With a Hint of Sudachi: Food Plating Can Facilitate the Fondness of Food

Among the senses of food, our subjective sense of taste is significantly influenced by our visual perception. In appetite science, previous research has reported that when we estimate quality in daily life, we rely considerably on visual information. This study focused on the multimodal mental imagery evoked by the visual information of food served on a plate and examined the effect of the peripheral visual information of garnish on the sensory impression of the main dish. A sensory evaluation experiment was conducted to evaluate the impressions of food photographs, and multivariate analysis was used to structure sensory values. It was found that the appearance of the garnish placed on the plates close to the main dish contributes to visual appetite stimulants. It is evident that color, moisture, and taste (sourness and spiciness) play a major role in the acceptability of food. To stimulate one’s appetite, it is important to make the main dish appear warm. These results can be used to modulate the eating experience and stimulate appetite. Applying these results to meals can improve the dining experience by superimposing visual information with augmented reality technology or by presenting real appropriate garnishes.

Racial disparities in supportive medication use among older patients with brain metastases: a population-based analysis

Background Brain metastases (BM) cause symptoms that supportive medications can alleviate. We assessed whether racial disparities exist in supportive medication utilization after BM diagnosis. Methods Medicare-enrolled patients linked with the Surveillance, Epidemiology, and End Results program (SEER) who had diagnoses of BM between 2007 and 2016 were identified. Fourteen supportive medication classes were studied: non-opioid analgesics, opioids, anti-emetics, anti-epileptics, headache-targeting medications, steroids, cognitive aids, antidepressants, anxiolytics, antidelirium/antipsychotic agents, muscle relaxants, psychostimulants, sleep aids, and appetite stimulants. Drug administration ≤30 days following BM diagnosis was compared by race using multivariable logistic regression. Results Among 17,957 patients, headache aids, antidepressants, and anxiolytics were prescribed less frequently to African Americans (odds ratio [95% CI] = 0.81 [0.73–0.90], P < 0.001; OR = 0.68 [0.57–0.80], P < 0.001; and OR = 0.68 [0.56–0.82], P < 0.001, respectively), Hispanics (OR = 0.83 [0.73–0.94], P = 0.004 OR = 0.78 [0.64–0.97], P = 0.02; and OR = 0.63 [0.49–0.81], P < 0.001, respectively), and Asians (OR = 0.81 [0.72–0.92], P = 0.001, OR = 0.67 [0.53–0.85], P = 0.001, and OR = 0.62 [0.48–0.80], P < 0.001, respectively) compared with non-Hispanic Whites. African Americans also received fewer anti-emetics (OR = 0.75 [0.68–0.83], P < 0.001), steroids (OR = 0.84 [0.76–0.93], P < 0.001), psychostimulants (OR = 0.14 [0.03–0.59], P = 0.007), sleep aids (OR = 0.71 [0.61–0.83], P < 0.001), and appetite stimulants (OR = 0.85 [0.77–0.94], P = 0.002) than Whites. Hispanic patients less frequently received antidelirium/antipsychotic drugs (OR = 0.57 [0.38–0.86], P = 0.008), sleep aids (OR = 0.78 [0.64–0.94, P = 0.01), and appetite stimulants (OR = 0.87 [0.76–0.99], P = 0.04). Asian patients received fewer opioids (OR = 0.86 [0.75–0.99], P = 0.04), anti-emetics (OR = 0.83 [0.73–0.94], P = 0.004), anti-epileptics (OR = 0.83 [0.71–0.97], P = 0.02), steroids (OR = 0.81 [0.72–0.92], P = 0.001), muscle relaxants (OR = 0.60 [0.41–0.89], P = 0.01), and appetite stimulants (OR = 0.87 [0.76–0.99], P = 0.03). No medication class was prescribed significantly less frequently to Whites. Conclusions Disparities in supportive medication prescription for non-White/Hispanic groups with BM exist; improved provider communication and engagement with at-risk patients is needed. Key Points 1. Patients with BM commonly experience neurologic symptoms. 2. Supportive medications improve quality of life among patients with BM. 3. Non-White patients with BM receive fewer supportive medications than White patients.

Saída do aleitamento materno e uso de estimulantes do apetite: qual a relação?

Este artigo procurou observar a relação existente entre o uso de medicamentos estimulantes do apetite e a prática do aleitamento materno, principalmente na busca das lactentes de abandonar o processo de amamentação. O presente estudo faz parte de um quadro de resultados retirados de uma pesquisa qualitativa maior, que tinha como objetivo investigar as razões envolvidas no consumo de medicamentos para estimular o apetite de crianças. O estudo foi realizado por meio de entrevistas semiestruturadas com 15 mães residentes de um bairro urbano de uma cidade baiana de pequeno porte. As mães selecionadas deveriam ter administrado em seus filhos menores de cinco anos medicamentos para estimular o apetite dos filhos. Os dados foram analisados com base na técnica de análise de conteúdo. Foi encontrado em algumas mães um olhar reprovador para a preferência da criança pelo leite materno. Um comportamento que deveria ser modificado. O medicamento passa desta forma a ser utilizado como uma estratégia para que a criança perca o interesse pelo leite materno. As mães entrevistadas apresentavam um desejo de não amamentar que tinha relações com a sua significação do que era comer bem. O medicamento apareceu como um instrumento auxiliador no desmame.Abstract This article aims to observe the relationship between the use of appetite stimulant drugs and breastfeeding, specially in the pursuit of nursing mothers to abandon the process of breastfeeding. This study is part of a results framework elaborated from a larger qualitative study that aimed to investigate the reasons involved in the use of appetite stimulants in children. The study was conducted through semistructured interviews with 15 mothers living in an urban neighbourhood of a small town in Bahia. The selected mothers should have administered drugs to stimulate the appetite in their under five years old children. Data were analysed based on the technique of content analysis. It was found in some mothers a disapproving view related to the preference of the child for maternal milk. A behaviour that should be changed. On this case, the drug becomes a strategy for the child to lose interest in the breast milk. The interviewed mothers presented a desire to do not breastfeed the children that had relationship with their concepts of what to eat well is. The medicine represented a supporting tool in weaning.

Upper Gastrointestinal Bleeding in a Male Patient Taking Megestrol Acetate and Rivaroxaban: A Case Report

OBJECTIVE: This report describes the case of a 76-year-old male who developed an upper gastrointestinal bleed shortly after beginning megestrol acetate (MGA) to treat geriatric failure to thrive (GFTT). He was also taking rivaroxaban for stroke prevention because of atrial fibrillation but had a low risk of bleeding. This article aims to provide the reader with an overview of MGA's impact on hemostasis, as well as a review of therapeutics on appetite stimulants and important transitions of care considerations for GFTT.<br/> SETTING: The primary setting was a community teaching hospital in Florida. The patient had many transitions of care, including hospital-to-skilled nursing facility and then a hospital readmission for the primary problem reported here. A skilled nursing facility medication administration record and outpatient community pharmacy were the primary sources of the patient's admission and discharge medication histories.<br/> PRACTICE CONSIDERATIONS: MGA's published labeling supports a prothrombotic mechanism; however, its pharmacology may also confer anticoagulant properties. This may lead to potential drug-drug interactions in patients on concomitant anticoagulant therapy. There is weak evidence supporting appetite stimulants in GFTT, and transitions of care in this population is especially important because of these patients' frequent care continuum contact.<br/> CONCLUSIONS: MGA, a synthetic derivative of endogenous progesterone used to treat GFTT, may exert either prothrombotic or anticoagulant effects, and as such potential for drug interactions with anticoagulants must be considered. Patients taking MGA should be closely monitored for coagulation changes throughout transitions of care.

Frequency, types of interventions and changes in symptoms after consultation with Rapid Access Supportive Care Clinic (RASCC).

153 Background: ASCO recommends an integration of palliative care to oncology care so as to improve outcomes. Recognizing the importance our center created a pilot RASCC. The aim of the study was to determine the most frequent interventions by RASCC and symptom change at first follow-up visit. Methods: In this retrospective study all patients seen as a part of RASCC clinic (August 2012- June 2013) were reviewed. Pts with stage 4 NSCLC with oncologist estimated survival of ≤ 6 months were eligible. Delivery of standardized palliative care was ensured using Palliative Care Checklist and weekly meetings. Care followed a standardized management plan. Results: 156 patients were evaluable. The median age was 63, 56% were male, 74% were white. SDS scores improved at follow-up (Table 1). The most common interventions were counseling (including advance cancer planning), medication changes. At the initial consultation, all patients received counseling n = 176 (pts received counseling by more than one IDT member); among the medications, dose initiation and increase of analgesics/opioids n = 122, laxatives n = 123, antiemetics 66, appetite stimulants 18, corticosteroids 10, antidepressants 9, methylphenidate 8, gabapentin 8, neuroleptics 5, sedatives 0. Among analgesics, dose initiation/increased morphine, n = 53, hydrocodone 24, oxycodone 18, hydromorphone12, methadone and fentanyl 6, codeine 1, NSAIDS3. Conclusions: RASCC was associated significant improvement of symptoms and SDS scores at 1st follow-up and the most common interventions were counseling, medication changes related to pain. Further studies are needed. [Table: see text]