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Jallouli A, Fakiri KE, Nassih H, Qadiry REL, Bourrahouat A, Sab IA, Rada N, Draiss G, Bouskraoui M. Digestive manifestations of Covid-19 in children: a retrospective study. Afr Health Sci 2023; 23:181-185. [PMID: 38357158 PMCID: PMC10862631 DOI: 10.4314/ahs.v23i3.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background The world is currently facing a pandemic due to a new species of the Coronaviridae family called SARS-CoV-2, discovered in the city of Wuhan in China in December 2019. The WHO has named the resulting disease COVID-19 (Coronavirus Disease 2019). It has been a global health problem due to its major socio-economic damage. The aim of this study was to show the prevalence of gastrointestinal and hepatic manifestations in symptomatic children with COVID-19. Methods We performed a retrospective study, including 36 symptomatic children infected by SARS-CoV-2 hospitalized at the mother and child hospital of university hospital of Mohammed VI, Marrakech in Morocco, over a period of 7 months. Clinical and biological manifestations of the digestive system were evaluated for all patients. Results The digestive symptomatology came in second place after the respiratory manifestations. 14 patients (38.89 % of symptomatic patients) in our study had digestive symptoms on admission: 12 (33.33%) presented with diarrhea, 4 (11.11%) had abdominal pain and only one child (2.78%) had vomiting. Aspartate aminotransferase (AST) was elevated in one patient, while alanine transaminase (ALT) was elevated in 6 patients. The prothrombin level was normal in all patients. All patients were discharged with good general condition without morbidity and mortality. Conclusion This study concludes with the high prevalence of digestive manifestations of COVID-19 in symptomatic children. There were no severe clinical or biological abnormalities in our study. Digestive manifestations during COVID-19 in children are frequent, which requires the awareness of health professionals.
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Affiliation(s)
- Abderrahmane Jallouli
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Karima El Fakiri
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Houda Nassih
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Rabiy EL Qadiry
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Aicha Bourrahouat
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Imane Ait Sab
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Noureddine Rada
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Ghizlane Draiss
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Mohammed Bouskraoui
- Department of Pediatrics, University hospital of Mohammed VI, Marrakesh, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
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Dervin H, Zarate-Lopez N, Sweis R, Mensah A, Fragkos K, Brugaletta C, Raeburn A, Emmanuel A. Low prevalence of positive hydrogen breath tests in patients with functional gastrointestinal conditions and hypermobile Ehlers-Danlos syndrome. Neurogastroenterol Motil 2023; 35:e14570. [PMID: 36989174 DOI: 10.1111/nmo.14570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/25/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Using hydrogen breath testing (HBT) to diagnose small intestinal bacterial overgrowth (SIBO) remains controversial in patients with functional gastrointestinal (GI) disorders, and unknown in those with hypermobility Ehlers-Danlos syndrome (hEDS). We assessed prevalence of positive HBTs in these groups, evaluated the predictive value of GI symptoms and the potential role of proton pump inhibitors (PPIs) on test results. METHODS Sequential patients referred for HBT to a tertiary unit were classified into the following groups: GI maldigestion/malabsorption, GI sensorimotor disorders, hEDS, and functional GI disorders. All underwent standardized HBT, and the yield was assessed against symptoms and PPI use. KEY RESULTS A total of 1062 HBTs were performed over 3 years (70% female, mean age 48 ± 16 years). Overall, 7.5% (80/1062) patients had a positive HBT. Prevalence of positive HBT was highest in patients with GI maldigestion/malabsorption (17.9%; DOR 16.16, p < 0.001), GI sensorimotor disorders (15.9%; DOR 8.84, p < 0.001), compared to functional GI disorders (1.6%; DOR 1.0) (p < 0.0001). None of the hEDS patients tested positive for HBT. A positive HBT was independently associated with increased age (DOR 1.03; p < 0.001) and symptoms of diarrhea (DOR 3.95; p < 0.0001). Patients on PPIs tended towards a positive HBT than patients off PPIs (16.1% vs 6.9%; DOR 2.47; p < 0.0001). CONCLUSIONS & INFERENCES Less than 2% of patients with functional GI disorders, and none of the patients with hEDS had a positive HBT. Pre-test probability was higher in patients with: GI structural or neurological disorders; use of long-term PPIs and symptoms of diarrhea. These criteria may be helpful in making appropriate therapeutic decisions and avoiding unnecessary hydrogen breath testing.
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Affiliation(s)
- Humayra Dervin
- GI Physiology Unit, University College London Hospitals, London, UK
| | | | - Rami Sweis
- GI Physiology Unit, University College London Hospitals, London, UK
| | - Alexia Mensah
- GI Physiology Unit, University College London Hospitals, London, UK
| | | | | | - Amanda Raeburn
- GI Physiology Unit, University College London Hospitals, London, UK
| | - Anton Emmanuel
- GI Physiology Unit, University College London Hospitals, London, UK
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Ham JY, Song KE, Oh HJ, Kim DI, Kim DW, Mok JH, Jung SJ, Kwon KT, Lee NY. Incidence and Distribution of the Pathogens Causing GI Infections at a University Hospital of Korea. Clin Lab 2023; 69. [PMID: 37702670 DOI: 10.7754/clin.lab.2023.230404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
BACKGROUND Gastrointestinal (GI) infections, caused by various pathogens such as bacteria, viruses, protozoa, and parasites, are the second most common infectious diseases. Molecular diagnostics that can simultaneously detect these pathogens are commonly used in syndromic approaches. The authors aimed to identify the causative pathogens of GI infections to provide clinically useful information. METHODS This retrospective study used molecular diagnostic methods to determine the incidence and distribution of GI pathogens according to gender, age, and season and analyze their coinfection from August 2020 to December 2022. RESULTS The overall incidence of at least one GI pathogen was 40.1% (991/2, 471). The positivity rates for bacteria and viruses were 33.1% (817/2, 471) and 9.2% (227/2,471), respectively; the positivity rate for bacteria was significantly higher than that for viruses (p < 0.001). The incidence of GI pathogens according to age group was highest in group 3 (59.9%), followed by group 4 (57.0%). The most common bacterial pathogen associated with GI infections was C. difficile, followed by diarrheagenic E. coli, Campylobacter spp., and Salmonella spp. Enteropathogenic E. coli accounted for a large percentage of diarrheagenic E. coli (63.6%, 157/247). Among the viral pathogens, norovirus GI/GII was the most commonly detected virus, followed by adenovirus F40/41 and rotavirus A. For bacterial- or viral-positive cases, the distribution of GI pathogens according to age group showed the highest proportion of C. difficile in all groups, except for group 2. In group 2, rotavirus A accounted for the highest percentage (61.1%, 22/36). The incidence of GI pathogens was the highest in summer (36.1%), followed by autumn (32.7%), and winter (18.0%). The co-infection rate with two or more pathogens was 16.9% (167/991). The rates of co-infection with two or more bacteria, bacteria and viruses, and two viruses were 58.1%, 31.7%, and 10.2%, re-spectively. CONCLUSIONS Information on the incidence and distribution of GI pathogens might be clinically useful; however, unlike the distribution of other infectious pathogens, it is necessary to consider that microorganisms identified through molecular diagnostics can be detected even in healthy people without clinical symptoms.
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Love NK, Douglas A, Gharbia S, Hughes H, Morbey R, Oliver I, Smith GE, Elliot AJ. Understanding the impact of the COVID-19 pandemic response on GI infection surveillance trends in England, January 2020-April 2022. Epidemiol Infect 2023; 151:e147. [PMID: 37622322 PMCID: PMC10540168 DOI: 10.1017/s095026882300136x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Stepwise non-pharmaceutical interventions and health system changes implemented as part of the COVID-19 response have had implications on the incidence, diagnosis, and reporting of other communicable diseases. Here, we established the impact of the COVID-19 outbreak response on gastrointestinal (GI) infection trends using routinely collected surveillance data from six national English laboratory, outbreak, and syndromic surveillance systems using key dates of governmental policy to assign phases for comparison between pandemic and historic data. Following decreases across all indicators during the first lockdown (March-May 2020), bacterial and parasitic pathogens associated with foodborne or environmental transmission routes recovered rapidly between June and September 2020, while those associated with travel and/or person-to-person transmission remained lower than expected for 2021. High out-of-season norovirus activity was observed with the easing of lockdown measures between June and October 2021, with this trend reflected in laboratory and outbreak systems and syndromic surveillance indicators. Above expected increases in emergency department (ED) attendances may have reflected changes in health-seeking behaviour and provision. Differential reductions across specific GI pathogens are indicative of the underlying routes of transmission. These results provide further insight into the drivers for transmission, which can help inform control measures for GI infections.
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Affiliation(s)
- Nicola K. Love
- North East Field Services, Health Protection Operations, UK Health Security Agency, Newcastle upon Tyne, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Amy Douglas
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK
| | - Saheer Gharbia
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK
| | - Helen Hughes
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- Farr Institute@HeRC, University of Liverpool, Liverpool, UK
| | - Roger Morbey
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
| | - Isabel Oliver
- Science Group, UK Health Security Agency, London, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation, Population Health Sciences, University of Bristol, Bristol, UK
| | - Gillian E. Smith
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
| | - Alex J. Elliot
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
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Xu P, Ge J, Jiang H, Lin Y, Ye Y, Huang X, He Y, Xue L. Gastrointestinal disease is an important influencing factor of osteoporosis fracture:a retrospective study in chinese postmenopausal women. BMC Musculoskelet Disord 2023; 24:659. [PMID: 37596616 PMCID: PMC10436643 DOI: 10.1186/s12891-023-06765-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/28/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUD The influencing factors of osteoporosis are complex, the incidence of osteoporosis is higher in middle-aged and elderly women, and osteoporotic fractures (OF) can seriously affect quality of life. Currently, the correlation analysis between gastrointestinal diseases and OF focuses more on diseases such as gastric cancer and inflammatory bowel disease (IBD). This study analyzed the risk factors for osteoporosis and osteoporotic fractures in 1567 postmenopausal women in Fuzhou, China. The purpose is to explore the potential influence of gastrointestinal diseases on the occurrence of OF. METHODS According to inclusion and exclusion criteria, a total of 1567 subjects were included in the analysis of OP risk factors, including 647 in the OP group and 920 in the NOP group. A total of 616 subjects were included in the analysis of correlation between OF and gastrointestinal diseases, including 132 in OF group and 484 in NF group. Statistical analysis shows that age (OR = 1.062, 95% CI = 1.045-1.080), height (OR = 0.089, 95% CI = 0.009-0.857), weight (OR = 0.981,95% CI = 0.967-0.995) and nature of work (P = 0.010) are the main risk factors for osteoporosis in postmenopausal women in southeast China, and gastrointestinal diseases (OR = 1.583, 95% CI = 1.070-2.343) and height (OR = 0.003, 95% CI = 0.000-0.104) are the main risk factors of OF. CONCLUSIONS The main factors affecting the occurrence of OP in postmenopausal women in southeast China are individual characteristic. Gastrointestinal diseases that do not directly affect BMD increase the risk of OF in osteoporotic patients.
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Affiliation(s)
- PengChao Xu
- Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou Upper Street, Fuzhou, Fujian, China
| | - JiRong Ge
- Fujian Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Osteoporosis(Fujian Academy of Chinese Medical Sciences, The Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine), Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Gulou District, Fuzhou, Fujian, China.
| | - Hong Jiang
- Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou Upper Street, Fuzhou, Fujian, China
| | - YuJuan Lin
- Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou Upper Street, Fuzhou, Fujian, China
| | - YunJin Ye
- Fujian Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Osteoporosis(Fujian Academy of Chinese Medical Sciences, The Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine), Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Gulou District, Fuzhou, Fujian, China
| | - XiaoBin Huang
- Fujian Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Osteoporosis(Fujian Academy of Chinese Medical Sciences, The Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine), Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Gulou District, Fuzhou, Fujian, China
| | - YanYan He
- Fujian Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Osteoporosis(Fujian Academy of Chinese Medical Sciences, The Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine), Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Gulou District, Fuzhou, Fujian, China
| | - LiPeng Xue
- Fujian Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Osteoporosis(Fujian Academy of Chinese Medical Sciences, The Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine), Fujian Academy of Chinese Medical Sciences, 282 Wusi Road, Gulou District, Fuzhou, Fujian, China
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Renaud A, Jirka A, Durant C, Connault J, Espitia O, Takoudju C, Agard C. [Gastrointestinal tract involvement in systemic sclerosis]. Rev Med Interne 2023; 44:410-422. [PMID: 37270380 DOI: 10.1016/j.revmed.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/17/2023] [Accepted: 05/08/2023] [Indexed: 06/05/2023]
Abstract
Gastrointestinal tract involvement in systemic sclerosis concerns more than 90% of patients but is of heterogeneous clinical expression. It can involve the entire intestinal tract and be responsible for multifactorial malnutrition, which is frequent in this disease. It is a major source of deterioration in the quality of life and can even be life-threatening. Management is complex and multidisciplinary, ranging from simple hygienic and dietary measures, to specialized endoscopic or surgical interventional procedures, also including medical treatments, particularly proton pump inhibitors and prokinetics, with potential side effects. Ongoing research for new diagnostic and therapeutic tools promises to improve the management and prognosis of these patients.
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Affiliation(s)
- A Renaud
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - A Jirka
- Service d'hépato-gastro-entérologie, Nantes université, CHU de Nantes, 44000 Nantes, France
| | - C Durant
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - J Connault
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - O Espitia
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - C Takoudju
- Service d'hépato-gastro-entérologie, Nantes université, CHU de Nantes, 44000 Nantes, France
| | - C Agard
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
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Pehlivan D, Ak M, Glaze DG, Suter B, Motil KJ. Exploring gastrointestinal health in MECP2 duplication syndrome. Neurogastroenterol Motil 2023; 35:e14601. [PMID: 37122114 PMCID: PMC10524027 DOI: 10.1111/nmo.14601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND MECP2 duplication syndrome (MDS) is a rare neurogenetic syndrome caused by duplications of MECP2 at the Xq28 region. Although constipation and gastrointestinal reflux are reported in MDS, a comprehensive characterization of gastrointestinal health has not been fully explored. METHODS We conducted a parent survey to explore the characteristics of gastrointestinal health in individuals with MDS using a secure online registry and compared differences in gastrointestinal symptoms between individuals with MDS and those with Rett syndrome (RTT). KEY RESULTS One hundred six surveys were analyzed. Symptoms commonly associated with constipation occurred in 72% to 89% of MDS individuals. Eleven percent of MDS individuals underwent surgery for complications associated with constipation. We observed a bimodal distribution for gastroesophageal reflux disease (GERD) and gastrostomy feeding, with higher prevalence in 0-3 and >12-year-old MDS individuals. Constipation and GERD were significantly more common, and gas bloating was significantly less common in MDS than in RTT. Biliary tract disease requiring surgery was an unrecognized problem in 5% of MDS individuals. We determined that gastrointestinal problems in MDS individuals contribute to caretaker burden. CONCLUSION AND INFERENCES Our study is the first in-depth investigation that characterizes gastrointestinal health in MDS and enumerates differences in gastrointestinal symptoms between MDS and RTT. Strategies to reduce gastrointestinal symptoms will alleviate caregiver burden in MDS. Further studies are needed to examine the mechanisms that cause gastrointestinal problems in MDS.
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Affiliation(s)
- Davut Pehlivan
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
- Blue Bird Circle Rett Center, Texas Children’s Hospital, Houston, Texas, 77030, USA
| | - Muharrem Ak
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Daniel G. Glaze
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
- Blue Bird Circle Rett Center, Texas Children’s Hospital, Houston, Texas, 77030, USA
| | - Bernhard Suter
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
- Blue Bird Circle Rett Center, Texas Children’s Hospital, Houston, Texas, 77030, USA
| | - Kathleen J. Motil
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Lasheras I, Real-López M, Santabárbara J. Prevalence of gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. An Pediatr (Barc) 2023; 99:102-110. [PMID: 37474417 DOI: 10.1016/j.anpede.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/22/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION A high prevalence of gastrointestinal (GI) symptoms has been described in children and adolescents with autism spectrum disorder (ASD). In addition, there is evidence that presence of GI symptoms is associated to greater severity of ASD. However, the frequency of GI symptoms in children and adolescents with ASD varies widely across studies, and their true prevalence is unknown. Therefore, the objective of this study was to estimate the prevalence of GI symptoms in children and adolescents with ASD. MATERIAL AND METHOD We conducted a meta-analysis following the PRISMA guidelines. We carried out a rapid systematic search for recent clinical and observational studies published from August 2012 in PubMed. The statistical analyses were performed with the software R. RESULTS Of 91 potentially eligible articles, only 8 met our inclusion criteria. The prevalence of GI symptoms ranged between 0% and 69%, with an estimated general prevalence of 33% (95% CI, 13%-57%), higher than that reported by a previous meta-analysis for the general paediatric population. This difference is even greater in the specific comparison of studies that applied the paediatric version of the ROME III questionnaire (QPGS-ROME III). CONCLUSIONS The results confirmed the hypothesis that there is a higher prevalence of functional GI symptoms in paediatric patients with ASD compared to their neurotypical peers.
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Affiliation(s)
- Isabel Lasheras
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain
| | - Matias Real-López
- Unidad Predepartamental de Medicina, Universitat Jaume I, Castellón, Spain; Programa de Trastorno Mental Grave de la Infancia y la Adolescencia, Consorcio Hospitalario Provincial de Castellón, Castellón, Spain.
| | - Javier Santabárbara
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Ministerio de Ciencia e Innovación, Madrid, Spain; Instituto de Investigación Sanitaria, IIS-Aragón, Zaragoza, Spain
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Thavamani A, Velayuthan S, Patel D, Al-Hammadi N, Sferra TJ, Sankararaman S. Association of Anxiety and Gastrointestinal Comorbidities in Repeat Hospital Admissions in Pediatric Cyclic Vomiting Syndrome. Am J Gastroenterol 2023; 118:1439-1445. [PMID: 37052354 DOI: 10.14309/ajg.0000000000002292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder with recurrent episodes of intense nausea and vomiting and thus may require frequent hospitalizations. There is paucity of data exploring the association of psychiatric and gastrointestinal comorbidities in repeat hospitalizations among pediatric patients with CVS. METHODS We analyzed the Pediatric Health Information System database and included all patients up to 18 years of age with a diagnosis of CVS between 2016 and 2020. We excluded patients with chronic conditions, which mimic CVS. The primary outcome variable was 90-day admission rate, which was defined as a visit to emergency department or admission to observation/inpatient unit with a primary diagnosis of CVS within 90 days after an index CVS hospitalization. RESULTS We evaluated a total of 2,604 hospitalizations represented by 1,370 unique individuals. The overall 90-day admission rate was 28.5%, which steadily decreased from 35.7% in 2016 to 23% in 2019 ( P < 0.001). Patients in the repeat hospitalization cohort were slightly older and more often men. Patients with repeat admissions had an increased proportion of anxiety and other gastrointestinal disorders. Multivariable logistic regression showed that anxiety, gastroesophageal reflux disease, functional dyspepsia, and abdominal migraine were associated with increased odds of repeat admissions. DISCUSSION Ninety-day admission rates in pediatric CVS are decreasing overall, although still contributing to significant healthcare expenditure. Anxiety and gastrointestinal comorbidities were associated with increased risk of repeat admissions. Further prospective studies are needed to better understand the complex interactions of these comorbidities and their management affecting the natural course of CVS.
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Affiliation(s)
- Aravind Thavamani
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Sujithra Velayuthan
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Dhiren Patel
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, SSM Health Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Noor Al-Hammadi
- The Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Thomas J Sferra
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Senthilkumar Sankararaman
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Holingue C, Pfeiffer D, Ludwig NN, Reetzke R, Hong JS, Kalb LG, Landa R. Prevalence of gastrointestinal symptoms among autistic individuals, with and without co-occurring intellectual disability. Autism Res 2023; 16:1609-1618. [PMID: 37323113 PMCID: PMC10527131 DOI: 10.1002/aur.2972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
Gastrointestinal symptoms (GI) are very common among individuals on the autism spectrum. Prior research reports mixed findings regarding whether individuals with autism and co-occurring intellectual disability (ID) have elevated risk of gastrointestinal symptoms relative to individuals with autism alone. GI symptoms can be challenging to assess in individuals with autism spectrum disorder (ASD) and/or ID given challenges with language, communication, and interoception. Prior research has tended to only include individuals with documented presence or absence of GI symptoms or conditions, that is, to exclude observations in which there is uncertainty regarding presence of GI symptoms. Therefore, none of the prior autism studies reported the association between ID and the certainty regarding presence or absence of GI symptoms. The objective of this study was to examine differences in parental certainty and odds of reporting gastrointestinal signs and symptoms among children on the autism spectrum, with and without intellectual disability. Participants were 308 children (36% ID) with a clinical diagnosis of autism spectrum disorder (6-17 years). Parents endorsed whether their child had experienced or displayed a range of signs or symptoms related to GI problems in the past 3 months. Parents of autistic children with ID were less certain about the presence of more subjective symptoms, including abdominal pain, nausea, and bloating. Conversely, certainty regarding more objective signs (e.g., constipation, diarrhea, spitting up, etc.) was not significantly different. More accurate measures for GI signs/symptoms are needed for this population.
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Affiliation(s)
- Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health
| | - Danika Pfeiffer
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine
- Department of Speech-Language Pathology and Audiology, Towson University
| | - Natasha N. Ludwig
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine
- Department of Neuropsychology, Kennedy Krieger Institute
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine
| | - Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine
| | - Luther G. Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine
- Department of Neuropsychology, Kennedy Krieger Institute
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine
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Curtin BF, Hill KL, Bhattacharya S, Powers A, Venkatesan A, Bagi P, Joyal E, Alimchandani M, Goldbach-Mansky R, Grayson P, Quezado M, Sibley C, Heller T. Clinical, Endoscopic, and Histopathologic Gastrointestinal Disease in an American Cohort With Behçet's Disease. Clin Transl Gastroenterol 2023; 14:e00591. [PMID: 37114910 PMCID: PMC10461961 DOI: 10.14309/ctg.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Behçet's disease (BD) is a chronic systemic vasculitis characterized by oral and genital ulcers, uveitis, and skin lesions. Patients with BD may develop gastrointestinal (GI) disease; however, characterization of GI disease in American cohorts is lacking. In this article, we present clinical, endoscopic, and histopathologic GI findings in an American cohort of patients with BD. METHODS Patients with established BD were evaluated prospectively at the National Institutes of Health. Demographic and clinical data were collected including BD manifestations and GI symptoms. Endoscopy with histopathologic sampling was performed for both clinical and research indications with written consent. RESULTS Eighty-three patients were evaluated. The majority were female (83.1%) and white (75.9%). Mean age was 36 ± 14.8 years. GI symptoms were reported in 75% of cohort with nearly half of reporting abdominal pain (48.2%) and significant numbers reporting acid reflux, diarrhea, and nausea/vomiting. Esophagogastroduodenoscopy was performed in 37 patients; erythema and ulcers were the most common found abnormalities. Colonoscopy was performed in 32 patients with abnormalities including polyps, erythema, and ulcers. Endoscopy was normal in 27% of esophagogastroduodenoscopies and 47% of colonoscopies. Vascular congestion was demonstrated on the majority of random biopsies throughout the GI tract. Inflammation was not highly prevalent on random biopsies except in the stomach. Wireless capsule endoscopy was performed on 18 patients; ulcers and strictures were the most common abnormalities. DISCUSSION GI symptoms were common in this cohort of American patients with BD. Endoscopic examination was often normal; however, histopathologic examination demonstrated vascular congestion throughout the GI tract.
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Affiliation(s)
- Bryan F. Curtin
- Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Kareen L. Hill
- Translational Hepatology Section, Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Sumona Bhattacharya
- Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Astin Powers
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Aradhana Venkatesan
- Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Preet Bagi
- Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Elizabeth Joyal
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Meghna Alimchandani
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Raphaela Goldbach-Mansky
- Translational Autoinflammatory Diseases AU2 Section, National Institute of Arthritis andMusculoskeletal and Skin Diseases and National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Peter Grayson
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Martha Quezado
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cailin Sibley
- Translational Autoinflammatory Diseases AU2 Section, National Institute of Arthritis andMusculoskeletal and Skin Diseases and National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Theo Heller
- Translational Hepatology Section, Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Wardenaar FC, Schott KD, Mohr AE, Ortega-Santos CP, Connolly JE. An Exploratory Study Investigating the Prevalence of Gastrointestinal Symptoms in Collegiate Division I American Football Athletes. Int J Environ Res Public Health 2023; 20:6453. [PMID: 37568995 PMCID: PMC10418726 DOI: 10.3390/ijerph20156453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Gastrointestinal (GI) symptoms may limit performance, but their prevalence and impact among team sports athletes is not well-documented. The objective of this study was to examine the prevalence of GI symptoms in a small sample of collegiate DI American football athletes, using a survey including the Gastrointestinal Symptoms Ratings Scale (GSRS). Forty-six athletes responded to the survey and reported scores for the 15-question GSRS with additional questions about dietary habits and supplement use. A total of 44 athletes were included in the study (45% of the current roster, age: 20.7 ± 1.7 years, 50% Afro-American or black, 39% skill position, 18% NSAIDs use, and 41% reporting protein supplement use); approximately half of the athletes (52%) reported experiencing GI complaints during exercise. Two-thirds of the athletes (61%) reported at least one or more GI symptoms in general, and 50% reported at least four moderate complaints. Seven athletes (16%) reported ≥2 severe GI symptoms with 5-13 moderate complaints. The most reported symptom was stomach pain (39%, n = 17), followed by hunger pain (36%, n = 16). Athletes reporting the use of protein supplements reported a higher GSRS score (22.0 and interquartile range (IQR) 17.0-31.8) vs. athletes not reporting protein use (15.0 and IQR 15.0-19.3), p = 0.001. Most athletes surveyed reported experiencing GI symptoms. A small group of these athletes reported multiple, varied, and severe symptoms that were associated with self-reported protein supplement use. In conclusion, the number of complaints varied among athletes, confirming the value of integrating the GSRS for screening purposes, and the expected need for individual dietary treatment approaches.
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Affiliation(s)
- Floris C. Wardenaar
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA; (K.D.S.); (A.E.M.)
| | - Kinta D. Schott
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA; (K.D.S.); (A.E.M.)
| | - Alex E. Mohr
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA; (K.D.S.); (A.E.M.)
| | - Carmen P. Ortega-Santos
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - John E. Connolly
- Sun Devil Athletics, Arizona State University, Tempe, AZ 85287, USA;
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Sun Z, Liu X, An P, Zhang B. Real-world safety profile of riluzole: a systematic analysis of data from the FAERS database and case reports. Expert Opin Drug Saf 2023; 22:967-974. [PMID: 37294137 DOI: 10.1080/14740338.2023.2223949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/26/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND The study aims to obtain the safety profile of riluzole in the real world and provide reference for clinical drug applications. RESEARCH DESIGN AND METHODS Proportional reporting ratio (PRR) was used to detect riluzole adverse drug reactions (ADRs) from the data between the first quarter of 2004 and the third quarter of 2022 in the FDA adverse event reporting system database (FAERS). Case reports of riluzole published in PubMed, Embase, and Web of Science before November 2022 were reviewed, and patient's data were extracted. RESULTS FAERS analysis identified 86 ADRs. Gastrointestinal system disorders and respiratory, thoracic, and mediastinal disorders account for 12 of the top 20 most frequent ADRs. Similarly, 9 of the 20 highest PRR ADRs were gastrointestinal system disorders and respiratory, thoracic, and mediastinal disorders. Twenty-two published riluzole-associated cases were identified in the literature. Respiratory, thoracic, and mediastinal disorders were the most commonly reported cases (n = 9), followed by gastrointestinal disorders, pancreatitis (n = 5). CONCLUSIONS Strong ADRs between riluzole and pancreatitis were identified, which reminds clinicians to monitor patients carefully. For patients with respiratory symptoms, clinicians should pay attention to distinguish the cause of their occurrence, and take appropriate measures. Beware that riluzole may increase the risk of inflammatory reactions and inappropriate vasopressin secretion and hyponatremia due to respiratory failure.
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Affiliation(s)
- Zhuo Sun
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Liu
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Pengjiao An
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Bo Zhang
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China
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64
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Lee S, Heo KN, Lee MY, Ah YM, Shin J, Lee JY. Derivation and validation of a risk prediction score for nonsteroidal anti-inflammatory drug-related serious gastrointestinal complications in the elderly. Br J Clin Pharmacol 2023; 89:2216-2223. [PMID: 36807272 DOI: 10.1111/bcp.15696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 12/27/2022] [Accepted: 02/09/2023] [Indexed: 02/22/2023] Open
Abstract
AIMS Few studies have quantified the impact of risk factors on GI complications in elderly nonsteroidal anti-inflammatory drug (NSAID) users. This study aimed to develop and validate a risk prediction score for severe GI complications to identify high-risk elderly patients using NSAID. METHODS We used the following two Korean claims datasets: customized data with an enrolment period 2016-2017 for model development, and the sample data in 2019 for external validation. We conducted a nested case-control study for model development and validation. NSAID users were identified as the elderly (≥65 years) who received NSAIDs for more than 30 days. Serious GI complications were defined as hospitalizations or emergency department visits, with a main diagnosis of GI bleeding or perforation. We applied the logistic least absolute shrinkage and selection operator (LASSO) regression model for variable selection and model fitting. RESULTS We identified 8176 cases and 81 760 controls with a 1:10 matched follow-up period in the derivation cohort. In the external validation cohort, we identified 372 cases from 254 551 patients. The risk predictors were high-dose NSAIDs, nonselective NSAID, complicated GI ulcer history, male sex, concomitant gastroprotective agents, relevant co-medications, severe renal disease and cirrhosis. Area under the receiver operating characteristic curve was 0.79 (95% confidence interval, 0.77-0.81) in the external validation dataset. CONCLUSIONS The prediction model may be a useful tool for reducing the risk of serious GI complications by identifying high-risk elderly patients.
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Affiliation(s)
- Suhyun Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-ro, Seoul, 08826, Republic of Korea
| | - Kyu-Nam Heo
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-ro, Seoul, 08826, Republic of Korea
| | - Mee Yeon Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-ro, Seoul, 08826, Republic of Korea
| | - Young-Mi Ah
- College of Pharmacy, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Jaekyu Shin
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, 533 Parnassus Avenue, U585, Box 0622, San Francisco, California, 94143-0622, USA
| | - Ju-Yeun Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-ro, Seoul, 08826, Republic of Korea
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Airs PM, Ventura-Cordero J, Mvula W, Takahashi T, Van Wyk J, Nalivata P, Safalaoh A, Morgan ER. Low-cost molecular methods to characterise gastrointestinal nematode co-infections of goats in Africa. Parasit Vectors 2023; 16:216. [PMID: 37386642 PMCID: PMC10311829 DOI: 10.1186/s13071-023-05816-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/20/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Veterinary diagnostics aid intervention strategies, track zoonoses, and direct selective breeding programs in livestock. In ruminants, gastrointestinal nematode (GIN) parasites are a major cause of production losses, but morphologically similar species limit our understanding of how specific GIN co-infections impact health in resource-limited settings. To estimate the presence and relative abundance of GINs and other helminths at the species level, we sought to develop a low-cost and low-resource molecular toolkit applied to goats from rural Malawi smallholdings. METHODS Goats were subjected to health scoring and faecal sampling on smallholdings in Lilongwe district, Malawi. Infection intensities were estimated by faecal nematode egg counts with a faecal subsample desiccated for DNA analysis. Two DNA extraction methods were tested (low-resource magbead kit vs high-resource spin-column kit), with resulting DNA screened by endpoint polymerase chain reaction (PCR), semi-quantitative PCR, quantitative PCR (qPCR), high-resolution melt curve analysis (HRMC), and 'nemabiome' internal transcribed spacer 2 (ITS-2) amplicon sequencing. RESULTS Both DNA isolation methods yielded comparable results despite poorer DNA purity and faecal contaminant carryover from the low-resource magbead method. GINs were detected in 100% of samples regardless of infection intensity. Co-infections with GINs and coccidia (Eimeria spp.) were present in most goats, with GIN populations dominated by Haemonchus contortus, Trichostrongylus colubriformis, Trichostrongylus axei, and Oesophagostomum columbianum. Both multiplex PCR and qPCR were highly predictive of GIN species proportions obtained using nemabiome amplicon sequencing; however, HRMC was less reliable than PCR in predicting the presence of particular species. CONCLUSIONS These data represent the first 'nemabiome' sequencing of GINs from naturally infected smallholder goats in Africa and show the variable nature of GIN co-infections between individual animals. A similar level of granularity was detected by semi-quantitative PCR methods, which provided an accurate summary of species composition. Assessing GIN co-infections is therefore possible using cost-efficient low-resource DNA extraction and PCR approaches that can increase the capacity of molecular resources in areas where sequencing platforms are not available; and also open the door to affordable molecular GIN diagnostics. Given the diverse nature of infections in livestock and wildlife, these approaches have potential for disease surveillance in other areas.
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Affiliation(s)
- Paul M Airs
- School of Biological Sciences, Queen's University Belfast, Belfast, Antrim, UK
| | | | - Winchester Mvula
- Animal Science Department, Lilongwe University of Agriculture and Natural Resources (LUANAR), Lilongwe, Malawi
| | - Taro Takahashi
- Net Zero and Resilient Farming Directorate, Rothamsted Research, Okehampton, Devon, UK
- Bristol Veterinary School, University of Bristol, Langford, Somerset, UK
| | - Jan Van Wyk
- Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria, South Africa
| | - Patson Nalivata
- Animal Science Department, Lilongwe University of Agriculture and Natural Resources (LUANAR), Lilongwe, Malawi
| | - Andrews Safalaoh
- Animal Science Department, Lilongwe University of Agriculture and Natural Resources (LUANAR), Lilongwe, Malawi
| | - Eric R Morgan
- School of Biological Sciences, Queen's University Belfast, Belfast, Antrim, UK.
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Chancharoenthana W, Kamolratanakul S, Leelahavanichkul A, Ariyanon W, Chinpraditsuk S, Saelim R, Vadcharavivad S, Phumratanaprapin W, Wilairatana P. Gastrointestinal manifestations of long-term effects after COVID-19 infection in patients with dialysis or kidney transplantation: An observational cohort study. World J Gastroenterol 2023; 29:3013-3026. [PMID: 37274795 PMCID: PMC10237091 DOI: 10.3748/wjg.v29.i19.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/13/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Prolonged symptoms after corona virus disease 2019 (Long-COVID) in dialysis-dependent patients and kidney transplant (KT) recipients are important as a possible risk factor for organ dysfunctions, especially gastrointestinal (GI) problems, during immunosuppressive therapy.
AIM To identify the characteristics of GI manifestations of Long-COVID in patients with dialysis-dependent or KT status.
METHODS This observational, prospective study included patients with COVID-19 infection, confirmed by reverse transcription polymerase chain reaction, with the onset of symptoms between 1 January 2022 and 31 July 2022 which was explored at 3 mo after the onset, either through the out-patient follow-up or by telephone interviews.
RESULTS The 645 eligible participants consisted of 588 cases with hemodialysis (HD), 38 patients with peritoneal dialysis (PD), and 19 KT recipients who were hospitalized with COVID-19 infection during the observation. Of these, 577 (89.5%) cases agreed to the interviews, while 64 (10.9%) patients with HD and 4 (10.5%) cases of PD were excluded. The mean age was 52 ± 11 years with 52% women. The median dialysis duration was 7 ± 3 and 5 ± 1 years for HD and PD groups, respectively, and the median time post-transplantation was 6 ± 2 years. Long-COVID was identified in 293/524 (56%) and 21/34 (62%) in HD and PD, respectively, and 7/19 (37%) KT recipients. Fatigue was the most prevalent (96%) of the non-GI tract symptoms, whereas anorexia (90.9%), loss of taste (64.4%), and abdominal pain (62.5%) were the first three common GI manifestations of Long-COVID. Notably, there were 6 cases of mesenteric panniculitis from 19 patients with GI symptoms in the KT group.
CONCLUSION Different from patients with non-chronic kidney disease, there was a high prevalence of GI manifestations of Long-COVID in dialysis-dependent patients and KT recipients. An appropriate long-term follow-up in these vulnerable populations after COVID-19 infection is possibly necessary.
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Affiliation(s)
- Wiwat Chancharoenthana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Supitcha Kamolratanakul
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Asada Leelahavanichkul
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Wassawon Ariyanon
- Cardiometabolic Centre, Department of Medicine, Bangkok Nursing Hospital, Bangkok 10500, Thailand
| | - Sutatip Chinpraditsuk
- Dialysis Center, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Rattanaporn Saelim
- Dialysis Center, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Somratai Vadcharavivad
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Weerapong Phumratanaprapin
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Söderlund JM, Hieta NK, Kurki SH, Orte KJ, Polo-Kantola P, Hietanen SH, Haataja MA. Comorbidity of Urogynecological and Gastrointestinal Disorders in Female Patients With Lichen Sclerosus. J Low Genit Tract Dis 2023; 27:156-160. [PMID: 36821789 PMCID: PMC10026967 DOI: 10.1097/lgt.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Lichen sclerosus (LS) is a chronic inflammatory disease with a significant impact on quality of life. The aim of this cross-sectional case-control study was to characterize concomitant urogynecological and gastrointestinal disorders in female patients with LS. METHODS A medical records search between 2004 and 2012 yielded 455 women and girls (mean age 64 years) with LS. The study cohort was compared with a 10-fold age- and sex-matched control cohort. Gynecological cancers and their precursors; gynecological, urinary, and gastrointestinal disorders; and pain syndromes were evaluated. RESULTS The well-known association between LS and increased risk of vulvar cancer and its precursors was also found in our study (relative risk [RR] = 100.0; p < .001 and high-grade squamous intraepithelial lesions RR = 110.0; p < .001, respectively), but we also found an increased risk for cervical cancer (RR = 6.0; p = .005) and endometrial cancer (RR = 2.9; p < .001). Gynecological pain syndromes such as dyspareunia (RR = 20.0; p < .001) and interstitial cystitis (RR = 5.0; p < .001) and urinary incontinence (RR = 4.8; p < .001) were also increased. Among gastrointestinal disorders, we found increased risk for celiac disease (RR = 6.8; p < .001), diverticular intestine diseases (RR = 1.9; p < .001), functional intestinal disorders (RR = 2.3; p = .003), and anal and rectal fissures (RR = 2.4; p = .046). CONCLUSIONS We found that female patients with LS have an increased risk for gynecological cancers as well as for several urogynecological and gastrointestinal disorders. Increased awareness is required to identify and treat these concomitant disorders.
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Affiliation(s)
- Jenni M. Söderlund
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
| | - Niina K. Hieta
- University of Turku, Turku, Finland
- Department of Dermatology, Turku University Hospital, Turku, Finland
| | - Samu H. Kurki
- University of Turku, Turku, Finland
- Auria Biobank, Turku University Hospital, Turku, Finland
| | - Katri J. Orte
- University of Turku, Turku, Finland
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
| | - Sakari H. Hietanen
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
| | - Marjut A.M. Haataja
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
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Zandi M, Soltani S, Sadooni R, Salmanzadeh S, Erfani Y, Shahbahrami R, Piri M, Pakzad R, Ghodratifard N, Moghadam AE, Abbasi S. No sign of Rotavirus co-infection in COVID-19 patients with gastrointestinal symptoms. Malawi Med J 2023; 35:27-30. [PMID: 38124694 PMCID: PMC10645899 DOI: 10.4314/mmj.v35i1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background and aims The main goal of the present study is to investigate the incidence of Rotavirus co-infection in COVID-19 patients. Methods and Results Fecal samples of COVID-19 patients with gastrointestinal symptoms which had positive PCR- were collected from Abadan's hospital, Iran during the period December 2020 to January 2021. Samples were analyzed by RT-PCR to determine the presence of Rotavirus. Finally, the total samples size of 37 were included in this study. The mean age of patients was 48.22 years. Abdominal pain alone was detected in 48.65% of the patients. At least one gastrointestinal symptom was detected in all of the patients. Diarrhea and fever were seen in 13.51% and 59.46% of patients, respectively. Nausea and vomiting were seen in 5.41% of the patients. RT-PCR showed no infection of Rotavirus among the patients. Conclusion Gastrointestinal symptoms related to COVID-19 are common. More studies is need among these patients groups for investigate co-infection with other fecal viral shedding carries, due to a worse prognosis and its association with disease severity.
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Affiliation(s)
- Milad Zandi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Soltani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Riam Sadooni
- Abadan University of Medical Sciences, Abadan, Iran
| | - Shokrollah Salmanzadeh
- Infectious and tropical diseases research center, Health research institute, Faculty of medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yousef Erfani
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University Medical Sciences, Tehran, Iran
| | - Ramin Shahbahrami
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University Medical Sciences, Tehran, Iran
| | - Maghsud Piri
- Abadan University of Medical Sciences, Abadan, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University Medical Sciences, Ilam, Iran
| | | | | | - Samaneh Abbasi
- Department of Microbiology, School of Medicine, Abadan University of Medical sciences, Abadan, Iran
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69
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Filipe JAN, Kyriazakis I, McFarland C, Morgan ER. Novel epidemiological model of gastrointestinal nematode infection to assess grazing cattle resilience by integrating host growth, parasite, grass and environmental dynamics. Int J Parasitol 2023; 53:133-155. [PMID: 36706804 DOI: 10.1016/j.ijpara.2022.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/31/2022] [Accepted: 11/04/2022] [Indexed: 01/26/2023]
Abstract
Gastrointestinal nematode (GIN) infections are ubiquitous and often cause morbidity and reduced performance in livestock. Emerging anthelmintic resistance and increasing change in climate patterns require evaluation of alternatives to traditional treatment and management practices. Mathematical models of parasite transmission between hosts and the environment have contributed towards the design of appropriate control strategies in ruminants, but have yet to account for relationships between climate, infection pressure, immunity, resources, and growth. Here, we develop a new epidemiological model of GIN transmission in a herd of grazing cattle, including host tolerance (body weight and feed intake), parasite burden and acquisition of immunity, together with weather-dependent development of parasite free-living stages, and the influence of grass availability on parasite transmission. Dynamic host, parasite and environmental factors drive a variable rate of transmission. Using literature sources, the model was parametrised for Ostertagia ostertagi, the prevailing pathogenic GIN in grazing cattle populations in temperate climates. Model outputs were validated on published empirical studies from first season grazing cattle in northern Europe. These results show satisfactory qualitative and quantitative performance of the model; they also indicate the model may approximate the dynamics of grazing systems under co-infection by O. ostertagi and Cooperia oncophora, a second GIN species common in cattle. In addition, model behaviour was explored under illustrative anthelmintic treatment strategies, considering impacts on parasitological and performance variables. The model has potential for extension to explore altered infection dynamics as a result of management and climate change, and to optimise treatment strategies accordingly. As the first known mechanistic model to combine parasitic and free-living stages of GIN with host feed-intake and growth, it is well suited to predict complex system responses under non-stationary conditions. We discuss the implications, limitations and extensions of the model, and its potential to assist in the development of sustainable parasite control strategies.
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Affiliation(s)
- J A N Filipe
- Biomathematics & Statistics Scotland, Rowett Institute of Nutrition and Health, University of Aberdeen, AB25 2ZD, UK.
| | - I Kyriazakis
- Institute for Global Food Security, Queen's University Belfast, Biological Sciences, 19, Chlorine Gardens, BT9 5DL, UK
| | - C McFarland
- Institute for Global Food Security, Queen's University Belfast, Biological Sciences, 19, Chlorine Gardens, BT9 5DL, UK
| | - E R Morgan
- Institute for Global Food Security, Queen's University Belfast, Biological Sciences, 19, Chlorine Gardens, BT9 5DL, UK
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70
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Moshiree B, Freeman AJ, Vu PT, Khan U, Ufret-Vincenty C, Heltshe SL, Goss CH, Schwarzenberg SJ, Freedman SD, Borowitz D, Sathe M. Multicenter prospective study showing a high gastrointestinal symptom burden in cystic fibrosis. J Cyst Fibros 2023; 22:266-274. [PMID: 36319569 PMCID: PMC10147845 DOI: 10.1016/j.jcf.2022.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 10/15/2022] [Accepted: 10/16/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND AIMS People with cystic fibrosis (PwCF) suffer from gastrointestinal (GI) symptoms affecting their quality of life (QOL). Despite the relevance of GI symptoms to the overall health of PwCF, a paucity of studies only have comprehensively assessed the prevalence, severity and QOL of GI symptoms in both children and adults with Cystic Fibrosis (CF). METHODS Eligible participants ≥2 years of age across 26 US CF centers were followed for 4 weeks. Three validated GI electronic patient-reported outcome measures (ePROMs) with a recall period of 2 weeks and a stool-specific questionnaire were administered weekly over four weeks. Total and domain scores of ePROMs were evaluated overall and in subgroups using linear mixed-effect models. RESULTS Of 402 enrolled, 58% were ≥ 18 years of age (52% male). The mean (SD) of the total score for PAC-SYM was 0.52 (0.55), for PAGI-SYM was 0.63 (0.67), and for PAC-QOL was 0.67 (0.55). For specific ePROM questions, prevalence of moderate to very severe symptoms were as follows: straining (20.3%), fullness (18.3%), incomplete bowel movements (17.1%), bloating (16.4%), distension (16.4%), abdominal pain (upper-5.1%, lower-7.5%). Comparing participants ≥18 versus <18, a higher prevalence of bloating (63.7% versus 27.3%), lower abdominal pain (39.8% vs 26.2%), stomach fullness (75.6% versus 56.2%), and abdominal distension (60.2% versus 34.9%) was found. Both age groups reported high treatment dissatisfaction as measured with PAC-QOL, mean 1.39 (95% CI: 1.30, 1.47). CONCLUSION GI symptoms were reported in all age ranges irrespective of gender, with higher prevalence observed amongst older and female subgroups. Dissatisfaction with GI targeted treatments were reported in a large proportion of participants despite therapy, highlighting an unmet need for clinical interventions. CLINICALTRIALS GOV: NCT03801993.
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Affiliation(s)
- Baha Moshiree
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Atrium Health, Charlotte, NC, United States.
| | - A Jay Freeman
- Division of Pediatric Gastroenterology, Nationwide Children's Hospital/The Ohio State University, Columbus, OH, United States
| | - Phuong T Vu
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA, United States
| | - Umer Khan
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA, United States
| | - Carmen Ufret-Vincenty
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA, United States
| | - Sonya L Heltshe
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA, United States; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Christopher H Goss
- Cystic Fibrosis Foundation Therapeutics Development Network Coordinating Center, Seattle Children's Research Institute, Seattle WA, United States; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States; Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Sarah Jane Schwarzenberg
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States
| | - Steven D Freedman
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Drucy Borowitz
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
| | - Meghana Sathe
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Texas Southwestern/Children's Health, Dallas, TX, United States
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Scarpato E, Salvatore S, Romano C, Bruzzese D, Ferrara D, Inferrera R, Zeevenhooven J, Steutel NF, Benninga MA, Staiano A. Prevalence and Risk Factors of Functional Gastrointestinal Disorders: A Cross-Sectional Study in Italian Infants and Young Children. J Pediatr Gastroenterol Nutr 2023; 76:e27-e35. [PMID: 36705695 DOI: 10.1097/mpg.0000000000003653] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Reports of prevalence of functional gastrointestinal disorders (FGIDs) in infants/toddlers are widely variable. Reasons for this variability are not yet fully understood. The objective of this study is to estimate the prevalence of FGIDs according to Rome IV criteria and to evaluate associated factors, in Italian infants and toddlers. METHODS Subjects aged 0-48 months were enrolled by general pediatricians from 3 Italian regions. Parents or legal guardians were administered questionnaires including information about the child, the family, and GI symptoms according to Rome IV criteria. RESULTS Five hundred eight infants aged 0-12 months [mean age 4.4 ± 3.4 months; females (F) 40.9%], and 268 children aged 13-48 months (mean age 30.8 ± 10.7 months; F 44.4%) were included. In infants, prevalence of FGIDs was 21.1%, and the most prevalent FGID was infant colic (9.3%). In toddlers, prevalence of FGIDs was 19.6%, with functional constipation being the most frequent disorder (16.1%). In infants, multivariable analysis found that being older, being the only child, and living in a rural environment were associated with a lower rate of FGIDs. Prevalence was, in contrast, higher in infants fed with formula. CONCLUSIONS One out of 5 Italian infants and young children is affected by at least 1 FGID. The most frequent FGID in infants is infant colic, while in toddlers this is functional constipation. In infants, prevalence of FGIDs is lower if the subject has no siblings, and in children living in a rural environment, while formula feeding represents a risk factor for FGIDs occurrence.
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Affiliation(s)
- Elena Scarpato
- From the Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Silvia Salvatore
- the Department of Pediatrics, Ospedale "F. Del Ponte", University of Insubria, Varese, Italy
| | - Claudio Romano
- the Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Dario Bruzzese
- the Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Dante Ferrara
- the Primary Care Pediatrician ASP6, Residency School of Pediatrics, University of Palermo, Palermo, Italy
| | - Ramona Inferrera
- the Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Judith Zeevenhooven
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands
| | - Nina F Steutel
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands
| | - Marc A Benninga
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands
| | - Annamaria Staiano
- From the Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
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Ku M, Je NK. Prescription changes in patients with gastrointestinal disorders after withdrawal of ranitidine: a nationwide population-based cohort study. Curr Med Res Opin 2023; 39:197-203. [PMID: 36519289 DOI: 10.1080/03007995.2022.2159147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Ranitidine products contain unacceptable levels of N-nitrosodimethylamine. This study aimed to investigate changes in the treatment regimen and their influencing factors after the ranitidine recall. METHODS This retrospective study used data from nationwide Korean claims from 2019. Patients with gastrointestinal disorders treated with ranitidine for at least a month on 25 September 2019, were selected for this study. Other histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), potassium-competitive acid blockers (PCABs), and prostaglandin E1 analogs were administered as alternatives to ranitidine. Kaplan-Meier survival and Cox proportional hazards regression analyses were performed to gauge the time until switching to alternative drugs and assess the influencing factors. RESULTS In total, 7502 patients were included in this study, among which 5164 (68.8%) switched from ranitidine to an alternative drug. The most prescribed alternative drugs were H2RAs, followed by PPIs, PCABs, and prostaglandin E1 analogs. Increasing age; Medical Aid insurance (MedAid); and a history of hypertension, diabetes mellitus, asthma, and osteoarthritis were associated with a higher probability of switching treatments. Patients with concomitant gastroesophageal reflux disease and peptic ulcers were more likely to switch to alternative drugs than patients with gastritis. CONCLUSIONS Approximately two-thirds of patients with gastrointestinal disorders switched from ranitidine to alternative drugs within 3 months after ranitidine withdrawal. The Cox regression analysis showed that age (>55 years); insurance type (MedAid); comorbidities, such as hypertension, diabetes mellitus, asthma, and osteoarthritis, and gastrointestinal disorder severity influenced the switch from ranitidine to alternative drugs.
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Affiliation(s)
- Minhee Ku
- College of Pharmacy, Pusan National University, Busan, Republic of Korea
- Department of Pharmacy, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea
| | - Nam Kyung Je
- College of Pharmacy, Pusan National University, Busan, Republic of Korea
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Nasr A, Hornung L, Thompson T, Lin TK, Vitale DS, Nathan JD, Varni JW, Abu-El-Haija M. Prevalence of Gastrointestinal Symptoms and Impact on Quality of Life at 1-Year Follow-Up of Initial Attack of Acute Pancreatitis. J Pediatr Gastroenterol Nutr 2023; 76:199-205. [PMID: 36705700 PMCID: PMC9886336 DOI: 10.1097/mpg.0000000000003668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES This study aims to describe the prevalence of gastrointestinal (GI) symptoms following the first time occurrence of acute pancreatitis (AP) and to measure the impact of the episode on patient health-related quality of life (HRQOL) from the perspectives of patients and parents. METHODS Questionnaires regarding GI symptoms 1 year following the initial occurrence of AP were obtained from 74 pediatric patients. Thirty of these patients completed both the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and the PedsQL Gastrointestinal Symptoms and Worry Scales. These data were compared to legacy-matched healthy controls. RESULTS Children with a standalone occurrence of AP experienced a similar rate of GI symptoms compared to those who progressed to acute recurrent pancreatitis (ARP) within 1 year. PedsQL 4.0 Generic Core Scales scores were significantly lower for children self-report and parent proxy-report for patients that experienced AP compared to healthy controls. AP patients also demonstrated significantly more symptoms than healthy controls in the Gastrointestinal Symptoms and Worry Scales across multiple domains. CONCLUSIONS Gastrointestinal symptoms affect many children who experience a single AP event even without recurrent attacks. The burden of symptoms is not significantly different from those who develop ARP. This is a novel study that evaluates patient-reported outcomes in children following an AP attack and demonstrates there is a significant impact on HRQOL in children and family experiences post AP. More data are needed to study the progression of disease and the extended impact of AP following an initial AP attack in pediatric patients.
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Affiliation(s)
- Alexander Nasr
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
| | - Lindsey Hornung
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
| | - Tyler Thompson
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
| | - Tom K. Lin
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine; Cincinnati, Ohio
| | - David S. Vitale
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine; Cincinnati, Ohio
| | - Jaimie D. Nathan
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
| | - James W. Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX
| | - Maisam Abu-El-Haija
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center; Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine; Cincinnati, Ohio
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Adekunle AD, Rubens M, Sedarous M, Tariq T, Okafor PN. Trends in gastrointestinal disease hospitalizations and outcomes during the first year of the coronavirus pandemic. World J Gastroenterol 2023; 29:744-757. [PMID: 36742171 PMCID: PMC9896617 DOI: 10.3748/wjg.v29.i4.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/05/2022] [Accepted: 11/29/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The impact of the coronavirus on hospitalizations for gastrointestinal (GI) disease, particularly at a population level is understudied.
AIM To investigate trends in hospitalizations, inpatient endoscopy resource utilization, and outcomes during the first year of the coronavirus pandemic and subsequent lockdowns.
METHODS Using the California State Inpatient Database for 2018-2020, we explored year-to-year and 2020 month-to-month trends in hospitalizations, length of stay, and inpatient mortality (all-cause & viral pneumonia-specific) for common inpatient GI diagnoses including acute pancreatitis, diverticulitis, cholelithiasis, non-infectious gastroenteritis, upper and lower GI bleeding (LGIB), Clostridium difficile, viral gastroenteritis, inflammatory bowel disease, and acute cholangitis.
RESULTS Disease-specific hospitalizations decreased for all included conditions except nonvariceal upper GI bleeding (NVUGIB), LGIB, and ulcerative colitis (UC) (ptrend < 0.0001). All-cause inpatient mortality was higher in 2020 vs 2019, for acute pancreatitis (P = 0.029), diverticulitis (P = 0.04), NVUGIB (P = 0.003), and Crohn’s disease (P = 0.004). In 2020, hospitalization rates were lowest in April, November, and December. There was no significant corresponding increase in inpatient mortality except in UC (ptrend = 0.048). Viral pneumonia and viral pneumonia complicated by respiratory failure increased (P < 0.001) among GI hospitalizations. Endoscopy utilization within 24 h of admission was unchanged for GI emergencies except NVUGIB (P < 0.001).
CONCLUSION Our findings suggest that hospitalization rates for common GI conditions significantly declined in California during the COVID pandemic, particularly in April, November and December 2020. All-cause mortality was significantly higher among acute pancreatitis, diverticulitis, NVUGIB, and Crohn’s disease hospitalizations. Emergency endoscopy rates were mostly comparable between 2020 and 2019.
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Affiliation(s)
| | - Muni Rubens
- Office of Clinical Research, Miami Cancer Institute, Miami, FL 33176, United States
| | - Mary Sedarous
- Division of Internal Medicine, McMaster University, Hamilton ON L8S 4L8, Ontario, Canada
| | - Tahniyat Tariq
- Division of Gastroenterology, Stanford University School of Medicine, Redwood City, CA 94063, United States
| | - Philip N Okafor
- Division of Gastroenterology, Stanford University College of Medicine, Redwood City, CA 94063, United States
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Ferreira PL, Genrinho I, Santiago T, Carones A, Mazeda C, Barcelos A, Beirão T, Costa F, Santos I, Couto M, Rato M, Terroso G, Monteiro P. Creation and Validation of a Portuguese Version of the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument. Int J Environ Res Public Health 2023; 20:1553. [PMID: 36674306 PMCID: PMC9865185 DOI: 10.3390/ijerph20021553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: The UCLA GIT 2.0 questionnaire has been recognized as a feasible and reliable instrument to assess gastrointestinal (GI) symptoms in systemic sclerosis (SSc) patients and their impact on quality of life. The aim of this study was to create and validate UCLA GIT 2.0 for Portuguese patients with SSc. (2) Methods: A multi-center study was conducted enrolling SSc patients. UCLA GIT 2.0 was validated in Portuguese using reliability (internal consistency, item -total correlation, and reproducibility) and validity (content, construct, and criterion) tests. Criterion tests included EQ-5D and SF-36v2. Social-demographic and clinical data were collected. (3) Results: 102 SSc patients were included, 82.4% of them female, and with a mean sample age of 57.0 ± 12.5 years old. The limited form of SSc was present in 62% of the patients and 56.9% had fewer than five years of disease duration. Almost 60% presented with SSc-GI involvement with a negative impact on quality of life. The means for SF-36v2 were 39.3 ± 10.3 in the physical component summary and 47.5 ± 12.1 in the mental component summary. Total GI score, reported as mild in 57.8% of the patients, was highly reliable (ICC = 0.912) and the Cronbach's alpha was 0.954. There was a high correlation between the total GI score and EQ-5D-5L and SF-36v2 scores. (4) Conclusion: The Portuguese version of UCLA GIT 2.0 showed good psychometric properties and can be used in research and clinical practice.
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Affiliation(s)
- Pedro L. Ferreira
- Centre for Health Studies and Research, Faculty of Economics, University of Coimbra, 3004-512 Coimbra, Portugal
| | - Inês Genrinho
- Rheumatology Department, Tondela Viseu Hospital Centre, 3504-509 Viseu, Portugal
- Rheumatology Department, Baixo Vouga Hospital Centre, 3810-164 Aveiro, Portugal
| | - Tânia Santiago
- Rheumatology Department, Coimbra and University Health Center, 3004-512 Coimbra, Portugal
| | - Adriana Carones
- Rheumatology Department, Coimbra and University Health Center, 3004-512 Coimbra, Portugal
| | - Carolina Mazeda
- Baixo Vouga Hospital Centre, Rheumatology Department, Egas Moniz Health Alliance, 3810-164 Aveiro, Portugal
- EpiDoC Unit, CEDOC, NOVA Medical School, NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - Anabela Barcelos
- Baixo Vouga Hospital Centre, Rheumatology Department, Egas Moniz Health Alliance, 3810-164 Aveiro, Portugal
- EpiDoC Unit, CEDOC, NOVA Medical School, NOVA University of Lisbon, 1169-056 Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - Tiago Beirão
- Rheumatology Department, Vila Nova de Gaia/Espinho Hospital Centre, 4434-502 Vila Nova de Gaia, Portugal
| | - Flávio Costa
- Rheumatology Department, Vila Nova de Gaia/Espinho Hospital Centre, 4434-502 Vila Nova de Gaia, Portugal
| | - Inês Santos
- Rheumatology Department, Tondela Viseu Hospital Centre Hospital Centre, 3460-525 Tondela, Portugal
| | - Maura Couto
- Rheumatology Department, Tondela Viseu Hospital Centre Hospital Centre, 3460-525 Tondela, Portugal
| | - Maria Rato
- Rheumatology Department, São João University Hospital Centre Hospital Centre, 4200-319 Porto, Portugal
| | - Georgina Terroso
- Rheumatology Department, São João University Hospital Centre Hospital Centre, 4200-319 Porto, Portugal
| | - Paulo Monteiro
- Rheumatology Department, Tondela Viseu Hospital Centre Hospital Centre, 3460-525 Tondela, Portugal
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Bi D, Jiang H, Yang K, Guan T, Hou L, Shu G. Neonatal risk factors for functional gastrointestinal disorders in preterm infants in the first year of life. Turk J Pediatr 2023; 65:919-930. [PMID: 38204306 DOI: 10.24953/turkjped.2022.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND An assessment of functional gastrointestinal disorders (FGIDs) in premature infants in their first year of life and neonatal factors influencing the progression of FGIDs was conducted in this research. METHODS Subjects selected for the retrospective study involved preterm infants being hospitalized in the neonatal department of Northern Jiangsu People`s Hospital from September 2018 to September 2021. Data on neonatal risk factors such as gestational age, gender, birth weight, mode of delivery, feeding pattern, antibiotic administration and addition of probiotics, duration of hospitalization, maternal history of smoking, and mental health status, were all collected and analyzed. FGIDs were diagnosed according to Rome IV criteria. RESULTS This study included 988 preterm infants, with 725 (73.4%) having at least one FGID, 449 (45.4%) with infant colic, 411 (41.6%) with infant regurgitation, 237 (24.0%) with infant dyschezia, 190 (19.2%) with functional constipation, and 34 (3.4%) with functional diarrhea throughout the first year of life. In total, 263 infants (26.6%) without FGID symptoms were included in the control group. Further, a higher prevalence of FGIDs was observed in preterm infants with infant colic as well as infant regurgitation in particular as being characterized by a low gestational age ( < 32 w), low birth weight ( < 1.5 kg), Cesarean section, formula feeding, neonatal antibiotics use, hospitalization longer than 7 days, and maternal history of smoking. It was found from association analyses that infants exclusively breastfed in their first month of life were at lower risk for regurgitation than those in the control group. CONCLUSIONS Unnecessary antibiotic use in the neonatal period, Cesarean delivery, passive smoking, lack of breastfeeding along with inappropriate probiotics usage are major risk factors for FGIDs, and their systematic control may be effective in reducing the susceptibility to and prevalence of FGIDs in preterm infants in the first year of life.
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Affiliation(s)
| | - Honghua Jiang
- Department of Pediatrics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou
| | - Kaiting Yang
- Department of Pediatrics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou
| | - Ting Guan
- Department of Pediatrics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou
| | - Lin Hou
- Department of Pediatrics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou
| | - Guihua Shu
- Department of Pediatrics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou
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Cabral Lopes A, Roque F, Lourenço O, Herdeiro MT, Morgado M. Gastrointestinal disorders potentially associated with Semaglutide: an analysis from the Eudravigilance Database. Expert Opin Drug Saf 2023; 22:455-461. [PMID: 36695099 DOI: 10.1080/14740338.2023.2172159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/09/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Semaglutide is a Glucagon-like peptide-1 receptor agonist used in the second-line treatment of poorly controlled type 2 diabetes and can be used in monotherapy or associated with other oral antidiabetics or even insulin, increasing the effectiveness of the treatment. This work aims to analyze the profile of adverse drug reactions reported for semaglutide in Eudravigilance. RESEARCH DESIGN AND METHODS Data on Individual Cases Safety Reports were obtained from the database of the centralized European spontaneous reporting system Eudravigilance by accessing www.adrreports.eu. (1 December 2021). RESULTS It is possible to observe a high prevalence of gastrointestinal disorders (N = 3502, 53.2%). The most severe reported cases were primarily gastrointestinal disorders, metabolic, and nutritional disorders, eye disorders, renal and urinary disorders and cardiac disorders, with an evident higher prevalence of adverse gastrointestinal events both in oral and injectable dosage form (N = 133, 50.0% vs N = 588, 47.2%, respectively). Through a comparative analysis, semaglutide had a greater number of reported gastrointestinal adverse events compared to sitagliptin and empaglifozin (p < 0.00001). CONCLUSIONS Semaglutide has a good safety profile, however the definition of subgroups within the type 2 diabetes population who are particularly prone to develop serious adverse event when treated with GLP-1 RAs is crucial.
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Affiliation(s)
- António Cabral Lopes
- Pharmaceutical Services of Unity Local of Health of Guarda (ULS da Guarda), Guarda, Portugal
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), Covilhã, Portugal
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Covilhã, Portugal
| | - Olga Lourenço
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), Covilhã, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Covilhã, Portugal
| | - Maria Teresa Herdeiro
- Institute of Biomedicine, Department of Medical Sciences (iBiMED-UA), University of Aveiro, Portugal
| | - Manuel Morgado
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), Covilhã, Portugal
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Covilhã, Portugal
- Pharmaceutical Services of University Hospital Center of Cova da Beira, Covilhã, Portugal
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Zhang C, Ren W, Sun C, Liu L, Li M, Wang W, Fang Y, Liu L, Yang X, Zhang X, Li S. Associations between gastrointestinal infection and urinary phthalate metabolite concentrations in US children and adolescents from NHANES 2005-2016. Environ Sci Pollut Res Int 2023; 30:4582-4591. [PMID: 35972658 DOI: 10.1007/s11356-022-22327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to evaluate at the link between gastrointestinal illness and urine phthalate metabolite concentrations in children and adolescents in the United States between 2005 and 2016. A total of 4008 National Health and Nutrition Examination Survey (NHANES) participants had urine samples obtained during the survey and self-reported their gastrointestinal functional status over the previous week. High performance liquid chromatography/tandem mass spectrometry (HPLC/MS-MS) was used to identify twelve phthalate metabolites in urine samples. The link between PAE concentrations and gastrointestinal illnesses was investigated using logistic regression, which was controlled for possible confounders. The combined and independent effects of PAEs on gastrointestinal illnesses were investigated using Bayesian Kernel Machine Regression (BKMR) and quantile-based g-computation (qgcomp). In children and adolescents, the prevalence of gastrointestinal infection was 9.0%. One log-unit increase in urinary concentrations was associated with an increased risk of gastrointestinal infection for monocarboxyoctyl phthalate (MCOP) (adjusted odd ratio (aOR) = 1.36, 95 percent confidence interval (95%ci): 1.08, 1.62), mono(2-ethylhexyl) phthalate (MEHP) (aOR = 1.18, 95 percent CI: 1.05, 1.32) and mono(2-eth The mixed exposure model findings revealed that the combined effect of PAEs was substantially linked with gastrointestinal infection; exposure to the combination of PAEs was positively associated with the risk of gastrointestinal infection. In the BKMR model, the exposure to the mixture of PAEs was positively associated with the risk of gastrointestinal infection. In qgcomp, a substantial positive correlation between PAEs and gastrointestinal illnesses was identified (OR = 1.16, 95 percent CI: 1.05, 1.28). MCOP and MEHP may be the major contributors after controlling for other PAE homologs. These associations were more pronounced in overweight and obese children and adolescents. Mixed exposure to phthalates (PAEs) in children and adolescents was significantly associated with gastrointestinal infections, with MCOP and MEHP accounting for the major proportions. These associations were more pronounced in overweight and obese children and adolescents.
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Affiliation(s)
- Chuang Zhang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Weirui Ren
- Department of Gastroenterology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Chi Sun
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Lin Liu
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Meng Li
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Wenbo Wang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Yanbin Fang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Lin Liu
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Xiaofeng Yang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Xiangjian Zhang
- Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease, Shijiazhuang, 050000, China
| | - Suolin Li
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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79
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Zhang Y, Guan Y, Shen Y, Qiao H, Yuan J, Xu F. The prevalence of functional gastrointestinal disorders related symptoms and the association with working place among healthcare workers who were in the fighting against COVID-19 in regional China. Front Public Health 2022; 10:1048935. [PMID: 36589969 PMCID: PMC9799257 DOI: 10.3389/fpubh.2022.1048935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives To investigate the prevalence of functional gastrointestinal disorders (FGIDs) related symptoms among healthcare workers (HWs) who were in the fighting against COVID-19 in Nanjing of China, and further to examine the association between working place and FGIDs-related symptoms among HWs during the period of COVID-19 epidemic. Methods An online anonymous survey was conducted among those HWs without history of FGIDs, who took part in the fighting against the COVID-19 epidemic between July and September of 2021 in Nanjing, China. All the 15 FGIDs-related symptoms included in the Rome IV diagnostic questionnaire for adults were investigated in this study. The outcome variable was the presence of FGIDs-related symptoms ("Yes" or "No"), while the independent measure was participants' working place ("in-ward" or "out-ward"). Logistics regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the association of working place with FGIDs-related symptoms among those healthcare workers. Results Totally, 336 eligible participants completed the survey. The prevalence of FGIDs-related symptoms was 48.8% (95%CI = 43.4%, 54.3%) among overall participants, with 40.7% (95%CI = 33.14%, 48.71%) and 56.3% (95%CI = 48.59%, 63.73%) for in-ward and out-ward HWs, respectively. Compared to their in-ward counterparts, those out-ward HWs were at a 1.88-fold likelihood (95%CI = 1.22, 2.89) to experience FGIDs-related symptoms during the period of fighting against the COVID-19 epidemic. After adjustment for potential confounders, such a positive association attenuated but still remained significant. Conclusions A high prevalence of FGIDs-related symptoms was observed among those HWs who were without history of FGIDs during the fighting against COVID-19, and out-ward HWs were at a significantly higher risk to experience FGIDs-related symptoms relative to their in-ward counterparts in regional China. It has important implications that particular attention shall be paid to functional gastrointestinal issues for healthcare workers, especially those who are at uncertain risks of infectious diseases, when they participate in response to public health emergencies in future.
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Affiliation(s)
- Yan Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yue Guan
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ya Shen
- Department of Integrated Service and Management, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Huifen Qiao
- Department of Medical Psychology, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jie Yuan
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
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Hamutyinei Dhliwayo T, Chonzi P, Madembo C, Juru TP, Chadambuka A, Gombe NT, Chikerema S, Shambira G, Umeokonkwo CD, Tshimanga M. Anthrax outbreak investigation in Tengwe, Mashonaland West Province, Zimbabwe, 2022. PLoS One 2022; 17:e0278537. [PMID: 36508405 PMCID: PMC9744298 DOI: 10.1371/journal.pone.0278537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anthrax continues to be a disease of public health concern in Zimbabwe. Between December 2021 and February 2022, Tengwe reported 36 cases of human anthrax. Gastrointestinal anthrax has the potential to cause serious outbreaks leading to loss of human life. We investigated the outbreak, identified the risk factors using one health approach to inform outbreak control. MATERIALS AND METHODS We conducted descriptive analysis of the outbreak and a 1:2 unmatched case control study to identify risk factors for anthrax. A case was any Tengwe resident who developed an ulcer and/or abdominal symptoms and epidemiologically linked to a confirmed environmental exposure. Validated, structured interviewer-administered questionnaires were used to collect data from the cases and neighbourhood controls. Soil and dried meat samples were collected for laboratory investigations. District preparedness and response was assessed using a checklist. Data was analysed using Epi Info version 7.2.5. The odds of exposure were calculated for each risk factor examined. Multivariable logistic regression analysis was performed to identify the independent factors associated with contracting anthrax. RESULTS Through active case finding we identified 36 cases, 31 were interviewed. Twenty-one (67.7%) were males. The median age was 33 years (Inter quartile range: 22-54). Nineteen (61.2%) cases presented with abdominal symptoms with zero deaths reported. The independent risk factor for contracting anthrax was eating under-cooked meat (aOR = 12.2, 95% CI: 1.41-105.74, p = 0.023). All samples collected tested positive for anthrax. No livestock vaccinations or zoonotic meetings were being conducted prior to the outbreak. Notification of the outbreak was done 11 days after index case presentation however one health response was instituted within 24 hours. CONCLUSION The anthrax was confirmed in Tengwe. Consumption of under-cooked meat was associated with gastrointestinal anthrax. The timely one health response resulted in excellent outcomes. Using one health approach in managing zoonotic threats is encouraged.
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Affiliation(s)
- Theresa Hamutyinei Dhliwayo
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Tsitsi Patience Juru
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Addmore Chadambuka
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
- * E-mail:
| | - Notion Tafara Gombe
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
- African Field Epidemiology Network, Harare, Zimbabwe
| | - Silvester Chikerema
- Department of Clinical Veterinary Studies, University of Zimbabwe, Harare, Zimbabwe
| | - Gerald Shambira
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | | | - Mufuta Tshimanga
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
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Nassar M, Ghernautan V, Nso N, Nyabera A, Castillo FC, Tu W, Medina L, Ciobanu C, Alfishawy M, Rizzo V, Eskaros S, Mahdi M, Khalifa M, El-Kassas M. Gastrointestinal involvement in systemic sclerosis: An updated review. Medicine (Baltimore) 2022; 101:e31780. [PMID: 36397401 PMCID: PMC9666124 DOI: 10.1097/md.0000000000031780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The gastrointestinal tract (GI) is the second most affected organ system in individuals suffering from systemic/localized scleroderma (SSc) or localized scleroderma. SSc can affect any part of the GI, between the oral cavity and anorectum. The annual incidence of SSc in the United States is estimated to be 19.3 cases per million adults, with the highest incidence reported in people aged 44 to 55. Females are 5 times more likely than males to suffer from SSc. Morbidity and mortality rates associated with SSc are predominantly elevated among patients with GI manifestations. Esophageal and intestinal manifestations impact 90% and 40% to 70% of patients with systemic scleroderma, respectively. SSc patients are known to suffer from small bowel hypomotility and small intestinal bacterial overgrowth, which cause malabsorption and malnutrition, ultimately contributing to the 50% mortality rate. Fecal incontinence is a common symptom of SSc that can lead to depression. SSc patients may suffer from gastrointestinal complications that can negatively impact their quality of life on a daily basis. Multidisciplinary approaches are necessary for systematically managing gastrointestinal complications associated with SSc. A prospective study should focus on developing targeted therapies to improve recovery patterns and prognosis in cases of SSc. This article summarizes the epidemiology, commonly reported clinical manifestations, complications, and available treatments for treating GI pathology in SSc patients.
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Affiliation(s)
- Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Victoria Ghernautan
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Akwe Nyabera
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Francisco Cuevas Castillo
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Wan Tu
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Luis Medina
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | | | - Mostafa Alfishawy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Vincent Rizzo
- Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Saphwat Eskaros
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA
| | - Mamdouh Mahdi
- Internal Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Mohamed Khalifa
- Hospital Management Department, Helwan University, Cairo, Egypt
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
- * Correspondence: Mohamed El-Kassas, Endemic Medicine Department, Faculty of Medicine, Helwan University, Ain Helwan 11795 Cairo, Egypt (e-mail: )
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82
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Karunanayake A, Devanarayana NM, Rajindrajith S. Early life events in functional abdominal pain disorders in children. PLoS One 2022; 17:e0275419. [PMID: 36322579 PMCID: PMC9629606 DOI: 10.1371/journal.pone.0275419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/18/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives Functional abdominal pain disorders (FAPDs) are common gastrointestinal problems in children, and the pathophysiology is thought to be multifactorial. Adverse early life events (ELE) induce alterations in the central nervous system, perhaps predisposing individuals to develop FAPDs. We aimed to study the potential adverse ELE that are associated with FAPDs. Methods We steered a school-based survey involving 1000 children from 4 randomly selected schools. FAPDs were assessed using the translated Rome III questionnaire, and ELE were identified using a pre-tested, parental questionnaire. FAPDs were diagnosed using the Rome III criteria. Results Hundred and eighty-two (182) children had FAPDs (62.1% girls, mean age 8.5, SD 2.1). ELE of them were compared with 571 children without FAPDs (51.1% girls, mean age 8.8, SD 1.9). According to the binary logistic regression analysis, family members with abdominal pain, family member with chronic pain other than abdominal pain, prenatal maternal complications and interventional deliveries, were recognized as potential risk factors for the development of FAPDs. Breast feeding over two years has shown to reduce the prevalence of FAPDs.a. Conclusions Prenatal maternal medical problems are associated a with higher prevalence of FAPDs later in life. Prolonged breastfeeding and normal vaginal delivery could be considered as factors that reduce the vulnerability of developing FAPDs in children. Therefore, minimizing pregnancy-related complications, encouraging vaginal deliveries, and encouraging breastfeeding are potentially valuable measures to prevent FAPDs during childhood.
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Leader G, Whelan S, Chonaill NN, Coyne R, Tones M, Heussler H, Bellgard M, Mannion A. Association between early and current gastro-intestinal symptoms and co-morbidities in children and adolescents with Angelman syndrome. J Intellect Disabil Res 2022; 66:865-879. [PMID: 36052644 PMCID: PMC9826167 DOI: 10.1111/jir.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Angelman syndrome (AS) is a neurogenetic disorder that causes severe intellectual disability, expressive language deficits, motor impairment, ataxia, sleep problems, epileptic seizures and a happy disposition. People with AS frequently experience gastrointestinal (GI) symptoms. METHOD This study used data from the Global Angelman Syndrome Registry to explore the relationship between early and current GI symptoms and co-morbidity in children and adolescents with AS (n = 173). Two groups that experienced a high (n = 91) and a low (n = 82) frequency of GI symptoms were examined in relation to feeding and GI history in infancy, sleep and toileting problems, levels of language and communication and challenging behaviours. Predictors of GI symptoms were then investigated using a series of logistic regressions. RESULTS This analysis found that constipation and gastroesophageal reflux affected 84% and 64%, of the sample, respectively. The high frequency of GI symptoms were significantly associated with: 'refusal to nurse', 'vomiting', 'arching', 'difficulty gaining weight', gastroesophageal reflux, 'solid food transition', frequency of night-time urinary continence and sleep hyperhidrosis during infancy. GI symptoms were not significantly associated with sleep, toileting, language or challenging behaviours. Significant predictors of high frequency GI symptoms were gastroesophageal reflux and sleep hyperhidrosis. CONCLUSIONS Future research needs to investigate the association between AS and GI co-morbidity in adults with AS.
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Affiliation(s)
- G. Leader
- Irish Centre for Autism and Neurodevelopmental Research, School of PsychologyNational University of IrelandGalwayIreland
| | - S. Whelan
- Irish Centre for Autism and Neurodevelopmental Research, School of PsychologyNational University of IrelandGalwayIreland
| | - N. N. Chonaill
- Irish Centre for Autism and Neurodevelopmental Research, School of PsychologyNational University of IrelandGalwayIreland
| | - R. Coyne
- Irish Centre for Autism and Neurodevelopmental Research, School of PsychologyNational University of IrelandGalwayIreland
| | - M. Tones
- eResearch OfficeQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - H. Heussler
- Children's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - M. Bellgard
- eResearch OfficeQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - A. Mannion
- Irish Centre for Autism and Neurodevelopmental Research, School of PsychologyNational University of IrelandGalwayIreland
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Robbertz AS, Cohen LL, Armistead LP, Reed B. Pandemic-Related Social Disruption and Well-Being in Pediatric Gastrointestinal Diseases. J Pediatr Psychol 2022; 47:981-990. [PMID: 35730966 PMCID: PMC9384296 DOI: 10.1093/jpepsy/jsac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has impacted everyone, but there are few data regarding how the pandemic has influenced the lives of children with gastrointestinal (GI) conditions. This cross-sectional study assessed pandemic-related social disruption (PRSD) in children with inflammatory bowel disease (IBD), celiac disease (CD), and irritable bowel syndrome (IBS), and the potential buffering effect of the parent-child relationship. METHODS A survey completed between September and December 2020 asked 146 children (ages 8-17) diagnosed with IBD (n = 44), CD (n = 81), or IBS (n = 51) and 185 parents how the pandemic has contributed to social disruption (i.e., financial stability, COVID-19 exposure, school changes, GI needs, and isolation) and their social-emotional well-being. Structural equation modeling was used to examine the role of social disruption on well-being, and the moderating effect of the parent-child relationship. RESULTS Increased social disruption predicted worse parent, β = 0.24, p = .02, and child well-being, β = 0.38, p < .01. The parent-child relationship moderated the relationship between parent and child well-being, β = 0.21, p = .03. Strong parent-child relationships predicted a positive association between parent and child well-being, β = 0.23, p = .003, whereas medium, β = 0.09, p = .14, and poor, β = -0.06, p = .52, relationships did not. CONCLUSIONS PRSD negatively impacted the well-being of children with GI conditions, and the parent-child relationship moderated this relationship. These findings are relevant to pediatric psychologists treating the physical and mental health needs of children with GI conditions and their parents.
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Affiliation(s)
| | | | | | - Bonney Reed
- Division of Gastroenterology, Hepatology, & Nutrition, Emory University School of Medicine, USA
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85
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Lin CY, Su SB, Chen KT. An overview of gastrointestinal diseases in patients with COVID-19: A narrative review. Medicine (Baltimore) 2022; 101:e30297. [PMID: 36086768 PMCID: PMC10980500 DOI: 10.1097/md.0000000000030297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/01/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has emerged as a global health concern. This study aimed to review the epidemiology and pathophysiology of COVID-19 and provide evidence for the implementation of control measures. We utilized several online databases, including MEDLINE (National Library of Medicine, Bethesda, Maryland, USA), PubMed, EMBASE, Web of Science, and Google Scholar, to collect relevant published papers using a combination of the following keywords: "COVID-19," "SARS-CoV-2," "novel coronavirus," "epidemiology," and "pathophysiology." The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this study. Globally, approximately 3-46% of patients with SARS-CoV-2 infection experience gastrointestinal symptoms. The clinical spectrum of COVID-19 is wide, ranging from mild to severe, and even fatal. COVID-19 was initially reported as a respiratory tract disease; however, gastrointestinal symptoms have only recently been reported. COVID-19 Patients with gastrointestinal symptoms may have more severe clinical manifestations and poor prognosis. This study highlights the need to better understand the mechanisms involved in the development of gastrointestinal symptoms in patients with COVID-19 to prevent the further spread of this pathogen.
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Affiliation(s)
- Cheng-Yao Lin
- Division of Hematology-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Taiwan
- Department of Senior Welfare and Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Mikocka-Walus A, Skvarc D, de Acosta MB, Evertsz FB, Bernstein CN, Burisch J, Ferreira N, Gearry RB, Graff LA, Jedel S, Mokrowiecka A, Stengel A, Trindade IA, van Tilburg MAL, Knowles SR. Exploring the Relationship Between Self-Isolation and Distress Among People with Gastrointestinal Disorders During the COVID-19 Pandemic. J Clin Psychol Med Settings 2022; 29:654-665. [PMID: 34494184 PMCID: PMC8423336 DOI: 10.1007/s10880-021-09818-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/17/2022]
Abstract
This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May-September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p < .001). GI symptoms moderated the association between isolation and distress (B = .047, t = 2.47, p = .015). Interventions targeting these factors may help to reduce distress in people with GI disorders at the time of major stressors such as the COVID-19 pandemic.
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Affiliation(s)
| | - David Skvarc
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Manuel Barreiro de Acosta
- Department of Gastroenterology, IBD Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Floor Bennebroek Evertsz
- Department of Medical Psychology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | | | - Johan Burisch
- Medical Division, Hvidovre Hospital, University of Copenhagen, GastrounitHvidovre, Denmark
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Richard B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Lesley A Graff
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Sharon Jedel
- Division of Digestive Diseases, Rush University Medical Center, Chicago, IL, USA
| | - Anna Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - Inês A Trindade
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Miranda A L van Tilburg
- College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, USA
- Division of Gastroenterology, University of North Carolina, Chapel Hill, NC, USA
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Simon R Knowles
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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Yousaf A, Mutalib M. Burden of Pediatric Functional Gastrointestinal Disorder in an Emergency Department-A Single-Center Experience. Pediatr Emerg Care 2022; 38:e1512-e1516. [PMID: 35969269 DOI: 10.1097/pec.0000000000002807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Functional gastrointestinal disorders (FGIDs) are recurrent or chronic gastrointestinal signs and symptoms in the absence of anatomical or biochemical alterations. They are commonly treated in outpatient setting but often present to emergency departments. We aimed to estimate the burden of pediatric FGID on a busy accident and emergency (A&E) department. METHODS Electronic patient records were used to retrospectively analyze the A&E attendances of 3866 patients presenting with either constipation or abdominal pain. Those found not to have a surgical/organic cause were assessed in terms of various parameters, that is, arrival times, wait times, and investigations performed. RESULTS A total of 91.31% of the attendances relating to constipation or nonsurgical, nonorganic causes of abdominal pain were self-referred with only 3.64% arriving via ambulance, an average wait time ranging between 138 and 156 minutes, and a total of 1008 investigations carried out on patients presenting with these symptoms. A total of 63.65% of the patients were discharged without follow-up. CONCLUSIONS Functional gastrointestinal disorders place considerable burden on the A&E, in terms of resource usage, time of clinicians, and financial strain. More education should be provided to families of those experiencing FGID in an outpatient setting to minimize A&E resource utilization. More research is needed to ascertain the true burden of FGIDs, both financially and in terms of time and resource.
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Affiliation(s)
- Afroze Yousaf
- From the Faculty of Life Science and Medicine, King's College London
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88
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Chagas ACDS, Tupy O, Santos IBD, Esteves SN. Economic impact of gastrointestinal nematodes in Morada Nova sheep in Brazil. Rev Bras Parasitol Vet 2022; 31:e008722. [PMID: 36000609 DOI: 10.1590/s1984-29612022044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
This study evaluated the economic impact of gastrointestinal nematode (GIN) infection in Morada Nova lambs under different parasite chemical control conditions. For this, 246 lambs, in the rainy and dry season, were randomized into groups according to their anthelmintic treatment with levamisole: control (CT: no treatment); routine treatment (RT: treated every 42 days); and targeted selective treatment (TST: treated according to the average daily weight gain, DWG). From 63 days of age (D63) to D210, the lambs were weighed and monitored for GIN infection parameters. Spending on anthelmintics in the production system was 1.3% of the total economic result. The economic result per animal (R$ 5.00 = US$ 1.00) was higher in the RT group, amounting to US$ 6.60 in the rainy and US$ 5.69 in the dry season, due to higher DWG. Thus, RT presented economic results 14.4% and 10.9% higher than CT, and 7.2% and 1.9% higher than TST, in the rainy and dry season, respectively. However, fast development of resistance made RT unfeasible. Here, the economic impact of GIN infection on a national scale is discussed, demonstrating its importance and the impossibility of profitable and sustainable sheep production without adequate control.
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Affiliation(s)
| | - Oscar Tupy
- Embrapa Pecuária Sudeste - CPPSE, São Carlos, SP, Brasil
| | - Isabella Barbosa Dos Santos
- Faculdade de Ciências Agrárias e Veterinárias - FCAV, Universidade Estadual Paulista - UNESP, Jaboticabal, SP, Brasil
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89
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Koens S, Strauß A, Klein J, Schäfer I, von dem Knesebeck O. Public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease. PLoS One 2022; 17:e0273000. [PMID: 35951633 PMCID: PMC9371268 DOI: 10.1371/journal.pone.0273000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is evidence that perceived urgency of medical complaints is associated with emergency care utilization. Patients’ perception of urgency can differ from physicians’ assessment. This study explored public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease and analyzed variations in perceptions of urgency by characteristics of the afflicted person in the vignettes and sociodemographic characteristics of respondents. Methods Vignettes with severe symptoms of either inflammatory gastrointestinal disease or COVID-19 with comparable urgency of treatment were used in a telephone survey in Germany (N = 1,207). Besides disease, the vignettes varied in terms of sex, age (child, middle-aged person, old person) and daytime (Tuesday morning, Tuesday evening). Respondents were asked to rate the urgency of the reported symptoms with four items. A sum scale was computed. Variations in perceptions of urgency according to vignette characteristics and sociodemographic characteristics of the respondents (sex, age, educational level, migration background, children (yes/no) and personal affliction) were analyzed using a linear regression model. Results In terms of vignette characteristics, multivariate analysis showed a lower estimated urgency for males, as well as for the middle-aged and aged persons, compared to the child vignettes, and for COVID-19, compared to inflammatory gastrointestinal disease. Regarding the characteristics of the respondents, estimated urgency increased with age and was lower among respondents, who were previously affected by the symptoms themselves. Conclusion Although urgency in the vignettes was comparable, variations in estimated urgency by age and sex of the afflicted person and the described disease as well as age and personal affliction of the respondents were identified. This could result in an inadequate health care service utilization. Therefore, variations in public perceptions of urgency should be considered in the planning of public campaigns on adequate health care services utilization.
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Affiliation(s)
- Sarah Koens
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Annette Strauß
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Klein
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ingmar Schäfer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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90
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Iimura S, Takasugi S. Sensory Processing Sensitivity and Gastrointestinal Symptoms in Japanese Adults. Int J Environ Res Public Health 2022; 19:9893. [PMID: 36011526 PMCID: PMC9408471 DOI: 10.3390/ijerph19169893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sensory processing sensitivity is a personality or temperamental trait defined as individual differences in the tendency to perceive and process both positive and negative stimuli and experiences. Studies have shown that high sensitivity is correlated with psychosocial health, including depression and anxiety. However, its relationship with physical health has not been clarified. To fill this gap, using a large sample size with sufficient statistical power, an adult sample not including university students, and a range of covariates, this study examined the association between gastrointestinal symptoms as an indicator of physical health and sensory processing sensitivity. METHODS In this cross-sectional study, the participants were 863 Japanese adults (female = 450; male = 413; Mage = 30.4 years; SD = 4.9) who completed a web-based questionnaire. We statistically controlled for sociodemographic characteristics and examined whether sensory processing sensitivity is correlated with gastrointestinal symptoms. RESULTS The results showed that highly sensitive individuals were more likely to experience a wide range of gastrointestinal symptoms in the past week, including reflux symptoms, abdominal pain, indigestion symptoms, diarrhea symptoms, and constipation symptoms, even when statistically controlling for the participants' sociodemographic characteristics. CONCLUSIONS Our findings suggest that high sensory processing sensitivity is associated with physical health. Some of the potential causes of this are also discussed.
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Affiliation(s)
- Shuhei Iimura
- Soka University, 1-236 Tangi-machi, Hachioji, Tokyo 192-8577, Japan
| | - Satoshi Takasugi
- R&D Division, Meiji Co., Ltd., 1-29-1 Nanakuni, Hachioji, Tokyo 192-0919, Japan
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91
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Rubin R. Highlights From Digestive Disease Week-Pandemic-Related Decline in Colorectal Cancer Screening, Lack of Association Between Proton Pump Inhibitors and Dementia, and More. JAMA 2022; 328:8-9. [PMID: 35687359 DOI: 10.1001/jama.2022.8946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms that are not explained by structural or biochemical abnormalities. Their relationship with prematurity has been increasingly studied. OBJECTIVE To compare the frequency of FGIDs in preterm and term infants and to evaluate whether invasive procedures during the neonatal period in preterm infants are associated with greater likelihood of FGIDs in the first two years of life. DESIGN AND SETTING Controlled nested cross-sectional study conducted in a Brazilian university hospital. METHODS This was a controlled nested cross-sectional study on a retrospective cohort of infants born preterm who were compared with infants born at term regarding the presence of FGIDs. Medical consultations were conducted by a single pediatric gastroenterologist to obtain information on the gestational and neonatal periods and on clinical manifestations of the digestive tract. The Rome IV criteria for the diagnosis of FGIDs were used. RESULTS A total of 197 infants (< 24 months), including 99 preterm and 98 term infants, were studied. Infant regurgitation was more prevalent in term infants (35.1% and 15.6%; P < 0.001). The frequencies of other FGIDs (infant colic, functional constipation, functional diarrhea and infant dyschezia) in preterm infants did not differ from those of term infants (P > 0.05). No relationship was found between invasive procedures during the neonatal period and development of FGIDs in preterm infants. CONCLUSION Infants born preterm did not have higher frequency of FGIDs in the first two years of life.
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Affiliation(s)
- Marcela Montenegro Braga Barroso Gondim
- MD. Physician, Division of Pediatric Gastroenterology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil
| | - Ana Lucia Goulart
- MD, PhD. Physician and Associate Professor, Division of Neonatal Pediatrics, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil
| | - Mauro Batista de Morais
- MD, PhD. Physician and Full Professor, Division of Pediatric Gastroenterology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil
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Woo SK, Kim SS, Chung WC, Kim JS, Kim BW, Choi HH, Kim SS. [Gastrointestinal Disease in the Population Aged 80 Years and above in Korea during Recent Decades: Multi-center Cross-sectional Study]. Korean J Gastroenterol 2022; 79:244-251. [PMID: 35746838 DOI: 10.4166/kjg.2022.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND/AIMS Globally, the population aged 80 years or older is growing faster due to the rising life expectancy. Korea has already entered into an advanced aged society, and a post-aged society is expected in 2025. This study evaluated the patterns of gastrointestinal disease in the population aged 80 years or older during the recent decade in Korea. METHOD This study retrospectively reviewed the medical records of patients admitted to the gastrointestinal department of Suwon St. Vincent's hospital, Incheon St. Mary's hospital, and Uijeongbu St. Mary's Hospital - general hospitals of Seoul-Gyeonggi province in Korea. It was a repeated cross-sectional study in 2009 and 2019. RESULTS The number of admitted patients aged 80 years or older increased from 549 (9.0%) in 2009 to 1,073 (14.4%) in 2019 (p<0.01). As for the in-hospital mortality, there was no significant difference (p=0.25). On the other hand, the combined morbidities increased, and the duration of admission also increased (7.2±7.8 days vs. 8.1±8.2 days, p=0.03). The number of upper gastrointestinal hemorrhage and patients who are bleeding associated with drugs users increased (p<0.01). The proportion of lower gastrointestinal disease decreased (p<0.01) because of the decrease in procedure-related admissions (p<0.01). The number of those with pancreaticobiliary tract disease increased markedly (p<0.01), and the rate of cases that could not perform the procedure decreased (p=0.04). CONCLUSION The patterns of gastrointestinal disease in the population aged 80 years or older have changed in the recent decade in Korea. Hence, more preparation for this medical environment is needed.
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Affiliation(s)
- Seo Kyung Woo
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, the Catholic University of Korea, Suwon, Korea
| | - Shin Seung Kim
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, the Catholic University of Korea, Suwon, Korea
| | - Woo Chul Chung
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, the Catholic University of Korea, Suwon, Korea
| | - Joon Sung Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Incheon, Korea
| | - Byung-Wook Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Incheon, Korea
| | - Hyun Ho Choi
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Uijeongbu, Korea
| | - Sung Soo Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Uijeongbu, Korea
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Yamamichi N, Shimamoto T, Takahashi Y, Takahashi M, Takeuchi C, Wada R, Fujishiro M. Trends in proton pump inhibitor use, reflux esophagitis, and various upper gastrointestinal symptoms from 2010 to 2019 in Japan. PLoS One 2022; 17:e0270252. [PMID: 35714110 PMCID: PMC9205527 DOI: 10.1371/journal.pone.0270252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
The increasing usage of proton pump inhibitors (PPIs) has been reported worldwide, but information on PPI use in East Asia is inadequate. This study aimed to examine the trends in PPI use in Japan, along with the changes in histamine H2 receptor antagonist (H2RA) use, disease rate of reflux esophagitis, and the prevalence of upper gastrointestinal symptoms. We analyzed 217,712 healthy subjects (127,607 men and 90,105 women; 51.4 ± 9.7 years old) participating in the health check program from 2010 to 2019. Various upper gastrointestinal symptoms were evaluated using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire. Reflux esophagitis was diagnosed by esophageal erosion using the Los Angeles classification grades A, B, C, and D. From 2010 to 2019, the percentage of PPI users increased markedly from approximately 1.8% to 5.3%, whereas that of H2RA users decreased gradually from approximately 2.5% to 1.9%. The use of all classical types of PPIs (omeprazole, lansoprazole, rabeprazole, and esomerazole) and a new type of PPI, a potassium-competitive acid blocker (vonoprazan), greatly increased during the 10 years. An upward trend in the prevalence of reflux esophagitis was observed from 2010 to 2015, but not from 2016 to 2019, indicating that the monotonic rising prevalence of reflux disease stopped in the middle of the 2010s in Japan. In contrast, various upper gastrointestinal symptoms significantly improved between 2010 and 2019. All 12 FSSG symptoms of PPI users were significantly worse than those of non-PPI users, suggesting that PPIs still cannot completely control upper gastrointestinal symptoms. In conclusion, this study revealed a significant increase in PPI use and a slight decrease in H2RA use from 2010 to 2019. Despite a plateau in the prevalence of reflux esophagitis and considerable improvement in various upper gastrointestinal symptoms, PPI use has continued to increase in Japan.
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Affiliation(s)
- Nobutake Yamamichi
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
| | - Takeshi Shimamoto
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
- Kameda Medical Center Makuhari CD-2, Mihama-ku, Chiba-City, Japan
| | - Yu Takahashi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mami Takahashi
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Chihiro Takeuchi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoichi Wada
- Kameda Medical Center Makuhari CD-2, Mihama-ku, Chiba-City, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Abid S, Rehman H, Awan S, Artani A, Siddiqui I. Epidemiology of functional gastrointestinal disorders using ROME III adult questionnaire, a population based cross sectional study in Karachi-Pakistan. PLoS One 2022; 17:e0268403. [PMID: 35696397 PMCID: PMC9191742 DOI: 10.1371/journal.pone.0268403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/28/2022] [Indexed: 12/13/2022] Open
Abstract
Objective Functional Gastrointestinal Disorder (FGIDs) are a heterogenous group of disorders, with Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) being the most common disorders worldwide. The purpose of this study was to identify the spectra of FGIDs classified according to the ROME III criteria amongst an adult Pakistani population. It also aimed to correlate the psychosocial alarm symptoms with the prevalence of FGIDs and report the overlap of all FGID. Design This was a community based cross-sectional study. Multi-stage cluster sampling technique was applied, and 1062 households were initially randomly chosen using systematic sampling technique. Only one person from each household was enrolled in the study. After eligibility screening, 860 participating individuals were requested to fill out a structured ROME III interview questionnaire, administered to them by a trained interviewer. Results FGIDs were diagnosed in 468 individuals (54.4%), out of 860 participants. FD was found to be the most prevalent (70.2%), followed by Functional Heartburn (58.9%) and Functional bloating (56.6%). Amongst a total of 468 participants diagnosed with FGIDs, 347 (74.1%) had overlapping disorders. There was also a higher incidence of psychosocial alarm symptoms including higher pain severity (62.6% vs 46.4%) and being victimized at some point in their lives (26.1% vs 6.6%) amongst FGID patients. Conclusion There is a high disease burden of FGIDs in this study population, with approximately half of the population suffering from at least one type of FGID. Overlapping disorders are also common in this part of the world.
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Affiliation(s)
- Shahab Abid
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
- * E-mail:
| | - Hareem Rehman
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
| | - Azmina Artani
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
| | - Imran Siddiqui
- Department of Pathology and Lab Medicine, Aga Khan University, Karachi, Pakistan
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Strisciuglio C, Cenni S, Serra MR, Dolce P, Kolacek S, Sila S, Trivic I, Bar Lev MR, Shamir R, Kostovski A, Papadopoulou A, Roma E, Katsagoni C, Jojkic-Pavkov D, Campanozzi A, Scarpato E, Miele E, Staiano A. Diet and Pediatric Functional Gastrointestinal Disorders in Mediterranean Countries. Nutrients 2022; 14:nu14112335. [PMID: 35684135 PMCID: PMC9183175 DOI: 10.3390/nu14112335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 12/10/2022] Open
Abstract
Background: The increased intake of FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyol) rich foods has been suggested as a possible trigger of functional gastrointestinal disorders (FGIDs). Despite the high FODMAP content, the Mediterranean diet (MD) appears to have beneficial effects on health. Our aim was to evaluate whether the prevalence of FGIDs in different Mediterranean countries may be influenced by FODMAP consumption and adherence to the MD. Methods: A school-based, cross-sectional, multicenter study was performed in six countries in the Mediterranean area: Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects 4-18 years were examined in relation to their eating habits and the presence of FGIDs, using Rome IV criteria, 3-day food diaries and Mediterranean Diet Quality Index in Children and Adolescents (KIDMED) questionnaires. Results: We enrolled 1972 subjects between 4 and 9 years old (Group A), and 2450 subjects between 10 and 18 years old (Group B). The overall prevalence of FGIDs was 16% in Group A and 26% in Group B. FODMAP intake was significantly different among countries for both age groups. In both groups, no significant association was found between FGIDs and FODMAPs. Adherence to the MD in all countries was intermediate, except for Serbia, where it was low. In both groups, we found a statistically significant association between FGIDs and the KIDMED score (Group A: OR = 0.83, p < 0.001; Group B: OR = 0.93, p = 0.005). Moreover, a significant association was found between the KIDMED score and functional constipation (Group A: OR = 0.89, p = 0.008; Group B: OR = 0.93, p = 0.010) and postprandial distress syndrome (Group A: OR = 0.86, p = 0.027; Group B: OR = 0.88, p = 0.004). Conclusions: Our data suggest that the prevalence of FGIDs in the Mediterranean area is not related to FODMAP consumption, whereas adherence to the MD seems to have a protective effect.
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Affiliation(s)
- Caterina Strisciuglio
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (C.S.); (S.C.)
| | - Sabrina Cenni
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (C.S.); (S.C.)
| | - Maria Rosaria Serra
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, 80138 Naples, Italy; (M.R.S.); (E.S.); (E.M.)
| | - Pasquale Dolce
- Department of Public Health, University of Naples “Federico II”, 80138 Naples, Italy;
| | - Sanja Kolacek
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital University of Zagreb Medical School, 10000 Zagreb, Croatia; (S.K.); (S.S.); (I.T.)
| | - Sara Sila
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital University of Zagreb Medical School, 10000 Zagreb, Croatia; (S.K.); (S.S.); (I.T.)
| | - Ivana Trivic
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital University of Zagreb Medical School, 10000 Zagreb, Croatia; (S.K.); (S.S.); (I.T.)
| | - Michal Rozenfeld Bar Lev
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel; (M.R.B.L.); (R.S.)
| | - Raanan Shamir
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel; (M.R.B.L.); (R.S.)
| | - Aco Kostovski
- Faculty of Medicine, University Children Hospital, 1000 Skopje, North Macedonia;
| | - Alexandra Papadopoulou
- Division of Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, “Agia Sofia” Children’s Hospital, 11527 Athens, Greece;
| | - Eleftheria Roma
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece;
| | - Christina Katsagoni
- Department of Clinical Nutrition, “Agia Sofia” Children’s Hospital, 11527 Athens, Greece;
| | - Danijela Jojkic-Pavkov
- Department of Paediatrics, Institute for Child and Youth Health Care of Vojvodina, Medical Faculty Novi Sad, 21000 Novi Sad, Serbia;
| | - Angelo Campanozzi
- Pediatrics, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy;
| | - Elena Scarpato
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, 80138 Naples, Italy; (M.R.S.); (E.S.); (E.M.)
| | - Erasmo Miele
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, 80138 Naples, Italy; (M.R.S.); (E.S.); (E.M.)
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, 80138 Naples, Italy; (M.R.S.); (E.S.); (E.M.)
- Correspondence: ; Tel.: +39-081-7462679; Fax: +39-081-7463116
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Vélez C, Paz M, Silvernale C, Stratton LW, Kuo B, Staller K. Factors Associated With Chronic De Novo Post-Coronavirus Disease Gastrointestinal Disorders in a Metropolitan US County. Clin Gastroenterol Hepatol 2022; 20:e1488-e1492. [PMID: 34687967 PMCID: PMC8529223 DOI: 10.1016/j.cgh.2021.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/04/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023]
Abstract
The first coronavirus disease 2019 (COVID-19) pandemic surge harshly impacted the medically underserved populations of the urbanized northeastern United States. SARS-CoV-2 virions infect the gastrointestinal (GI) tract, and GI symptoms are common during acute infection.1 Post-COVID syndromes increasingly are recognized as important public health considerations.2 Postinfectious disorders of gut-brain interaction (DGBIs; formerly known as functional gastrointestinal disorders) can occur after enteric illness; the COVID-19 pandemic is anticipated to provoke DGBI development3 within a rapidly evolving post-COVID framework of illness. Here, we evaluate factors associated with DGBI-like post-COVID gastrointestinal disorders (PCGIDs) in our hospital's surrounding communities comprised predominantly of racial/ethnic minorities and those of reduced socioeconomic status.
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Affiliation(s)
- Christopher Vélez
- Center for Neurointestinal Health, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Mary Paz
- Center for Neurointestinal Health, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Casey Silvernale
- Center for Neurointestinal Health, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lawrence W Stratton
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Braden Kuo
- Center for Neurointestinal Health, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kyle Staller
- Center for Neurointestinal Health, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Wang JK, He Y, Chen LL, Zhang HX, Qi XJ, Sun L, Zhang SF, Chen J, Zhang RH. A population-based survey of the prevalence of self-reported acute gastrointestinal illness in Zhejiang Province, China. PLoS One 2022; 17:e0268717. [PMID: 35584149 PMCID: PMC9116671 DOI: 10.1371/journal.pone.0268717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022] Open
Abstract
Acute gastrointestinal illness (AGI) is a prevalent public health concern worldwide. This study investigated the magnitude, distribution and burden of self-reported AGI among residents of Zhejiang Province, China. A face-to-face household survey was conducted using a multi-stage stratified random sampling method in 10 counties in Zhejiang Province between July 2018 and June 2019. In total, 12,021 participants were recruited. The prevalence of AGI 28 days after standardization was 1.8% (95% confidence interval (CI), 1.6–2.1), with an incidence rate of 0.24 episodes of AGI per person-year and an estimated 14 million cases of AGI in Zhejiang Province. Univariate and multivariable analyses showed a higher AGI prevalence among people who performed housework and were unemployed in summer and autumn among respondents living in western or northern cities (p < 0.05). More than 50% of AGI cases were attributed to the consumption of contaminated food. The disease burden caused by AGI in Zhejiang Province was approximately 975 million Chinses yuan (CNY). These results indicated that the disease burden of AGI in Zhejiang Province should be addressed and highlights the need for an improved active surveillance system of foodborne diseases to assess the impact of AGI on society and health.
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Affiliation(s)
- Ji-Kai Wang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yue He
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Li-Li Chen
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - He-Xiang Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiao-Juan Qi
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Liang Sun
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuang-Feng Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiang Chen
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rong-Hua Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Tseng PH, Hung CS, Tu CH, Chen CC, Liao WC, Lee YC, Chiu HM, Yang WS, Wu MS. Association of Incidence of Acid-related Upper Gastrointestinal Disorders With Glycated Hemoglobin Level. J Clin Endocrinol Metab 2022; 107:e2563-e2571. [PMID: 35134176 DOI: 10.1210/clinem/dgac062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Previous cross-sectional studies show diabetes and higher levels of plasma hemoglobin A1c (HbA1c) are associated with a higher prevalence of gastrointestinal (GI) complications. However, whether the glycemic status is associated with incident acid-related upper GI disorders remains unclear. OBJECTIVE We aimed to determine the effect of hyperglycemia per se, in terms of HbA1c, on the incidence of acid-related disorders. METHODS We analyzed consecutive subjects who had undergone repeated upper endoscopies as part of the health examinations at the National Taiwan University Hospital from 2005 to 2011. Acid-related endoscopic abnormalities were defined as erosive esophagitis (EE), Barrett's esophagus (BE), and peptic ulcer disease (PUD), which included gastric ulcers (GUs) and duodenal ulcers (DUs). All subjects were categorized by 3 tertiles of HbA1c levels. We analyzed the occurrence of respective acid-related disorders during the follow-up period. RESULTS A total of 11 391 participants (mean HbA1c level 5.6 ± 0.7%) were enrolled in this longitudinal study. During the 38 426.3 person-years of follow-up (mean duration 3.37 ± 1.59 years), the incidence of EE, BE, GU, DU, PUD, and any acid-related disorders were 22.1%, 0.5%, 4.5%, 8.6%, 12.3%, and 30.3%, respectively. The higher HbA1c level was associated with higher risk of disease incidents, except BE, during the follow-up (all log-rank P < .001). In the Cox regression analyses with confounding factors fully adjusted, the hazard ratios for EE, GU, DU, PUD, and acid-related disorders were 1.174, 1.339, 1.24, 1.24, and 1.186, respectively, for the third tertile of HbA1c (all P < .05). CONCLUSION Higher HbA1c level was associated with a higher risk of acid-related upper GI endoscopic abnormalities. Efforts toward better glycemic control may help to prevent the development of late GI complications.
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Affiliation(s)
- Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Sheng Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Tu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chuan Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wan-Chung Liao
- Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Shiung Yang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Velasco-Benítez CA, Collazos-Saa LI, García-Perdomo HA. A SYSTEMATIC REVIEW AND META-ANALYSIS IN SCHOOLCHILDREN AND ADOLESCENTS WITH FUNCTIONAL GASTROINTESTINAL DISORDERS ACCORDING TO ROME IV CRITERIA. Arq Gastroenterol 2022; 59:304-313. [PMID: 35830045 DOI: 10.1590/s0004-2803.202202000-53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria. METHODS We included cohorts and observational descriptive studies, including information for the prevalence of FGIDs according to Rome IV criteria in children 4 to 18 years old. We searched the MEDLINE (Ovid), EMBASE, LILACS, and CENTRAL databases from May 2016 to nowadays. Gray literature and other databases were also consulted. The risk of bias was assessed using the STROBE Statement. The results were reported in forest plots of the estimated effects of the included studies with a 95% confidence interval (95%CI). RESULTS We included 14 studies involving a total of 17427 participants. Three studies were conducted in Europe, two in North America, and nine in Latin America. Most studies were school-based (n=14670, 84.18%), participants were mostly female (55.49%), white (51.73%), 8 to 18 years old (77.64%), and assisted to a public school (81.53%). Thirteen studies used the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS-RIV) to assess FGIDs. We found a global prevalence for FGIDs of 23% (95%CI 21-25%, I2 99%). Main disorders were functional constipation (FC) with 12% (95%CI 11-15%) followed by functional dyspepsia (FD) (5%, 95%CI 11-15%) and irritable bowel syndrome (IBS) (3%, 95%CI 2-4%). The prevalence of FGIDs was higher in the Americas, representing 23.67% (95%CI 21.2-26.2%, I2 91.3%). CONCLUSION FGIDs are present in one of four children and adolescents, representing a common condition in this age group the central disorders were FC, FD, and IBS.
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