Relationship between Adverse Gastric Reactions and the Timing of Enteric-Coated Aspirin Administration

Review on recent advancements in understanding acetylsalicylic acid-induced gastrointestinal injury: mechanisms, medication, and dosage refinement

Acetylsalicylic acid (ASA) is a clinical drug with multiple effects, including prevention of cardiovascular adverse events and anti-cancer effects. However, gastrointestinal side effects, such as gastrointestinal ulcers and bleeding, limit the use of ASA and reduce patient compliance. Various studies have investigated the mechanisms of ASA-induced gastrointestinal injury, and many medicines have been reported to be effective in preventing and treating the adverse gastrointestinal effects of ASA. New formulations of ASA have demonstrated milder gastrointestinal injury than ASA alone. In this article, we summarized the mechanisms of ASA-induced gastrointestinal injury, drugs that resist gastrointestinal side effects of ASA, and progress in research on formulation improvement of ASA to help resolve the clinical dilemma of ASA usage.

Letter: the hidden reasons of long-term risk of upper gastrointestinal bleeding after Helicobacter pylori eradication

This article is linked to Jiang et al papers. To view these articles, visit https://doi.org/10.1111/apt.16604 and https://doi.org/10.1111/apt.16746

Interactions of food matrix and dietary components on neonicotinoid bioaccessibility in raw fruit and vegetables

Humans are frequently exposed to the residues of various neonicotinoids, highlighting the need to understand human exposure through oral ingestion of contaminated foods. In this study, the effects of different food matrices (tomato, cucumber, and carrot) and their interaction with dietary component additives, including proteins and dietary fiber, was investigated. The results showed that the presence of a food matrix had a significant effect on the bioaccessibility of neonicotinoids (imidacloprid, thiamethoxam, acetamiprid, and thiacloprid) in both the gastric and intestinal environments. Neonicotinoids in tomato presented relatively low bioaccessibility, indicating that the daily intake of the tomato can be regarded as being relatively safer. Moreover, the addition of protein or dietary fiber to fruit and vegetables had a marked influence on neonicotinoid bioaccessibility and the effects varied between the different matrices. In particular, the addition of 2.0% dietary fiber significantly reduced the bioaccessibility (18.38-67.91%). Therefore, we recommend that consuming an increased intake of dietary fiber could improve the safety of fruit and vegetables in daily life. The present results can support the identification of suitable food intake conditions for the significant reduction of pesticide residue levels.

Aspirin and the prevention of venous thromboembolism following total joint arthroplasty: commonly asked questions

The number of arthroplasties being performed increases each year. Patients undergoing an arthroplasty are at risk of venous thromboembolism (VTE) and appropriate prophylaxis has been recommended. However, the optimal protocol and the best agent to minimise VTE under these circumstances are not known. Although many agents may be used, there is a difference in their efficacy and the risk of bleeding. Thus, the selection of a particular agent relies on the balance between the desire to minimise VTE and the attempt to reduce the risk of bleeding, with its undesirable, and occasionally fatal, consequences.

Acetylsalicylic acid (aspirin) is an agent for VTE prophylaxis following arthroplasty. Many studies have shown its efficacy in minimising VTE under these circumstances. It is inexpensive and well-tolerated, and its use does not require routine blood tests. It is also a ‘milder’ agent and unlikely to result in haematoma formation, which may increase both the risk of infection and the need for further surgery. Aspirin is also unlikely to result in persistent wound drainage, which has been shown to be associated with the use of agents such as low-molecular-weight heparin (LMWH) and other more aggressive agents.

The main objective of this review was to summarise the current evidence relating to the efficacy of aspirin as a VTE prophylaxis following arthroplasty, and to address some of the common questions about its use.

There is convincing evidence that, taking all factors into account, aspirin is an effective, inexpensive, and safe form of VTE following arthroplasty in patients without a major risk factor for VTE, such as previous VTE.

Cite this article: Bone Joint J 2017;99-B:1420–30.

In-vitro bioaccessibility of five pyrethroids after human ingestion and the corresponding gastrointestinal digestion parameters: A contribution for human exposure assessments

Bioaccessibility is a crucial parameter in assessing the absorption of contaminants during the human digestive process, but few studies have involved the differences in the bioaccessibilities of pesticides. To investigate the mode of using the in vitro bioaccessibility to refine estimates of dietary exposure to pesticide residues, this study measured the bioaccessibilities of five pyrethroids in apples, and then, it modelled physicochemical predictors (gastrointestinal pH, digestive times, and the solid-liquid (S/L) ratio) of the bioaccessibilities of pyrethroids. Apple samples of gastric and intestinal phase digestive juices were obtained from an in vitro simulated digestion model. Our survey of in vitro digestion models found that the bioaccessibilities ranged from 4.42% to 31.22% and 10.58%-35.63% in the gastric and intestinal phases, respectively. A sharp trend similar to a normal distribution was observed between the bioaccessibilities and pH values. The bioaccessibility reached its highest value at a pH of 1.91 in the simulated gastric juice and did not significantly change with an increase of the digestive time. A significant negative correlation occurred between the bioaccessibility and S/L ratio, which followed a logarithmic equation. The correlation coefficients (R²) ranged from 0.9259 to 0.9831 and 0.9077 to 0.9960 in the simulated gastric and intestinal juice, respectively, suggested that both the pH value and S/L ratio were the main factors affecting the bioaccessibility. Furthermore, a combination of the acceptable daily intake (ADI) and bioaccessibility for human exposure assessments indicated the implication that traditional risk assessment using ADI may seriously overestimate the actual risk.