- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Review, Journal: Hepatic Encephalopathy: Diagnosis and Management. (Pubmed Central) - Jan 30, 2021
In recurrent/persistent HE, the treatment options include fecal transplantation, TIPS revision and closure of eventual splenorenal shunts. Treatment of MHE should be individualized on a case-by-case basis.
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Journal: Increased intestinal permeability in primary Sjögren's syndrome and multiple sclerosis. (Pubmed Central) - Jan 29, 2021
Intestinal permeability was increased in both pSS and MS patients, while faecal calprotectin was elevated in pSS but normal in MS. Our findings suggest different mechanisms mediating a leaky gut in these two diseases: in pSS there is autoimmune attack directly on the intestinal wall; in MS, with autoimmunity being limited to the CNS, it may be due to a disturbed CNS regulation of enteric nerve function.
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Clinical, Journal: Dietary intake from complementary feeding is associated with intestinal barrier function and environmental enteropathy in Brazilian children from the MAL-ED cohort study. (Pubmed Central) - Jan 26, 2021
Intestinal barrier function was assessed using the lactulose-mannitol test (L-M), and EE was determined as a composite measure using faecal biomarkers concentrations - α-1-antitrypsin, myeloperoxidase (MPO) and neopterin (NEO) at 15 months of age...Multiple linear regression models showed that energy intakes were inversely associated with intestinal barrier function (β = -0.19, p = 0.02) and, fiber intake was inversely associated with the EE scores (β = -0.20, p = 0.04). Findings suggest that dietary intake from complementary feeding is associated with decreased intestinal barrier function and EE in children.
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Clinical, Review, Journal: Treatment of Childhood Constipation: a synthesis of systematic reviews and meta-analyses. (Pubmed Central) - Jan 21, 2021
This review covers meta-analyses and evidence for treatment of paediatric constipation since 2016 and new emerging treatments.Expert opinion: Since 2016, meta-analyses conclude 1) fibre should be included in a normal diet, but further supplementation does not improve constipation; 2) probiotics may increase stool frequency in children, but evidence from larger RCTs is needed; 3) comparing laxatives, polyethylene glycol (PEG) is superior to placebo, lactulose and milk of magnesia, and 4) appendix stomas are effective and should be considered before surgery...For research, outcome measures need standardising to allow comparison between studies and allow meta-analyses. To assist this validated GI instruments have been developed by Rome IV and PedsQl.
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Preclinical, Journal: In vitro demonstration of intestinal absorption mechanisms of different sugars using 3D organotypic tissues in a fluidic device. (Pubmed Central) - Jan 13, 2021
This platform was investigated in both healthy and induced pathological conditions by monitoring the absorption of two non-metabolized sugars, lactulose and mannitol, frequently used as indicators of intestinal barrier dysfunctions...Interestingly, after calcium depletion treatment, the pattern of sugar passage comparable with the healthy tissue was completely restored only in dynamic conditions within MIVO® chamber, due to the beneficial role of the dynamic fluid flow beneath the membrane. Therefore, the MIVO® combined with EpiIntestinalTM™ platform can represent a reliable in vitro model of healthy and pathological small intestinal barrier to study the passage of molecules, by discriminating the two main intestinal absorption mechanisms.
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Clinical, Journal, HEOR: Effects of flaxseed supplementation on functional constipation and quality of life in a Chinese population: A randomized trial. (Pubmed Central) - Jan 13, 2021
Therefore, the MIVO® combined with EpiIntestinalTM™ platform can represent a reliable in vitro model of healthy and pathological small intestinal barrier to study the passage of molecules, by discriminating the two main intestinal absorption mechanisms. Flaxseed flour is somewhat more effective at increasing defecation frequency than lactulose, improving bowel movements and promoting life quality of subjects with chronic functional constipation in the Chinese population.
- |||||||||| Journal: Hydrolysis of lactose and transglycosylation of selected sugar alcohols by LacA β-galactosidase from Lactobacillus plantarum WCFS1. (Pubmed Central) - Jan 13, 2021
High hydrolysis capacity toward the β(1 → 4) linkages between galactose and glucose (lactose) or fructose (lactulose) was found...Galactosyl-derivatives of xylitol were characterized for the first time as 3-O-β-D-galactopyranosyl-xylitol and 1-O-β-D-galactopyranosyl-xylitol displaying the great preference of LacA β-galactosidase for the transfer of galactosyl residues from lactose to the C1 or C3 hydroxyl group of xylitol. These results indicate the feasibility of using LacA β-galactosidase for the synthesis of different galactosyl-polyols, which could be promising candidates for beneficial and appealing functional and technological applications such as novel prebiotics or hypocaloric sweeteners.
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Clinical, Review, Journal: Mechanisms of Action of Prebiotics and Their Effects on Gastro-Intestinal Disorders in Adults. (Pubmed Central) - Jan 13, 2021
There is an increasing interest in dietary strategies to modulate microbiota. The aim of this review is to explore the mechanisms of action of prebiotics and their effects on the principal gastro-intestinal disorders in adults, with a special focus on Galacto-oligosaccharides, Fructo-oligosaccharides, lactulose and new emerging substances which currently have evidence of prebiotics effects, such as xilooligosaccharides, soybean oligosaccharides, isomaltooligosaccharides, lactobionic acid, resistant starch and polyphenols.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Clinical, Review, Journal: Efficacy of rifaximin in the different clinical scenarios of hepatic encephalopathy. (Pubmed Central) - Jan 1, 2021
Even though many of them have been shown to be effective to greater or lesser degrees, it is important to understand the differences between them, so that every patient receives individualized treatment and the best option is chosen, in accordance with the different clinical scenarios. Thus, the aim of the present study was to analyze the evidence on the advantages and disadvantages of the individual or combined use of the 3 main treatments for hepatic encephalopathy, specifically taking into consideration their different degrees of efficacy, their impact on quality of life, prophylaxis, and cost reduction.
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Journal: Chemical Characterization, Gastrointestinal Motility and Sensory Evaluation of Dark Chocolate: A Nutraceutical Boosting Consumers' Health. (Pubmed Central) - Dec 30, 2020
Fifty healthy volunteers joined the study of the sensory characteristics of both types of chocolate; another 16 subjects underwent the study of gallbladder and gastric emptying by functional ultrasonography and orocecal transit time by lactulose H-breath test after ingestion of dark chocolate...For agreeability, Choco-A scored higher than Choco-I for smell, texture, and taste and they did not show significant differences in the gastrointestinal motility. In conclusion as for gastrointestinal motility studies, we report that the ingestion of a small amount of chocolate induced a mild gallbladder, gastric contraction and a fast transit time compared to the test meal in healthy subjects.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
[VIRTUAL] Evaluation of rifaximin use at a large tertiary care community hospital () - Dec 26, 2020 - Abstract #ASHP2020ASHP_4702;
The appropriateness of rifaximin use in the treatment of HE will be assessed in two ways: (1) by recording if rifaximin was used as first line or add-on therapy and (2) by determining if lactulose therapy was optimized prior to rifaximin initiation. Lactulose therapy optimization will be evaluated by recording the dose used and the number of bowel movements 24 hours prior to rifaximin initiation.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
[VIRTUAL] Evaluation of appropriate rifaximin use for hepatic encephalopathy at Lifebridge health hospitals () - Dec 26, 2020 - Abstract #ASHP2020ASHP_3853;
Data collection includes demographics, comorbidities, precipitating factors (e.g. gastrointestinal bleed, infection), primary diagnosis, hepatic encephalopathy type (first occurrence, episodic, recurrent, persistent, overt, covert), West Haven criteria stage, and first ammonia levels. It also consists of rifaximin and lactulose data (dose and number of doses), including if they were home medications per external fill history (filled within 6 months prior to admission).
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
[VIRTUAL] Rifaximin administration for hepatic encephalopathy, a medication use evaluation () - Dec 26, 2020 - Abstract #ASHP2020ASHP_3528;
This medication use evaluation illustrates that there are opportunities for optimization of lactulose by clinicians before the administration of rifaximin. If patients remain encephalopathic after the appropriate titration of lactulose, a rifaximin regimen of 550mg by mouth twice daily may be warranted.
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Journal: Computer-aided search for a cold-active cellobiose 2-epimerase. (Pubmed Central) - Dec 18, 2020
Cellobiose 2-epimerase (CE) is a promising industrial enzyme that can catalyze bioconversion of lactose to its high-value derivatives, namely epilactose and lactulose...In situ production of epilactose was carried out at 8°C: 20.9% of 68.4 g/L lactose was converted into epilactose in 4 h using 0.02 mg/mL (1.5 U/mL, measured at 45°C) of recombinant enzyme. The enzyme discovered by this in silico method is suitable for low-temperature applications.
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Clinical, Journal: Lactulose may reduce Clostridium difficile-related diarrhea among patients receiving antibiotics. (Pubmed Central) - Dec 17, 2020
Two (2.3%) patients who received lactulose and antibiotic therapy developed C. difficile infection during the course of hospitalization, compared with 10 (9.7%) patients who received antibiotic therapy alone (P = 0.04, Fisher exact test). Administration of lactulose may reduce the incidence of C. difficile-related diarrhea among hospitalized adult patients receiving antibiotics.
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Journal: Increased Colonic Permeability and Lifestyles as Contributing Factors to Obesity and Liver Steatosis. (Pubmed Central) - Dec 17, 2020
In 120 patients (61F:59M; mean age 45 ± SEM 1.2 years, range: 18-75), IP was distinctively studied by urine recovery of orally administered sucrose (SO, stomach), lactulose/mannitol ratio (LA/MA, small intestine), and sucralose (SA, colon)...The exact role of these last factors, however, requires specific studies focusing on intestinal permeability. Results should pave the way to both primary prevention measures and new therapeutic strategies in metabolic and liver diseases.
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Clinical, Journal: Role of Lactulose Rhamnose Permeability Test in Assessing Small Bowel Mucosal Damage in Children with Celiac Disease. (Pubmed Central) - Nov 28, 2020
Standardized median delta rhamnose was lower in CD group as compared to control group (147.5 vs 3153.1, P = 0.040). The low median rhamnose absorption in children with celiac disease as compared to other groups suggests that this test can differentiate between damaged and healthy mucosa, hence can it potentially can be used as a noninvasive test of mucosal healing in children with celiac disease.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Clinical: Here’s an example case: 62-year-old man with cirrhosis due to EtOH presents to HFpEF clinic confused, SOB, volume overloaded. Meds: bumetanide, spironolactone, lactulose, rifaximin. JVP 16 cm, ascites, 3+ leg edema. LVEF 57%. GLS -12.3%. What would you do next? (Twitter) - Nov 28, 2020
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Review, Journal: Application-Oriented Marine Isomerases in Biocatalysis. (Pubmed Central) - Nov 27, 2020
This class, named "isomerases," can transform cheap biomolecules into expensive isomers with suitable stereochemistry useful in synthetic medicinal chemistry, and interesting cases of production of l-ribose, d-psicose, lactulose, and d-phenylalanine are known...However, the major fields in which application examples are framed are placed at the cutting edge of current biotechnological development. Since these enzymes can offer properties of industrial interest, this will act as a promoter for future studies of marine-originating isomerases in applied biocatalysis.
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Journal: Bile acid abnormality induced by intestinal dysbiosis might explain lipid metabolism in Parkinson's disease. (Pubmed Central) - Nov 25, 2020
This was a prospective investigation of the presence of SIBO using the lactulose breath test, Parkinson's disease symptoms, medications, abdominal symptoms, and blood data involving 39 Parkinson's disease patients...By a similar mechanism, there is less absorption of vitamin D as bile acid levels decrease, leading to osteoporosis and fractures. The possibility that some of the non-motor manifestations accompanying Parkinson's disease are caused by intestinal dysbiosis needs to be considered.
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Trial completion date, Trial primary completion date: Oral Administration of MB-102 Versus Dual Sugar Testing for Gut Permeability (clinicaltrials.gov) - Nov 25, 2020
P1, N=20, Recruiting,
These data inform the development of care coordination efforts for subjects with cirrhosis. Trial completion date: Aug 2020 --> Apr 2021 | Trial primary completion date: Jul 2020 --> Apr 2021
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Clinical, Journal: Efficacy and Safety of Acupuncture at Tianshu (ST25) for Functional Constipation: Evidence from 10 Randomized Controlled Trials. (Pubmed Central) - Nov 21, 2020
Meta-analysis showed that the Cleveland Constipation Score (CCS) for deep needling was significantly lower than that for lactulose (deep needling with low-frequency dilatational wave: MD -0.58, 95% CI -0.94 to -0.22; deep needling with sparse wave: MD -3.67, 95% CI -6.40 to -0.94; deep needling with high-frequency dilatational wave: MD -3.42, 95% CI -5.03 to -1.81)...Additionally, acupuncture at ST25 was shown to be safer than conventional treatment, with the rate of AE being significantly lower for both deep needling and shallow needling. The trial is registered with https://www.crd.york.ac.uk/prospero/(CRD42019141017)).
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Clinical, Journal: Evidence of altered mucosa-associated and fecal microbiota composition in patients with Irritable Bowel Syndrome. (Pubmed Central) - Nov 21, 2020
SIBO was evaluated by bacterial culture of duodenal aspirate, glucose and lactulose breath tests...This study demonstrates that alterations in the bacterial composition of the sigmoid colon of IBS patients were linked to symptoms and immune activation. While breath tests reflected the mucosa-associated bacterial composition, there was no evidence for high prevalence of SIBO or small intestinal bacterial alterations in IBS.
- |||||||||| Preclinical, Journal: Liraglutide modulates gut microbiome and attenuates nonalcoholic fatty liver in db/db mice. (Pubmed Central) - Nov 21, 2020
The results of the present study suggested that liraglutide had a certain therapeutic effect on fatty liver in db/db mice and had an impact on the composition of the intestinal microflora, especially some bacteria related to glucolipid metabolism and intestinal inflammation. Affecting gut microbiome might be a potential mechanism of liraglutide in treating NAFL.
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