Food-drug interaction as a risk factor of drug-induced diseases: epidemiology, risk factors, potential mechanisms of interaction

Any drug is potentially associated with the risk of adverse drug reactions (ADRs), the incidence of which in developed and developing countries is estimated at 6.3 (3.3—11.0) and 5.5 % (1.1—16.9), respectively. Many ADRs increase mortality and / or morbidity and / or cause clinical manifestations that require a patient to seek medical help or hospitalization; a special term has been introduced — drug-induced diseases. Food can interact with drugs and increase the risk of ADRs, including serious ones. The simultaneous intake of food and drugs can affect the bioavailability, pharmacokinetics, pharmacodynamics and therapeutic efficacy of drugs due to changes in drug absorption and metabolism. A striking example of the effect of food on the pharmacokinetic profile of drugs is the change in the bioavailability of the tyrosine kinase inhibitor lapatinib: compared with taking on an empty stomach, the bioavailability of lapatinib in a single dose of 1 500 mg after taking it together with high-calorie standard food increases by an average of 325 % — 4.25 times. In other words, the concentration of the drug in the blood serum after taking one tablet at the same time with food is comparable to taking 4 tablets on an empty stomach. Currently, there are no recommendations for choosing a dosage regimen for drugs depending on the qualitative and quantitative composition of food, as well as taking into account potential interactions with food components, although these recommendations are extremely necessary for patients and healthcare professionals. In this regard, this article summarizes the data available at the time of writing in open sources concerning the effect of food on the absorption and metabolism of drugs, and also describes the possible mechanisms of interaction.

Development of an energy-dense biscuit suitable for primary school learners for the South African National School Nutrition Programme

South Africa has a well established National School Nutrition Programme (NSNP). Despite rescheduling the mealtime to two hours after the start of the school day to accommodate learners who come to school on an empty stomach, a gap still exists as many children start their learning day with low energy and concentration levels. A cost-effective, energy-dense snack served at the start of the school day can be a solution to sustain learners until the main meal is served. Cross-sectional surveys were used to determine the snack preferences of children and the product development process was used to develop a suitable snack. An energy-dense peanut butter biscuit was developed based on those surveys as well as a scoping review of previous snack studies. The energy-dense developed product provided 1388kJ (61.0%) of energy from fat, 688kJ (30.2%) of energy from carbohydrates and 201kJ (8.8%) of energy from protein per 100g. The biscuit conformed to microbial testing standards. Shelf-life analysis projected a shelf-life of five weeks fresh and five months in food grade packaging. Sensory results showed that there was no significant difference in sensory scores across gender (p=0.691) and age (p=0.706). More of the learners (n=56, 69.1%) found the biscuit to be ‘Super good’ than the other ratings (p<.0005). When compared with similar biscuit products currently on the market, it was found that the developed biscuit was the most reasonably priced. The developed biscuit has the potential to serve as a solution to hidden hunger for children that come to school on an empty stomach. This versatile snack solution has potential for continuity of use even during periods of national crisis as with COVID-19, when learners’ nutritional needs may be most vulnerable.

Clinical and diagnostic features of polycystic ovary syndrome on the background of isulinresistance and hyperandrogenism

Aim of the study: to study the clinicodiagnostic features of polycystic ovarian syndrome (PCOS) against the background of insulin resistance (IR) and hyperandrogenism (HA).Material and methods. We examined 120 women with PCOS and HA, 76 (63.3%) of the total number had IR. The average age of women was 28.54 ± 0.74 (20–44). In women with HA and PCOS against the background of IR, the levels of follicle-stimulating (hFSH), luteinizing (LH), thyrotropic (TТH) hormones were detected, as well as LH/hFSH ratio, prolactin (PRL), estradiol (E2), estrone (E1), total testosterone (T-total), DHEAS, androstenedione (Adione), cortisol (C), 17 hydroxyprogesterone (17-OPG), free triiodothyronine (T3), free thyroxine (T4), SHBG and Anti- Mullerian Hormone (AMH). The levels of carbohydrate metabolism, including glucose, insulin (on an empty stomach), after glucose loading, were determined as well as the HOMA and CARO indices.Results. It was found that according to the Ferriman–Gallwey score, hirsutism was within the range of 16.15 ± 0.34 (11–24) points, hormones — 13.17 ± 0.30 (9–20) points in the examined patients. The indiff erent number was 2.93 ± 0.11 (2–4) points. The average weight of patients was 74.1 ± 1.79 (50–134) kg, height 1.62 ± 0.005 (1.52–1.78) m, Index of Mass Corporal was within 28.56 ± 0.66 (19.5–51.4) kg/m2. In 81.5% of patients with HA and PCOS, absolute sterility was noted on the background of IR. According to hormones studies, there was a statistically signifi cant increase in LH (14.0 ± 0.87 mIU/ml), LH/hFSH (2.39 ± 0.15), TSH (2.83 ± 0.23 mIU/ml), DHEAS (3.32 ± 0.21 pg / ml), 17-OPG (1.0 ± 0.08 ng/ml), Adione (3.94 ± 0.1 ng/ml), T-total (1, 15 ± 0.006 ng/ml), K (125.39 ± 2.86 ng/ml), AMH (7.84 ± 0.36 ng/ml), E1 (153.36 ± 4.56 ng/ml) and decrease in E2 (65.32 ± 2.38 pg/ml), SHBG (36.1 ± 2.0 nmol/l). The study of carbohydrate metabolism and some anthropometric parameters revealed an increase in OB (100.66 ± 1.76 cm), OB / OT (0.86 ± 0.005), glucose and insulin (on an empty stomach) parameters and after glucose loading and HOMA index with a signifi cant decrease in the SAR index. According to the ultrasound data, patients with HA and PCOS against the background of IR revealed a statistically signifi cant decrease in the length and width of the uterus and an increase in the length, thickness, volume of the endometrium, the number of atresic follicles in both ovaries compared to similar data in practically healthy women (p <0.05).

Why Cato did not want to feed the sick slaves, or Some observations on the Roman economy of slavery

The article is devoted to the study of the Second Chapter Agriculture of Cato the Elder. The author pays the main attention to the advice of Cato not to give full rations to sick slaves, which became widely known thanks to the biographical work of Plutarch. Not denying the possibility the existence of such a practice, the author attempts to identify its roots, originating in the traditions of traditional medicine, which is reflected in the 126-157 chapters of Catos Agriculture. In particular, attention is drawn to the author's repeated mention that medication should be taken on an empty stomach, for which Cato consistently uses the Latin term ieiunus. In particular, the author draws attention to the fact that Cato often mentions that the intake of medicines should be made on a empty stomach, for which the Roman author often uses the Latin term ieiunus. In general, the text of Catos work reflects work reflects as archaic beliefs and norms, as well as new concepts and values.

Stomach Content of Tillapia zilli and Oreochromis nilocticus from Wanzun River, Lavun Local Government, Niger State Nigeria

This study was conducted to investigate the stomach contents of two commercially important fish species (Tilapia zilli and Oreochromis nilocticus) from Wanzun River, Northcentral Nigeria using frequency of occurrence and volumetric methods between January to April 2019. Fish samples were collected monthly with help of Fishermen using various fishing nets and traps. One hundred (100) individual fish of each species were collected and their stomach contents were examined. The results obtained expressed in mean percentage indicated that out of the one hundred (100) individual fish of each species examined,Twelve (12%) fish had an empty stomach contents in Tilapia zilli, and out of the 100 samples examined, Seventeen (17%) fish had an empty stomach content in Oreochromis nilocticus. The stomach contents of both Tilapia zilli and Oreochromis nilocticus consist of detritus, insects, fish remains. Algae/protozoans plant materials and molluscs. Both fish species are omnivorous feeders and occupy the same ecological niche.The study reveals the importance of algae, fish, insects and plant materials as food for fishes and they form important part in the diet of the species examined.

Adrenal Stereotactic Body Radiation Therapy: The Effects of a Full and Empty Stomach on Radiation Dose to Organs at Risk

BackgroundStereotactic Body Radiation Therapy (SBRT) has been reported to be curative in the treatment of oligometastases to the adrenal glands. However, the adrenals are surrounded by radiation-sensitive organs. We performed an Organ at Risk (OAR) analysis for SBRT to the left adrenal gland based on gastric state.Patients and MethodsTwenty random stomachs were divided into “empty” or “full” groups of 10 each based on size. The PTV dose was 54 Gy/6 fx and D 95 coverage of PTV(CTV) (the dose to 95% of the PTV volume). ResultsThe gastric OAR dose in the empty group was significantly lower than the full group. The OAR dose to the left kidney in the empty group was significantly higher than in the full group.ConclusionThe smaller the stomach size, the lower the dose to the stomach. It is therefore better to perform SBRT on patients with an empty stomach.

The effect of the drug “Bendamin” on the biochemical parameters of the blood of dogs in heart failure

Experimental studies obtained in recent years indicate the urgency of developing drugs of complex action to prevent the development of cardiovascular disease in dogs. This requires a much deeper study of the pathogenesis of heart failure, including cardiomyopathy. The aim of the study was to investigate the effect of the drug “Bendamin” on the biochemical parameters of the blood of dogs in heart failure. Two groups of dogs were formed for research: control (healthy) and experimental (sick). The 30-day experiment included 10 dogs of the control group and 10 dogs of the experimental (sick) breed of spaniel and dog 10–12 years of age. Treatment regimen for sick dogs: furosemide was administered orally on an empty stomach at 2 mg/kg every 12 hours; enalapril was administered orally at 0.5 mg/kg every 12 hours; bendamine was administered orally on an empty stomach at 20 mg/kg every 24 hours. It is recommended to divide the dose into two doses. An increase in the activity of aminotransferases (ALT by 59.2 %, AST – by 51.9 %) was found in the serum of dogs at heart failure. An increase in alkaline phosphatase activity was also found, which in the complex is an additional confirmation of changes in the heart muscle. Lactate dehydrogenase activity increased in the blood of sick dogs by 23.5 %. Minor changes in the content of total bilirubin and urea in the serum of sick dogs indicate the initial stage of liver pathology with impaired liver function due to congestion in the small circulation. This is also indicated by a decrease in the level of total protein in the blood of sick dogs, which was respectively 57.2 ± 3.57 g/l against the control group of 63.5 ± 4.15 g/l. On the basis of cardiac dysfunction and on the background of congestion, the function of not only the liver but also the kidneys is impaired (the so-called cardiorenal syndrome in heart failure). This is indicated by an increase in urea and creatinine by 38.5 and 36.9 %, respectively, compared with animals in the control group. The use of the drug “Bendamin” alleviated the manifestations of functional failure of the heart, liver and kidneys, as indicated by biochemical studies. Studies confirm the feasibility of using the drug “Bendamin” in dogs with the development of heart failure. The use of the drug “Bendamine” in patients with heart failure in dogs had a positive effect on the restoration of hematopoiesis and the normalization of biochemical parameters of the blood.

Gambling on an empty stomach: Hunger modulates preferences for learned but not described risks

We assess risks differently when they are explicitly described, compared to when we learn directly from experience, suggesting dissociable decision-making systems. Our needs, such as hunger, could globally affect our risk preferences, but do they affect described and learned risks equally? On one hand, explicit decision-making is often considered flexible and contextsensitive, and might therefore be modulated by metabolic needs. On the other hand, implicit preferences learned through reinforcement might be more strongly coupled to biological drives. To answer this, we asked participants to choose between two options with different risks, where the probabilities of monetary outcomes were either described or learned. In agreement with previous studies, rewarding contexts induced risk-aversion when risks were explicitly described, but risk-seeking when they were learned through experience. Crucially, hunger attenuated these contextual biases, but only for learned risks. The results suggest that our metabolic state determines risk-taking biases when we lack explicit descriptions.