaque psoriasis usually in combination with other therapies such as TCS. Vitamin D analogs alone in combination with TCS are useful in stable plaques over limbs and palmoplantar psoriasis. Topical therapies for scalp psoriasis include TCS, Vitamin D analogs, salicylic acid, coal tar, and anthralin in various formulations such as solutions, foams, and shampoos. TCS, vitamin D analogs, and tazarotene can be used in the treatment of nail psoriasis. PMID:28761838

  2. Topical treatment of melasma.

    PubMed

    Bandyopadhyay, Debabrata

    2009-01-01

    Melasma is a common hypermelanotic disorder affecting the face that is associated with considerable psychological impacts. The management of melasma is challenging and requires a long-term treatment plan. In addition to avoidance of aggravating factors like oral pills and ultraviolet exposure, topical therapy has remained the mainstay of treatment. Multiple options for topical treatment are available, of which hydroquinone (HQ) is the most commonly prescribed agent. Besides HQ, other topical agents for which varying degrees of evidence for clinical efficacy exist include azelaic acid, kojic acid, retinoids, topical steroids, glycolic acid, mequinol, and arbutin. Topical medications modify various stages of melanogenesis, the most common mode of action being inhibition of the enzyme, tyrosinase. Combination therapy is the preferred mode of treatment for the synergism and reduction of untoward effects. The most popular combination consists of HQ, a topical steroid, and retinoic acid. Prolonged HQ usage may lead to untoward effects like depigmentation and exogenous ochronosis. The search for safer alternatives has given rise to the development of many newer agents, several of them from natural sources. Well-designed controlled clinical trials are needed to clarify their role in the routine management of melasma.

  3. TOPICAL TREATMENT OF MELASMA

    PubMed Central

    Bandyopadhyay, Debabrata

    2009-01-01

    Melasma is a common hypermelanotic disorder affecting the face that is associated with considerable psychological impacts. The management of melasma is challenging and requires a long-term treatment plan. In addition to avoidance of aggravating factors like oral pills and ultraviolet exposure, topical therapy has remained the mainstay of treatment. Multiple options for topical treatment are available, of which hydroquinone (HQ) is the most commonly prescribed agent. Besides HQ, other topical agents for which varying degrees of evidence for clinical efficacy exist include azelaic acid, kojic acid, retinoids, topical steroids, glycolic acid, mequinol, and arbutin. Topical medications modify various stages of melanogenesis, the most common mode of action being inhibition of the enzyme, tyrosinase. Combination therapy is the preferred mode of treatment for the synergism and reduction of untoward effects. The most popular combination consists of HQ, a topical steroid, and retinoic acid. Prolonged HQ usage may lead to untoward effects like depigmentation and exogenous ochronosis. The search for safer alternatives has given rise to the development of many newer agents, several of them from natural sources. Well-designed controlled clinical trials are needed to clarify their role in the routine management of melasma. PMID:20101327

  4. The Influence of Sugar Cane Bagasse Type and Its Particle Size on Xylose Production and Xylose-to-Xylitol Bioconversion with the Yeast Debaryomyces hansenii.

    PubMed

    Aghcheh, Razieh Karimi; Bonakdarpour, Babak; Ashtiani, Farzin Zokaee

    2016-11-01

    In the present study, the effect of the type of sugar cane bagasse (non-depithed or depithed) and its particle size on the production of xylose and its subsequent fermentation to xylitol by Debaryomyces hansenii CBS767 was investigated using a full factorial experimental design. It was found that the particle size range and whether bagasse was depithed or not had a significant effect on the concentration and yield of xylose in the resulting hemicellulose hydrolysate. Depithed bagasse resulted in higher xylose concentrations compared to non-depithed bagasse. The corresponding detoxified hemicellulose hydrolysates were used as fermentation media for the production of xylitol. The hemicellulose hydrolysate prepared from depithed bagasse also yielded meaningfully higher xylitol fermentation rates compared to non-depithed bagasse. However, in the case of non-depithed bagasse, the hemicellulose hydrolysate prepared from larger particle size range resulted in higher xylitol fermentation rates, whereas the effect in the case of non-depithed bagasse was not pronounced. Therefore, depithing of bagasse is an advantageous pretreatment when it is to be employed in bioconversion processes.

  5. Prebiotic potential of L-sorbose and xylitol in promoting the growth and metabolic activity of specific butyrate-producing bacteria in human fecal culture.

    PubMed

    Sato, Tadashi; Kusuhara, Shiro; Yokoi, Wakae; Ito, Masahiko; Miyazaki, Kouji

    2017-01-01

    Dietary low-digestible carbohydrates (LDCs) affect gut microbial metabolism, including the production of short-chain fatty acids. The ability of various LDCs to promote butyrate production was evaluated in in vitro human fecal cultures. Fecal suspensions from five healthy males were anaerobically incubated with various LDCs. L-Sorbose and xylitol markedly promoted butyrate formation in cultures. Bacterial 16S rRNA gene-based denaturing gradient gel electrophoresis analyses of these fecal cultures revealed a marked increase in the abundance of bacteria closely related to the species Anaerostipes hadrus or A. caccae or both, during enhanced butyrate formation from L-sorbose or xylitol. By using an agar plate culture, two strains of A. hadrus that produced butyrate from each substrate were isolated from the feces of two donors. Furthermore, of 12 species of representative colonic butyrate producers, only A. hadrus and A. caccae demonstrated augmented butyrate production from L-sorbose or xylitol. These findings suggest that L-sorbose and xylitol cause prebiotic stimulation of the growth and metabolic activity of Anaerostipes spp. in the human colon. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Systematic strain construction and process development: Xylitol production by Saccharomyces cerevisiae expressing Candida tenuis xylose reductase in wild-type or mutant form.

    PubMed

    Pratter, S M; Eixelsberger, T; Nidetzky, B

    2015-12-01

    A novel Saccharomyces cerevisiae whole-cell biocatalyst for xylitol production based on Candida tenuis xylose reductase (CtXR) is presented. Six recombinant strains expressing wild-type CtXR or an NADH-specific mutant were constructed and evaluated regarding effects of expression mode, promoter strength, biocatalyst concentration and medium composition. Intracellular XR activities ranged from 0.09 U mgProt(-1) to 1.05 U mgProt(-1) but did not correlate with the strains' xylitol productivities, indicating that other factors limited xylose conversion in the high-activity strains. The CtXR mutant decreased the biocatalyst's performance, suggesting use of the NADPH-preferring wild-type enzyme when (semi-)aerobic conditions are applied. In a bioreactor process, the best-performing strain converted 40 g L(-1) xylose with an initial productivity of 1.16 g L(-1)h(-1) and a xylitol yield of 100%. The obtained results underline the potential of CtXR wild-type for xylose reduction and point out parameters to improve "green" xylitol production. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Comparing the efficacy of xylitol-containing and conventional chewing gums in reducing salivary counts of Streptococcus mutans: An in vivo study

    PubMed Central

    Haghgoo, Rosa; Afshari, Elahe; Ghanaat, Tahere; Aghazadeh, Samaneh

    2015-01-01

    Objective: Dental caries is among the most common chronic diseases in humans. Streptococcus mutans is generally responsible for most cases of dental caries. The present study sought to compare the effects of xylitol-containing and conventional chewing gums on salivary levels of S. mutans. Materials and Methods: This study adopted a crossover design. Two type of chewing gums (one containing 70% xylitol and approved by the Iranian Dental Association, and another containing sucrose) were purchased. The participants were 32 individuals aged 18–35 years whose oral hygiene was categorized as moderate or poor based on a caries risk assessment table. Salivary levels of S. mutans were measured at baseline, after the first and second phases of chewing gums, and after the washout period. The measurements were performed on blood agar and mitis salivarius-bacitracin agar (MSBA). Pairwise comparisons were then used to analyze the collected data. Results: Salivary levels of S. mutans in both groups were significantly higher during the two stages of chewing gum than in the washout period or baseline. Moreover, comparisons between the two types of gums suggested that chewing xylitol-containing gums led to greater reductions in S. mutans counts. This effect was more apparent in subjects with poor oral hygiene than in those with moderate oral hygiene. Conclusions: Xylitol-containing chewing gums are more effective than conventional gums in reducing salivary levels of S. mutans in individuals with poor–moderate oral hygiene. PMID:26942114

  8. Fermentation of oat and soybean hull hydrolysates into ethanol and xylitol by recombinant industrial strains of Saccharomyces cerevisiae under diverse oxygen environments

    USDA-ARS?s Scientific Manuscript database

    In this study, we evaluated the capacity of recombinant industrial Saccharomyces cerevisiae YRH 396 and YRH 400 strains to ferment sugars from oat hull and soybean hull hydrolysates into ethanol and xylitol. The strains were genetically modified by chromosomal integration of Pichia stipitis XYLI/XYL...

  9. The effect of 1% chlorhexidine varnish and 40% xylitol solution on Streptococcus mutans and plaque accumulation in children.

    PubMed

    Simões Moraes, Renata; Modesto, Adriana; Regina Netto Dos Santos, Kátia; Drake, David

    2011-01-01

    The purpose of this study was to determine the effect of the association of 1% chlorhexidine varnish (CHX) and 40% xylitol solution (XYL) on Streptococcus mutans (SM) counts and plaque indices in 2- to 5-year-olds. Sixty-eight children were selected with medium levels (1 x 10³) to very high levels (>1 x 10⁵) of SM in the saliva. Subjects were divided into 4 groups of 17 children each: (1) CHX; (2) CHX+XYL; (3) XYL; and(4) 0.05% sodium fluoride (F). An assessment of SM levels and plaque indices was done on all children at baseline, 15 days, and at 1, 3, and 6 months. SM levels were determined by the spatula method. Although the reduction in SM counts in all groups was statistically significant, differences among groups were not observed, and the CHX and F groups seemed to show the greatest effect. Plaque reduction was observed in all groups, whereas statistically significant decreases among groups were not observed. One percent chlorhexidine varnish associated with 40% xylitol solution tested in the present study does not provide significant suppression of Streptococcus mutans counts and reduction of plaque accumulation at any follow-up time points.

  10. A Burkholderia sacchari cell factory: production of poly-3-hydroxybutyrate, xylitol and xylonic acid from xylose-rich sugar mixtures.

    PubMed

    Raposo, Rodrigo S; de Almeida, M Catarina M D; de Oliveira, M da Conceição M A; da Fonseca, M Manuela; Cesário, M Teresa

    2017-01-25

    Efficient production of poly-3-hydroxybutyrate (P(3HB)) based on glucose-xylose mixtures simulating different types of lignocellulosic hydrolysate (LCH) was addressed using Burkholderia sacchari, a wild strain capable of metabolizing both sugars and producing P(3HB). Carbon catabolite repression was avoided by maintaining glucose concentration below 10g/L. Xylose concentrations above 30g/L were inhibitory for growth and production. In fed-batch cultivations, pulse size and feed addition rate were controlled in order to reach high productivities and efficient sugar consumptions. High xylose uptake and P(3HB) productivity were attained with glucose-rich mixtures (glucose/xylose ratio in the feed=1.5w/w) using high feeding rates, while with xylose-richer feeds (glucose/xylose=0.8w/w), a lower feeding rate is a robust strategy to avoid xylose build-up in the medium. Xylitol production was observed with xylose concentrations in the medium above 30-40g/L. With sugar mixtures featuring even lower glucose/xylose ratios, i.e. xylose-richer feeds (glucose/xylose=0.5), xylonic acid (a second byproduct) was produced. This is the first report of the ability of Burkholderia sacchari to produce both xylitol and xylonic acid. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Evaluation of xylitol production using corncob hemicellulosic hydrolysate by combining tetrabutylammonium hydroxide extraction with dilute acid hydrolysis.

    PubMed

    Jia, Honghua; Shao, Tingting; Zhong, Chao; Li, Hengxiang; Jiang, Min; Zhou, Hua; Wei, Ping

    2016-10-20

    In this paper, we produced hemicellulosic hydrolysate from corncob by tetrabutylammonium hydroxide (TBAH) extraction and dilute acid hydrolysis combined, further evaluating the feasibility of the resultant corncob hemicellulosic hydrolysate used in xylitol production by Candida tropicalis. Optimized conditions for corncob hemicellulose extraction by TBAH was obtained via response surface methodology: time of 90min, temperature of 60°C, liquid/solid ratio of 12 (v/w), and TBAH concentration of 55%, resulting in a hemicellulose extraction of 80.07% under these conditions. The FT-IR spectrum of the extracted corncob hemicellulose is consistent with that of birchwood hemicellulose and exhibits specific absorbance of hemicelluloses at 1380, 1168, 1050, and 900cm(-1). In addition, we found that C. tropicalis can ferment the resulting corncob hemicellulosic hydrolysate with pH adjustment and activated charcoal treatment leading to a high xylitol yield and productivity of 0.77g/g and 2.45g/(Lh), respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. [Studies of local anaesthetics - part 197. Effect of xylitol on pharmaceutical availability of lidocaine and flow properties of hydrogels].

    PubMed

    Zuzana, Vitková; Petra, Herdová; Jozef, Cižmárik; Daniel, Grančai; Lukáš, Benč

    2012-06-01

    The paper examines the formulation of hydrogel on the base of a synthetic polymer containing a local anaesthetic and a mass-produced drug in the form of a solution with an antiphlogistic effect. It aimed to prepare a hydrogel of a suitable composition with suitable flow properties and drug release, the active ingredient being lidocaine hydrochloride. Besides the role of a synthetic polymer which ensures that the active ingredient remains at the affected site, an important role in the formulation is played by the presence of an artificial sweetener, which to a great extent as a taste correcting agent of the unpleasant taste of the active ingredient influences the compliance of many patients. The study examined the effect of concentration of the artificial sweetener xylitol on the liberation of the active ingredient from prepared hydrogels. The optimum concentration of the artificial sweetener was adjusted to a degree which does not affect the qualitative properties of the active ingredient. lidocaine hydrochloride, xylitol, hydrogel, liberation.

  13. A novel aldose-aldose oxidoreductase for co-production of D-xylonate and xylitol from D-xylose with Saccharomyces cerevisiae.

    PubMed

    Wiebe, Marilyn G; Nygård, Yvonne; Oja, Merja; Andberg, Martina; Ruohonen, Laura; Koivula, Anu; Penttilä, Merja; Toivari, Mervi

    2015-11-01

    An open reading frame CC1225 from the Caulobacter crescentus CB15 genome sequence belongs to the Gfo/Idh/MocA protein family and has 47 % amino acid sequence identity with the glucose-fructose oxidoreductase from Zymomonas mobilis (Zm GFOR). We expressed the ORF CC1225 in the yeast Saccharomyces cerevisiae and used a yeast strain expressing the gene coding for Zm GFOR as a reference. Cell extracts of strains overexpressing CC1225 (renamed as Cc aaor) showed some Zm GFOR type of activity, producing D-gluconate and D-sorbitol when a mixture of D-glucose and D-fructose was used as substrate. However, the activity in Cc aaor expressing strain was >100-fold lower compared to strains expressing Zm gfor. Interestingly, C. crescentus AAOR was clearly more efficient than the Zm GFOR in converting in vitro a single sugar substrate D-xylose (10 mM) to xylitol without an added cofactor, whereas this type of activity was very low with Zm GFOR. Furthermore, when cultured in the presence of D-xylose, the S. cerevisiae strain expressing Cc aaor produced nearly equal concentrations of D-xylonate and xylitol (12.5 g D-xylonate l(-1) and 11.5 g D-xylitol l(-1) from 26 g D-xylose l(-1)), whereas the control strain and strain expressing Zm gfor produced only D-xylitol (5 g l(-1)). Deletion of the gene encoding the major aldose reductase, Gre3p, did not affect xylitol production in the strain expressing Cc aaor, but decreased xylitol production in the strain expressing Zm gfor. In addition, expression of Cc aaor together with the D-xylonolactone lactonase encoding the gene xylC from C. crescentus slightly increased the final concentration and initial volumetric production rate of both D-xylonate and D-xylitol. These results suggest that C. crescentus AAOR is a novel type of oxidoreductase able to convert the single aldose substrate D-xylose to both its oxidized and reduced product.

  14. Discriminative Relational Topic Models.

    PubMed

    Chen, Ning; Zhu, Jun; Xia, Fei; Zhang, Bo

    2015-05-01

    Relational topic models (RTMs) provide a probabilistic generative process to describe both the link structure and document contents for document networks, and they have shown promise on predicting network structures and discovering latent topic representations. However, existing RTMs have limitations in both the restricted model expressiveness and incapability of dealing with imbalanced network data. To expand the scope and improve the inference accuracy of RTMs, this paper presents three extensions: 1) unlike the common link likelihood with a diagonal weight matrix that allows the-same-topic interactions only, we generalize it to use a full weight matrix that captures all pairwise topic interactions and is applicable to asymmetric networks; 2) instead of doing standard Bayesian inference, we perform regularized Bayesian inference (RegBayes) with a regularization parameter to deal with the imbalanced link structure issue in real networks and improve the discriminative ability of learned latent representations; and 3) instead of doing variational approximation with strict mean-field assumptions, we present collapsed Gibbs sampling algorithms for the generalized relational topic models by exploring data augmentation without making restricting assumptions. Under the generic RegBayes framework, we carefully investigate two popular discriminative loss functions, namely, the logistic log-loss and the max-margin hinge loss. Experimental results on several real network datasets demonstrate the significance of these extensions on improving prediction performance.

  15. Quantifying and qualifying the use of topical anesthetics in retinopathy of prematurity examinations.

    PubMed

    Ahmed, Masih; Forcina, Blake; Bonsall, Dean

    2016-04-01

    The American Academy of Pediatrics advocates efforts to minimize discomfort and systemic effect of retinopathy of prematurity (ROP) examinations. Although many ophthalmologists use topical anesthetics, many do not believe them necessary. We present the results of the first survey to quantify the use of topical anesthetics in ROP examinations by clinicians who screen for ROP. The results show that although use of topical anesthetic is common, it is not universal. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  16. Conscious Sedation: Emerging Trends in Pediatric Dentistry

    PubMed Central

    Attri, Joginder Pal; Sharan, Radhe; Makkar, Vega; Gupta, Kewal Krishan; Khetarpal, Ranjana; Kataria, Amar Parkash

    2017-01-01

    Dental fear and anxiety is a common problem in pediatric patients. There is considerable variation in techniques used to manage them. Various sedation techniques using many different anesthetic agents have gained considerable popularity over the past few years. Children are not little adults; they differ physically, psychologically, and emotionally. The purpose of this review is to survey recent trends and concerning issues in the rapidly changing field of pediatric sedation. We will study the topic from the perspective of an anesthesiologist. It will also provide information to practitioners on the practice of conscious sedation in dentistry and will also outline the route of administration, pharmacokinetics, and pharmacodynamics of various drugs used. PMID:28663606

  17. Pediatric Donation After Circulatory Determination of Death: A Scoping Review.

    PubMed

    Weiss, Matthew J; Hornby, Laura; Witteman, William; Shemie, Sam D

    2016-03-01

    remain an event less common than brain death, albeit with the potential to substantially expand the existing organ donation pool. Limited data suggest outcomes comparable with organs donated after neurologic determination of death. Although there is continued debate around ethical aspects of pediatric donation after circulatory determination of death, all pediatric donation after circulatory determination of death publications from professional societies contend that pediatric donation after circulatory determination of death can be practiced ethically. This review provides a comprehensive overview of the published literature related to pediatric donation after circulatory determination of death. In addition to informing the development of pediatric-specific guidelines, this review serves to highlight several important knowledge gaps in this topic.

  18. IP Internal Movement and Topicalization

    ERIC Educational Resources Information Center

    Kuo, Pei-Jung

    2009-01-01

    In this dissertation, I investigate the phenomenon of internal topicalization cross-linguistically, using Chinese as a starting point. Internal topicalization refers to constructions in which a topic phrase is placed between the subject and the verb (in contrast to external topicalization, which involves a topic in the CP domain). I argue that…

  19. Pediatric nasoorbitoethmoid fractures.

    PubMed

    Liau, James Y; Woodlief, Justin; van Aalst, John A

    2011-09-01

    The pediatric craniofacial trauma literature largely focuses on the management of mandible fractures, with very little information focusing on pediatric midface fractures, specifically nasoorbitethmoid (NOE) fractures. Because the diagnosis and surgical treatment plan for adult NOE fractures is well established in the literature, the treatment algorithms for NOE are essentially a transfer of adult practices to pediatric patients. This article reviews the differences between the pediatric and adult facial skeleton and the pathology and presentation of NOE fractures in the pediatric craniomaxillofacial skeleton. It also presents the effects of NOE fractures on the growth and development of the pediatric facial skeleton and describes the current surgical management for NOE fractures.

  20. Topical botulinum toxin.

    PubMed

    Collins, Ashley; Nasir, Adnan

    2010-03-01

    Nanotechnology is a rapidly growing discipline that capitalizes on the unique properties of matter engineered on the nanoscale. Vehicles incorporating nanotechnology have led to great strides in drug delivery, allowing for increased active ingredient stability, bioavailability, and site-specific targeting. Botulinum toxin has historically been used for the correction of neurological and neuromuscular disorders, such as torticollis, blepharospasm, and strabismus. Recent dermatological indications have been for the management of axillary hyperhydrosis and facial rhytides. Traditional methods of botulinum toxin delivery have been needle-based. These have been associated with increased pain and cost. Newer methods of botulinum toxin formulation have yielded topical preparations that are bioactive in small pilot clinical studies. While there are some risks associated with topical delivery, the refinement and standardization of delivery systems and techniques for the topical administration of botulinum toxin using nanotechnology is anticipated in the near future.

  1. Topical Research: Africa.

    ERIC Educational Resources Information Center

    Lynn, Karen

    This lesson plan can be used in social studies, language arts, or library research. The instructional objective is for students to select a topic of study relating to Africa, write a thesis statement, collect information from media sources, and develop a conclusion. The teacher may assign the lesson for written or oral evaluation. The teacher…

  2. Differential Topic Models.

    PubMed

    Chen, Changyou; Buntine, Wray; Ding, Nan; Xie, Lexing; Du, Lan

    2015-02-01

    In applications we may want to compare different document collections: they could have shared content but also different and unique aspects in particular collections. This task has been called comparative text mining or cross-collection modeling. We present a differential topic model for this application that models both topic differences and similarities. For this we use hierarchical Bayesian nonparametric models. Moreover, we found it was important to properly model power-law phenomena in topic-word distributions and thus we used the full Pitman-Yor process rather than just a Dirichlet process. Furthermore, we propose the transformed Pitman-Yor process (TPYP) to incorporate prior knowledge such as vocabulary variations in different collections into the model. To deal with the non-conjugate issue between model prior and likelihood in the TPYP, we thus propose an efficient sampling algorithm using a data augmentation technique based on the multinomial theorem. Experimental results show the model discovers interesting aspects of different collections. We also show the proposed MCMC based algorithm achieves a dramatically reduced test perplexity compared to some existing topic models. Finally, we show our model outperforms the state-of-the-art for document classification/ideology prediction on a number of text collections.

  3. Transportation: Topic Paper E.

    ERIC Educational Resources Information Center

    National Council on the Handicapped, Washington, DC.

    As one of a series of topic papers assessing federal laws and programs affecting persons with disabilities, this paper reviews the issue of transportation services. In the area of urban mass transit, four relevant pieces of legislation and public transportation accessibility regulations are cited, and cost issues are explored. Paratransit systems,…

  4. Topical anesthesia in phacoemulsification.

    PubMed

    Waheeb, Saad

    2010-09-01

    To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Prospective non-comparative evaluation of patients' and surgeon's satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation. None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon's and the patients' satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon.

  5. Topical anesthesia in phacoemulsification

    PubMed Central

    Waheeb, Saad

    2010-01-01

    Purpose: To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Materials and Methods: Prospective non-comparative evaluation of patients’ and surgeon’s satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation. Results: None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon’s and the patients’ satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Conclusion: Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon. PMID:21120050

  6. Topics for Mathematics Clubs.

    ERIC Educational Resources Information Center

    Dalton, LeRoy C., Ed.; Snyder, Henry D., Ed.

    The ten chapters in this booklet cover topics not ordinarily discussed in the classroom: Fibonacci sequences, projective geometry, groups, infinity and transfinite numbers, Pascal's Triangle, topology, experiments with natural numbers, non-Euclidean geometries, Boolean algebras, and the imaginary and the infinite in geometry. Each chapter is…

  7. Pediatric Thyroid Cancer

    MedlinePlus

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  8. Pediatric heart surgery - discharge

    MedlinePlus

    ... of the aorta repair - discharge; Heart surgery for children - discharge; Atrial septal defect repair - discharge; Ventricular septal ... discharge; Acquired heart disease - discharge; Heart valve surgery - ... Heart surgery - pediatric - discharge; Heart transplant - pediatric - ...

  9. Find a Pediatric Dentist

    MedlinePlus

    ... Litch's Law Log HIPAA Forms Practice Management and Marketing Newsletter Webinar Materials Member Resources 2017 General Assembly ... Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral ...

  10. Pediatric Brain Tumor Foundation

    MedlinePlus

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  11. Pediatric MATCH Infographic

    Cancer.gov

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  12. Pediatric portal hypertension

    PubMed Central

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  13. Pediatric neurocritical care.

    PubMed

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  14. An update on local anesthesia for pediatric dental patients

    PubMed Central

    Peedikayil, Faizal C.; Vijayan, Ajoy

    2013-01-01

    Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients. PMID:25885712

  15. Comparison of antimicrobial effects of titanium tetrafluoride, chlorhexidine, xylitol and sodium fluoride on streptococcus mutans: An in-vitro study.

    PubMed

    Eskandarian, Tahereh; Motamedifar, Mohammad; Arasteh, Peyman; Eghbali, Seyed Sajad; Adib, Ali; Abdoli, Zahra

    2017-03-01

    No studies have yet documented the bactericidal effects of TiF4, and its role in the treatment of dental caries, and no definite protocol has been introduced to regulate its use. The aim of this study was to determine the antimicrobial/bactericidal effects of TiF4 on Streptococcus Mutans ( S. Mutans ) and to compare it with chlorhexidine (Chx), sodium fluoride (NaF) and xylitol. This study was conducted at the Shiraz University of Medical Sciences microbiology laboratory during March 2015 to September 2015. In this in-vitro study, first a bacterial suspension was prepared and adjusted to a 0.5 McFarland standard (equivalent to 1×10 8 CFU/ml). The minimal inhibitory concentration (MIC) and minimal bactericidal concentrations (MBC) of TiF4, Chx, NaF and xylitol were assessed using broth microdilution assay and disk diffusion methods. In order to neutralize the acidic nature of TiF4, we used a sodium hydroxide preparation to obtain a pH of 7.2 and repeated all of the previous tests with the neutralized TiF4 solution. We reported the final results as percentages where appropriate. The MIC of TiF4, NaF and Chx for S. Mutans were 12.5%, 12.5% and 6.25%, respectively. At a concentration of 12.5% the inhibition zone diameters were 9 mm, 15mm and 14mm for TiF4, NaF and Chx, respectively. The MBC was 25%, 12.5% and 12.5% for TiF4, NaF and Chx, respectively. Xylitol failed to show any bactericidal or growth inhibitory effect in all of its concentrations. When we repeated the tests with an adjusted pH, identical results were obtained. TiF4 solutions have anti-growth and bactericidal effects on S. Mutans at a concentration of 12.5% which is comparable with chlorhexidine and NaF, indicating the possible use of this solution in dental practice as an anti-cariogenic agent, furthermore the antimicrobial activity is unaffected by pH of the environment.

  16. Comparison of antimicrobial effects of titanium tetrafluoride, chlorhexidine, xylitol and sodium fluoride on streptococcus mutans: An in-vitro study

    PubMed Central

    Eskandarian, Tahereh; Motamedifar, Mohammad; Arasteh, Peyman; Eghbali, Seyed Sajad; Adib, Ali; Abdoli, Zahra

    2017-01-01

    Introduction No studies have yet documented the bactericidal effects of TiF4, and its role in the treatment of dental caries, and no definite protocol has been introduced to regulate its use. The aim of this study was to determine the antimicrobial/bactericidal effects of TiF4 on Streptococcus Mutans (S. Mutans) and to compare it with chlorhexidine (Chx), sodium fluoride (NaF) and xylitol. Methods This study was conducted at the Shiraz University of Medical Sciences microbiology laboratory during March 2015 to September 2015. In this in-vitro study, first a bacterial suspension was prepared and adjusted to a 0.5 McFarland standard (equivalent to 1×108 CFU/ml). The minimal inhibitory concentration (MIC) and minimal bactericidal concentrations (MBC) of TiF4, Chx, NaF and xylitol were assessed using broth microdilution assay and disk diffusion methods. In order to neutralize the acidic nature of TiF4, we used a sodium hydroxide preparation to obtain a pH of 7.2 and repeated all of the previous tests with the neutralized TiF4 solution. We reported the final results as percentages where appropriate. Results The MIC of TiF4, NaF and Chx for S. Mutans were 12.5%, 12.5% and 6.25%, respectively. At a concentration of 12.5% the inhibition zone diameters were 9 mm, 15mm and 14mm for TiF4, NaF and Chx, respectively. The MBC was 25%, 12.5% and 12.5% for TiF4, NaF and Chx, respectively. Xylitol failed to show any bactericidal or growth inhibitory effect in all of its concentrations. When we repeated the tests with an adjusted pH, identical results were obtained. Conclusion TiF4 solutions have anti-growth and bactericidal effects on S. Mutans at a concentration of 12.5% which is comparable with chlorhexidine and NaF, indicating the possible use of this solution in dental practice as an anti-cariogenic agent, furthermore the antimicrobial activity is unaffected by pH of the environment. PMID:28461883

  17. PREFACE: CEWQO Topical Issue CEWQO Topical Issue

    NASA Astrophysics Data System (ADS)

    Bozic, Mirjana; Man'ko, Margarita

    2009-09-01

    This topical issue of Physica Scripta collects selected peer-reviewed contributions based on invited and contributed talks and posters presented at the 15th Central European Workshop on Quantum Optics (CEWQO) which took place in Belgrade 29 May-3 June 2008 (http://cewqo08.phy.bg.ac.yu). On behalf of the whole community took place in Belgrade 29 May-3 June 2008 (http://cewqo08.phy.bg.ac.yu, cewqo08.phy.bg.ac.yu). On behalf of the whole community of the workshop, we thank the referees for their careful reading and useful suggestions which helped to improve all of the submitted papers. A brief description of CEWQO The Central European Workshop on Quantum Optics is a series of conferences started informally in Budapest in 1992. Sometimes small events transform into important conferences, as in the case of CEWQO. Professor Jozsef Janszky, from the Research Institute of Solid State Physics and Optics, is the founder of this series. Margarita Man'ko obtained the following information from Jozsef Janszky during her visit to Budapest, within the framework of cooperation between the Russian and Hungarian Academies of Sciences in 2005. He organized a small workshop on quantum optics in Budapest in 1992 with John Klauder as a main speaker. Then, bearing in mind that a year before Janszky himself was invited by Vladimir Buzek to give a seminar on the same topic in Bratislava, he decided to assign the name 'Central European Workshop on Quantum Optics', considering the seminar in Bratislava to be the first workshop and the one in Budapest the second. The third formal workshop took place in Bratislava in 1993 organized by Vladimir Buzek, then in 1994 (Budapest, by Jozsef Janszky), 1995 and 1996 (Budmerice, Slovakia, by Vladimir Buzek), 1997 (Prague, by Igor Jex), 1999 (Olomouc, Czech Republic, by Zdenek Hradil), 2000 (Balatonfüred, Hungary, by Jozsef Janszky ), 2001 (Prague, by Igor Jex), 2002 (Szeged, Hungary, by Mihaly Benedict), 2003 (Rostock,Germany, by Werner Vogel and

  18. Pharmacologic Treatment for Pediatric Gastroparesis: A Review of the Literature

    PubMed Central

    Smetana, Keaton S.; Bantu, Likeselam; Buckley, Merrion G.

    2016-01-01

    There have been a number of agents that have been tried for treatment of gastroparesis over the past 3 decades, with varying levels of success. Guidelines exist for the management of gastroparesis in adults; however, even though the cause of gastroparesis in children is similar to that in adults, no guidelines exist for treating pediatric gastroparesis as studies on the topic are limited. With what little information we have on pediatric gastroparesis, medications used in children's studies do not seem to demonstrate the same results as in adult patients with gastroparesis; thus, future studies of whether certain medications are effective for treating pediatric gastroparesis and at what dose still need to be conducted. Pharmacological treatment options for pediatric gastroparesis do not show a clear correlation of resolving or even maintaining gastroparesis-associated symptoms or disease state. This article reviews the available studies of drugs that have shown some efficacy, with an emphasis on pediatric studies. PMID:27199619

  19. New Trends and Recent Care Approaches in Pediatric Oncology Nursing

    PubMed Central

    Toruner, Ebru Kilicarslan; Altay, Naime

    2018-01-01

    Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches. PMID:29607375

  20. Pediatric surgeons on the Internet: a multi-institutional experience.

    PubMed

    Wulkan, M L; Smith, S D; Whalen, T V; Hardin, W D

    1997-04-01

    An estimated 24 million people, or 11% of the North American population over 16 years of age, use the Internet. An estimated 40% of households have computers, and 37 million people have Internet access. The experience of three pediatric surgery Internet sites are reviewed to evaluate current practices and future potential of the Internet to practicing pediatric surgeons. The sites reviewed are the Pediatric Surgery Bulletin Board System (BBS), the Pediatric Surgery List Server, and the Pediatric Surgery Website. Statistics were collected at each site to characterize the number of users, traffic load, topics of interest, and times of peak use. There are currently 79 subscribers to the Pediatric Surgery BBS and 100 subscribers to the Pediatric Surgery List Server. The average user of the BBS is a young man who has placed an average of 52 calls to the BBS since joining. There have been 1413 Internet electronic mail messages sent. Twenty-five percent of the traffic has been related to clinical problems and 5% to research, teaching, and career issues. Traffic at this site has been increasing exponentially with most of the dialogue concentrated on clinical issues and problem cases. In a 3-month period the Pediatric Surgery Website received 16,270 hits. The most commonly accessed areas include an electronic mail directory, case studies, the job board, information on the pediatric surgical residency, and information on upcoming meetings. Pediatric surgeons are exploring the Internet and using available pediatric surgery resources. The scope of professional information available to pediatric surgeons on the Internet is still limited but is increasing rapidly. The Internet will impact the way physicians practice medicine through education and communication.

  1. Xylitol production from waste xylose mother liquor containing miscellaneous sugars and inhibitors: one-pot biotransformation by Candida tropicalis and recombinant Bacillus subtilis.

    PubMed

    Wang, Hengwei; Li, Lijuan; Zhang, Lebin; An, Jin; Cheng, Hairong; Deng, Zixin

    2016-05-16

    The process of industrial xylitol production is a massive source of organic pollutants, such as waste xylose mother liquor (WXML), a viscous reddish-brown liquid. Currently, WXML is difficult to reuse due to its miscellaneous low-cost sugars, high content of inhibitors and complex composition. WXML, as an organic pollutant of hemicellulosic hydrolysates, accumulates and has become an issue of industrial concern in China. Previous studies have focused only on the catalysis of xylose in the hydrolysates into xylitol using one strain, without considering the removal of other miscellaneous sugars, thus creating an obstacle to subsequent large-scale purification. In the present study, we aimed to develop a simple one-pot biotransformation to produce high-purity xylitol from WXML to improve its economic value. In the present study, we developed a procedure to produce xylitol from WXML, which combines detoxification, biotransformation and removal of by-product sugars (purification) in one bioreactor using two complementary strains, Candida tropicalis X828 and Bacillus subtilis Bs12. At the first stage of micro-aerobic biotransformation, the yeast cells were allowed to grow and metabolized glucose and the inhibitors furfural and hydroxymethyl furfural (HMF), and converted xylose into xylitol. At the second stage of aerobic biotransformation, B. subtilis Bs12 was activated and depleted the by-product sugars. The one-pot process was successfully scaled up from shake flasks to 5, 150 L and 30 m(3) bioreactors. Approximately 95 g/L of pure xylitol could be obtained from the medium containing 400 g/L of WXML at a yield of 0.75 g/g xylose consumed, and the by-product sugars glucose, L-arabinose and galactose were depleted simultaneously. Our results demonstrate that the one-pot procedure is a viable option for the industrial application of WXML to produce value-added chemicals. The integration of complementary strains in the biotransformation of hemicellulosic hydrolysates is

  2. Coupling two sizes of CSTR-type bioreactors for sequential lactic acid and xylitol production from hemicellulosic hydrolysates of vineshoot trimmings.

    PubMed

    Salgado, José Manuel; Rodríguez, Noelia; Cortés, Sandra; Domínguez, José Manuel

    2012-02-15

    This study develops a system for the efficient valorisation of hemicellulosic hydrolysates of vineshoot trimmings. By connecting two reactors of 2L and 10L, operational conditions were set up for the sequential production of lactic acid and xylitol in continuous fermentation, considering the dependence of the main metabolites and fermentation parameters on the dilution rate. In the first bioreactor, Lactobacillus rhamnosus consumed all the glucose to produce lactic acid at 31.5°C, with 150rpm and 1L of working volume as the optimal conditions. The residual sugars were employed for the xylose to xylitol bioconversion by Debaryomyces hansenii in the second bioreactor at 30°C, 250rpm and an air-flow rate of 2Lmin(-1). Several steady states were reached at flow rates (F) in the range of 0.54-5.33mLmin(-1), leading to dilution rates (D) ranging from 0.032 to 0.320h(-1) in Bioreactor 1 and from 0.006 to 0.064h(-1) in Bioreactor 2. The maximum volumetric lactic acid productivity (Q(P LA)=2.908gL(-1)h(-1)) was achieved under D=0.266h(-1) (F=4.44mLmin(-1)); meanwhile, the maximum production of xylitol (5.1gL(-1)), volumetric xylitol productivity (Q(P xylitol)=0.218gL(-1)h(-1)), volumetric rate of xylose consumption (Q(S xylose)=0.398gL(-1)h(-1)) and product yield (0.55gg(-1)) were achieved at an intermediate dilution rate of 0.043h(-1) (F=3.55mLmin(-1)). Under these conditions, ethanol, which was the main by-product of the fermentation, was produced in higher amounts (1.9gL(-1)). Finally, lactic acid and xylitol were effectively recovered by conventional procedures. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Purification and characterization of xylitol dehydrogenase with l-arabitol dehydrogenase activity from the newly isolated pentose-fermenting yeast Meyerozyma caribbica 5XY2.

    PubMed

    Sukpipat, Wiphat; Komeda, Hidenobu; Prasertsan, Poonsuk; Asano, Yasuhisa

    2017-01-01

    Meyerozyma caribbica strain 5XY2, which was isolated from an alcohol fermentation starter in Thailand, was found to catabolize l-arabinose as well as d-glucose and d-xylose. The highest production amounts of ethanol from d-glucose, xylitol from d-xylose, and l-arabitol from l-arabinose were 0.45 g/g d-glucose, 0.60 g/g d-xylose, and 0.61 g/g l-arabinose with 21.7 g/L ethanol, 20.2 g/L xylitol, and 30.3 g/l l-arabitol, respectively. The enzyme with l-arabitol dehydrogenase (LAD) activity was purified from the strain and found to exhibit broad specificity to polyols, such as xylitol, d-sorbitol, ribitol, and l-arabitol. Xylitol was the preferred substrate with K m =16.1 mM and k cat /K m =67.0 min -1 mM -1 , while l-arabitol was also a substrate for the enzyme with K m =31.1 mM and k cat /K m =6.5 min -1  mM -1 . Therefore, this enzyme from M. caribbica was named xylitol dehydrogenase (McXDH). McXDH had an optimum temperature and pH at 40°C and 9.5, respectively. The McXDH gene included a coding sequence of 1086 bp encoding a putative 362 amino acid protein of 39 kDa with an apparent homopentamer structure. Native McXDH and recombinant McXDH exhibited relative activities toward l-arabitol of approximately 20% that toward xylitol, suggesting the applicability of this enzyme with the functions of XDH and LAD to the development of pentose-fermenting Saccharomyces cerevisiae. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  4. Group Discussion Topics. Revised Edition.

    ERIC Educational Resources Information Center

    Area Education Agency 7, Cedar Falls, IA.

    A collection of group disussion topics, developed and field-tested by a group of Iowa teachers, is presented in this guide. Twenty-eight topics for K-6 students, 24 topics for K-12 students, and 7 topics for students in grades 7-12 are included. Warm-up activities are given for introducing some of the topics, and lists of questions to provoke…

  5. Adolescent medicine training in pediatric residency programs.

    PubMed

    Fox, Harriette B; McManus, Margaret A; Klein, Jonathan D; Diaz, Angela; Elster, Arthur B; Felice, Marianne E; Kaplan, David W; Wibbelsman, Charles J; Wilson, Jane E

    2010-01-01

    The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine. We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience. Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training. Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.

  6. USSOCOM Research Topics 2011

    DTIC Science & Technology

    2010-01-01

    Law and legal institutions G31. U.S. SOF training of foreign military/security forces “to enhance their capacity” in counterterrorism, COIN, and...engagement advice to SOF. G31. U.S. SOF training of foreign military/security forces “to enhance their capacity” in counterterrorism, COIN, and FID is a...AND SUBTITLE USSOCOM Research Topics 2011 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  7. Acquisition Research Topics Catalog.

    DTIC Science & Technology

    1981-01-01

    AD-AG98 929 AIR FORCE BUSINESS RESEARCH MANAGEMENT CENTER WRIGHT--ETC F/S 5/1 1981ACQUISITION RESEARCH TOPICS CATALOG.(U) I UNCLASSIFIED NL I EEL...kELECTE MAY 14 1981 uoAIR FORCE BUSINESS RESEARCH MANAGEMENT CENTERI Wright-Patterson Air Force Base, Ohio 45433- ’ ’jCH MA G’ A rs l "-DIT.’u7 I ST AMEN’T...A /, App --vA fc, piibli release; I. . . ’li iLl :i ’.n: ix~lited *1,.: THE AIR FORCE BUSINESS RESEARCH MANAGEMENT CENTER WRIGHT-PATTERSON AIR FORCE

  8. N-Guanidino Derivatives of 1,5-Dideoxy-1,5-imino-d-xylitol are Potent, Selective, and Stable Inhibitors of β-Glucocerebrosidase.

    PubMed

    Sevšek, Alen; Šrot, Luka; Rihter, Jakob; Čelan, Maša; van Ufford, Linda Quarles; Moret, Ed E; Martin, Nathaniel I; Pieters, Roland J

    2017-04-06

    A series of lipidated guanidino and urea derivatives of 1,5-dideoxy-1,5-imino-d-xylitol were prepared from d-xylose using a concise synthetic protocol. Inhibition assays with a panel of glycosidases revealed that the guanidino analogues display potent inhibition against human recombinant β-glucocerebrosidase with IC 50 values in the low nanomolar range. Related urea analogues of 1,5-dideoxy-1,5-imino-d-xylitol were also synthesized and evaluated in the same fashion and found to be selective for β-galactosidase from bovine liver. No inhibition of human recombinant β-glucocerebrosidase was observed for the urea analogues. Computational studies provided insight into the potent activity of analogues bearing the substituted guanidine moiety in the inhibition of lysosomal glucocerebrosidase (GBA). © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Topical Benzocaine and Methemoglobinemia.

    PubMed

    Hieger, Michelle A; Afeld, Jamiee L; Cumpston, Kirk L; Wills, Brandon K

    Methemoglobinemia can cause life-threatening hypoxia associated with cyanosis and dyspnea not responsive to oxygen. We present a case of recurrent methemoglobinemia because of occult use of topical benzocaine to the vulva. A 47-year-old female with medical history of vulvar cancer and HIV undergoing chemoradiation was sent by the oncology clinic to the emergency department for worsening dyspnea, fatigue, hypoxia to 78% on room air, and gradual onset of cyanosis over the past week. A methemoglobin (MetHb) level was 49%. She received methylene blue, and repeat MetHb levels initially decreased but later increased to 56% despite continued treatment. Additional interviews with the patient revealed she was applying vagicaine (20% benzocaine), an over the counter preparation to the vulvar area for analgesia, and she continued application while hospitalized. She received a total of 6 mg/kg methylene blue and underwent vaginal lavage with 60 mL of sterile saline and cleansed with soapy water. Cyanosis, hypoxia, and dyspnea resolved, and the MetHb level decreased to 5.4% on the day of discharge. Benzocaine is a frequent cause of iatrogenic methemoglobinemia. In this case, additional medication inquiries were helpful in making the diagnosis. Many patients do not consider over-the-counter medications to be potentially harmful. Methemoglobinemia from occult topical benzocaine administration to the vulva is an uncommon exposure route. Occult medication use can be a source of methemoglobinemia.

  10. A Novel Aqueous Two Phase System Composed of Surfactant and Xylitol for the Purification of Lipase from Pumpkin (Cucurbita moschata) Seeds and Recycling of Phase Components.

    PubMed

    Amid, Mehrnoush; Manap, Mohd Yazid; Hussin, Muhaini; Mustafa, Shuhaimi

    2015-06-17

    Lipase is one of the more important enzymes used in various industries such as the food, detergent, pharmaceutical, textile, and pulp and paper sectors. A novel aqueous two-phase system composed of surfactant and xylitol was employed for the first time to purify lipase from Cucurbita moschata. The influence of different parameters such as type and concentration of surfactants, and the composition of the surfactant/xylitol mixtures on the partitioning behavior and recovery of lipase was investigated. Moreover, the effect of system pH and crude load on the degree of purification and yield of the purified lipase were studied. The results indicated that the lipase was partitioned into the top surfactant rich phase while the impurities partitioned into the bottom xylitol-rich phase using an aqueous two phase system composed of 24% (w/w) Triton X-100 and 20% (w/w) xylitol, at 56.2% of tie line length (TLL), (TTL is one of the important parameters in this study and it is determined from a bimodal curve in which the tie-line connects two nodes on the bimodal, that represent concentration of phase components in the top and bottom phases) and a crude load of 25% (w/w) at pH 8.0. Recovery and recycling of components was also measured in each successive step process. The enzyme was successfully recovered by the proposed method with a high purification factor of 16.4 and yield of 97.4% while over 97% of the phase components were also recovered and recycled. This study demonstrated that the proposed novel aqueous two phase system method is more efficient and economical than the traditional aqueous two phase system method for the purification and recovery of the valuable enzyme lipase.

  11. Effect of three-year consumption of erythritol, xylitol and sorbitol candies on various plaque and salivary caries-related variables.

    PubMed

    Runnel, Riina; Mäkinen, Kauko K; Honkala, Sisko; Olak, Jana; Mäkinen, Pirkko-Liisa; Nõmmela, Rita; Vahlberg, Tero; Honkala, Eino; Saag, Mare

    2013-12-01

    The objective of the present paper is to report results from oral biologic studies carried out in connection with a caries study. Samples of whole-mouth saliva and dental plaque were collected from initially 7- to 8-year-old subjects who participated in a 3-year school-based programme investigating the effect of the consumption of polyol-containing candies on caries rates. The subjects were randomized in three cohorts, consumed erythritol, xylitol, or sorbitol candies. The daily polyol consumption from the candies was approximately 7.5 g. A significant reduction in dental plaque weight from baseline (p<0.05) occurred in the erythritol group during almost all intervention years while no changes were found in xylitol and sorbitol groups. Usage of polyol candies had no significant or consistent effect on the levels of plaque protein, glucose, glycerol, or calcium, determined yearly in connection with caries examinations. After three years, the plaque of erythritol-receiving subjects contained significantly (p<0.05) lower levels of acetic acid and propionic acid than that of subjects receiving xylitol or sorbitol. Lactic acid levels partly followed the same pattern. The consumption of erythritol was generally associated with significantly (p<0.05) lower counts of salivary and plaque mutans streptococci compared with the other groups. There was no change in salivary Lactobacillus levels. Three-year consumption of erythritol-containing candies by initially 7- to 8-year old children was associated with reduced plaque growth, lower levels of plaque acetic acid and propionic acid, and reduced oral counts of mutans streptococci compared with the consumption of xylitol or sorbitol candies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Effects of sugar-free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial.

    PubMed

    Keukenmeester, R S; Slot, D E; Rosema, N A M; Van Loveren, C; Van der Weijden, G A

    2014-11-01

    The objective of this study was to test the effect of sugar-free chewing gum sweetened with xylitol or maltitol compared to the use of a gum base or no gum on gingivitis and plaque scores under both brushing and non-brushing circumstances. The design of the study was a four-group, double-blinded, randomized controlled study with a 3-week duration. In each group, the participants did not brush the teeth in the lower jaw designated to develop experimental gingivitis, while maintaining normal oral hygiene procedures in the upper jaw. After professional dental prophylaxis, the participants were allocated into one of four groups (xylitol, maltitol, gum base or no gum). Chewing gum was used five times a day for 10 min. 220 participants completed the study and provided evaluable data. The increase in bleeding on marginal probing (BOMP) and plaque scores (PS) in the non-brushed (lower) jaw with experimental gingivitis was significant in all groups (P < 0.001). As compared to the gum base, the increase in BOMP in the xylitol and maltitol group was significantly lower. In the brushed upper jaw, no significant changes for BOMP were observed from the baseline to the end point of the study, and there were no significant differences in BOMP and PS between the groups. In circumstances where regular brushing is performed, no effect of chewing gum was observed on bleeding and plaque scores. In the absence of brushing, chewing xylitol or maltitol gum provided a significant inhibitory effect on gingivitis scores compared to chewing gum base. The difference when compared to the group not using gum was not significant. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Anti-MRSA activity of oxysporone and xylitol from the endophytic fungus Pestalotia sp. growing on the Sundarbans mangrove plant Heritiera fomes.

    PubMed

    Nurunnabi, Tauhidur Rahman; Nahar, Lutfun; Al-Majmaie, Shaymaa; Rahman, S M Mahbubur; Sohrab, Md Hossain; Billah, Md Morsaline; Ismail, Fyaz M D; Rahman, M Mukhlesur; Sharples, George P; Sarker, Satyajit D

    2018-02-01

    Heritiera fomes Buch.-Ham., a mangrove plant from the Sundarbans, has adapted to a unique habitat, muddy saline water, anaerobic soil, brackish tidal activities, and high microbial competition. Endophytic fungal association protects this plant from adverse environmental conditions. This plant is used in Bangladeshi folk medicine, but it has not been extensively studied phytochemically, and there is hardly any report on investigation on endophytic fungi growing on this plant. In this study, endophytic fungi were isolated from the surface sterilized cladodes and leaves of H. fomes. The antimicrobial activities were evaluated against two Gram-positive and two Gram-negative bacteria and the fungal strain, Candida albicans. Extracts of Pestalotia sp. showed activities against all test bacterial strains, except that the ethyl acetate extract was inactive against Escherichia coli. The structures of the purified compounds, oxysporone and xylitol, were elucidated by spectroscopic means. The anti-MRSA potential of the isolated compounds were determined against various MRSA strains, that is, ATCC 25923, SA-1199B, RN4220, XU212, EMRSA-15, and EMRSA-16, with minimum inhibitory concentration values ranging from 32 to 128 μg/ml. This paper, for the first time, reports on the anti-MRSA property of oxysporone and xylitol, isolation of the endophyte Pestalotia sp. from H. fomes, and isolation of xylitol from a Pestalotia sp. Copyright © 2017 John Wiley & Sons, Ltd.

  14. [Carbohydrate and lipid metabolism following heart bypass operations. The effect of the intravenous hypocaloric administration of glucose versus glucose xylitol (1:1)].

    PubMed

    Gross, G; Schricker, T; Hilpert, W; Braun, G; von der Emde, J; Georgieff, M

    1992-10-30

    The effect of glucose-xylitol infusion on carbohydrate and lipid metabolism was investigated in 18 metabolically normal men (mean age 56.1 [35-65] years) with coronary heart disease after they had undergone a coronary artery bypass operation. During the first postoperative hours, group I (n = 6) received glucose only (2 mg/kg.min), group II (n = 6) glucose+xylitol (1 mg/kg.min each), and group II a glucose-containing electrolyte solution (0.83 mg/kg.min glucose). Blood glucose and insulin concentrations during the infusion period were significantly (P < 0.05) lower in groups II and III than I (glucose after 6 h: group I 21.5 [15.3-26.8] mmol/l; group II 14.2 [11.2-18.1] mmol/l; group III 12.6 [6.8-16.0] mmol/l). The highest lactate concentrations were reached in group I, 6 hours after the operation. Palmitine and stearine, as well as oleic and linoleic acid concentrations were significantly lower 12 hours postoperatively in group I than groups II and III (P < 0.05). These data indicate that energy-ineffective high glucose concentrations were avoided and endogenous lactate production reduced by the postoperative infusion of glucose+xylitol. In addition, it achieved a higher supply of free fatty acids as energy source to the myocardium without reaching toxic concentrations in the postischaemic myocardium.

  15. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals

    PubMed Central

    2016-01-01

    Sugar alcohols (polyols) are used in food manufacturing and in medical tests and examinations. d-Glucitol (sorbitol) and d-mannitol were previously the most common alditols used for these purposes. After the 1960s, xylitol became a common ingredient in noncariogenic confectioneries, oral hygiene products, and diabetic food. Erythritol, a polyol of the tetritol type, can be regarded as the sweetener of the “next generation.” The disaccharide polyols maltitol, lactitol, and isomalt have also been used in food manufacturing and in medical tests. Consumption of pentitol- and hexitol-type polyols and disaccharide polyols may cause gastrointestinal disturbances at least in unaccustomed subjects. The occurrence of disturbances depends on consumer properties and on the molecular size and configuration of the polyol molecule. Adaptation may take place as a result of enzyme induction in the intestinal flora. Some of the literature on xylitol has been difficult to access by health-care professionals and will be reviewed here. Research and clinical field experience have found no pathology in polyol-associated osmotic diarrhea—the intestinal mucosa having normal basic structure, except in extreme instances. Xylitol is better tolerated than hexitols or the disaccharide polyols. Erythritol, owing to its smaller molecular weight and configuration that differ from other alditols, normally avoids the gastrointestinal reactions encountered with other polyols. This review will also touch upon the FODMAPs diet concept. PMID:27840639

  16. Age Limit of Pediatrics.

    PubMed

    Hardin, Amy Peykoff; Hackell, Jesse M

    2017-09-01

    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  17. What is Pediatric Palliative Care?

    MedlinePlus

    ... FAQ Handout for Patients and Families What Is Pediatric Palliative Care? Pediatric Palliative care (pronounced pal-lee-uh-tiv) is ... life for both the child and the family. Pediatric palliative care is provided by a team of ...

  18. Symbiosis: Rich, Exciting, Neglected Topic

    ERIC Educational Resources Information Center

    Rowland, Jane Thomas

    1974-01-01

    Argues that the topic of symbiosis has been greatly neglected and underemphasized in general-biology textbooks. Discusses many types and examples of symbiosis, and provides an extensive bibliography of the literature related to this topic. (JR)

  19. Topical Acne Treatments and Pregnancy

    MedlinePlus

    ... are benzoyl peroxide, azelaic acid, glycolic acid, and salicylic acid. Prescription acne medications include tretinoin, adapalene, dapsone, and ... ACOG) recommends topical benzoyl peroxide, azelaic acid, topical salicylic acid and glycolic acid for treatment of acne in ...

  20. Pediatric Urologic Interventional Radiology

    PubMed Central

    Linscott, Luke

    2011-01-01

    Interventional radiologists are playing an increasingly important role in pediatric urologic intervention, working closely with the pediatric urologist. Interventional radiologists are frequently asked to establish percutaneous access to the renal collecting system prior to nephrolithotomy. Additionally, procedures such as percutaneous nephrostomy, ureteral stent placement and exchange, and renal parenchymal biopsy are frequently encountered requests. This article will review these common procedures and highlight techniques and pathology that are unique to the pediatric population. PMID:23204639

  1. The ACEII recombinant Trichoderma reesei QM9414 strains with enhanced xylanase production and its applications in production of xylitol from tree barks.

    PubMed

    Xiong, Lili; Kameshwar, Ayyappa Kumar Sista; Chen, Xi; Guo, Zhiyun; Mao, Canquan; Chen, Sanfeng; Qin, Wensheng

    2016-12-28

    ACEII transcription factor plays a significant role in regulating the expression of cellulase and hemicellulase encoding genes. Apart from ACEII, transcription factors such as XYR1, CRE1, HAP2/3/5 complex and ACEI function in a coordinated pattern for regulating the gene expression of cellulases and hemicellulases. Studies have demonstrated that ACEII gene deletion results in decreased total cellulase and xylanase activities with reduced transcript levels of lignocellulolytic enzymes. In this study, we have successfully transformed the ACEII transcription factor encoding gene in Trichoderma reesei to significantly improve its degrading abilities. Transformation experiments on parental strain T. reesei QM9414 has resulted in five genetically engineered strains T/Ace2-2, T/Ace2-5, T/Ace2-8, T/Ace5-4 and T/Ace10-1. Among which, T/Ace2-2 has exhibited significant increase in enzyme activity by twofolds, when compared to parental strain. The T/Ace2-2 was cultured on growth substrates containing 2% bark supplemented with (a) sugar free + MA medium (b) glucose + MA medium and (c) xylose + MA medium. The bark degradation efficiency of genetically modified T/Ace2-2 strain was assessed by analyzing the xylitol production yield using HPAEC. By 6th day, about 10.52 g/l of xylitol was produced through enzymatic conversion of bark (2% bark + MA + xylose) by the T/Ace2-2 strain and by 7th day the conversion rate was found to be 0.21 g/g. Obtained results confirmed that bark growth medium supplemented with D-xylose has profoundly increased the conversion rate of bark by T/Ace2-2 strain when compared to sugar free and glucose supplemented growth media. Results obtained from scanning electron microscopy has endorsed our current results. Bark samples inoculated with T/Ace2-2 strain has showed large number of degraded cells with clearly visible cavities and fractures, by exposing the microfibrillar interwoven complex. We propose a cost effective and ecofriendly method for

  2. What Is a Pediatric Gastroenterologist?

    MedlinePlus

    ... Life Medical Home Health Insurance Pediatric Specialists Family ... Page Content Article Body If your child has a digestive system, liver, or nutritional problem, a pediatric gastroenterologist has ...

  3. Availability of pediatric rheumatology training in United States pediatric residencies.

    PubMed

    Mayer, Michelle L; Brogan, Laura; Sandborg, Christy I

    2006-12-15

    To characterize the availability of pediatric rheumatology training in general pediatric residencies. We surveyed 195 pediatric residency program directors in the US using a combined Web-based and paper-based survey format. The survey asked directors about the availability of an on-site pediatric rheumatologist in their institution, the availability of formal pediatric rheumatology rotations, and the types of physicians involved in teaching curriculum components related to pediatric rheumatology. Survey responses were analyzed using descriptive and bivariate statistics. Of the 195 program directors surveyed, 127 (65%) responded. More than 40% of responding programs did not have a pediatric rheumatologist on site. Programs with on-site pediatric rheumatologists were significantly more likely than those without on-site pediatric rheumatologists to have an on-site pediatric rheumatology rotation available (94% versus 9%; P < 0.001). Although pediatric rheumatologists' involvement in 4 curriculum areas relevant to pediatric rheumatology is nearly universal in programs with on-site pediatric rheumatologists, nearly two-thirds of programs without on-site pediatric rheumatologists rely on internist rheumatologists, general pediatricians, or other physicians to cover these areas. Programs without pediatric rheumatologists on site are less likely to have pediatric rheumatology rotations and are more likely to rely on internist rheumatologists and nonrheumatologists to address rheumatology-related curriculum components. Lack of exposure to pediatric rheumatology during residency may impede general pediatricians' ability to identify and treat children with rheumatic diseases, undermine resident interest in this field, and perpetuate low levels of supply.

  4. Hot topics in noise

    NASA Astrophysics Data System (ADS)

    Stinson, Michael R.

    2003-10-01

    Our world continues to be a noisy place and the challenge to ``increase and diffuse knowledge of noise propagation, passive and active noise control, and the effects of noise'' remains. In the last several years, noise in the classroom has emerged as one of the hotter topics: Considerable progress has been made in the underpinning research, the formulation of recommendations, and the process of educating society on the social and personal impact of inadequate acoustical conditions in classrooms. The establishment of the ANSI S12.60-2002 standard for classroom acoustics was a milestone event. Noise in cities and the understanding of our soundscapes are subjects of ongoing significance. The development of standards and regulations is a continuing process, with urban community noise regulations, aviation noise, and the preservation of natural quiet in national parks being of current concern. New methods to reduce noise are under development and include passive and active methods of noise control, techniques for modeling the performance of noise barriers, and approaches for designing product sound quality.

  5. Type 2 diabetes mellitus in pediatrics: a new challenge.

    PubMed

    Van Name, Michelle; Santoro, Nicola

    2013-11-01

    The increased prevalence of childhood obesity in the last few years has been accompanied by the increase in prevalence of type 2 diabetes in pediatrics. In this paper, we will review the risk factors and the pathogenic determinants leading to type 2 diabetes in youth. We searched on PubMed with the key words: obesity, type 2 diabetes, children, adolescents, youth, non-alcoholic fatty liver disease, genes and selected those publications written in English that we judged to be relevant to the topic of the review. Based on the data present in the literature, we reviewed the following three topics: 1) the role of ectopic fat deposition, in particular of fatty liver, in the pathogenesis of pediatric type 2 diabetes; 2) the progression to type 2 diabetes in pediatrics and how it differs from adults, and 3) current theraputic options. Type 2 diabetes in youth is a complex disease, creating new challenges in treatment and prevention.

  6. HIV/AIDS and Pediatric AIDS. The Arc Q & A.

    ERIC Educational Resources Information Center

    Kowalski, Jo Anne T.

    This fact sheet uses a question-and-answer format to summarize what is known about HIV/AIDS (Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome) and pediatric AIDS and applies this information to children in school settings. Questions and answers address the following topics: what the AIDS disease and HIV infection are; estimates…

  7. Economics of pediatric burns.

    PubMed

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

  8. Teaching Prevention in Pediatrics.

    ERIC Educational Resources Information Center

    Cheng, Tina L.; Greenberg, Larrie; Loeser, Helen; Keller, David

    2000-01-01

    Reviews methods of teaching preventive medicine in pediatrics and highlights innovative programs. Methods of teaching prevention in pediatrics include patient interactions, self-directed learning, case-based learning, small-group learning, standardized patients, computer-assisted instruction, the Internet, student-centered learning, and lectures.…

  9. Pediatric oncologic endosurgery.

    PubMed

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

    2017-08-01

    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  10. Physical activity and pediatric multiple sclerosis: Developing a research agenda.

    PubMed

    Yeh, E Ann; Kinnett-Hopkins, Dominique; Grover, Stephanie A; Motl, Robert W

    2015-11-01

    Three-quarters of children with multiple sclerosis (MS) experience fatigue or depression, and progressive neurocognitive decline may be seen as early as two years after MS diagnosis. Furthermore, a higher magnetic resonance imaging disease burden is seen in pediatric-onset MS compared with adult-onset MS. To date, limited knowledge exists regarding behavioral methods for managing symptoms and disease progression in pediatric MS. To that end, this paper builds an evidence-based argument for the possible symptomatic and disease-modifying effects of exercise and physical activity in pediatric MS. This will be accomplished through: (a) a review of pediatric MS and its consequences; (b) a brief overview of physical activity and its consequences in children and adults with MS; and (c) a selective review of research on the neurological benefits of physical activity in pediatric populations. This topical review concludes with a list of 10 questions to guide future research on physical activity and pediatric MS. The objective of this paper is the provision of a research interest, focus and agenda involving pediatric MS and its lifelong management though exercise and physical activity behavior. Such an agenda is critical as the effects and maintenance of physical activity and exercise track across the lifespan, particularly when developed in the early stages of life. © The Author(s), 2015.

  11. General practitioners' use of caries-preventive agents in adult patients versus pediatric patients: findings from the dental practice-based research network.

    PubMed

    Riley, Joseph L; Gordan, Valeria V; Rindal, D Brad; Fellows, Jeffrey L; Williams, O Dale; Ritchie, Lloyd K; Gilbert, Gregg H

    2010-06-01

    In this study, the authors tested the frequency of dentists' recommendations for and use of caries-preventive agents for children as compared with adults. The authors surveyed 467 general dentists in the Dental Practice-Based Research Network who practice within the United States and treat both pediatric and adult patients. They asked dentists to identify the percentage of their patients for whom they had administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse and xylitol gum. Dentists were less likely to provide adult patients than pediatric patients with in-office caries-preventive agents. However, the rate at which they recommended at-home preventive regimens for the two groups of patients was similar. Dentists with a conservative approach to caries treatment were the most likely to use and recommend the use of caries-preventive agents at similar rates in adults as in children. In addition, dentists in practices with a greater number of patients who had dental insurance were significantly more likely to provide in-office fluoride or sealants to adult patients than to pediatric patients. General dentists use in-office caries-preventive agents more commonly with their pediatric patients than with their adult patients. General dentists should consider providing additional in-office caries-preventive agents for their adult patients who are at increased risk of experiencing dental caries.

  12. Topics in Bethe Ansatz

    NASA Astrophysics Data System (ADS)

    Wang, Chunguang

    Integrable quantum spin chains have close connections to integrable quantum field. theories, modern condensed matter physics, string and Yang-Mills theories. Bethe. ansatz is one of the most important approaches for solving quantum integrable spin. chains. At the heart of the algebraic structure of integrable quantum spin chains is. the quantum Yang-Baxter equation and the boundary Yang-Baxter equation. This. thesis focuses on four topics in Bethe ansatz. The Bethe equations for the isotropic periodic spin-1/2 Heisenberg chain with N. sites have solutions containing ±i/2 that are singular: both the corresponding energy and the algebraic Bethe ansatz vector are divergent. Such solutions must be carefully regularized. We consider a regularization involving a parameter that can be. determined using a generalization of the Bethe equations. These generalized Bethe. equations provide a practical way of determining which singular solutions correspond. to eigenvectors of the model. The Bethe equations for the periodic XXX and XXZ spin chains admit singular. solutions, for which the corresponding eigenvalues and eigenvectors are ill-defined. We use a twist regularization to derive conditions for such singular solutions to bephysical, in which case they correspond to genuine eigenvalues and eigenvectors of. the Hamiltonian. We analyze the ground state of the open spin-1/2 isotropic quantum spin chain. with a non-diagonal boundary term using a recently proposed Bethe ansatz solution. As the coefficient of the non-diagonal boundary term tends to zero, the Bethe roots. split evenly into two sets: those that remain finite, and those that become infinite. We. argue that the former satisfy conventional Bethe equations, while the latter satisfy a. generalization of the Richardson-Gaudin equations. We derive an expression for the. leading correction to the boundary energy in terms of the boundary parameters. We argue that the Hamiltonians for A(2) 2n open quantum spin chains

  13. The outcomes of children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

    PubMed

    Quasney, Michael W; López-Fernández, Yolanda M; Santschi, Miriam; Watson, R Scott

    2015-06-01

    To provide additional details and evidence behind the recommendations for outcomes assessment of patients with pediatric acute respiratory distress syndrome from the Pediatric Acute Lung Injury Consensus Conference. Consensus conference of experts in pediatric acute lung injury. A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. The outcomes subgroup comprised four experts. When published data were lacking, a modified Delphi approach emphasizing strong professional agreement was used. The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the topics related to pediatric acute respiratory distress syndrome, seven of which related to outcomes after pediatric acute respiratory distress syndrome. All seven recommendations had strong agreement. Children with acute respiratory distress syndrome continue to have a high mortality, specifically, in relation to certain comorbidities and etiologies related to pediatric acute respiratory distress syndrome. Comorbid conditions, such as an immunocompromised state, increase the risk of mortality even further. Likewise, certain etiologies, such as non-pulmonary sepsis, also place children at a higher risk of mortality. Significant long-term effects were reported in adult survivors of acute respiratory distress syndrome: diminished lung function and exercise tolerance, reduced quality of life, and diminished neurocognitive function. Little knowledge of long-term outcomes exists in children who survive pediatric acute respiratory distress syndrome. Characterization of the longer term consequences of pediatric acute respiratory distress syndrome in children is vital to help identify opportunities for improved therapeutic and rehabilitative strategies that will lessen the long-term burden of pediatric acute

  14. [Non adherence and topical steroids].

    PubMed

    Aubert, H; Barbarot, S

    2012-01-01

    Compliance raises very specific questions in dermatology related to the frequent use of local treatments: creams or ointments, including topical corticosteroids. The adherence in dermatology is a complex issue. It is difficult to quantify objectively because of the patient subjectivity, the constant adaptation to changes in the course of the disease, and due to the lack of adapted device. Moreover poor compliance may be related to topical corticosteroid phobia, defined as a fear vis-à-vis the topical corticosteroids, rational or not. The topical corticosteroid phobia is very common in the management of chronic inflammatory skin diseases especially in atopic dermatitis. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Pediatric maxillary fractures.

    PubMed

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

    2011-07-01

    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  16. [Robotics in pediatric surgery].

    PubMed

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  17. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.

    PubMed

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P

    2016-02-01

    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  18. 78 FR 15958 - Submission for OMB Review; 30-day Comment Request: Pediatric Palliative Care Campaign Pilot Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... Information Collection: NINR developed a Pediatric Palliative Care Campaign to address the communications... conversation and addressing the communications needs of health care providers around this topic. This...; 30-day Comment Request: Pediatric Palliative Care Campaign Pilot Survey SUMMARY: Under the provisions...

  19. Resources for Topics in Architecture.

    ERIC Educational Resources Information Center

    Van Noate, Judith, Comp.

    This guide for conducting library research on topics in architecture or on the work of a particular architect presents suggestions for utilizing four categories of resources: books, dictionaries and encyclopedias, indexes, and a periodicals and series list (PASL). Two topics are researched as examples: the contemporary architect Richard Meier, and…

  20. Linguistic Extensions of Topic Models

    ERIC Educational Resources Information Center

    Boyd-Graber, Jordan

    2010-01-01

    Topic models like latent Dirichlet allocation (LDA) provide a framework for analyzing large datasets where observations are collected into groups. Although topic modeling has been fruitfully applied to problems social science, biology, and computer vision, it has been most widely used to model datasets where documents are modeled as exchangeable…

  1. [Violence Prevention: A Topical Newsletter.

    ERIC Educational Resources Information Center

    Bourland, Eric

    1995-01-01

    This newsletter theme issue addresses the issue of violence prevention in American schools and is based on presentations and discussions at the Workgroup To Improve the Quality of Technical Assistance around the Topic of Violence Prevention held in Washington, D.C. on June 12-14, 1995. The newsletter reports on the following presentation topics:…

  2. Recent advances in topical anesthesia

    PubMed Central

    2016-01-01

    Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain. PMID:28879311

  3. The purification and properties of human liver ketohexokinase. A role for ketohexokinase and fructose-bisphosphate aldolase in the metabolic production of oxalate from xylitol.

    PubMed Central

    Bais, R; James, H M; Rofe, A M; Conyers, R A

    1985-01-01

    Ketohexokinase (EC 2.7.1.3) was purified to homogeneity from human liver, and fructose-bisphosphate aldolase (EC 4.1.2.13) was partially purified from the same source. Ketohexokinase was shown, by column chromatography and polyacrylamide-gel electrophoresis, to be a dimer of Mr 75000. Inhibition studies with p-chloromercuribenzoate and N-ethylmaleimide indicate that ketohexokinase contains thiol groups, which are required for full activity. With D-xylulose as substrate, ketohexokinase and aldolase can catalyse a reaction sequence which forms glycolaldehyde, a known precursor of oxalate. The distribution of both enzymes in human tissues indicates that this reaction sequence occurs mainly in the liver, to a lesser extent in the kidney, and very little in heart, brain and muscle. The kinetic properties of ketohexokinase show that this enzyme can phosphorylate D-xylulose as readily as D-fructose, except that higher concentrations of D-xylulose are required. The kinetic properties of aldolase show that the enzyme has a higher affinity for D-xylulose 1-phosphate than for D-fructose 1-phosphate. These findings support a role for ketohexokinase and aldolase in the formation of glycolaldehyde. The effect of various metabolites on the activity of the two enzymes was tested to determine the conditions that favour the formation of glycolaldehyde from xylitol. The results indicate that few of these metabolites affect the activity of ketohexokinase, but that aldolase can be inhibited by several phosphorylated compounds. This work suggests that, although the formation of oxalate from xylitol is normally a minor pathway, under certain conditions of increased xylitol metabolism oxalate production can become significant and may result in oxalosis. Images Fig. 1. PMID:2996495

  4. Single-cell Protein and Xylitol Production by a Novel Yeast Strain Candida intermedia FL023 from Lignocellulosic Hydrolysates and Xylose.

    PubMed

    Wu, Jiaqiang; Hu, Jinlong; Zhao, Shumiao; He, Mingxiong; Hu, Guoquan; Ge, Xiangyang; Peng, Nan

    2018-05-01

    Yeasts are good candidates to utilize the hydrolysates of lignocellulose, the most abundant bioresource, for bioproducts. This study aimed to evaluate the efficiencies of single-cell protein (SCP) and xylitol production by a novel yeast strain, Candida intermedia FL023, from lignocellulosic hydrolysates and xylose. This strain efficiently assimilated hexose, pentose, and cellubiose for cell mass production with the crude protein content of 484.2 g kg -1 dry cell mass. SCP was produced by strain FL023 using corncob hydrolysate and urea as the carbon and nitrogen sources with the dry cell mass productivity 0.86 g L -1  h -1 and the yield of 0.40 g g -1 sugar. SCP was also produced using NaOH-pretreated Miscanthus sinensis straw and corn steep liquor as the carbon and nitrogen sources through simultaneous saccharification and fermentation with the dry cell productivity of 0.23 g L -1  h -1 and yield of 0.17 g g -1 straw. C. intermedia FL023 was tolerant to 0.5 g L -1 furfural, acetic acid, and syringaldehyde in xylitol fermentation and produced 45.7 g L -1 xylitol from xylose with the productivity of 0.38 g L -1  h -1 and the yield of 0.57 g g -1 xylose. This study provides feasible methods for feed and food additive production from the abundant lignocellulosic bioresources.

  5. Causes of Pediatric Cardiomyopathy

    MedlinePlus

    ... pediatric cardiomyopathy. Mutations are defects in the DNA spiral, the protein structure of many genes. The abnormalities ... in the future there will be a clinical method to identify carriers of the gene within affected ...

  6. [Complications in pediatric anesthesia].

    PubMed

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia.

  7. Pediatric liver transplantation

    PubMed Central

    Spada, Marco; Riva, Silvia; Maggiore, Giuseppe; Cintorino, Davide; Gridelli, Bruno

    2009-01-01

    In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of improvements in medical, surgical and anesthetic management, organ availability, immunosuppression, and identification and treatment of postoperative complications. The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients. Newer immunosuppression regimens, including induction therapy, have had a significant impact on graft and patient survival. Future developments of pediatric liver transplantation will deal with long-term follow-up, with prevention of immunosuppression-related complications and promotion of as normal growth as possible. This review describes the state-of-the-art in pediatric liver transplantation. PMID:19222089

  8. Effects of xylitol chewing gum on salivary flow rate, pH, buffering capacity and presence of Streptococcus mutans in saliva.

    PubMed

    Ribelles Llop, M; Guinot Jimeno, F; Mayné Acién, R; Bellet Dalmau, L J

    2010-03-01

    The first studies on the use of chewing gum in dentistry were done in the 1970s. The Turku Sugar Studies, carried out between 1970 and 1973, showed the excellent anticaries properties of xylitol chewing gums. Since then, many dentists, particularly in Scandinavian countries, have studied the role of chewing xylitol-sweetened chewing gums as another preventive strategy in the control of dental caries. To compare variations in salivary flow rate, pH, buffering capacity, and levels of Streptococcus mutans in baseline conditions and after chewing paraffin pellets or xylitol chewing gum in children between the ages of 6 and 12 years who eat lunch in a school canteen. The study sample consisted of 90 children divided into 2 study groups, and a control group. The children ate lunch at the canteen of the Escultor Ortells state school in the town of Vila-real (Castellón, Spain). The baseline data recorded in the first phase of the study were compared with the data recorded in the second phase, after 15 minutes of chewing xylitol- sweetened chewing gums or paraffin pellets, depending on the study group. Salivary flow rate was measured by collecting the stimulated saliva in a graduated beaker. Levels of pH were measured using a Cyberscan pH 110 pH meter (Eutech Instruments). CRT buffer strips and the CRT bacteria test (Ivoclar-Vivadent) were used to measure buffering capacity and levels of S. mutans, respectively. The data obtained after sample collection were compared by means of a 1-way analysis of variance using the StatGraphics Plus statistical software package, version 5.0. Statistically significant differences were found (p<.05) when pH, buffering capacity and levels of S. mutans were compared between the 3 groups. Comparison of salivary flow rates revealed no statistically significant differences (p>.05), though salivary flow rates were higher in the groups where gum was chewed. The effect of chewing is essential to the stimulation of salivary flow and the resulting

  9. Pediatric Salivary Gland Malignancies.

    PubMed

    Ord, Robert A; Carlson, Eric R

    2016-02-01

    Pediatric malignant salivary gland tumors are extremely rare. The percentage of malignant tumors is higher than that seen in adults, although the outcomes in terms of survival are better in pediatric patients. The mainstay of treatment is surgical excision with negative margins. This article reviews current concepts in demographics, etiology, management, and outcomes of malignant salivary tumors in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Pediatric oncology in Turkey.

    PubMed

    Kebudi, Rejin

    2012-03-01

    The survival of children with cancer has increased dramatically in the last decades, as a result of advances in diagnosis, treatment and supportive care. Each year in Turkey, 2500-3000 new childhood cancer cases are expected. According to the Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Societies Registry, about 2000 new pediatric cancer cases are reported each year. The population in Turkey is relatively young. One fourth of the population is younger than 15 years of age. According to childhood mortality, cancer is the fourth cause of death (7.2%) after infections, cardiac deaths and accidents. The major cancers in children in Turkey are leukemia (31%), lymphoma (19%), central nervous system (CNS) neoplasms (13%), neuroblastomas (7%), bone tumors (6.1%), soft tissue sarcomas (6%), followed by renal tumors, germ cell tumors, retinoblastoma, carcinomas-epithelial neoplasms, hepatic tumors and others. Lymphomas rank second in frequency as in many developing countries in contrast to West Europe or USA, where CNS neoplasms rank second in frequency. The seven-year survival rate in children with malignancies in Turkey is 65.8%. The history of modern Pediatric Oncology in Turkey dates back to the 1970's. Pediatric Oncology has been accepted as a subspecialty in Turkey since 1983. Pediatric Oncologists are all well trained and dedicated. All costs for the diagnosis and treatment of children with cancer is covered by the government. Education and infrastructure for palliative care needs improvement.

  11. [Pediatric organ transplantation].

    PubMed

    Carcassonne, M; Delarue, A; Monfort, G; Noirclerc, M; Guys, J M; Torres, C

    1989-01-01

    Since we started our pediatric kidney transplant program in 1970, we advocate children's transplantation to be performed in pediatric surgery units. Recent progress in immuno-suppression with ciclosporine and in operative procedures lead us to extend the program to liver transplantations in 1986, then to heart and lung transplantations in 1988. The Pediatric Transplant Unit was designed to assume the pre-operative evaluation of the recipients and the post-operative course of transplanted patients, closely connected to all specialists dealing with medical and surgical diseases of children. 29 patients were transplanted (kidney: 8, liver: 14, heart: 1, lungs: 6) with a 83% overall survival rate. The goal of this paper is not to discuss and compare indications or results with others series. Through our experience of pediatric organ transplantation, we shall try to point out the main advantages of a Pediatric Transplantation Unit: it optimizes the management of the rare pediatric donnors, and allows better skill and efficiency of the numerous specialities concerned by organ transplantation, such as intensive care, infectiology, immunology, radiology... The common medical and para-medical staff, common operative theater, and common use of equipment in the same department for transplantation of different organs is also an important matter to be considered now in term of cost-effectiveness.

  12. Mental Mechanisms for Topics Identification

    PubMed Central

    2014-01-01

    Topics identification (TI) is the process that consists in determining the main themes present in natural language documents. The current TI modeling paradigm aims at acquiring semantic information from statistic properties of large text datasets. We investigate the mental mechanisms responsible for the identification of topics in a single document given existing knowledge. Our main hypothesis is that topics are the result of accumulated neural activation of loosely organized information stored in long-term memory (LTM). We experimentally tested our hypothesis with a computational model that simulates LTM activation. The model assumes activation decay as an unavoidable phenomenon originating from the bioelectric nature of neural systems. Since decay should negatively affect the quality of topics, the model predicts the presence of short-term memory (STM) to keep the focus of attention on a few words, with the expected outcome of restoring quality to a baseline level. Our experiments measured topics quality of over 300 documents with various decay rates and STM capacity. Our results showed that accumulated activation of loosely organized information was an effective mental computational commodity to identify topics. It was furthermore confirmed that rapid decay is detrimental to topics quality but that limited capacity STM restores quality to a baseline level, even exceeding it slightly. PMID:24744775

  13. Topic Model for Graph Mining.

    PubMed

    Xuan, Junyu; Lu, Jie; Zhang, Guangquan; Luo, Xiangfeng

    2015-12-01

    Graph mining has been a popular research area because of its numerous application scenarios. Many unstructured and structured data can be represented as graphs, such as, documents, chemical molecular structures, and images. However, an issue in relation to current research on graphs is that they cannot adequately discover the topics hidden in graph-structured data which can be beneficial for both the unsupervised learning and supervised learning of the graphs. Although topic models have proved to be very successful in discovering latent topics, the standard topic models cannot be directly applied to graph-structured data due to the "bag-of-word" assumption. In this paper, an innovative graph topic model (GTM) is proposed to address this issue, which uses Bernoulli distributions to model the edges between nodes in a graph. It can, therefore, make the edges in a graph contribute to latent topic discovery and further improve the accuracy of the supervised and unsupervised learning of graphs. The experimental results on two different types of graph datasets show that the proposed GTM outperforms the latent Dirichlet allocation on classification by using the unveiled topics of these two models to represent graphs.

  14. Femtosecond laser-assisted cataract surgery in pediatric patients.

    PubMed

    Corredor-Ortega, Claudia; Gonzalez-Salinas, Roberto; Montero, María José; González-Flores, Rocío; Collura-Merlier, Allan; Cervantes-Coste, Guadalupe; Mendoza-Schuster, Erick; Velasco-Barona, Cecilio

    2018-04-01

    Pediatric cataract surgery poses a significant challenge for the cataract surgeon, in part because an elastic anterior capsule can make capsulorhexis difficult. With the use of femtosecond laser-assisted cataract surgery (FLACS), however, the continuous curvilinear capsulorhexis can be made with predictable size, circular shape, centration, and accuracy. In addition, topical anesthesia can be used for the FLACS docking procedure in cooperative children above 6 years of age, using transparent adhesive polyurethane film segments. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  15. Common pediatric head and neck congenital/developmental anomalies.

    PubMed

    LaPlante, Justin K; Pierson, Nicholas S; Hedlund, Gary L

    2015-01-01

    Pediatric head and neck neuroradiology is a broad and complex topic. This article focuses on several of the common and sometimes challenging pediatric head and neck congenital/developmental anomalies physicians may encounter in clinical practice. Although some diagnoses may be evident on physical examination, others may present a diagnostic dilemma. Patients may initially present with a variety of secondary findings. Imaging serves an important role in making a diagnosis, guiding referral, and in some cases even providing treatment options through interventional radiology. Key diagnostic criteria and critical points of interest for each diagnosis are presented. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Ocular bioavailability and systemic loss of topically applied ophthalmic drugs.

    PubMed

    Patton, T F; Francoeur, M

    1978-02-01

    We used 20-day-old rabbits as a model to show that the ocular bioavailability of topically applied pilocarpine nitrate increased as the instilled volume of the drug was decreased. Decreasing the instilled volume from 25 to 5 microliter permitted a dosage reduction of greater than 2.5 times without sacrificing overall drug concentrations in the eye. Since only a small fraction of topically applied doses to the eye actually reached the interior of the eye, the remainder of the dose was lost and available for systemic absorption. The reduction in dosage permitted by this approach resulted in less drug appearing in the general circulation, as shown by comparative plasma level-time profiles. The advantages of reducing drop size are improved ocular bioavailability permitting the use of smaller doses; and less systemic drug loss, thus reducing the potential for systemic side effects. These advantages could be especially significant in the pediatric and geriatric age groups.

  17. Neonatal and pediatric regionalized systems in pediatric emergency mass critical care

    PubMed Central

    Barfield, Wanda D.; Krug, Steven E.; Kanter, Robert K.; Gausche-Hill, Marianne; Brantley, Mary D.; Chung, Sarita; Kissoon, Niranjan

    2015-01-01

    Introduction Improved health outcomes are associated with neonatal and pediatric critical care in well-organized, cohesive, regionalized systems that are prepared to support and rehabilitate critically ill victims of a mass casualty event. However, present systems lack adequate surge capacity for neonatal and pediatric mass critical care. In this document, we outline the present reality and suggest alternative approaches. Methods In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations. Steering Committee members established subcommittees by topic area and performed literature reviews of MEDLINE and Ovid databases. The Steering Committee produced draft outlines through consensus-based study of the literature and convened October 6–7, 2009, in New York, NY, to review and revise each outline. Eight draft documents were subsequently developed from the revised outlines as well as through searches of MEDLINE updated through March 2010. The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29–30, 2010. Feedback on each manuscript was compiled and the Steering Committee revised each document to reflect expert input in addition to the most current medical literature. Task Force Recommendations States and regions (facilitated by federal partners) should review current emergency operations and devise appropriate plans to address the population-based needs of infants and children in large-scale disasters. Action at

  18. Heterologous expression of Spathaspora passalidarum xylose reductase and xylitol dehydrogenase genes improved xylose fermentation ability of Aureobasidium pullulans.

    PubMed

    Guo, Jian; Huang, Siyao; Chen, Yefu; Guo, Xuewu; Xiao, Dongguang

    2018-04-30

    Aureobasidium pullulans is a yeast-like fungus that can ferment xylose to generate high-value-added products, such as pullulan, heavy oil, and melanin. The combinatorial expression of two xylose reductase (XR) genes and two xylitol dehydrogenase (XDH) genes from Spathaspora passalidarum and the heterologous expression of the Piromyces sp. xylose isomerase (XI) gene were induced in A. pullulans to increase the consumption capability of A. pullulans on xylose. The overexpression of XYL1.2 (encoding XR) and XYL2.2 (encoding XDH) was the most beneficial for xylose utilization, resulting in a 17.76% increase in consumed xylose compared with the parent strain, whereas the introduction of the Piromyces sp. XI pathway failed to enhance xylose utilization efficiency. Mutants with superior xylose fermentation performance exhibited increased intracellular reducing equivalents. The fermentation performance of all recombinant strains was not affected when glucose or sucrose was utilized as the carbon source. The strain with overexpression of XYL1.2 and XYL2.2 exhibited excellent fermentation performance with mimicked hydrolysate, and pullulan production increased by 97.72% compared with that of the parent strain. The present work indicates that the P4 mutant (using the XR/XDH pathway) with overexpressed XYL1.2 and XYL2.2 exhibited the best xylose fermentation performance. The P4 strain showed the highest intracellular reducing equivalents and XR and XDH activity, with consequently improved pullulan productivity and reduced melanin production. This valuable development in aerobic fermentation by the P4 strain may provide guidance for the biotransformation of xylose to high-value products by A. pullulans through genetic approach.

  19. Optimized extraction by cetyl trimethyl ammonium bromide reversed micelles of xylose reductase and xylitol dehydrogenase from Candida guilliermondii homogenate.

    PubMed

    Cortez, Ely Vieira; Pessoa, Adalberto; das Graças de Almeida Felipe, Maria; Roberto, Inês Conceição; Vitolo, Michele

    2004-07-25

    The intracellular enzymes xylose reductase (XR, EC 1.1.1.21) and xylitol dehydrogenase (XD, EC 1.1.1.9) from Candida guilliermondii, grown in sugar cane bagasse hydrolysate, were separated by reversed micelles of cetyl trimethyl ammonium bromide (CTAB) cationic surfactant. An experimental design was employed to optimize the extraction conditions of both enzymes. Under these conditions (temperature = 5 degree C, hexanol: isooctane proportion = 5% (v/v), 22 %, surfactant concentration = 0.15M, pH = 7.0 and electrical conductivity = 14 mScm(-1)) recovery values of about 100 and 80% were achieved for the enzymes XR and XD, respectively. The purity of XR and XD increased 5.6- and 1.8-fold, respectively. The extraction process caused some structural modifications in the enzymes molecules, as evidenced by the alteration of K(M) values determined before and after extraction, either in regard to the substrate (up 35% for XR and down 48% for XD) or cofactor (down 29% for XR and up 11% for XD). However, the average variation of V(max) values for both enzymes was not higher than 7%, indicating that the modified affinity of enzymes for their respective substrates and cofactors, as consequence of structural modifications suffered by them during the extraction, are compensated in some extension. This study demonstrated that liquid-liquid extraction by CTAB reversed micelles is an efficient process to separate the enzymes XR and XD present in the cell extract, and simultaneously increase the enzymatic activity and the purity of both enzymes produced by C. guilliermondii.

  20. Bed Bug Clearinghouse by Topic

    EPA Pesticide Factsheets

    This information is intended to help states, communities, and consumers prevent and control bed bug infestations. Topics include bed bug biology and behavior, detection and monitoring, non-chemical techniques such as heat treatment, and pesticides.

  1. Simulation in pediatric anesthesiology.

    PubMed

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  2. The topical treatment of psoriasis.

    PubMed

    van de Kerkhof, P C M; Vissers, W H P M

    2003-01-01

    According to the patients, improvement of efficacy, long-term safety and improvement of compliance are needed. The topical treatment has been innovated during the last decade. Most important are the introduction of two new classes of treatments: topical vitamin D(3) analogues and the retinoid tazarotene. To what extent, however, have we achieved developments which are in line with the needs as expressed by the patients? Improved efficacy has been realized by successful combinations of topical treatments. In particular, the combinations of dithranol, vitamin D(3) and tazarotene with a topical corticosteroid proved to be very effective with a reduced profile of side-effects. The efficacy of vitamin D(3) analogues and tazarotene is such that the efficacy of a potent corticosteroid (betamethasone-17-valerate) is approached; calcipotriol even showed an efficacy which is at least as good as this corticosteroid. The long-term safety of new compounds has been evaluated for at least 12 months in large studies. Remarkably for corticosteroids such information is available for only 12 weeks. However, intermittent applications of a topical corticosteroid in combination with another topical treatment provide an effective and safe long-term control of psoriasis. Compliance is a conditio sine qua non for an effective topical treatment. Important progress has been made to increase compliance. Short-contact dithranol has been popularized as an ambulatory treatment which is a highly effective approach as a care instruction programme. Formulations which are better from a cosmetical point of view have been developed for various topical treatments. Reduction of the frequency of applications proved to be possible for most treatments. Once daily applications for corticosteroids, vitamin D(3) analogues and retinoids have been developed, and intermittent applications, a few times per week, are possible for corticosteroids, which proved to be very effective with a reduced profile of side

  3. Thermophysical Characterization of MgCl2·6H2O, Xylitol and Erythritol as Phase Change Materials (PCM) for Latent Heat Thermal Energy Storage (LHTES)

    PubMed Central

    Höhlein, Stephan; König-Haagen, Andreas; Brüggemann, Dieter

    2017-01-01

    The application range of existing real scale mobile thermal storage units with phase change materials (PCM) is restricted by the low phase change temperature of 58 ∘C for sodium acetate trihydrate, which is a commonly used storage material. Therefore, only low temperature heat sinks like swimming pools or greenhouses can be supplied. With increasing phase change temperatures, more applications like domestic heating or industrial process heat could be operated. The aim of this study is to find alternative PCM with phase change temperatures between 90 and 150 ∘C. Temperature dependent thermophysical properties like phase change temperatures and enthalpies, densities and thermal diffusivities are measured for the technical grade purity materials xylitol (C5H12O5), erythritol (C4H10O4) and magnesiumchloride hexahydrate (MCHH, MgCl2·6H2O). The sugar alcohols xylitol and erythritol indicate a large supercooling and different melting regimes. The salt hydrate MgCl2·6H2O seems to be a suitable candidate for practical applications. It has a melting temperature of 115.1 ± 0.1 ∘C and a phase change enthalpy of 166.9 ± 1.2 J/g with only 2.8 K supercooling at sample sizes of 100 g. The PCM is stable over 500 repeated melting and solidification cycles at differential scanning calorimeter (DSC) scale with only small changes of the melting enthalpy and temperature. PMID:28772806

  4. Atomic layer deposited highly dispersed platinum nanoparticles supported on non-functionalized multiwalled carbon nanotubes for the hydrogenation of xylose to xylitol

    NASA Astrophysics Data System (ADS)

    Liang, Xinhua; Jiang, Chengjun

    2013-09-01

    Highly dispersed platinum nanoparticles were deposited on gram quantities of non-functionalized multiwalled carbon nanotubes (MWCNTs) by atomic layer deposition (ALD) in a fluidized bed reactor at 300 °C. (Methylcyclopentadienyl) trimethylplatinum and oxygen were used as precursors. The results of TEM analysis showed that 1.3 nm Pt nanoparticles were highly dispersed on non-functionalized MWCNTs. The porous structures of MWCNTs did not change with the deposition of Pt nanoparticles. For comparison, the commercial 3 wt% Pt/C catalyst was also characterized. The ALD-prepared Pt/MWCNT was used for the hydrogenation of xylose to xylitol. The ALD-prepared Pt/MWCNT showed the best catalytic performance with 100 % conversion of xylose and 99.3 % selectivity to xylitol, compared to commercially available Pt/C, Ru/C, and Raney Ni catalysts. The stability of ALD produced Pt/MWCNT catalyst was higher than that of the commercial Pt/C, due to the presence of surface defects on the MWCNTs and the strong metal-support interaction for the ALD-prepared Pt/MWCNT catalyst.

  5. Thermophysical Characterization of MgCl₂·6H₂O, Xylitol and Erythritol as Phase Change Materials (PCM) for Latent Heat Thermal Energy Storage (LHTES).

    PubMed

    Höhlein, Stephan; König-Haagen, Andreas; Brüggemann, Dieter

    2017-04-24

    The application range of existing real scale mobile thermal storage units with phase change materials (PCM) is restricted by the low phase change temperature of 58 ∘ C for sodium acetate trihydrate, which is a commonly used storage material. Therefore, only low temperature heat sinks like swimming pools or greenhouses can be supplied. With increasing phase change temperatures, more applications like domestic heating or industrial process heat could be operated. The aim of this study is to find alternative PCM with phase change temperatures between 90 and 150 ∘ C . Temperature dependent thermophysical properties like phase change temperatures and enthalpies, densities and thermal diffusivities are measured for the technical grade purity materials xylitol (C 5 H 12 O 5 ), erythritol (C 4 H 10 O 4 ) and magnesiumchloride hexahydrate (MCHH, MgCl 2 · 6H 2 O). The sugar alcohols xylitol and erythritol indicate a large supercooling and different melting regimes. The salt hydrate MgCl 2 · 6H 2 O seems to be a suitable candidate for practical applications. It has a melting temperature of 115.1 ± 0.1 ∘ C and a phase change enthalpy of 166.9 ± 1.2 J / g with only 2.8 K supercooling at sample sizes of 100 g . The PCM is stable over 500 repeated melting and solidification cycles at differential scanning calorimeter (DSC) scale with only small changes of the melting enthalpy and temperature.

  6. Pharmacokinetics and Plasma Cellular Antioxidative Effects of Flavanols After Oral Intake of Green Tea Formulated with Vitamin C and Xylitol in Healthy Subjects.

    PubMed

    Son, Yu-Ra; Park, Tae-Sik; Shim, Soon-Mi

    2016-02-01

    This study aimed to test whether green tea formulated with vitamin C and xylitol (GTVX) could improve absorption of flavanols and total antioxidant activity (TAC) of plasma compared with green tea only (GT) in healthy subjects. The total radical-trapping antioxidant parameter method was used to measure the TAC of plasma. Cmax, Tmax, and area under the curve (AUC) of flavanols in plasma after consumption of GTVX were 5980.58 μg/mL, 2.14 h, and 18,915.56 h·μg/mL, respectively, indicating that GTVX showed significantly higher AUC than GT (13,855.43 μg/mL). The peak TACs occurred at 3 and 0.5 h after intake of GT and GTVX, respectively. The TAC of plasma was found to be significantly higher in GTVX than in GT at each time point. This study suggests that formulating green tea with vitamin C and xylitol could increase the absorption of flavanols in green tea, enhancing cellular antioxidative effects.

  7. Radiolysis of carbohydrates as studied by ESR and spin-trapping—II. Glycerol- d8 xylitol, dulcitol, d-sorbitol and d-mannitol

    NASA Astrophysics Data System (ADS)

    Kuwabara, M.; Zhang, Z.-Y.; Inanami, O.; Yoshii, G.

    Studies concerning the radicals produced in glycerol by reactions with OH radicals have been carried out by investigating deuterated glycerol (glycerol-d 8) by spin-trapping with 2-methyl-2-nitrosopropane. Free radicals produced in linear carbohydrates such as xylitol, dulcitol, D-sorbitol and D-mannitol by reactions with OH radicals as well as by direct γ-radiolysis have been also investigated by spin-trapping. The ESR spectra of the spin-trapped radicals were analysed on the basis of the results from ESR and spin-trapping experiments on glycerol and deuterated glycerol, and the formation of three radical species, CHO-CH-, CH 2-CO- and HO-CH-, due to both OH reactions and direct γ-radiolysis was confirmed for all compounds. The presence of a radical, -CO-CH-, was detected for xylitol, D-sorbitol and D-mannitol. General reactions processes induced by OH reactions or γ-radiolysis in the solid state are discussed.

  8. Xylose reductase and xylitol dehydrogenase activities of Candida guilliermondii as a function of different treatments of sugarcane bagasse hemicellulosic hydrolysate employing experimental design.

    PubMed

    Alves, Lourdes A; Vitolo, Michele; Felipe, Maria das Graças A; de Almeida e Silva, João Batista

    2002-01-01

    The sugarcane bagasse hydrolysate, which is rich in xylose, can be used as culture medium for Candida guilliermondii in xylitol production. However, the hydrolysate obtained from bagasse by acid hydrolysis at 120 degrees C for 20 min has by-products (acetic acid and furfural, among others), which are toxic to the yeast over certain concentrations. So, the hydrolysate must be pretreated before using in fermentation. The pretreatment variables considered were: adsorption time (15,37.5, and 60 min), type of acid used (H2So4 and H3Po4), hydrolysate concentration (original, twofold, and fourfold concentrated), and active charcoal (0.5, 1.75 and 3.0%). The suitability of the pretreatment was followed by measuring the xylose reductase (XR) and xylitol dehydrogenase (XD) activity of yeast grown in each treated hydrolysate. The response surface methodology (2(4) full factorial design with a centered face) indicated that the hydrolysate might be concentrated fourfold and the pH adjusted to 7.0 with CaO, followed by reduction to 5.5 with H3PO4. After that it was treated with active charcoal (3.0%) by 60 min. This pretreated hydrolysate attained the high XR/XD ratio of 4.5.

  9. A simple method for determination of erythritol, maltitol, xylitol, and sorbitol in sugar-free chocolates by capillary electrophoresis with capacitively coupled contactless conductivity detection.

    PubMed

    Coelho, Aline Guadalupe; de Jesus, Dosil Pereira

    2016-11-01

    In this work, a novel and simple analytical method using capillary electrophoresis (CE) with capacitively coupled contactless conductivity detection (C 4 D) is proposed for the determination of the polyols erythritol, maltitol, xylitol, and sorbitol in sugar-free chocolate. CE separation of the polyols was achieved in less than 6 min, and it was mediated by the interaction between the polyols and the borate ions in the background electrolyte, forming negatively charged borate esters. The extraction of the polyols from the samples was simply obtained using ultra-pure water and ultrasonic energy. Linearity was assessed by calibration curves that showed R 2 varying from 0.9920 to 0.9976. The LOQs were 12.4, 15.9, 9.0, and 9.0 μg/g for erythritol, maltitol, xylitol, and sorbitol, respectively. The accuracy of the method was evaluated by recovery tests, and the obtained recoveries varied from 70 to 116% with standard deviations ranging from 0.2 to 19%. The CE-C 4 D method was successfully applied for the determination of the studied polyols in commercial samples of sugar-free chocolate. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Parents as passengers during pediatric transport.

    PubMed

    Lewis, M M; Holditch-Davis, D; Brunssen, S

    1997-01-01

    The transport environment presents a unique setting in which the feasibility, advantages, and disadvantages of passengers accompanying a patient must be assessed carefully. The purpose of this study was to describe the current practice of including parents as passengers during pediatric interfacility transport. One-hundred-eighty-eight critical care transport programs in the United States responded to a voluntary mail survey, providing information about current policies, practices, and crew perceptions of the advantages and disadvantages of carrying parents as passengers. Extra seating for passengers was available in 96% of ambulances, 86% of fixed-wing aircraft, and 54% of helicopters used for pediatric transport. Parents traveled as passengers in all types of vehicles; most frequently in ambulances and fixed-wing aircraft. Twenty percent of helicopter programs allowed parent passengers on more than half of their pediatric transports in this vehicle. Advantages of parent passengers included emotional benefit for the parent and child, availability of parents for history and consent, good public relations, and having the parent present if the child dies. Disadvantages included potential parent anxiety, crew distraction, and space limitations. This study reflects the widely diverse policies, practices, and opinions relevant to this topic and confirms a need for further study.

  11. Screening and assessment tools for pediatric malnutrition.

    PubMed

    Huysentruyt, Koen; Vandenplas, Yvan; De Schepper, Jean

    2016-06-18

    The ideal measures for screening and assessing undernutrition in children remain a point of discussion in literature. This review aims to provide an overview of recent advances in the nutritional screening and assessment methods in children. This review focuses on two major topics that emerged in literature since 2015: the practical endorsement of the new definition for pediatric undernutrition, with a focus on anthropometric measurements and the search for a consensus on pediatric nutritional screening tools in different settings. Few analytical tools exist for the assessment of the nutritional status in children. The subjective global nutritional assessment has been validated by anthropometric as well as clinical outcome parameters. Nutritional screening can help in selecting patients that benefit the most from a full nutritional assessment. Two new screening tools have been developed for use in a general (mixed) hospital population, and one for a population of children with cancer. The value of screening tools in different disease-specific and outpatient pediatric populations remains to be proven.

  12. NCI Pediatric Preclinical Testing Consortium

    Cancer.gov

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  13. What Is a Pediatric Endocrinologist?

    MedlinePlus

    ... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... and the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors ...

  14. What Is a Pediatric Urologist?

    MedlinePlus

    ... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... to treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors ...

  15. Pediatric maxillofacial fractures.

    PubMed

    Spring, P M; Cote, D N

    1996-05-01

    Maxillofacial trauma in the pediatric population is a relatively infrequent occurrence. Studies have demonstrated consistently that 5% of all facial fractures occur in children. The low percentage of facial fractures in this age group has been attributed, in part, to the lack of full pneumatization of the sinuses until later in childhood. Review of the literature indicates that boys are more commonly affected than girls and that the majority of pediatric facial fractures occur in children between 6 and 12 years of age. Motor vehicle accidents, falls, and blunt trauma are responsible for the largest number of pediatric facial fractures. The most common site of facial fracture is the nose and dentoalveolan complex, followed by the mandible, orbit, and midface in most pediatric cohorts. Management of the mandible is often conservative owing to the high percentage of isolated condylar fractures in children. Open reduction and internal fixation of pediatric facial fractures is indicated in complex mandible, midface, and orbital fractures. The effect of rigid fixation on facial skeleton growth is not completely understood.

  16. Pediatric Inflammatory Bowel Disease.

    PubMed

    Kapoor, Akshay; Bhatia, Vidyut; Sibal, Anupam

    2016-11-15

    The incidence of inflammatory bowel disease is increasing in the pediatric population worldwide. There is paucity of high quality scientific data regarding pediatric inflammatory bowel disease. Most of the guidelines are offshoots of work done in adults, which have been adapted over time to diagnose and treat pediatric patients. This is in part related to the small numbers in pediatric inflammatory bowel disease and less extensive collaboration for multicentric trials both nationally and internationally. A literature search was performed using electronic databases i.e. Pubmed and OVID, using keywords: pediatric, inflammatory bowel disease, Crohns disease, Ulcerative colitis, epidemiology and guidelines. This article amalgamates the broad principles of diagnosing and managing a child with suspected inflammatory bowel disease. 25% of the patients with inflammatory bowel disease are children and and young adolescents. The primary concern is its impact on growth velocity, puberty and quality of life, including psychosocial issues. Treatment guidelines are being re-defined as the drug armamentarium is increasing. The emphasis will be to achieve mucosal healing and normal growth velocity with minimal drug toxicity.

  17. Pediatric Electrocardiographic Imaging (ECGI) Applications

    PubMed Central

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  18. [Liability of pediatric nurses for professional negligence in Taiwan: a case study].

    PubMed

    Huang, Hui-Man; Sun, Fan-Ko

    2014-04-01

    Liability attribution and professional negligence in pediatric nursing are topics that have been neglected in Taiwan. (1) Identify the definitions of related criminal activities in accordance with domestic criminal law; (2) Elucidate the facts and the dispute in a current case involving a pediatric nurse; (3) Elucidate the principle of 'no punishment without law'; (4) Explore the reasons why the pediatric nurse in the current case received a verdict of 'not guilty'. A literature review and case study approach were used to analyze a sentence reconsideration of the first instance No. 1 (2011) issued by the Taiwan high court, Kaohsiung branch court. The conditions for the scrutiny of criminal activity under Taiwan criminal law are statement of facts, illegality (justifiable cause), and liability (excuse). In this case, the pediatric nurse was accused of failing to prevent an infant from suffocation and of not discharging her obligations as a nurse. The pediatric nurse rebutted the charge of criminal negligence. The intervening behaviors of the pediatric nurse were found to be legal and not culpable. In this case, the High Court and Supreme Court made a final criminal judgment based on the presumption of innocence, and the pediatric nurse was pronounced innocent of the charge. This article intends to assist pediatric nurses understand their liabilities under Taiwan's criminal law. Pediatric nurses should gain a better understanding of the nature of liability for professional negligence in order to clarify how actions that may be illegal do not necessarily make nurses culpable.

  19. Topics

    ERIC Educational Resources Information Center

    Mathematics Teaching, 1971

    1971-01-01

    Problems involving divisibility, the ten coin triangle, five times a week with 4 D, a nomogram for the lens formula, the box and ladder problem, chains of circles, tessellating hexagons, topological woggles, and numbers of triangles are discussed. (CT)

  20. Topics

    ERIC Educational Resources Information Center

    Mathematics Teaching, 1973

    1973-01-01

    This column includes the description of a game involving addition and subtraction of integers represented by colored bricks, a general formula for an enlargement in the Cartesian plane, an analysis of the possibilities for certain games of board Solitaire, and a BASIC program for a recreational mathematics problem. (DT)

  1. Sleeping beauties in pediatrics.

    PubMed

    Završnik, Jernej; Kokol, Peter

    2016-10-01

    Sleeping beauties (SBs) in science have been known for few decades; however, it seems that only recently have they become popular. An SB is a publication that "sleeps" for a long time and then almost suddenly awakes and becomes highly cited. SBs present interesting findings in science. Pediatrics research literature has not yet been analyzed for their presence, and 5 pediatrics SBs were discovered in this research. Their prevalence was approximately 0.011%. Some environments or periods are more "SB fertile" than others: 3 of 5 SBs were published in the journal Pediatrics, 4 originated from the United States, and 4 were published in the period from 1992 to 1993. No institutions or authors published more than 1 SB.

  2. Pediatric nuclear medicine

    SciTech Connect

    Not Available

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures ismore » now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.« less

  3. Assessment of nutrition education among pediatric gastroenterologists: a survey of NASPGHAN members.

    PubMed

    Lin, Henry C; Kahana, Doron; Vos, Miriam B; Black, Dennis; Port, Zack; Shulman, Robert; Scheimann, Ann; Mascarenhas, Maria R

    2013-02-01

    Pediatric gastroenterology is the only pediatric subspecialty with nutrition as part of its official curriculum and objective; however, pediatric gastroenterology fellows believe that their baseline knowledge in nutrition is suboptimal. The purpose of the present study was to assess the perceived effectiveness of nutrition training among pediatric gastroenterologists, identify areas of need for additional education, and determine the perceived role of the gastroenterologist in obesity management. A survey was sent to members and fellows of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition to assess general nutrition education as well as obesity management and educational needs. A total of 272 responses were received, for an overall response rate of 15.2% (272/1784). Most responders reported having average or above-average knowledge base in all nutritional topics. There was strong interest in additional resources and a continuing medical education (CME) module on several nutrition topics including nutritional requirements in specific gastrointestinal (GI) disease, failure to thrive/growth failure, and parenteral nutrition support, with the format of CME dependent on the topic. There was also a strong interest in additional CME on the management of pediatric obesity (67%), as most responders believed that the management of obesity in children requires subspecialty care. The perceived role of the pediatric gastroenterologist was, however, one of support to treat the GI and hepatic comorbidities of obesity rather than serve as the main provider of comprehensive obesity care. Pediatric gastroenterologists identified gaps in their nutrition knowledge base that may be attributed to the present nutrition education training during fellowship. Multiple topics were identified for additional nutrition education, including obesity management. The nutrition management challenges of today necessitate improved baseline nutrition knowledge and this

  4. Assessment of Nutrition Education Among Pediatric Gastroenterologists: A Survey of NASPGHAN Members

    PubMed Central

    Lin, Henry C; Kahana, Doron; Vos, Miriam B; Black, Dennis; Port, Zack; Shulman, Robert; Scheimann, Ann; Mascarenhas, Maria R.

    2012-01-01

    Pediatric gastroenterology is the only pediatric subspecialty with nutrition as part of its official curriculum and objective. However, pediatric gastroenterology fellows feel that their baseline knowledge in nutrition is suboptimal. The purpose of this study was to assess the perceived effectiveness of nutrition training among pediatric gastroenterologists, identify areas of need for additional education, and determine the perceived role of the gastroenterologist in obesity management. Methods A survey was sent to members and fellows of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) to assess general nutrition education as well as obesity management and educational needs. Results A total of 272 responses were received, for an overall response rate of 15.2% (272/1,784). Most responders reported having average or above-average knowledge base in all nutritional topics. There was strong interest in additional resources and a continuing medical education (CME) module on several nutrition topics including: nutritional requirements in specific gastrointestinal (GI) disease, failure to thrive/growth failure, and parenteral nutrition support, with the format of CME dependent on the topic. There was also a strong interest in additional CME on the management of pediatric obesity (67%), as most responders felt that the management of obesity in children requires subspecialty care. However, the perceived role of the pediatric gastroenterologist was one of support to treat the gastrointestinal and hepatic co-morbidities of obesity rather than serve as the main provider of comprehensive obesity care. Conclusion Pediatric gastroenterologists identified gaps in their nutrition knowledge base that may be attributed to the current nutrition education training during fellowship. Multiple topics were identified for additional nutrition education, including obesity management. The nutrition management challenges of today necessitate

  5. Update on the Systemic Risks of Superpotent Topical Steroids.

    PubMed

    Nakamura, Mio; Abrouk, Michael; Zhu, Henry; Farahnik, Benjamin; Koo, John; Bhutani, Tina

    2017-07-01

    INTRODUCTION: The potential for systemic effects due to percutaneous absorption of superpotent topical steroids has been a longstanding concern. The Food and Drug Administration currently recommends limiting the use of superpotent topical steroids to 50g per week for 2 or 4 consecutive weeks depending on the formulation, which is mostly based on the exact duration with which phase 3 clinical trials were allowed to be conducted per the FDA. This article reviews all published clinical incidence of adrenal adverse effects in the medical literature, specifically Cushing's syndrome (CS) and pathologic adrenal suppression (PAAS), to try to ascertain a more realistic limit for the safe use of superpotent topical steroids as it pertains to its potential systemic effects.

    METHODS: Literature search was conducted using PubMed. Only cases of CS and PAAS secondary to the use of Class I superpotent topical steroids were included. Pediatric cases and full articles unavailable in English were excluded.

    RESULTS: There were a total of 14 cases of CS and 5 cases of subsequent PAAS found in the current literature.

    DISCUSSION: From our review of these cases, if the amount used per week is within FDA guidelines, it appears that patients needed to use superpotent topical steroids for far greater than 2 or 4 weeks to develop CS or PAAS. CS did not necessarily predict occurrence of PAAS, but in all cases CS appeared to be a prerequisite for developing PAAS. All cases of CS and all but one case of PAAS were reversible. If excessive amount of greater than 50g per week is avoided, it appears that superpotent topical steroids may be safe to use consecutively for months, perhaps even years, without causing systemic effects.

    J Drugs Dermatol. 2017;16(7):643-648.

    .

  6. A World Wide Web selected bibliography for pediatric infectious diseases.

    PubMed

    Jenson, H B; Baltimore, R S

    1999-02-01

    A pediatric infectious diseases bibliography of selected medical reference citations has been developed and placed on the World Wide Web (WWW) at http://www.pedid.uthscsa.edu. A regularly updated bibliography of >2,500 selected literature citations representing general reviews and key articles has been organized under a standard outline for individual infectious diseases and related topics that cover the breadth of pediatric infectious diseases. Citations are categorized by infectious disease or clinical syndrome, and access can be achieved by the disease or by syndrome or the name of the pathogen. Abstracts, and in some cases the complete text of articles, may be viewed by use of hypertext links. The bibliography provides medical students, residents, fellows, and clinicians with a constantly available resource of current literature citations in pediatric infectious diseases. The WWW is an emerging educational and clinical resource for the practice of clinical infectious diseases.

  7. Current Management of Pediatric Vitiligo.

    PubMed

    Van Driessche, Freya; Silverberg, Nanette

    2015-08-01

    Vitiligo is a common inflammatory disorder with worldwide prevalence of 0.4-2 % of the population, with half of cases beginning in childhood. The management of childhood vitiligo should be tailored to avoid negative effects on the overall growth and psychological development of the patient. Therapy of vitiligo in childhood is chosen based on the location of the lesions, lesion age, and extent of lesions in the context of the child's age and the developmental status of the child. There are four age categories in childhood vitiligo: [1] infantile and toddler (rare) (ages 0-3 years), [2] ages 4-8 years, [3] ages 9-12 years, and [4] 13+ years of age, based on developmental stage, psychological maturation, and ability to comply or participate in therapy. These categories are also differentiated psychologically by susceptibility to bullying, self-image development, and personal concern with lesion appearance, which increases with time. Intervention is advisable in cases with facial and leg involvement due to prominence of lesions and cosmetic defect. Medical interventions are largely the usage of topical therapies including corticosteroids and calcineurin inhibitors, some vitamin therapy (oral and topical vitamin D), and judicious introduction of phototherapy sources based on age and severity. Screening and appropriate subspecialist referral for co-morbidities (e.g., thyroid disease, celiac disease, psychological distress, and vitamin D deficiency) may enhance overall health. Cosmesis and camouflage are generally safe in childhood and have been noted to improve overall quality of life in this grouping. Genetic transmission of vitiligo is minimal at 5-6 % in first-degree relatives. This article reviews the therapeutics of pediatric vitiligo from the perspective of developmental stages and response to therapy.

  8. Pediatric lung transplantation

    PubMed Central

    2017-01-01

    Pediatric lung transplantation has been undertaken since the 1980s, and it is today considered an accepted therapy option in carefully selected children with end-stage pulmonary diseases, providing carefully selected children a net survival benefit and improved health-related quality of life. Nowadays, >100 pediatric lung transplants are done worldwide every year. Here, specific pediatric aspects of lung transplantation are reviewed such as the surgical challenge, effects of immunosuppression on the developing pediatric immune system, and typical infections of childhood, as it is vital to comprehend that children undergoing lung transplants present a real challenge as children are not ‘just small adults’. Further, an update on the management of the pediatric lung transplant patient is provided in this review, and future challenges outlined. Indications for lung transplantation in children are different compared to adults, the most common being cystic fibrosis (CF). However, the primary diagnoses leading to pediatric lung transplantation vary considerably by age group. Furthermore, there are regional differences regarding the primary indication for lung transplantation in children. Overall, early referral, careful patient selection and appropriate timing of listing are crucial to achieve real survival benefit. Although allograft function is to be preserved, immunosuppressant-related side effects are common in children post-transplantation. Strategies need to be put into practice to reduce drug-related side effects through careful therapeutic drug monitoring and lowering of target levels of immunosuppression, to avoid acute-reversible and chronic-irreversible renal damage. Instead of a “one fits all approach”, tailored immunosuppression and a personalized therapy is to be advocated, particularly in children. Further, infectious complications are a common in children of all ages, accounting for almost 50% of death in the first year post

  9. Deep Unfolding for Topic Models.

    PubMed

    Chien, Jen-Tzung; Lee, Chao-Hsi

    2018-02-01

    Deep unfolding provides an approach to integrate the probabilistic generative models and the deterministic neural networks. Such an approach is benefited by deep representation, easy interpretation, flexible learning and stochastic modeling. This study develops the unsupervised and supervised learning of deep unfolded topic models for document representation and classification. Conventionally, the unsupervised and supervised topic models are inferred via the variational inference algorithm where the model parameters are estimated by maximizing the lower bound of logarithm of marginal likelihood using input documents without and with class labels, respectively. The representation capability or classification accuracy is constrained by the variational lower bound and the tied model parameters across inference procedure. This paper aims to relax these constraints by directly maximizing the end performance criterion and continuously untying the parameters in learning process via deep unfolding inference (DUI). The inference procedure is treated as the layer-wise learning in a deep neural network. The end performance is iteratively improved by using the estimated topic parameters according to the exponentiated updates. Deep learning of topic models is therefore implemented through a back-propagation procedure. Experimental results show the merits of DUI with increasing number of layers compared with variational inference in unsupervised as well as supervised topic models.

  10. Orthobiologics in Pediatric Orthopedics.

    PubMed

    Murphy, Robert F; Mooney, James F

    2017-07-01

    Orthobiologics are biologic devices or products used in orthopedic surgery to augment or enhance bone formation. The use of orthobiologics in pediatric orthopedics is less frequent than in other orthopedic subspecialties, mainly due to the naturally abundant healing potential and bone formation in children compared with adults. However, orthobiologics are used in certain situations in pediatric orthopedics, particularly in spine and foot surgery. Other uses have been reported in conjunction with specific procedures involving the tibia and pelvis. The use of bioabsorable implants to stabilize children's fractures is an emerging concept but has limited supporting data. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Pediatric chest imaging.

    PubMed

    Gross, G W

    1992-10-01

    The highlight of recent articles published on pediatric chest imaging is the potential advantage of digital imaging of the infant's chest. Digital chest imaging allows accurate determination of functional residual capacity as well as manipulation of the image to highlight specific anatomic features. Reusable photostimulable phosphor imaging systems provide wide imaging latitude and lower patient dose. In addition, digital radiology permits multiple remote-site viewing on monitor displays. Several excellent reviews of the imaging features of various thoracic abnormalities and the application of newer imaging modalities, such as ultrafast CT and MR imaging to the pediatric chest, are additional highlights.

  12. Contact Dermatitis in Pediatrics.

    PubMed

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.

  13. Risk in pediatric anesthesia.

    PubMed

    Paterson, Neil; Waterhouse, Peter

    2011-08-01

    Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk. © 2010 Blackwell Publishing Ltd.

  14. Children's rights in pediatrics.

    PubMed

    Streuli, Jürg C; Michel, Margot; Vayena, Effy

    2011-01-01

    The United Nations Convention of Children's Rights (UNCRC) introduced in 1989 has generated a global movement for the protection of children's rights and has brought about a paradigm change in how children are perceived. Pediatric healthcare professionals are interacting with children and therefore with children's rights on a daily basis. However, although at least 18 of the 54 articles are relevant for pediatric practice, there is limited systematic training on how pediatricians can support children's rights in the clinical setting. This article discusses the principles and aims of the UNCRC and proposes a comprehensive checklist of rights vis-à-vis issues that arise in clinical practice.

  15. Tracheostomy: pediatric considerations.

    PubMed

    Deutsch, Ellen S

    2010-08-01

    Pediatric patients for whom tracheotomy is a consideration have different anatomy, medical conditions, and prognoses than adults; even the tracheotomy tubes are different. Indications for pediatric tracheotomy generally include bypassing airway obstruction, providing access for prolonged mechanical ventilation, and facilitating tracheobronchial toilet. Subglottic stenosis is an important indication for tracheotomy in children; its etiology, prevention, and alternative options for management are presented. Discussion includes the benefits, risks, impact on families, techniques for tracheotomy tube changes, and alternatives to tracheotomy, with illustrative photographs and diagrams.

  16. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  17. Daily Bathing with Chlorhexidine and Its Effects on Nosocomial Infection Rates in Pediatric Oncology Patients.

    PubMed

    Raulji, Chittalsinh M; Clay, Kristin; Velasco, Cruz; Yu, Lolie C

    2015-01-01

    Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group received daily bath with Chlorhexidine, while the control group did not receive daily bath. The results showed that daily bath with antiseptic chlorhexidine as daily prophylactic antiseptic topical wash leads to decreased infection density amongst the pediatric oncology patients, especially in patients older than 12 years of age. Furthermore, daily chlorhexidine bathing significantly reduced the rate of hospital acquired infection in patients older than 12 years of age. The findings of this study suggest that daily bathing with chlorhexidine may be an effective measure of reducing nosocomial infection in pediatric oncology patients.

  18. Confronting pediatric brain tumors: parent stories.

    PubMed

    McMillan, Gigi

    2014-01-01

    This narrative symposium brings to light the extreme difficulties faced by parents of children diagnosed with brain tumors. NIB editorial staff and narrative symposium editors, Gigi McMillan and Christy A. Rentmeester, developed a call for stories that was distributed on several list serves and posted on Narrative Inquiry in Bioethics' website. The call asks parents to share their personal experience of diagnosis, treatment, long-term effects of treatment, social issues and the doctor-patient-parent dynamic that develops during this process. Thirteen stories are found in the print version of the journal and an additional six supplemental stories are published online only through Project MUSE. One change readers may notice is that the story authors are not listed in alphabetical order. The symposium editors had a vision for this issue that included leading readers through the timeline of this topic: diagnosis-treatment-acute recovery-recurrence-treatment (again)-acute recovery (again)-long-term quality of life-(possibly) end of life. Stories are arranged to help lead the reader through this timeline.Gigi McMillan is a patient and research subject advocate, co-founder of We Can, Pediatric Brain Tumor Network, as well as, the mother of a child who suffered from a pediatric brain tumor. She also authored the introduction for this symposium. Christy Rentmeester is an Associate Professor of Health Policy and Ethics in the Creighton University School of Medicine. She served as a commentator for this issue. Other commentators for this issue are Michael Barraza, a clinical psychologist and board member of We Can, Pediatric Brain Tumor Network; Lisa Stern, a pediatrician who has diagnosed six children with brain tumors in her 20 years of practice; and Katie Rose, a pediatric brain tumor patient who shares her special insights about this world.

  19. [Topical therapy of ulcerative colitis].

    PubMed

    Rogler, G; Beglinger, C; Mottet, C; Seibold, F; Gross, V

    2011-11-16

    The availability of new topical preparations for the treatment of left sided ulcerative colitis ulcerosa offers a therapy optimization for many patients. Rectal application of steroids and 5-aminosalicylic acid (5-ASA) is associated with fewer side effects and has a higher therapeutic efficacy in mild to moderate-active left-sided colitis as compared to a systemic therapy. Often it is argued that the patients' compliance is insufficient with a rectal therapy. However, with sufficient information on the proven advantages this is usually not the case. The rectal application of drugs in distal ulcerative colitis is suitable also for the maintenance of remission. Therefore the new therapy guidelines recommend topical therapy more than in former times. Subsequently, these manuscripts focussed specifically on the topical therapy of distal colitis, to elucidate that clear treatment advantages are present in daily practice.

  20. Successful treatment of pediatric psoriasis with Indigo naturalis composite ointment.

    PubMed

    Lin, Yin-Ku; Yen, Hung-Rong; Wong, Wen-Rou; Yang, Sien-Hung; Pang, Jong-Hwei Su

    2006-01-01

    The treatment of psoriasis in children is still an intractable problem and demands a long-term therapy with prolonged efficacy that is free from serious adverse events. Many modes of therapy are currently in use but the disease is often resistant to treatment owing to the unacceptable toxicity that leads to poor compliance. Therefore, to develop an alternative treatment is indispensable. Traditional Chinese medicine has been documented for over 1000 years to provide various effective treatments for inflammatory skin diseases. Herein, we report an 8-year-old boy with recalcitrant pediatric psoriasis who, after multiple treatment failures with conventional antipsoriatic medications, showed remarkable clinical improvement with 8 weeks of topical treatment with Indigo naturalis composite ointment. Remission has lasted for over 2 years until now. Our patient's response suggests that topical Indigo naturalis composite ointment may provide a safe and effective alternative treatment for pediatric psoriasis.

  1. Pediatric Bilateral Blue Laser Pointer-Induced Maculopathy

    PubMed Central

    Raevis, Joseph; Shrier, Eric

    2017-01-01

    Background We report the first case of pediatric bilateral blue laser pointer maculopathy with complete resolution of visual symptoms. Case A 12-year-old boy presented with bilateral decreased visual acuity and central scotomata after blue laser pointer exposure. He was treated with a Medrol Dosepak and topical nonsteroidal anti-inflammatory drug (NSAID), with gradual visual acuity improved from 20/40 OU to 20/20 OU over 22 weeks, but with persistent evidence of outer retinal layer disruption from the external limiting membrane to the interdigitation zone. Conclusion Oral steroids and topical NSAIDs may be effective in improving visual outcomes in laser pointer maculopathy in the pediatric population. PMID:28611647

  2. Topical therapies in hyperhidrosis care.

    PubMed

    Pariser, David M; Ballard, Angela

    2014-10-01

    Primary focal hyperhidrosis affects 3% of the US population; about the same number as psoriasis. More than half of these patients have primary focal axillary hyperhidrosis: sweating that is beyond what is anticipated or necessary for thermoregulation. Most topical therapies are based on aluminum salts, which work by a chemical reaction that forms plugs in the eccrine sweat ducts. Topical anticholinergics may also be used. Instruction on proper methods and timing of antiperspirants enhances effect and may be effective alone or in combination with other treatments in patients with hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Pediatric sepsis: actions to decrease sepsis in children.

    PubMed

    Marraro, Giuseppe A

    2009-10-01

    The European Society of Pediatric and Neonatal Intensive Care is the physicians' and nurses' annual meeting that was held in Verona, Italy from 14 to 17 June 2009, and approximately 1000 participants from around the world (84 countries) attended. The Congress gave an opportunity to experts to discuss ongoing research and exchange opinions on the future development of studies to identify optimal supportive, preventive and therapeutic strategies for sepsis. A wide range of topics were discussed and several lectures, oral presentations and posters were dedicated to sepsis and its treatment. High scientific-level topics were presented, and stimulated much interest and discussion.

  4. Pediatric Urinary Tract Infection

    MedlinePlus

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and ... To protect the kidneys from damage – By preventing urinary tract infections (UTI) – By identifying and treating vesicoureteral remux (VUR). ...

  5. Pediatric esophagopleural fistula

    PubMed Central

    Cui, Yun; Ren, Yuqian; Shan, Yijun; Chen, Rongxin; Wang, Fei; Zhu, Yan; Zhang, Yucai

    2017-01-01

    Abstract Esophagopleural fistula (EPF) is rarely reported in children with a high misdiagnosis rate. This study aimed to reveal the clinical manifestations and managements of EPF in children. Two pediatric cases of EPF in our hospital were reported. A bibliographic search was performed on the PubMed, WANFANG, and CNKI databases for EPF-related reports published between January 1980 and May 2016. The pathogeny, clinical manifestations, diagnosis, treatments, and prognosis of EPF patients were collected and discussed. Based on conservative treatments, 1 pediatric EPF case induced by cervical trauma was cured by longitudinal septum incision-mediated drainage. The other pediatric EPF induced by endoscopic balloon dilation was cured by dual stent implantation. A total of 38 studies of 197 EPF patients (191 adults and 6 children) were reviewed. Latrogenic factor, esophageal foreign body, and infection are considered the main causes of EPF in children. Unilateral pleural effusion accompanied by food residue was the main manifestations of EPF. Chest computed tomography (CT) and contrast esophagography were usually used in the diagnosis of EPF with high accuracy. Surgical treatment in adults with EPF exhibited a significantly higher cure rate and lower mortality rate than conservative treatment (P < .01). Pleural effusion with food residue is a specific finding in EPF. Chest CT exhibited high sensitivity for the diagnosis of EPF. Conservative treatment may be preferable for pediatric patients with EPF. PMID:28489746

  6. Pediatric functional gastrointestinal disorders

    USDA-ARS?s Scientific Manuscript database

    Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irrita...

  7. Pharmacotherapy of Pediatric Insomnia

    ERIC Educational Resources Information Center

    Owens, Judith A.

    2009-01-01

    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  8. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  9. Pediatric Endocrinology Nurses Society

    MedlinePlus

    ... Scholarship applications are DUE no later than April 1, 2018. Click here for scholarship information. ​ ​ ​​​​​​​​​​​ Recent PENS Announcements Text2 ​ 2018 PENS Call for Presentations & Advanced Case Studies PENS Recognition Program Journal of Pediatric Nursing - ​Call ...

  10. Topical Knowledge and ESL Writing

    ERIC Educational Resources Information Center

    He, Ling; Shi, Ling

    2012-01-01

    This study investigates the effects of topical knowledge on ESL (English as a Second Language) writing performance in the English Language Proficiency Index (LPI), a standardized English proficiency test used by many post-secondary institutions in western Canada. The participants were 50 students with different levels of English proficiency…

  11. Vocational Education Today: Topical Issues.

    ERIC Educational Resources Information Center

    Kenway, Jane, Ed.; Tregenza, Karen, Ed.; Watkins, Peter, Ed.

    This book contains 13 papers examining topical issues in vocational education and training (VET) in Victoria, Australia. The following papers are included: "Vocational Education and Schooling: The Changing Scene" (Jane Kenway, Sue Willis, Peter Watkins, Karen Tregenza); "The Enterprise Approach" (James Mulraney); "VET…

  12. The Health Curriculum: 500 Topics.

    ERIC Educational Resources Information Center

    Byrd, Oliver E.

    2001-01-01

    This 1958 paper divides 500 health topics into 20 categories: health as a social accomplishment/social problem; nutrition; physical fitness; mental health and disease; heredity/eugenics; infection/immunity; chronic and degenerative disease; substance abuse; skin care; vision, hearing, and speech; dental health; safety; physical environment; health…

  13. Resources for Topics in Nursing.

    ERIC Educational Resources Information Center

    Riordan, Dale B.

    This guide is intended to help the user become familiar with a selected group of reference tools and resources which are useful in nursing education and practice. It is important for students to use the correct medical or scientific terminology, understand the scope of a topic, and then utilize the tools necessary to research subjects of interest.…

  14. Topics in Biomedical Optics: Introduction

    NASA Astrophysics Data System (ADS)

    Hebden, Jeremy C.; Boas, David A.; George, John S.; Durkin, Anthony J.

    2003-06-01

    The field of biomedical optics is experiencing tremendous growth. Biomedical technologies contribute in the creation of devices used in healthcare of various specialties (ophthalmology, cardiology, anesthesiology, and immunology, etc.). Recent research in biomedical optics is discussed. Overviews of meetings held at the 2002 Optical Society of America Biomedical Topical Meetings are presented.

  15. Hot Topics in Science Teaching

    ERIC Educational Resources Information Center

    Ediger, Marlow

    2018-01-01

    There are vital topics in science teaching and learning which are mentioned frequently in the literature. Specialists advocate their importance in the curriculum as well as science teachers stress their saliency. Inservice education might well assist new and veteran teachers in knowledge and skills. The very best science lessons and units of…

  16. Debridement Techniques in Pediatric Trauma and Burn-Related Wounds

    PubMed Central

    Block, Lisa; King, Timothy W.; Gosain, Ankush

    2015-01-01

    Significance: Traumatic injuries are the leading cause of morbidity and mortality in children. The purpose of this review is to provide an overview of the initial assessment and management of traumatic and burn wounds in children. Special attention is given to wound cleansing, debridement techniques, and considerations for pain management and psychosocial support for children and families. Recent Advances: Basic and translational research over the last 5–7 years has advanced our knowledge related to the optimal care of acute pediatric traumatic and burn wounds. Data concerning methods, volume, solution and timing for irrigation of acute traumatic wounds, timing and methods of wound debridement, including hydrosurgery and plasma knife coblation, and wound dressings are presented. Additionally, data concerning the long-term psychosocial outcomes following acute injury are presented. Critical Issues: The care of pediatric trauma and burn-related wounds requires prompt assessment, pain control, cleansing, debridement, application of appropriate dressings, and close follow-up. Ideally, a knowledgeable multidisciplinary team cares for these patients. A limitation in the care of these patients is the relative paucity of data specific to the care of acute traumatic wounds in the pediatric population. Future Directions: Research is ongoing in the arenas of new debridement techniques and instruments, and in wound dressing technology. Dedicated research on these topics in the pediatric population will serve to strengthen and advance the care of pediatric patients with acute traumatic and burn wounds. PMID:26487978

  17. Oral Health Education for Pediatric Nurse Practitioner Students

    PubMed Central

    Golinveaux, Jay; Gerbert, Barbara; Cheng, Jing; Duderstadt, Karen; Alkon, Abbey; Mullen, Shirin; Lin, Brent; Miller, Arthur; Zhan, Ling

    2014-01-01

    The aim of this study was to evaluate whether an interdisciplinary, multifaceted oral health education program delivered to pediatric nurse practitioner students at the University of California, San Francisco, would improve their knowledge, confidence, attitudes, and behaviors regarding the provision of oral health assessments, consultations, referrals, and services to young children during well-child visits. Thirty pediatric nurse practitioner students were included in the study. Participants completed a written survey before and after receiving an interdisciplinary educational intervention that included didactic education, simulation exercises, and clinical observation by a pediatric dental resident. Between pre-intervention and post-intervention, a significant improvement was seen in the pediatric nurse practitioners’ knowledge of oral health topics (p<0.001), confidence when providing oral health counseling (p<0.001), and attitudes about including oral health counseling in their examinations (p=0.006). In the post-intervention survey, 83 percent of the subjects reported having incorporated oral examinations into their well-child visits. Our study suggests that providing an interdisciplinary oral health educational program for pediatric nurse practitioner students can improve their knowledge, confidence, attitudes, and behaviors regarding the incorporation of oral health care services during routine well-child visits. PMID:23658403

  18. Topical anesthesia for penetrating trabeculectomy.

    PubMed

    Sauder, Gangolf; Jonas, Jost B

    2002-09-01

    To evaluate the efficacy and clinical practicability of topical anesthesia in comparison with retrobulbar anesthesia for penetrating trabeculectomy. The prospective single-surgeon clinical interventional trial included 20 consecutive patients, who were randomly distributed into a topical anesthesia group ( n=10) and a retrobulbar anesthesia group ( n=10). In the topical anesthesia group, patients received preoperatively oxybuprocaine 0.4% eye drops and cocaine hydrochloride eye drops 10%. The patients of the retrobulbar group received 5 ml mepivacaine 2% injected into the retrobulbar space. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10-point pain rating scale. The topical anesthesia group and the retrobulbar anesthesia study group did not vary significantly in duration of surgery (21.5+/-3.37 min vs 20.2+/-4.46 min, P=0.31), preoperative intraocular pressure (32.2+/-14.62 mmHg vs 30.6+/-12.33 mmHg, P=0.22), postoperative intraocular pressure (8.0+/-4.47 mmHg vs 9.12+/-3.13 mmHg, P=0.64), subjective pain score by the patient (2.25+/-1.23 relative units vs 2.33+/-1.08 relative units ( P= 0.71), and practicability score by the surgeon (2.24+/-1.76 vs 2.56+/-1.58, P=0.82). In view of its clinical feasibility and its minimally invasive character, topical anesthesia may be an option for penetrating trabeculectomy.

  19. Topical Review: Adherence Interventions for Youth on Gluten-Free Diets.

    PubMed

    Holbein, Christina E; Carmody, Julia K; Hommel, Kevin A

    2018-05-01

    To summarize gluten-free diet (GFD) nonadherence risk factors, nonadherence rates, and current intervention research within an integrative framework and to develop a research agenda for the development and implementation of evidence-based GFD adherence interventions. Topical review of literature published since 2008 investigating GFD adherence in pediatric samples. Reviews of pediatric studies indicate GFD nonadherence rates ranging from 19 to 56%. There are few evidence-based, published pediatric GFD adherence interventions. Novel assessments of GFD adherence are promising but require further study. Nonmodifiable and modifiable factors within individual, family, community, and health systems domains must be considered when developing future interventions. Clinical implications are discussed. Avenues for future research include development and refinement of adherence assessment tools and development of evidence-based GFD adherence interventions. Novel technologies (e.g., GFD mobile applications) require empirical study but present exciting opportunities for adherence intervention.

  20. Evaluation of the efficacy of a topical sialogogue spray containing malic acid 1% in elderly people with xerostomia: a double-blind, randomized clinical trial.

    PubMed

    Gómez-Moreno, Gerardo; Cabrera-Ayala, Maribel; Aguilar-Salvatierra, Antonio; Guardia, Javier; Ramírez-Fernández, María Piedad; González-Jaranay, Maximino; Calvo-Guirado, José Luis

    2014-12-01

    The aim of this study was to evaluate the clinical efficacy of a topical sialogogue spray containing 1% malic acid for elderly people affected by xerostomia. This research took the form of a double-blind, randomized clinical trial. Forty-one individuals (mean age: 78.7 years) with xerostomia were divided into two groups: for the first 'intervention group' (21 subjects) a topical sialogogue spray (1% malic acid) was applied, while for the second 'control group' (20 subjects), a placebo spray was applied; for both groups, the sprays were applied on demand during 2 weeks. The Xerostomia Inventory (XI) was used to evaluate xerostomia levels before and after product/placebo application. Unstimulated and stimulated salivary flows rates, before and after spray application, were measured. XI scores decreased significantly (clinically meaningful) from 36.4 ± 7.3 points to 29.1 ± 7.1 (p < 0.05) with an XI difference of 7.2 ± 6.1, after the combination among 1% malic acid with xylitol and fluoride application. After 2 weeks of 1% malic acid application, unstimulated and stimulated salivary flows rates increased significantly (p < 0.05). A topical sialogogue spray containing 1% malic acid improved xerostomia in an elderly population and increased unstimulated and stimulated salivary flows rates. © 2013 The Gerodontology Society and John Wiley & Sons A/S.

  1. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors

    PubMed Central

    Boykan, Rachel; Jacobson, Robert M.

    2017-01-01

    Objective: The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. Methods: We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. Results: A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). Conclusions: While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians’ expertise in teaching EBM is underutilized. Programs should work to better integrate librarians’ expertise, both in the didactic and clinical teaching of EBM. PMID:28983199

  2. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    PubMed

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  3. Topical cyclosporine for atopic keratoconjunctivitis.

    PubMed

    González-López, Julio J; López-Alcalde, Jesús; Morcillo Laiz, Rafael; Fernández Buenaga, Roberto; Rebolleda Fernández, Gema

    2012-09-12

    Atopic keratoconjunctivitis (AKC) is a chronic ocular surface non-infectious inflammatory condition that atopic dermatitis patients may suffer at any time point in the course of their dermatologic disease and is independent of its degree of severity. AKC is usually not self resolving and it poses a higher risk of corneal injuries and severe sequelae. Management of AKC should prevent or treat corneal damage. Although topical corticosteroids remain the standard treatment for patients with AKC, prolonged use may lead to complications. Topical cyclosporine A (CsA) may improve AKC signs and symptoms, and be used as a corticosteroid sparing agent. To determine the efficacy and gather evidence on safety from randomised controlled trials (RCTs) of topical CsA in patients with AKC. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to July 2012), EMBASE (January 1980 to July 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to July 2012), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to July 2012), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en), the IFPMA Clinical Trials Portal (http://clinicaltrials.ifpma.org/no_cache/en/myportal/index.htm) and Web of Science Conference Proceedings Citation Index- Science (CPCI-S). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 9 July 2012. We also handsearched the following conference proceedings: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, International Council of Opthalmology and Societas

  4. Pediatric Idiopathic Intracranial Hypertension

    PubMed Central

    Sheldon, Claire A.; Paley, Grace L.; Xiao, Rui; Kesler, Anat; Eyal, Ori; Ko, Melissa W.; Boisvert, Chantal J.; Avery, Robert A.; Salpietro, Vincenzo; Phillips, Paul H.; Heidary, Gena; McCormack, Shana E.; Liu, Grant T.

    2017-01-01

    Purpose To examine anthropometric and maturational characteristics at diagnosis in pediatric idiopathic intracranial hypertension (IIH). Design Retrospective, international, multisite study. Participants Pediatric patients (2–18 years of age at diagnosis) with IIH. Main Outcome Measures Body mass index (BMI), height, and weight Z-scores; sexual maturation. Methods Cases of IIH were identified retrospectively based on diagnostic code, pediatric neuroophthalmologist databases, or both and updated diagnostic criteria (2013) were applied to confirm definite IIH. Anthropometric measurements were converted into age- and gender-specific height, weight, and BMI Z-scores CDC 2000 growth charts. When available, sexual maturation was noted. Results Two hundred thirty-three cases of definite IIH were identified across 8 sites. In boys, a moderate association between age and BMI Z-scores was noted (Pearson’s correlation coefficient, 0.50; 95% confidence interval [CI], 0.30–0.66; P < 0.001; n = 72), and in girls, a weak association was noted (Pearson’s correlation coefficient, 0.34; 95% CI, 0.20–0.47; P < 0.001; n = 161). The average patient was more likely to be overweight at diagnosis at age 6.7 years in girls and 8.7 years in boys, and obese at diagnosis at age 12.5 years in girls and 12.4 years in boys. Compared with age- and gender-matched reference values, early adolescent patients were taller for age (P = 0.002 in girls and P = 0.02 in boys). Data on Tanner staging, menarchal status, or both were available in 25% of cases (n = 57/233). Prepubertal participants (n = 12) had lower average BMI Z-scores (0.95±1.98) compared with pubertal participants (n = 45; 1.92±0.60), but this result did not reach statistical significance (P = 0.09). Conclusions With updated diagnostic criteria and pediatric-specific assessments, the present study identifies 3 subgroups of pediatric IIH: a young group that is not overweight, an early adolescent group that is either overweight

  5. Common pediatric and adolescent skin conditions.

    PubMed

    Sanfilippo, Angela M; Barrio, Victoria; Kulp-Shorten, Carol; Callen, Jeffrey P

    2003-10-01

    Skin lesions are encountered in all areas of medicine, and it is therefore important for physicians to understand the fundamentals of explaining and diagnosing common skin conditions. This article begins with a discussion of description and documentation of skin lesions based on color, size, morphology, and distribution. Pigmentation disorders such as vitiligo are depicted. Cutaneous growths that are found in the pediatric and adolescent population include acrochordons, dermatofibromas, keloids, milia, neurofibromas, and pyogenic granulomas. Treatment of these growths usually involves observation or curettage with electrodessication.Psoriasis, atopic dermatitis, poison ivy, and eczema are comprised of scaling patches and plaques; poison ivy and atopic dermatitis may also present with bullous and vesicular changes. Therapy typically consists of topical emollients and corticosteroids; phototherapy is reserved for refractory cases. Acne vulgaris is the most common skin disease of the pediatric and adolescent population. This condition can be psychologically debilitating and, therefore, proper treatment is of paramount importance. Therapeutic options include topical as well as oral antibiotics and retinoids. Extreme caution must be used when prescribing retinoids to post-pubescent females, as these agents are teratogenic. Vascular anomalies are most commonly exemplified as port wine stains and hemangiomas. Port wine stains may be treated with pulsed dye laser or may be observed if they are not of concern to the patient or physician. Hemangiomas typically spontaneously regress by age ten; however, there has been recent concern that certain cases may need to be treated. Dermal rashes may be localized or generalized. Treatment of generalized drug eruptions involves elimination of the inciting agent, topical antipruritics, and systemic corticosteroids for severe reactions. Infectious etiologic agents of skin disease include bacteria, fungi, and viruses. Many sexually

  6. Do scientists trace hot topics?

    PubMed

    Wei, Tian; Li, Menghui; Wu, Chensheng; Yan, Xiao-Yong; Fan, Ying; Di, Zengru; Wu, Jinshan

    2013-01-01

    Do scientists follow hot topics in their scientific investigations? In this paper, by performing analysis to papers published in the American Physical Society (APS) Physical Review journals, it is found that papers are more likely to be attracted by hot fields, where the hotness of a field is measured by the number of papers belonging to the field. This indicates that scientists generally do follow hot topics. However, there are qualitative differences among scientists from various countries, among research works regarding different number of authors, different number of affiliations and different number of references. These observations could be valuable for policy makers when deciding research funding and also for individual researchers when searching for scientific projects.

  7. Do scientists trace hot topics?

    PubMed Central

    Wei, Tian; Li, Menghui; Wu, Chensheng; Yan, Xiao-Yong; Fan, Ying; Di, Zengru; Wu, Jinshan

    2013-01-01

    Do scientists follow hot topics in their scientific investigations? In this paper, by performing analysis to papers published in the American Physical Society (APS) Physical Review journals, it is found that papers are more likely to be attracted by hot fields, where the hotness of a field is measured by the number of papers belonging to the field. This indicates that scientists generally do follow hot topics. However, there are qualitative differences among scientists from various countries, among research works regarding different number of authors, different number of affiliations and different number of references. These observations could be valuable for policy makers when deciding research funding and also for individual researchers when searching for scientific projects. PMID:23856680

  8. Topical antifungal agents: an update.

    PubMed

    Diehl, K B

    1996-10-01

    So many topical antifungal agents have been introduced that it has become very difficult to select the proper agent for a given infection. Nonspecific agents have been available for many years, and they are still effective in many situations. These agents include Whitfield's ointment, Castellani paint, gentian violet, potassium permanganate, undecylenic acid and selenium sulfide. Specific antifungal agents include, among others, the polyenes (nystatin, amphotericin B), the imidazoles (metronidazole, clotrimazole) and the allylamines (terbinafine, naftifine). Although the choice of an antifungal agent should be based on an accurate diagnosis, many clinicians believe that topical miconazole is a relatively effective agent for the treatment of most mycotic infections. Terbinafine and other newer drugs have primary fungicidal effects. Compared with older antifungal agents, these newer drugs can be used in lower concentrations and shorter therapeutic courses. Studies are needed to evaluate the clinical efficacies and cost advantages of both newer and traditional agents.

  9. Do scientists trace hot topics?

    NASA Astrophysics Data System (ADS)

    Wei, Tian; Li, Menghui; Wu, Chensheng; Yan, Xiao-Yong; Fan, Ying; di, Zengru; Wu, Jinshan

    2013-07-01

    Do scientists follow hot topics in their scientific investigations? In this paper, by performing analysis to papers published in the American Physical Society (APS) Physical Review journals, it is found that papers are more likely to be attracted by hot fields, where the hotness of a field is measured by the number of papers belonging to the field. This indicates that scientists generally do follow hot topics. However, there are qualitative differences among scientists from various countries, among research works regarding different number of authors, different number of affiliations and different number of references. These observations could be valuable for policy makers when deciding research funding and also for individual researchers when searching for scientific projects.

  10. Major research topics in combustion

    SciTech Connect

    Hussaini, M.Y.; Kumar, A.; Voigt, R.G.

    1992-01-01

    The Institute for Computer Applications in Science and Engineering (ICASE) and NASA Langley Research Center (LaRC) hosted a workshop on October 2--4, 1989 to discuss some combustion problems of technological interest to LaRC and to foster interaction with the academic community in these research areas. The topics chosen for this purpose were flame structure, flame holding/extinction, chemical kinetics, turbulence-kinetics interaction, transition to detonation, and reacting free shear layers. This document contains the papers and edited versions of general discussions on these topics. The lead paper set the stage for the meeting by discussing the status and issues of supersonic combustionmore » relevant to the scramjet engine. Experts were then called upon to review the current knowledge in the aforementioned areas, to focus on how this knowledge can be extended and applied to high-speed combustion, and to suggest future directions of research in these areas.« less

  11. Pediatric cardiovascular safety: challenges in drug and device development and clinical application.

    PubMed

    Bates, Katherine E; Vetter, Victoria L; Li, Jennifer S; Cummins, Susan; Aguel, Fernando; Almond, Christopher; Dubin, Anne M; Elia, Josephine; Finkle, John; Hausner, Elizabeth A; Joseph, Francesca; Karkowsky, Abraham M; Killeen, Matthew; Lemacks, Jodi; Mathis, Lisa; McMahon, Ann W; Pinnow, Ellen; Rodriguez, Ignacio; Stockbridge, Norman L; Stockwell, Margaret; Tassinari, Melissa; Krucoff, Mitchell W

    2012-10-01

    Development of pediatric medications and devices is complicated by differences in pediatric physiology and pathophysiology (both compared with adults and within the pediatric age range), small patient populations, and practical and ethical challenges to designing clinical trials. This article summarizes the discussions that occurred at a Cardiac Safety Research Consortium-sponsored Think Tank convened on December 10, 2010, where members from academia, industry, and regulatory agencies discussed important issues regarding pediatric cardiovascular safety of medications and cardiovascular devices. Pediatric drug and device development may use adult data but often requires additional preclinical and clinical testing to characterize effects on cardiac function and development. Challenges in preclinical trials include identifying appropriate animal models, clinically relevant efficacy end points, and methods to monitor cardiovascular safety. Pediatric clinical trials have different ethical concerns from adult trials, including consideration of the subjects' families. Clinical trial design in pediatrics should assess risks and benefits as well as incorporate input from families. Postmarketing surveillance, mandated by federal law, plays an important role in both drug and device safety assessment and becomes crucial in the pediatric population because of the limitations of premarketing pediatric studies. Solutions for this wide array of issues will require collaboration between academia, industry, and government as well as creativity in pediatric study design. Formation of various epidemiologic tools including registries to describe outcomes of pediatric cardiac disease and its treatment as well as cardiac effects of noncardiovascular medications, should inform preclinical and clinical development and improve benefit-risk assessments for the patients. The discussions in this article summarize areas of emerging consensus and other areas in which consensus remains elusive

  12. Fixed cutaneous sporotrichosis treated with topical amphotericin B in an immune suppressed patient.

    PubMed

    Mahajan, Vikram K; Mehta, Karaninder S; Chauhan, Pushpinder S; Gupta, Mrinal; Sharma, Rajni; Rawat, Ritu

    2015-03-01

    Both fixed cutaneous and lymphocutaneous sporotrichosis are associated with significant morbidity due to chronicity. Although treatment with itraconazole, saturated solution of potassium iodide or terbinafine is recommended in most cases, the described patient with fixed cutaneous sporotrichosis could not tolerate any of these. Her lesion healed after 8weeks of topical amphotericin-B (0.1% w/w). Topical amphotericin-B appears useful treatment modality for uncomplicated cutaneous sporotrichosis when systemic treatment needs deferment, remains contraindicated, or in pediatric patients.

  13. Topical fluoride for caries prevention

    PubMed Central

    Weyant, Robert J.; Tracy, Sharon L.; Anselmo, Theresa (Tracy); Beltrán-Aguilar, Eugenio D.; Donly, Kevin J.; Frese, William A.; Hujoel, Philippe P.; Iafolla, Timothy; Kohn, William; Kumar, Jayanth; Levy, Steven M.; Tinanoff, Norman; Wright, J. Timothy; Zero, Domenick; Aravamudhan, Krishna; Frantsve-Hawley, Julie; Meyer, Daniel M.

    2015-01-01

    Background A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. Types of Studies Reviewed The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents—including mouthrinses, varnishes, gels, foams and pastes—with caries increment outcomes published in English through October 2012. Results The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. Practical Implications The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.5 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from “in favor” to “expert opinion for.” As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. PMID:24177407

  14. TOPTRAC: Topical Trajectory Pattern Mining

    PubMed Central

    Kim, Younghoon; Han, Jiawei; Yuan, Cangzhou

    2015-01-01

    With the increasing use of GPS-enabled mobile phones, geo-tagging, which refers to adding GPS information to media such as micro-blogging messages or photos, has seen a surge in popularity recently. This enables us to not only browse information based on locations, but also discover patterns in the location-based behaviors of users. Many techniques have been developed to find the patterns of people's movements using GPS data, but latent topics in text messages posted with local contexts have not been utilized effectively. In this paper, we present a latent topic-based clustering algorithm to discover patterns in the trajectories of geo-tagged text messages. We propose a novel probabilistic model to capture the semantic regions where people post messages with a coherent topic as well as the patterns of movement between the semantic regions. Based on the model, we develop an efficient inference algorithm to calculate model parameters. By exploiting the estimated model, we next devise a clustering algorithm to find the significant movement patterns that appear frequently in data. Our experiments on real-life data sets show that the proposed algorithm finds diverse and interesting trajectory patterns and identifies the semantic regions in a finer granularity than the traditional geographical clustering methods. PMID:26709365

  15. Moral distress in Iranian pediatric nurses.

    PubMed

    Ghasemi, Elham; Negarandeh, Reza; Janani, Leila

    2017-01-01

    Moral distress is a very common experience in the nursing profession, and it is one of the main reasons for job dissatisfaction, burnout, and quitting among nurses. For instance, morally difficult situations in taking care of child patients who are severely ill may lead to moral distress for nurses. However, most of the studies about moral distress have been conducted on nurses of special wards and adult medical centers with much focus on developed countries. Subsequently, little has been researched on this topic among nurses in other nations such as Iran, and most certainly, there has been hardly any such research involving Iranian pediatric nurses. Aim/objectives: This study was conducted to evaluate moral distress among nurses in selected pediatric hospitals in Tehran, Iran. This cross-sectional study was conducted on eligible nurses who were selected through proportional stratified sampling and who completed demographic characteristics and the pediatric version of Moral Distress Scale-Revised questionnaires. Data were analyzed using descriptive statistics, t test, one-way analysis of variance, and Pearson correlation coefficient. Participants and research context: In total, 195 pediatric nurses working at three selected children's specialized university hospitals in Tehran participated in this study. Ethical considerations: This study was evaluated and approved by the institutional review board of Tehran University of Medical Sciences. The mean and standard deviation of total score of moral distress was 106.41 ± 61.64 within a range of 10-257. Also, the difference between the mean score of moral distress of the group who had not quitted their position and those who have quit in the past was statistically significant (p = 0.043). The situation that was associated with the highest moral distress was "observing medical students performing painful procedures on patients just to gain some skill." Total score of moral distress was significantly higher among male

  16. Pediatric digital chest imaging.

    PubMed

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  17. Hippocrates on Pediatric Dermatology.

    PubMed

    Sgantzos, Markos; Tsoucalas, Gregory; Karamanou, Marianna; Giatsiou, Styliani; Tsoukalas, Ioannis; Androutsos, George

    2015-01-01

    Hippocrates of Kos is well known in medicine, but his contributions to pediatric dermatology have not previously been examined. A systematic study of Corpus Hippocraticum was undertaken to document references of clinical and historical importance of pediatric dermatology. In Corpus Hippocraticum, a variety of skin diseases are described, along with proposed treatments. Hippocrates rejected the theory of the punishment of the Greek gods and supported the concept that dermatologic diseases resulted from a loss of balance in the body humors. Many of the terms that Hippocrates and his pupils used are still being used today. Moreover, he probably provided one of the first descriptions of skin findings in smallpox, Henoch-Schönlein purpura (also known as anaphylactoid purpura, purpura rheumatica, allergic purpura), and meningococcal septicemia. © 2015 Wiley Periodicals, Inc.

  18. Telemedicine: Pediatric Applications

    PubMed Central

    Burke, Bryan L.; Hall, R. W.

    2017-01-01

    Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine’s current use bears testimony to its effectiveness and potential. Telemedicine’s widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits. PMID:26122813

  19. Cannabinoids in Pediatrics

    PubMed Central

    Phillips, Marjorie Shaw; Manasco, Kalen

    2017-01-01

    Despite its controversial nature, the use of medical marijuana and cannabis-derived medicinal products grows more popular with each passing year. As of November 2016, over 40 states have passed legislation regarding the use of either medical marijuana or cannabidiol products. Many providers have started encountering patients experimenting with cannabis products for a wide range of conditions. While the debate continues regarding these agents for both medicinal and recreational use in the general population, special consideration needs to be made for pediatric use. This review will deliver the history of marijuana use and legislation in the United States in addition to the currently available medical literature to equip pediatric health care providers with resources to provide patients and their parents the best recommendation for safe and appropriate use of cannabis-containing compounds. PMID:28638299

  20. Pharmacogenomics in pediatric rheumatology.

    PubMed

    Becker, Mara L

    2012-09-01

    Despite major advancements in therapeutics, variability in drug response remains a challenge in both adults and children diagnosed with rheumatic disease. The genetic contribution to interindividual variability has emerged as a promising avenue of exploration; however, challenges remain in making this knowledge relevant in the clinical realm. New genetic associations in patients with rheumatic disease have been reported for disease modifying antirheumatic drugs, antimetabolites and biologic drugs. However, many of these findings are in need of replication, and few have taken into account the concept of ontogeny, specific to pediatrics. In the current era in which we practice, genetic variation will undoubtedly contribute to variability in therapeutic response and may be a factor that will ultimately impact individualized care. However, preliminary studies have shown that there are many hurdles that need to be overcome as we explore pharmacogenomic associations specifically in the field of pediatric rheumatology.

  1. Pediatric Somatic Symptom Disorders.

    PubMed

    Malas, Nasuh; Ortiz-Aguayo, Roberto; Giles, Lisa; Ibeziako, Patricia

    2017-02-01

    Somatic symptom disorder (SSD) is a common disorder encountered in pediatric medicine. It involves the presentation of physical symptoms that are either disproportionate or inconsistent with history, physical examination, laboratory, and other investigative findings. SSDs result in significant impairment with considerable increase in healthcare utilization, school absenteeism, and the potential for unnecessary diagnostic evaluation and treatment intervention. Patients and families often feel dismissed and may worry that a serious condition has been missed. Primary care providers are frequently frustrated due to a lack of a successful approach to patients and families impacted by SSD. The result is often a cycle of disability, frustration and missed opportunities for collaboration towards enhanced patient functionality. This review summarizes the current evidence-based understanding, as well as insights from clinician experience, on the evaluation and management of pediatric SSD.

  2. Neurotrauma pediatric scales

    PubMed Central

    Alexandru, Vlad Ciurea; Aurelia, Mihaela Sandu; Mihai, Popescu; Stefan, Mircea Iencean; Bogdan, Davidescu

    2008-01-01

    Cranial traumas have different particularities in infants, toddlers, preschool child, school child and teenagers. The assessment of these cases must be individualized according to age. It is completely different in children that in adults. Trauma scales, very useful in grading the severity and predicting outcome in traumatic brain injury, used in adults must be adapted in children. Children have age-related specificity and anatomic particularities, for each of this period of development. Neurotrauma scales, specific for infants and children, such as Pediatric Coma Scale, Children’s Coma Score, Trauma Infant Neurological Score, Glasgow Coma Scale, Liege Scale are reviewed, as well as neurotrauma outcome scales, like Glasgow Outcome Scale, modified Rankin score, KOSCHI score and Barthel Index. The authors present these scales in an exhaustive manner for thoroughgoing pediatric neurotrauma standards. PMID:20108520

  3. Pediatric robotic urologic surgery-2014

    PubMed Central

    Kearns, James T.; Gundeti, Mohan S.

    2014-01-01

    We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide. PMID:25197187

  4. Prevalence and Clinical Characteristics of Chronic Spontaneous Urticaria in Pediatric Patients.

    PubMed

    Balp, Maria-Magdalena; Weller, Karsten; Carboni, Veruska; Chirilov, Alexandra; Papavassilis, Charis; Severin, Thomas; Tian, Haijun; Zuberbier, Torsten; Maurer, Marcus

    2018-04-21

    Data on the prevalence and disease management of chronic urticaria (CU) and chronic spontaneous urticaria (CSU) in the pediatric population are scarce. The present study assessed the prevalence of CU and CSU, and disease management among pediatric patients (0-17 years). A physician-based online survey was conducted in 5 European countries (United Kingdom, Germany, Italy, France, and Spain) assessing the annual diagnosed prevalence, disease characteristics and treatment patterns in the target population. Results are based on physician responses and analyzed using descriptive statistics. Prevalence estimates were calculated based on the number of CU/CSU pediatric patients seen, treated and referred by the respondents and extrapolated to the total pediatric population from each country. Across 5 European countries, the one-year diagnosed prevalence of CU and CSU in pediatric patients was 1.38% (95% CI, 0.94-1.86) and 0.75% (95% CI, 0.44-1.08), respectively. Angioedema was reported in 6%-14% of patients. A large proportion of CSU pediatric patients (40%-60%) were treated with H1-antihistamines at approved dose and 16% to 51% received H1-antihistamines at higher doses. Approximately 1/3 of pediatric CSU patients remained uncontrolled with H1- antihistamines at approved/higher doses. Other prescribed treatments were oral corticosteroids (10% to 28%) and topical creams (15% to 26%). This study revealed a prevalence of CSU among pediatric population comparable to adults and also suggested an unmet need for approved treatments for inadequately-controlled pediatric CSU patients. It is truly of concern that harmful (oral steroids) or insufficient (topical creams) treatments were frequently used despite of better and guideline recommended alternatives. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Common Pediatric Urological Disorders

    PubMed Central

    Robson, Wm. Lane M.; Leung, Alexander K.C.; Boag, Graham S.

    1991-01-01

    The clinical and radiological presentations of 12 pediatric urological disorders are described. The described disorders include pyelonephritis, vesicoureteral reflux, ureteropelvic obstruction, ureterovesical obstruction, ectopic ureterocele, posterior urethral valves, multicystic dysplastic kidney, polycystic kidney disease, ectopic kidney, staghorn calculi, urethral diverticulum, and urethral meatal stenosis. ImagesFigure 1-2Figure 3Figure 3Figure 4Figure 5Figure 6-7Figure 8-9Figure 10Figure 11-12 PMID:21229068

  6. Pediatric sports elbow injuries.

    PubMed

    Greiwe, R Michael; Saifi, Comron; Ahmad, Christopher S

    2010-10-01

    Elbow injuries in the pediatric and adolescent population represent a spectrum of pathology that can be categorized as medial tension injuries, lateral compression injuries, and posterior shear injuries. Early and accurate diagnosis can improve outcomes for both nonoperative and operative treatments. Prevention strategies are important to help reduce the increasing incidence of elbow injuries in youth athletes. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Pediatric pyogenic liver abscess.

    PubMed

    Israeli, Rafi; Jule, Jose Ernesto; Hom, Jeffrey

    2009-02-01

    Pyogenic liver abscess (PLA) is a rare pediatric disease. Typically, PLA is found in adults with biliary disease. There are no typical physical findings or symptoms. Often, pathogenic organisms are not recovered for identification. This case illustrates a teenager presenting with prolonged episodes of fever and vomiting. With percutaneous drainage and month-long antibiotic therapy, the PLA resolved. This case illustrates that a high index of suspicion is needed for diagnosis.

  8. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Managing the Pediatric Facial Fracture

    PubMed Central

    Cole, Patrick; Kaufman, Yoav; Hollier, Larry H.

    2009-01-01

    Facial fracture management is often complex and demanding, particularly within the pediatric population. Although facial fractures in this group are uncommon relative to their incidence in adult counterparts, a thorough understanding of issues relevant to pediatric facial fracture management is critical to optimal long-term success. Here, we discuss several issues germane to pediatric facial fractures and review significant factors in their evaluation, diagnosis, and management. PMID:22110800

  10. Obesity in pediatric trauma.

    PubMed

    Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

    2017-04-01

    The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values <0.001). On multivariable analysis, higher BMI percentiles were associated with significantly increased likelihood of death, deep venous thrombosis, pulmonary embolus and pneumonia; although there was no difference in risk of overall complications. Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Pediatric Acute Kidney Injury.

    PubMed

    Fragasso, Tiziana; Ricci, Zaccaria; Goldstein, Stuart L

    2018-01-01

    Acute kidney injury (AKI) in children is a serious condition with an important impact on morbidity and mortality. Onset can be insidious and it is frequently unrecognized in the early phase when the therapeutic opportunities are theoretically more effective. The present review focuses on the most recent epidemiology studies and the progress in pediatric AKI (pAKI) research. Standardization of definition (presented in the Kidney Disease: Improving Global Outcomes) and novel biomarkers have been developed to help clinicians recognize kidney injury in a timely manner, both in adult and pediatric populations. Strengths and weaknesses of these diagnostic tools are discussed and the clinical scoring system (Renal Angina Index), which aims to provide a rational context for biomarker utilization, is also presented. Even if effective treatments are not currently available for established AKI, specific preventive approaches and some promising pharmacological treatments will be detailed. Renal replacement therapy is currently considered the most effective way to manage fluid balance when severe AKI occurs. Key Messages: Great efforts in pAKI research have today led to new strategies for early AKI detection and prevention strategies. Further studies have to be conducted in the next future in order to definitely improve the outcomes of pediatric patients experiencing this deadly syndrome. © 2018 S. Karger AG, Basel.

  12. Antibiotic Allergy in Pediatrics.

    PubMed

    Norton, Allison Eaddy; Konvinse, Katherine; Phillips, Elizabeth J; Broyles, Ana Dioun

    2018-05-01

    The overlabeling of pediatric antibiotic allergy represents a huge burden in society. Given that up to 10% of the US population is labeled as penicillin allergic, it can be estimated that at least 5 million children in this country are labeled with penicillin allergy. We now understand that most of the cutaneous symptoms that are interpreted as drug allergy are likely viral induced or due to a drug-virus interaction, and they usually do not represent a long-lasting, drug-specific, adaptive immune response to the antibiotic that a child received. Because most antibiotic allergy labels acquired in childhood are carried into adulthood, the overlabeling of antibiotic allergy is a liability that leads to unnecessary long-term health care risks, costs, and antibiotic resistance. Fortunately, awareness of this growing burden is increasing and leading to more emphasis on antibiotic allergy delabeling strategies in the adult population. There is growing literature that is used to support the safe and efficacious use of tools such as skin testing and drug challenge to evaluate and manage children with antibiotic allergy labels. In addition, there is an increasing understanding of antibiotic reactivity within classes and side-chain reactions. In summary, a better overall understanding of the current tools available for the diagnosis and management of adverse drug reactions is likely to change how pediatric primary care providers evaluate and treat patients with such diagnoses and prevent the unnecessary avoidance of antibiotics, particularly penicillins. Copyright © 2018 by the American Academy of Pediatrics.

  13. Moral Dilemmas in Pediatric Orthopedics.

    PubMed

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y

    2015-12-01

    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result. Copyright 2015, SLACK Incorporated.

  14. Update on pediatric resuscitation drugs: high dose, low dose, or no dose at all.

    PubMed

    Sorrentino, Annalise

    2005-04-01

    Pediatric resuscitation has been a topic of discussion for years. It is difficult to keep abreast of changing recommendations, especially for busy pediatricians who do not regularly use these skills. This review will focus on the most recent guidelines for resuscitation drugs. Three specific questions will be discussed: standard dose versus high-dose epinephrine, amiodarone use, and the future of vasopressin in pediatric resuscitation. The issue of using high-dose epinephrine for cardiopulmonary resuscitation refractory to standard dose epinephrine has been a topic of debate for many years. Recently, a prospective, double-blinded study was performed to help settle the debate. These results will be reviewed and compared with previous studies. Amiodarone is a medication that was added to the pediatric resuscitation algorithms with the most recent recommendations from the American Heart Association in 2000. Its use and safety will also be discussed. Another topic that is resurfacing in resuscitation is the use of vasopressin. Its mechanism and comparisons to other agents will be highlighted, although its use in the pediatric patient has not been thoroughly studied. Pediatric resuscitation is a constantly evolving subject that is on the mind of anyone taking care of sick children. Clinicians are continually searching for the most effective methods to resuscitate children in terms of short- and long-term outcomes. It is important to be familiar with not only the agents being used but also the optimal way to use them.

  15. Topical glycopyrrolate reduces axillary hyperhidrosis.

    PubMed

    Baker, D M

    2016-12-01

    Oral anti-cholinergic medications reduce generalized hyperhidrosis, but the effectiveness of topical anticholinergic solutions on axillary hyperhidrosis is unclear. This study determines the initial effectiveness of 1% and 2% topical glycopyrrolate spray and compares this with Botulinum toxin type A injections for the management of axillary hyperhidrosis. In a non-randomized, consecutive patient, prospective questionnaire, treatment comparison study, 40 patients with axillary hyperhidrosis were allocated to one of four study groups (10 patients to each group): (a) 1% glycopyrrolate spray, (b) 2% glycopyrrolate spray, (c) subcutaneous Botulinum toxin type A injections, (d) no treatment. Clinical outcomes were measured by comparing a prospectively administered questionnaire, completed both pre-treatment and 6 weeks after starting treatment. Forty healthy volunteers without axillary hyperhidrosis completed the same questionnaire. The three treatment groups showed a significant (P < 0.05) improvement in their hyperhidrosis scores following treatment. The degree of improvement was less for the 1% glycopyrrolate group when compared with the Botulinum toxin type A group (P < 0.05), but there was no difference in treatment outcomes between the 2% glycopyrrolate and Botulinum toxin type A groups. No treatment group experienced reduced hyperhidrosis to a level similar to those without hyperhidrosis. Patients in both, the 2% glycopyrrolate and Botulinum toxin type A groups reported a significant improvement in axillary hyperhidrosis symptoms. These included reduction in psychologically precipitating factors (e.g. public speaking) and axillary hyperhidrosis-specific physical effects (e.g. limitation of clothing choice). Topical glycopyrrolate spray could provide a further treatment modality to manage axillary hyperhidrosis. © 2016 European Academy of Dermatology and Venereology.

  16. Tactile friction of topical formulations.

    PubMed

    Skedung, L; Buraczewska-Norin, I; Dawood, N; Rutland, M W; Ringstad, L

    2016-02-01

    The tactile perception is essential for all types of topical formulations (cosmetic, pharmaceutical, medical device) and the possibility to predict the sensorial response by using instrumental methods instead of sensory testing would save time and cost at an early stage product development. Here, we report on an instrumental evaluation method using tactile friction measurements to estimate perceptual attributes of topical formulations. Friction was measured between an index finger and an artificial skin substrate after application of formulations using a force sensor. Both model formulations of liquid crystalline phase structures with significantly different tactile properties, as well as commercial pharmaceutical moisturizing creams being more tactile-similar, were investigated. Friction coefficients were calculated as the ratio of the friction force to the applied load. The structures of the model formulations and phase transitions as a result of water evaporation were identified using optical microscopy. The friction device could distinguish friction coefficients between the phase structures, as well as the commercial creams after spreading and absorption into the substrate. In addition, phase transitions resulting in alterations in the feel of the formulations could be detected. A correlation was established between skin hydration and friction coefficient, where hydrated skin gave rise to higher friction. Also a link between skin smoothening and finger friction was established for the commercial moisturizing creams, although further investigations are needed to analyse this and correlations with other sensorial attributes in more detail. The present investigation shows that tactile friction measurements have potential as an alternative or complement in the evaluation of perception of topical formulations. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Health Literacy among Parents of Pediatric Patients

    PubMed Central

    Tran, T. Paul; Robinson, Laura M.; Keebler, John R.; Walker, Richard A.; Wadman, Michael C.

    2008-01-01

    Background Health literacy is an important predictor of healthcare outcomes, but research on this topic has largely been absent from the emergency medicine literature. Objective We measured the prevalence of health literacy in parents or guardians of pediatric patients seen in the emergency department (ED). Methods This was an observational study conducted in a Midwestern urban, university-based, tertiary, Level 1 trauma center ED with 33,000 visits/year. Using convenience sampling during a three-month period, English-speaking parents or guardians of pediatric patients (< 19 yrs.) were asked to complete the short version of the Test of Functional Health Literacy for Adults (s-TOFHLA). Parents/guardians were excluded if they had uncorrected visual impairment, required an interpreter, had altered mental status, or if the patients they accompanied were the subjects of a medical or trauma activation. Results Of the 188 parents or guardians approached, six did not consent or withdrew, one was excluded, leaving 181 (96.3%) in the study. Of these, 19 (10.5%) had either “marginal” or “inadequate” health literacy, while 162 (89.5%, 95% CI: 84.1%, 93.6%) had “adequate” health literacy. Conclusion A large majority (89.5%) of English-speaking parents or guardians of pediatric patients evaluated in the ED have adequate health literacy. This data may prompt ED professionals to adjust their communication styles in the evaluation of children. Future multi-center studies are needed to confirm the findings in this pilot study. PMID:19561727

  18. Topical microbicides--what's new?

    PubMed

    Karim, Quarraisha Abdool; Baxter, Cheryl; Karim, Salim Abdool

    2013-07-01

    Topical microbicides are an important, promising but complex HIV prevention technology under development. After 11 disappointing effectiveness trial outcomes of 6 candidate products (some tested as multiple doses and formulations) over the past 20 years, there is renewed optimism that a safe and effective microbicide will soon be available if the recent success of coitally linked use of the antiretroviral-based microbicide, 1% tenofovir gel, is confirmed. Studies of new antiviral agents, novel delivery mechanisms, and combination/multipurpose products that address challenges of adherence, enhance the effectiveness of tenofovir gel, and address sexual and reproductive health needs of men and women, including preventing HIV infection, are already underway.

  19. Advances in pediatric asthma and atopic dermatitis.

    PubMed

    Foroughi, Shabnam; Thyagarajan, Ananth; Stone, Kelly D

    2005-10-01

    Allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, food allergy, and urticaria are common in general pediatric practice. This review highlights several significant advances in pediatric allergy over the past year, focusing on asthma and atopic dermatitis. With increasing options for the treatment of allergic diseases, much work is now focused on methods for individualizing treatments to a patient's phenotype and genotype. Progress over the past year includes the characterization of effects of regular albuterol use in patients with genetic variations in the beta-adrenergic receptor. Maintenance asthma regimens for children in the first years of life are also an ongoing focus. The relation between upper airway allergic inflammation and asthma has continued to accumulate support and now extends to the middle ear. Environmental influences on asthma and interventions have been described, including environmental controls for asthma and the role of air pollution on lung development in children. Finally, concerns have been raised regarding the use of topical immunomodulators in young children with atopic dermatitis. Progress continues in the care of children with atopic diseases. Attention to treatment with appropriate medications, patient-individualized environmental controls, and extensive education are the keys to successfully treating atopic children. This review highlights several recent advances but is not intended to be a comprehensive review.

  20. Comparative evaluation of the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and xylitol-containing chewing gum on salivary flow rate, pH and buffering capacity in children: An in vivo study.

    PubMed

    Hegde, Rahul J; Thakkar, Janhavi B

    2017-01-01

    This study aimed to compare and evaluate the changes in the salivary flow rate, pH, and buffering capacity before and after chewing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and xylitol-containing chewing gums in children. Sixty children aged between 8 and 12 years were selected for the study. They were randomly divided into Group 1 (CPP-ACP chewing gum) and Group 2 (xylitol-containing chewing gum) comprising thirty children each. Unstimulated and stimulated saliva samples at 15 and 30 min interval were collected from all children. All the saliva samples were estimated for salivary flow rate, pH, and buffering capacity. Significant increase in salivary flow rate, pH, and buffering capacity from baseline to immediately after spitting the chewing gum was found in both the study groups. No significant difference was found between the two study groups with respect to salivary flow rate and pH. Intergroup comparison indicated a significant increase in salivary buffer capacity in Group 1 when compared to Group 2. Chewing gums containing CPP-ACP and xylitol can significantly increase the physiochemical properties of saliva. These physiochemical properties of saliva have a definite relation with caries activity in children.

  1. Strategic Planning for Research in Pediatric Critical Care.

    PubMed

    Tamburro, Robert F; Jenkins, Tammara L; Kochanek, Patrick M

    2016-11-01

    To summarize the scientific priorities and potential future research directions for pediatric critical care research discussed by a panel of experts at the inaugural Strategic Planning Conference of the Pediatric Trauma and Critical Illness Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Expert opinion expressed during the Strategic Planning Conference. Not applicable. Chaired by an experienced expert from the field, issues relevant to the conduct of pediatric critical care research were discussed and debated by the invited participants. Common themes and suggested priorities were identified and coalesced. Of the many pathophysiologic conditions discussed, the multiple organ dysfunction syndrome emerged as a topic in need of more study that is most relevant to the field. Additionally, the experts offered that the interrelationship and impact of critical illness on child development and family functioning are important research priorities. Consequently, long-term outcomes research was encouraged. The expert group also suggested that multidisciplinary conferences are needed to help identify key knowledge gaps to advance and direct research in the field. The Pediatric Critical Care and Trauma Scientist Development National K12 Program and the Collaborative Pediatric Critical Care Research Network were recognized as successful and important programs supported by the branch. The development of core data resources including biorepositories with robust phenotypic data using common data elements was also suggested to foster data sharing among investigators and to enhance disease diagnosis and discovery. Multicenter clinical trials and innovative study designs to address understudied and poorly understood conditions were considered important for field advancement. Finally, the growth of the pediatric critical care research workforce was offered as a priority that could be spawned in many ways including by expanded

  2. Strategic Planning for Research in Pediatric Critical Care

    PubMed Central

    Tamburro, Robert F.; Jenkins, Tammara L.; Kochanek, Patrick M.

    2016-01-01

    Objective To summarize the scientific priorities and potential future research directions for pediatric critical care research discussed by a panel of experts at the inaugural Strategic Planning Conference of the Pediatric Trauma and Critical Illness Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Data Sources Expert opinion expressed during the Strategic Planning Conference. Study Selection Not applicable Data Extraction Chaired by an experienced expert from the field, issues relevant to the conduct of pediatric critical care research were discussed and debated by the invited participants. Data Synthesis Common themes and suggested priorities were identified and coalesced. Conclusions Of the many pathophysiological conditions discussed, the multiple organ dysfunction syndrome emerged as a topic in need of more study that is most relevant to the field. Additionally, the experts offered that the inter-relationship and impact of critical illness on child development and family functioning are important research priorities. Consequently, long-term outcomes research was encouraged. The expert group also suggested that multidisciplinary conferences are needed to help identify key knowledge gaps to advance and direct research in the field. The Pediatric Critical Care and Trauma Scientist Development National K12 Program and the Collaborative Pediatric Critical Care Research Network were recognized as successful and important programs supported by the branch. The development of core data resources including biorepositories with robust phenotypic data using common data elements was also suggested to foster data sharing among investigators and to enhance disease diagnosis and discovery. Multicenter clinical trials and innovative study designs to address understudied and poorly understood conditions were considered important for field advancement. Finally, the growth of the pediatric critical care research workforce was offered

  3. Satellite DNA: An Evolving Topic

    PubMed Central

    Garrido-Ramos, Manuel A.

    2017-01-01

    Satellite DNA represents one of the most fascinating parts of the repetitive fraction of the eukaryotic genome. Since the discovery of highly repetitive tandem DNA in the 1960s, a lot of literature has extensively covered various topics related to the structure, organization, function, and evolution of such sequences. Today, with the advent of genomic tools, the study of satellite DNA has regained a great interest. Thus, Next-Generation Sequencing (NGS), together with high-throughput in silico analysis of the information contained in NGS reads, has revolutionized the analysis of the repetitive fraction of the eukaryotic genomes. The whole of the historical and current approaches to the topic gives us a broad view of the function and evolution of satellite DNA and its role in chromosomal evolution. Currently, we have extensive information on the molecular, chromosomal, biological, and population factors that affect the evolutionary fate of satellite DNA, knowledge that gives rise to a series of hypotheses that get on well with each other about the origin, spreading, and evolution of satellite DNA. In this paper, I review these hypotheses from a methodological, conceptual, and historical perspective and frame them in the context of chromosomal organization and evolution. PMID:28926993

  4. The 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care: an overview of the changes to pediatric basic and advanced life support.

    PubMed

    Spencer, Becky; Chacko, Jisha; Sallee, Donna

    2011-06-01

    The American Heart Association (AHA) has a strong commitment to implementing scientific research-based interventions for cardiopulmonary resuscitation and emergency cardiovascular care. This article presents the 2010 AHA major guideline changes to pediatric basic life support (BLS) and pediatric advanced life support (PALS) and the rationale for the changes. The following topics are covered in this article: (1) current understanding of cardiac arrest in the pediatric population, (2) major changes in pediatric BLS, and (3) major changes in PALS. Copyright © 2011. Published by Elsevier Inc.

  5. Pediatric Residents' Responses that Discourage Discussion of Psychosocial Problems in Primary Care

    ERIC Educational Resources Information Center

    Wissow, Lawrence S.; Larson, Susan; Anderson, Jada; Hadjiisky, Elizabeth

    2005-01-01

    Objective: Studies spanning nearly 4 decades demonstrate that doctors ignore or dismiss many patient bids for discussion of psychosocial topics. We sought to understand characteristics of doctors, patients, and visits in which this occurs. Methods: Reanalysis of 167 audiotapes from 2 studies of parent-doctor communication in a pediatric residents'…

  6. Obesity and Pediatric Drug Development.

    PubMed

    Vaughns, Janelle D; Conklin, Laurie S; Long, Ying; Zheng, Panli; Faruque, Fahim; Green, Dionna J; van den Anker, John N; Burckart, Gilbert J

    2018-05-01

    There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies. FDA labels were also reviewed for statements addressing obesity in pediatric patients. Forty-five drugs studied in pediatric patients under the FDA Amendments Act were found to have statements and key words in the medical and clinical pharmacology reviews and labels related to obesity. Forty-four products were identified similarly with pediatric studies under FDASIA. Of the 89 product labels identified, none provided dosing information related to obesity. The effect of body mass index on drug pharmacokinetics was mentioned in only 4 labels. We conclude that there is little information presently available to provide guidance related to dosing in obese pediatric patients. Moving forward, regulators, clinicians, and the pharmaceutical industry should consider situations in drug development in which the inclusion of obese patients in pediatric trials is necessary to facilitate the safe and effective use of new drug products in the obese pediatric population. © 2018, The American College of Clinical Pharmacology.

  7. Educational Preparation of Pediatric Audiologists

    ERIC Educational Resources Information Center

    Roush, Jackson

    2010-01-01

    Pediatric audiologists play a vital role in detection, diagnosis, and intervention for young children with hearing loss and their families. Preparing the next generation of pediatric audiologists necessitates a creative approach that balances the requirements of a broad curriculum with the special skills needed to serve a unique and varied…

  8. Psychosocial Issues in Pediatric Oncology

    PubMed Central

    Marcus, Joel

    2012-01-01

    Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology. PMID:23049457

  9. Epidemiology of pediatric skin diseases in the mid-western Anatolian region of Turkey.

    PubMed

    Kacar, Seval Dogruk; Ozuguz, Pinar; Polat, Serap; Manav, Vildan; Bukulmez, Aysegul; Karaca, Semsettin

    2014-10-01

    The field of pediatric dermatology has gained importance with the increment of pediatric patients and the discrepancy of their skin diseases with the adult versions. We aimed to describe frequency and distribution of pediatric skin diseases, and the diagnostic procedures and treatments prescribed. Cross-sectional epidemiological study. We collected data about diagnostic patterns, diagnostic methods and treatment modalities in pediatric dermatology outpatient clinic visits over 18 months. Infectious diseases (27.9%) and among them viral warts (17.5%) were the most prevalent diagnoses, followed by acne-acneiform diseases (19.9%) and allergic diseases (14.5%). Among the diagnostic tests histopathology was required in 5.2%, usually to diagnose inflammatory and tumoral lesions. Topical treatments (49.3%) were followed by systemic treatments (32.4%) in majority of cases. Viral warts were among the most common dermatoses, and preventive measures for HPV transmission should become important part of public health efforts in children.

  10. Environmental pediatrics: an introduction and evaluation of online resources.

    PubMed

    Weinstangel, Hannah; Buka, Irena; Campbell, Sandra

    2016-12-01

    The World Health Organization (WHO) estimates that three million children under the age of 5 die annually from environmentally related disease. In the United States, the cost of environmentally related public health concerns is estimated as greater than $55 billion. Environmental exposure is among parents' top health concerns for children. Yet, the study of the effects of environmental exposure on health outcomes is a developing field, and clinicians feel inadequately prepared to address these concerns. The Children's Environmental Health Clinic (ChEHC) is the first clinic of its kind in Canada. Their website includes a list of online resources on major topics related to child health and the environment. There has not yet been an objective evaluation of the comprehensiveness of the topics or scientific quality of the information on the website. This study seeks to offer an accessible introduction to the field of environmental pediatrics, including an online resource for evidence-based information on key topics in the field. These resources assist in disease prevention, health promotion, education, and the increasing need to balance environmental health risks. A scoping review of scientific and gray literature in the field of environmental pediatrics was performed to inform a written introduction to the field and to identify gaps in the content of the ChEHC website. The content of the ChEHC website was then objectively evaluated using the National Network of Libraries of Medicine checklist for health websites. Ten categories within the field of environmental pediatrics emerged from the literature review. A small number of gaps were identified on the website and in the literature. The content of the ChEHC website was found to be of high quality. The website will be updated using the results of the study as a guide, to make it as relevant, complete, and evidence-based as possible. Environmental pediatrics is an important, emerging topic. There is a need for accessible

  11. Pediatric obesity: Current concepts.

    PubMed

    Greydanus, Donald E; Agana, Marisha; Kamboj, Manmohan K; Shebrain, Saad; Soares, Neelkamal; Eke, Ransome; Patel, Dilip R

    2018-04-01

    This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21 st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity. We conclude with a discussion of future directions in pediatric obesity management. Copyright © 2018 Mosby, Inc. All rights reserved.

  12. Pediatric ambulatory anesthesia.

    PubMed

    August, David A; Everett, Lucinda L

    2014-06-01

    Pediatric patients often undergo anesthesia for ambulatory procedures. This article discusses several common preoperative dilemmas, including whether to postpone anesthesia when a child has an upper respiratory infection, whether to test young women for pregnancy, which children require overnight admission for apnea monitoring, and the effectiveness of nonpharmacological techniques for reducing anxiety. Medication issues covered include the risks of anesthetic agents in children with undiagnosed weakness, the use of remifentanil for tracheal intubation, and perioperative dosing of rectal acetaminophen. The relative merits of caudal and dorsal penile nerve block for pain after circumcision are also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Incarcerated Pediatric Hernias.

    PubMed

    Abdulhai, Sophia A; Glenn, Ian C; Ponsky, Todd A

    2017-02-01

    Indirect inguinal hernias are the most commonly incarcerated hernias in children, with a higher incidence in low birth weight and premature infants. Contralateral groin exploration to evaluate for a patent processus vaginalis or subclinical hernia is controversial, given that most never progress to clinical hernias. Most indirect inguinal hernias can be reduced nonoperatively. It is recommended to repair them in a timely fashion, even in premature infants. Laparoscopic repair of incarcerated inguinal hernia repair is considered a safe and effective alternative to conventional open herniorrhaphy. Other incarcerated pediatric hernias are extremely rare and may be managed effectively with laparoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Complications Following Pediatric Tracheotomy.

    PubMed

    D'Souza, Jill N; Levi, Jessica R; Park, David; Shah, Udayan K

    2016-05-01

    Pediatric tracheotomy is a complex procedure with significant postoperative complications. Wound-related complications are increasingly reported and can have considerable impact on clinical course and health care costs to tracheotomy-dependent children. The primary objective of this study was to identify the type and rate of complications arising from pediatric tracheotomy. A retrospective review of medical records of 302 children who underwent tracheotomy between December 1, 2000, and February 28, 2014, at a tertiary care pediatric referral center. Records were reviewed for preoperative diagnoses, gestational age, age at tracheotomy, tracheotomy technique, and incidence of complication. Main outcome measures included incidence, type, and timing of complications. Secondary measures included medical diagnoses and surgical technique. Of the 302 children who underwent tracheotomy, the median (SD) age at time of tracheotomy was 5 months (64 months) and the range was birth to 21 years. The most frequent diagnosis associated with performance of a tracheotomy was ventilator-associated respiratory failure (61.9%), followed by airway anomaly or underdevelopment (25.2%), such as subglottic or tracheal stenosis, laryngotracheomalacia, or bronchopulmonary dysplasia. The remaining indications for tracheotomy included airway obstruction (11.6% [35 of 302]) and vocal fold dysfunction (1.3% [4 of 302]). No statistical significance was found associated with diagnosis and incidence of complications. Sixty children (19.9%) had a tracheotomy-related complication. Major complications, such as accidental decannulation (1.0% [3 of 302]). There were no deaths associated with tracheotomy. Minor complications, such as peristomal wound breakdown or granuloma (12.9% [39 of 302]) and bleeding from stoma (1.7% [5 of 302]), were more common. Of all complications, 70% (42 of 60) occurred early (≤7 days postoperatively) and 20% (12 of 60) were late (>7 days postoperatively). Pediatric

  15. Pediatric Renal Neoplasms.

    PubMed

    Ranganathan, Sarangarajan

    2009-03-01

    Renal tumors in childhood consist of a diverse group of tumors ranging from the most common Wilms' tumor, to the uncommon and often fatal rhabdoid tumor. Diagnosis is based on morphologic features and aided by ancillary techniques such as immunohistochemistry and cytogenetics. Molecular techniques have helped identify a group of pediatric renal cell carcinomas that have specific translocations, called translocation-associated carcinomas. Differential diagnosis of the various tumors is discussed. Pathogenesis and nephroblastomatosis, the precursor lesions of Wilms tumor, also are discussed briefly, as are the handling of these tumor specimens and prognostic factors. Copyright © 2009 Elsevier Inc. All rights reserved.

  16. Recent developments in pediatric headache.

    PubMed

    Hershey, Andrew D

    2010-06-01

    This review will focus on some of the recent findings in pediatric headache including headache characteristics, epidemiology, comorbid associations and treatment updates. Pediatric headache remains a frequent health problem for children and their families, yet there remain many gaps in our knowledge. This review will broadly address some of the recent findings and highlight the gaps in our understanding and treatment of pediatric headache. There will be a focus on pediatric migraine as this has been the best characterized and studied. Our understanding of pediatric headache is improving with increased recognition of the characteristics and associated symptomology. This should further guide the individualized treatment approaches for improved outcome and reduction of progression into adulthood.

  17. Competencies in Training at the Graduate Student Level: Example of a Pediatric Psychology Seminar Course

    PubMed Central

    Ievers-Landis, Carolyn E.; Hazen, Rebecca A.; Fehr, Karla K.

    2015-01-01

    The recently developed competencies in pediatric psychology from the Society of Pediatric Psychology (SPP) Task Force on Competencies and Best Training Practices in Pediatric Psychology provide a benchmark to evaluate training program practices and student progress toward training in level-specific competency goals. Graduate-level training presents a unique challenge for addressing the breadth of competencies required in pediatric psychology while maintaining development of broader clinical psychology training goals. We describe a recurring graduate-level pediatric psychology seminar course that addresses training in a number of the competency cluster areas. The structure of the seminar, examples of classroom topics that correspond with competency cluster areas as well as benchmarks used to evaluate each student’s development in the competency area are provided. Specific challenges in developing and maintaining the seminar in this format are identified, and possible solutions are offered. This training format could serve as a model for established pediatric psychology programs to expand their didactic training goals or for programs without formal pediatric psychology training to address competencies outside of clinical placements. PMID:26900536

  18. Toxicities of topical ophthalmic anesthetics.

    PubMed

    McGee, Hall T; Fraunfelder, F W

    2007-11-01

    Topical ocular anesthesia has been part of ophthalmology for more than a century. The most commonly used drugs today are proparacaine, tetracaine, benoxinate (oxybuprocaine) cocaine and lidocaine. Although generally well tolerated, all these can be toxic, particularly when abused. The most common toxicities are to the ocular surface, but abuse can cause deep corneal infiltrates, ulceration and even perforation. Fortunately, systemic side effects are rare. Cocaine is unique for its higher incidence of systemic side effects and high abuse potential, both of which impede its clinical use. When used appropriately, all these drugs are remarkably safe. They are generally not prescribed for home use, as prolonged abuse of these drugs can be expected to result in serious complications.

  19. On the Topical Structure of Medical Charts

    PubMed Central

    Archbold, Armar A.; Evans, David A.

    1989-01-01

    In a study of 55 H&P sections of hospital charts, we tested the hypothesis that topic-sub-topic sequencing is sufficiently regular to provide ‘missing’ information in the construction of explicit propositions from elliptical text. ‘Propositions’ were taken to be frames with the slots topic, sub-topic, method, site, attribute, value, and qualifier. Topic was identifiable in 96% of all cases; attribute-value pairs were uniquely recoverable from topics in 69% of all cases; site was co-determined by topic, method, and attribute. Our results suggest that uncertainties in the automated processing of H&P statements can be overcome by appealing to knowledge about the topical structure of medical charts.

  20. Current Topics in Epilepsy Surgery.

    PubMed

    Usui, Naotaka

    2016-05-15

    This article reviews the current topics in the field of epilepsy surgery. Each type of epilepsy is associated with a different set of questions and goals. In mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS), postoperative seizure outcome is satisfactory. A recent meta-analysis revealed superior seizure outcome after anterior temporal lobectomy compared with selective amygdalohippocampectomy; in terms of cognitive outcome; however, amygdalohippocampectomy may be beneficial. In temporal lobe epilepsy with normal magnetic resonance imaging (MRI), postoperative seizure outcome is not as favorable as it is in MTLE with HS; further improvement of seizure outcome in these cases is necessary. Focal cortical dysplasia is the most common substrate in intractable neocortical epilepsy, especially in children, as well as in MRI-invisible neocortical epilepsy. Postoperative seizure-free outcome is approximately 60-70%; further diagnostic and therapeutic improvement is required. Regarding diagnostic methodology, an important topic currently under discussion is wideband electroencephalogram (EEG) analysis. Although high-frequency oscillations and ictal direct current shifts are considered important markers of epileptogenic zones, the clinical significance of these findings should be clarified further. Regarding alternatives to surgery, neuromodulation therapy can be an option for patients who are not amenable to resective surgery. In addition to vagus nerve stimulation, intracranial stimulation such as responsive neurostimulation or anterior thalamic stimulation is reported to have a modest seizure suppression effect. Postoperative management such as rehabilitation and antiepileptic drug (AED) management is important. It has been reported that postoperative rehabilitation improves postoperative employment status. Pre- and post-operative comprehensive care is mandatory for postoperative improvement of quality of life.