Perceived stress as a risk factor for peptic ulcers: a register-based cohort study

In vivo and In silico evidence of the protective properties of carvacrol against experimentally-induced gastric ulcer: Implication of antioxidant, anti-inflammatory, and antiapoptotic mechanisms

Gastric ulcer is a serious disease that affects millions of individuals worldwide. Alcohol consumption is a major contributor to the disease pathogenesis and ethanol-induced ulcer in rats closely recapitulates the clinical pathology of ulcer. In this study, rats were pretreated with carvacrol (CAR,50 and 100 mg/kg, orally) 1 h before absolute ethanol administration to induce gastric ulcer. CAR prevented ethanol-induced increases in gastric volume and acidity while restored mucin content. The gastro-protective activity of CAR, particularly the higher dose (100 mg/kg), was further supported by histopathological examination, as manifested by reduced gastric lesions. Interestingly, oxidative stress is linked to early stages of ulcer development and progression. In this study, ethanol administration upregulated the levels of ROS-producing enzymes, NADPH oxidase homologs 1 and 4 (Nox1 and Nox4) and lipid peroxides while depleting the antioxidant defense mechanisms, including GSH, Glutathione Peroxidase (GPX) and catalase. Interestingly, these alterations were significantly ameliorated by CAR pretreatment. Additionally, CAR possesses anti-inflammatory and anti-apoptotic activities. Pretreatment with CAR blunted ethanol-induced increases in inflammatory cytokines (NF-κB and TNF-α) and rectified the apoptosis regulator (Bax/Bcl2 ratio) in gastric tissue. Moreover, the docking simulation of CAR illustrated good fitting and interactions with GPX, Nox1 and TNF-α through the formation of hydrogen and hydrophobic (pi-H) bonds with conservative amino acids, thus, further supporting the anti-inflammatory and antioxidant effects underlying the gastroprotective effects of CAR. In conclusion, this study elucidates, using in silico and in vivo models, that the gastroprotective activity of CAR is attributed, at least in part, to its mucin-secretagogue, antioxidative, anti-inflammatory, and anti-apoptotic mechanisms.

Exploring Cytokines as Potential Target in Peptic Ulcer Disease: A Systematic Update

Peptic ulcer disease (PUD) is a widespread condition that affects millions of people each year, with an incidence rate of 0.1%-1.5%, and has a significant impact on human health. A range of stimuli, such as Helicobacter pylori, non-steroidal anti-inflammatory drugs, hyperacidity, stress, alcohol, smoking, and idiopathic disease states, can produce a sore in the gastrointestinal mucosal layer. For individuals infected with H. pylori, 2%-3% remain asymptomatic throughout their life. Although PUD treatments are available, genetic variations occurring in individuals because of geographical dissimilarity and antibiotic resistance pose limitations. Specifically, inflammatory cytokine gene polymorphisms have received immense attention in recent years because they appear to affect the severity and duration of stomach inflammation, which is induced by H. pylori infection, contributing to the initiation of PUD. In such a context, in-depth knowledge of interleukins may aid in the discovery of new targets and provide precautionary approaches for the treatment of PUD. This review aims to give insights into the importance of several interleukins that cognate with PUD and contribute to ulcer progression or healing by activating or dampening the host immunity. Furthermore, the available targets with clinical evidence have been explored in this review.

Perceived stress in different countries at the beginning of the coronavirus pandemic

OBJECTIVE

The coronavirus has spread around the world, causing an ongoing pandemic. After the lockdown and quarantine protocols, an evaluation of the population's current emotional state was made through a web-based survey available in both English and Spanish. The objective was to observe how respondents perceived stress and worry as a result of COVID-19.

METHODS

The survey gathered data across three sections: socio-demographic data, the Perceived Stress Scale (PSS-10) by Cohen, and additional queries on current worries and behaviors due to this pandemic.

RESULTS

The survey received 1523 respondents from 48 countries. The mean of the PSS-10 score was 17.4 (SD 6.5). Significantly higher scores were observed among women, young adults, students, and those who expressed concern about getting infected and considered themselves high-risk. No significant differences were observed between health professionals and other professions.

CONCLUSIONS

We describe an increase in stress levels due to the COVID-19 and point out groups at high risk. These findings could help to address the mental health care that is needed.

Emerging role of mitochondrial DAMPs, aberrant mitochondrial dynamics and anomalous mitophagy in gut mucosal pathogenesis

Gastroduodenal inflammation and ulcerative injuries are increasing due to expanding socio-economic stress, unhealthy food habits-lifestyle, smoking, alcoholism and usage of medicines like non-steroidal anti-inflammatory drugs. In fact, gastrointestinal (GI) complications, associated with the prevailing COVID-19 pandemic, further, poses a challenge to global healthcare towards safeguarding the GI tract. Emerging evidences have discretely identified mitochondrial dysfunctions as common etiological denominators in diseases. However, it is worth realizing that mitochondrial dysfunctions are not just consequences of diseases. Rather, damaged mitochondria severely aggravate the pathogenesis thereby qualifying as perpetrable factors worth of prophylactic and therapeutic targeting. Oxidative and nitrosative stress due to endogenous and exogenous stimuli triggers mitochondrial injury causing production of mitochondrial damage associated molecular patterns (mtDAMPs), which, in a feed-forward loop, inflicts inflammatory tissue damage. Mitochondrial structural dynamics and mitophagy are crucial quality control parameters determining the extent of mitopathology and disease outcomes. Interestingly, apart from endogenous factors, mitochondria also crosstalk and in turn get detrimentally affected by gut pathobionts colonized during luminal dysbiosis. Although mitopathology is documented in various pre-clinical/clinical studies, a comprehensive account appreciating the mitochondrial basis of GI mucosal pathologies is largely lacking. Here we critically discuss the molecular events impinging on mitochondria along with the interplay of mitochondria-derived factors in fueling mucosal pathogenesis. We specifically emphasize on the potential role of aberrant mitochondrial dynamics, anomalous mitophagy, mitochondrial lipoxidation and ferroptosis as emerging regulators of GI mucosal pathogenesis. We finally discuss about the prospect of mitochondrial targeting for next-generation drug discovery against GI disorders.

Effect of psychological problems and interventions on gastrointestinal diseases

Many gastrointestinal diseases may develop under the social-psychological-biomedical model; their onset is closely related to psychological factors, and psychological intervention can improve the therapeutic efficacy. This paper reviews the effects of psychological problems and interventions on gastroesophageal reflux disease, irritable bowel syndrome, peptic ulcer, inflammatory bowel disease, and gastrointestinal tumors.

Migraine and gastrointestinal disorders in middle and old age: A UK Biobank study

INTRODUCTION

Migraine is a prevalent condition causing a substantial level of disability worldwide. Despite this, the pathophysiological mechanisms are not fully understood. Migraine often co-occurs with gastrointestinal disorders, but the direction of a potential causal link is unclear. The aim of this project was to investigate the associations between migraine and several gastrointestinal disorders in the same cohort in order to determine the relative strengths of these associations.

METHODS

This cross-sectional study examined whether migraine is associated with irritable bowel syndrome (IBS), peptic ulcers, Helicobacter pylori (HP) infections, celiac disease, Crohn's disease and ulcerative colitis. Baseline data covering 489,753 UK Biobank participants (migraine group: n = 14,180) were analyzed using Pearson's chi-square tests and adjusted binary logistic regression models.

RESULTS

Migraine was significantly associated with IBS (odds ratio [OR] 2.24, 95% confidence interval [CI] 2.08-2.40, p <.001) and peptic ulcers (OR 1.55, 95% CI 1.35-1.77, p <.001). Migraine was not associated with HP infection (OR 1.34, 95% CI 1.04-1.73, p = .024), celiac disease (OR 1.29, 95% CI 1.04-1.60, p = .023), Crohn's disease (OR 1.08, 95% CI 0.80-1.45, p = .617) or ulcerative colitis (OR 1.00, 95% CI 0.79-1.27, p = .979) after adjusting for multiple testing.

CONCLUSIONS

Migraine was associated with IBS and peptic ulcers in this large population-based cohort. The associations with HP infection, celiac disease, Crohn's disease, and ulcerative colitis did not reach significance, suggesting a weaker link between migraine and autoimmune gastrointestinal conditions or HP infection.

Clinically significant endoscopic findings in patients of dyspepsia with no warning symptoms: A cross-sectional study

BACKGROUND

Dyspepsia is one of the commonest clinical disorder. However, controversy remains over the role of endoscopy in patients with dyspepsia. No studies have evaluated the diagnostic value of endoscopy in patients with no warning symptoms according to the Rome IV criteria.

AIM

To study the diagnostic value of endoscopy in dyspeptic patients with no warning symptoms.

METHODS

This cross-sectional study included dyspeptic patients with no warning symptoms who met the inclusion and exclusion criteria at The First Affiliated Hospital, Zhejiang Chinese Medical University from April 2018 to February 2019. The clinical data were collected using questionnaires, including dyspeptic information, warning symptoms, other diseases, family history and basic demographic data. Based on dyspeptic symptoms, patients can be divided into epigastric pain syndrome, postprandial distress syndrome or overlapping subtypes.

RESULTS

A total of 1016 cases were enrolled, 304 (29.9%) had clinically significant findings that were detectable by endoscopy. The endoscopy findings included esophageal lesions in 180 (17.7%) cases, peptic ulcers in 115 (11.3%) cases and malignancy in 9 (0.89%) patients. Multivariate logistic regression analysis showed that males [odds ratio (OR) = 1.758, P < 0.001], body mass index > 25 (OR = 1.660; P = 0.005), epigastric pain (OR = 1.423; P = 0.019) and Helicobacter pylori infection (OR = 1.949; P < 0.001) were independently associated with risk factors for the presence of clinically significant findings on endoscopy.

CONCLUSION

Chinese patients with dyspepsia with no warning symptoms should undergo endoscopy, particularly males, patients with body mass index > 25, epigastric pain or Helicobacter pylori infection.

Edible and highly biocompatible nanodots from natural plants for the treatment of stress gastric ulcers

The incidence rate of stress ulcers has increased in recent years, with an increase in life pressure, unavoidable trauma and other factors. The therapy of acute stress ulcers has always been an important challenge. Carbon dots (CDs) have been reported to show excellent biological activities, but research on the stress ulcer curative effect of CDs is unprecedented. Here, we prepared a series of semi-carbonized nanodots (SCNDs) from natural plants or herbs as precursors and the as prepared SCNDs were later proved to be effective in the treatment and inhibition of stress gastric ulcers in a rat model. One kind of SCND from edible and medicinal plants, charred Atractylodes macrocephala (SCNDs-1), is demonstrated in detail for its strong anti-stress gastric ulcer effect with inhibition up to 90% and shows extremely high biocompatibility and ultra-low toxicity. These SCNDs lead to the reduction of inflammatory factors and oxidative stress, and the protection of the gastric mucosa. The SCNDs also reduce the excessive neuroendocrine response caused by stress, regulate the energy metabolism and the structure of intestinal flora, improve the damage to the body caused by the stress state, thus alleviating the occurrence of stress-induced gastric ulcers. This work provides new insights into the preparation of carbon nanomaterials from natural plants through a semi-carbonization process and opens new ways to apply bio-active and bio-safe SCNDs in the modern pharmaceutical field.

Mechanism of rutaecarpine on ethanol-induced acute gastric ulcer using integrated metabolomics and network pharmacology

This study was aimed to explore the mechanism of rutaecarpine (RUT) on ethanol-induced gastric ulcer (GU) in mice by integrated approaches. At first, the efficacy was determined through the macroscopic and microscopic state of stomach tissue and the expression levels of GU-related factors. Then, the serum metabolomics method based on UPLC-Q-TOF/MS was used to explore the specific metabolites and metabolic pathways. Finally, the upstream key protein targets of these specific metabolites were analyzed by network pharmacology and verified by PCR to explore the potential mechanism. RUT alleviated the histological and pathological damage of gastric tissue caused by ethanol, and could remarkably ameliorate the level of GU-related factors. Subsequently, a total of 7 potential metabolites involved in 9 metabolic pathways were identified by metabolomics analysis. Then, a 'component-targets-metabolites' interaction network was constructed, and therefore 4 key target proteins (PLA2G1B, PDE5A, MIF and SRC) that may regulate the specific metabolites were obtained. This case was further verified by the results of PCR. ALL the above results strongly demonstrated that RUT exerted a gastroprotective effect against GU. And it is the first time to combine metabolomics combined with network pharmacology to elucidate the mechanism of RUT on GU, which may be related to the regulation of energy metabolism, oxidative stress, and inflammation, and these pathways may be regulated through the upstream protein PLA2G1B, PDE5A, MIF and SRC.

Peptic ulcer disease: a cross-sectional study of symptoms and risk factors among students at Jimma University, Ethiopia

Background:

Peptic ulcer disease (PUD), which includes gastric and duodenal ulcers, is a common condition with symptoms including epigastric or abdominal pain. It is multifactorial, with physiological, demographic and environmental risk factors, some of which make it more prevalent in developing countries.

Aims:

This study aims to assess the symptoms of and risk factors for PUD among students at Jimma University, Jimma, Ethiopia.

Methods:

This institutional based cross-sectional study design used a self-administered questionnaire to collect data for analysis. This included logistic regression analysis, in which a p-value of <0.05 at 95% CI indicated statistical significance.

Findings:

Of the 240 respondents, 41.3% had symptoms indicative of PUD. Most students developed symptoms after enrolling at university and primarily managed them with medication. PUD-like symptoms were found to be associated with year of study, frequent Non-steroidal anti-inflammatory drugs(NSAIDs use, smoking, prolonged fasting and anxiety.

Conclusions:

PUD is highly prevalent in this setting. Therefore, the university may wish to raise awareness of PUD and aim to reduce anxiety among students.

Rutaecarpine Ameliorates Ethanol-Induced Gastric Mucosal Injury in Mice by Modulating Genes Related to Inflammation, Oxidative Stress and Apoptosis

Background: Rutaecarpine (RUT), a major quinazolino carboline alkaloid compound from the dry unripe fruit Tetradium ruticarpum (A. Juss.) T. G. Hartley, has various pharmacological effects. The aim of this present study was to investigate the potential gastroprotective effect of rutaecarpine on ethanol-induced acute gastric mucosal injury in mice and associated molecular mechanisms, such as activating Nrf2 and Bcl-2 via PI3K/AKT signaling pathway and inhibiting NF-κB.

Methods: Gastric ulcer index and histopathology was carried out to determine the efficacy of RUT in gastric ulceration, and the content of SOD, GSH in serum and CAT, MDA, MPO, TNF-α, IL-6, IL-1β in tissue were measured by kits. Besides, in order to illustrate the potential inflammatory, oxidative, and apoptotic perturbations, the mRNA levels of NF-κB p65, PI3K, AKT, Nrf2, Nqo1, HO-1, Bcl-2 and Bax were analyzed. In addition, the protein expression of NF-κB p65 and Nrf2 in cytoplasm and nucleus, AKT, p-AKT, Bcl-2 Bax and Caspase 3 were analyzed for further verification. Finally, immunofluorescence analysis was performed to further verify nuclear translocation of NF-κB p65.

Results: Current data strongly demonstrated that RUT alleviated the gross gastric damage, ulcer index and the histopathology damage caused by ethanol. RUT inhibited the expression and nuclear translocation of NF-κB p65 and the expression of its downstream signals, such as TNF-α, IL-6, IL-1β and MPO. Immunofluorescence analysis also verifies the result. In the context of oxidative stress, RUT improved the antioxidant milieu by remarkably upregulating the expression Nqo1 and HO-1 with activating Nrf2, and could remarkably upregulate antioxidant SOD, GSH, CAT and downregulate levels of MDA. Additionally, RUT activate the expression of Bcl-2 and inhibited the expression of downstream signals Bax and Caspase 3 to promote gastric cellular survival. These were confirmed by RUT activation of the PI3K/AKT pathway manifested by enhanced expression of PI3K and promotion of AKT phosphorylation.

Conclusion: Taken together, these results strongly demonstrated that RUT exerted a gastroprotective effect against gastric mucosal injury induced by ethanol. The underlying mechanism might be associated with the improvement of anti-inflammatory, anti-oxidation and anti-apoptosis system.

The intervention of tert-butylhydroquinone protects ethanol-induced gastric ulcer in type II diabetic rats: the role of Nrf2 pathway

Ethanol consumption increases the prevalence of gastric ulcer (GU) in rats with type II diabetes (T2D). Induction of GU by absolute ethanol (5 mL/kg or 3.94 g/kg) in the animal model resembles human ulcer characteristics. The aim was to investigate the role of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway in the treatment of GU in diabetic condition. The rats were exposed to absolute ethanol 1 h before sacrifice and T2D was induced by combined exposure of high-fat diet and low dose streptozotocin. Pretreatment of tert-butylhydroquinone (tBHQ) (25 and 50 mg/kg), metformin (500 mg/kg), and omeprazole (20 mg/kg) were given once daily for last three consecutive weeks. In ethanol-exposed diabetic rats, pretreatment with tBHQ, omeprazole, and metformin reduced gastric mucosal lesion, ulcer index, histological alterations, malondialdehyde level, and apoptosis. Furthermore, the intervention of tBHQ, omeprazole, and metformin improved the integrity of the stomach mucosa, glutathione, gastric pH, collagen, and goblet cells. tBHQ treatment improved ethanol-induced alterations of Nrf2, catalase, heat shock protein 70 (HSP70), NF-κB, and endothelin-1 expressions in diabetic rats. In diabetic conditions, the incidence of GU is increased due to elevated levels of reactive oxygen species, inflammatory mediators, depleted levels of cellular antioxidants, and altered gastric parameters. The tBHQ intervention could be a rational strategy to protect these changes.

Peptic ulcer does not increase the risk of dementia: A nested case control study using a national sample cohort

Studies have shown that peptic ulcer disease (PUD) increases the risk of dementia via the mechanism of systemic inflammation. We examined the association between PUD and the risk of dementia using a population-based national sample cohort from South Korea.Using the national cohort study from the Korean National Health Insurance Service, we extracted data for patients with dementia (n = 11,434) and for 1:4 matched control participants (n = 45,736) and then analyzed the previous histories of PUD from 2002 to 2013 using conditional logistic regression analyses. The controls were matched to the patients according to age, sex, income, region of residence, and past medical history. Subgroup analyses were performed based on age and sex.There was no statistically significant difference in the incidence of PUD between the dementia and control groups (18.0% vs 17.4%, P = .107). The adjusted odds ratio (OR) for PUD was 0.92 (95% confidence interval [CI] = 0.88-0.97, P = .002). In the subgroup analysis based on age, the adjusted ORs for PUD were 0.93 (95% CI = 0.88-0.99) in the <80-year-old group and 0.90 (95% CI = 0.82-1.00) in the ≥80-year-old group (each P < .05). In the subgroup analysis based on sex, the adjusted ORs for PUD were 0.89 (95% CI = 0.81-0.97; P < .05) in men and 0.94 (95% CI = 0.89-1.00; P = .06) in women.PUD does not increase the risk of dementia at any age or in either sex after adjusting for age and the history of hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, and depression.

Effect of work-related factors on the prevalence of peptic ulcer disease among Korean workers: a nationwide population-based study

BACKGROUND

Working environment such as psychosocial factors impacts the health of workers. However, few studies have assessed the association of work-related factors with the prevalence of peptic ulcer disease (PUD) in large population based study.

METHODS

After exclusion of military personnel, 16,099 wage workers (20 ≤ age ≤ 65 years) from the Fourth Korea National Health and Nutrition Examination Survey (2008-2011) were included in this study. Job status was defined as the place of employment of longest duration. To evaluate the working environment, we used a comprehensive work-stressor measure. Univariate and multivariable regression analyses were performed to assess the effect of occupation type on the prevalence of PUD.

RESULTS

Among the subjects, 5540, 3398, and 7161 were white-, pink-, and blue-collar workers, respectively. The prevalence of PUD was highest among blue-collar workers (n = 336, 7.1%), followed by pink-collar (n = 116, 5.1%) and white-collar (n = 180, 4.9%) workers. In the multivariable analysis, work type and uncomfortable gestures were independently associated with the risk of PUD. Compared with office workers, operators in industrial plants and machine operators had a significantly higher prevalence of PUD (odds ratio, 1.9; 95% confidence interval, 1.1-3.3) after adjusting for age, socioeconomic factors, sex, smoking, alcohol consumption, daily exercise, sleep duration, and working conditions.

DISCUSSION

In conclusion, work-related factors, particularly blue-collar work and uncomfortable job gestures, are independently associated with the risk of PUD. Therefore, it is important to monitor the development of PUD in workers exposed to these factors.

Reciprocal association between depression and peptic ulcers: Two longitudinal follow-up studies using a national sample cohort

This study was aimed to explore the bidirectional association between depression and peptic ulcers. The ≥20-year-old participants of the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013 were included in the study. In study I, 30,306 depression patients were 1:4 matched with 121,224 control I participants. In study II, 127,590 peptic ulcer patients were 1:1 matched with 127,590 control II participants. The stratified Cox-proportional hazards models were used to analyse the hazard ratio (HR) of depression for peptic ulcers (study I) and of peptic ulcers for depression (study II). A total of 8.9% (2,703/ 30,306) of depression patients and 7.3% (8,896/ 121,224) of patients in the control I group had peptic ulcers (P < 0.001). The depression group had an adjusted HR for peptic ulcers that was 1.14-fold higher than that of the control I group (95% confidence interval [95% CI] = 1.09–1.19, P < 0.001). A total of 6.4% (8,144/ 127,590) of peptic ulcer patients and 3.5% (4,515/127,590) of patients in the control II group had depression (P < 0.001). The peptic ulcer group had an adjusted HR for depression that was 1.68-fold higher than that of the control II group (95% CI = 1.62–1.74, P < 0.001). Depression and peptic ulcers exhibited a bidirectional relationship.

Ethanol-induced gastric ulcer in rats and intervention of tert-butylhydroquinone: Involvement of Nrf2/HO-1 signalling pathway

Gastric ulcer (GU) is the most common health concern that occurs due to alcohol consumption, smoking and physiological stress. Ethanol-induced GU in animal model resembles the pathophysiology of human ulcer. The present study was designed to investigate the cytoprotective and anti-inflammatory properties of tert-butylhydroquinone (tBHQ), a nuclear factor erythroid 2-related factor 2 (Nrf2) activator, against gastric mucosal damage induced by acute exposure of ethanol (5 ml/kg). The intervention of tBHQ (25 and 50 mg/kg, per os (po)) and omeprazole (20 mg/kg, po) was done for 10 consecutive days. Omeprazole was chosen as a standard drug because it is prescribed for the treatment of GU. Pretreatment of tBHQ decreased gastric mucosal lesion, ulcer index, apoptotic cells and lipid peroxidation level induced by ethanol. Furthermore, the intervention of tBHQ increased gastric mucosa integrity, pH, reduced glutathione, collagen and mucus-producing goblet cells. Intervention of tBHQ increased the expression of antioxidant markers such as Nrf2, haeme oxygenase-1 and catalase and decreased the expressions of inflammatory markers such as nuclear factor kappa-light-chain-enhancer of activated B cells and cyclooxygenase-2. The cytoprotective potential of tBHQ against gastric mucosal damage might be due to its ability to enhance cellular antioxidants and anti-inflammatory responses.

The Interaction Effects of Burnout and Job Support on Peptic Ulcer Disease (PUD) among Firefighters and Policemen

Policemen and firefighters encounter numerous emergency events that frequently lead to high burnout and low job support, resulting in adverse health effects. A number of studies reported the correlation between job characteristics and the risk of peptic ulcer diseases (PUD) across various industries. However, there is very little research on evaluating the interaction effects of burnout and job support on the prevalence of PUD among firefighters and policemen. The objective of this study was to assess the interactional effects between burnout and job support on the prevalence of PUD among firefighters and policemen. This was a cross-sectional quantitative study. Registered, full-time police officers and firefighters in Taiwan were anonymously interviewed by a mail-delivered questionnaire. All female workers were excluded due to different job characteristics and a limited sample size. A total of 9328 firefighters and 42,798 policemen completed the questionnaire, with a response rate of 78.7%. Overall, prevalence rates of self-reported and self-reports of physician-diagnosed PUD were 8.3% and 6.5% for policemen and 7.1% and 5.5% for firefighters, respectively. There was a 22% reduced odds ratio of PUD as diagnosed by physicians for the group with low burnout and high job support, but an increased odds ratio of 53% for the group with high burnout and low job support, after adjusting for lifestyle and demographic variables. There must be an increase of job support and reduction of burnout through the modification of work structure and setting up of counseling services to reduce workplace stress and the prevalence of PUD among policemen and firefighters.

Cumulative exposure to nighttime environmental noise and the incidence of peptic ulcer

BACKGROUND

Exposure to noise poses auditory and non-auditory effects on health. The gastrointestinal tract is considered as the site of adverse reactions to noise-induced stress; little attention has been paid to a potential link between noise and peptic ulcers.

OBJECTIVES

The aim of this study was to investigate whether cumulative exposure to environmental noise affects the incidence of peptic ulcer in adults.

METHODS

We analyzed the data from the National Health Insurance Service-National Sample Cohort (2002-2013). The final study sample comprised 217,308 adults assessed for gastric ulcer and 249,514 adults assessed for duodenal ulcer. The diagnosis of gastric (ICD-10: K25) and duodenal (ICD-10: K26) ulcers during an 8-year follow-up (2006-2013). Environmental noise data was obtained from the National Noise Information System, a nationwide monitors system of noise.

RESULTS

During the follow-up period, gastric ulcers occurred in 32.1% subjects and duodenal ulcers occurred in 10.7% subjects. The rate of diagnosis for gastric and duodenal ulcers was increased with the increases in cumulative mean levels of nighttime environmental noise. With increases in the increase in interquartile range (IQR) of nighttime noise, the hazard ratio (HR) was significantly increased by 12% (HR = 1.12; 95% CI, 1.10-1.13) for gastric ulcer and 17% (HR = 1.17; 95% CI, 1.15-1.20) for duodenal ulcer based on the fully adjusted model.

CONCLUSION

Our finding supports previous reports on the damaging effect of environmental noise on the gastrointestinal tract and suggests that cumulative exposure to environmental nighttime noise affects the development of peptic ulcers.

The prevalence of Burnout Syndrome among Turkish Urologists: Results of a Nationwide Survey

OBJECTIVE

To investigate the prevalence of Burnout syndrome (BS) with its emotional exhausting (EE), depersonalization (DP), and personal accomplishment (PA) dimensions among Turkish urologists.

MATERIAL AND METHODS

A total of 2,259 certified Turkish urologists were invited by e-mail to participate in this cross-sectional survey-based study. An online survey was conducted to evaluate three dimensions of BS ie: -EE, DP and PA-and their association with socio-demographic variables of Turkish urologists using the Maslach Burnout Inventory (MBI).

RESULTS

Of the 2259 urologists contacted, 362 (with a mean age of 44±9.9 years) completed the survey. The mean EE, DP and PA scores were 16.8±8.7, 6.6±4.6 and 8.2±5.6, respectively. Cronbach's α reliability co-efficiencies were 0.920 for EE, 0.819 for DP and 0.803 for PA. Antidepressant drug usage was quite prevalent among participants (21.9%), and the most common comorbidity was hypertension (13%). The academic title, age, smoking status, monthly income and relationships between colleagues and employers were associated with BS (p<0.05).

CONCLUSION

The prevalence of BS among Turkish urologists is quite prevalent in terms of EE and DP subscales and may negatively affect the psychosocial status and well-being of the urologists. In this study, a high prevalence of BS has been reported among Turkish urologists. In conclusion the BS could become an important occupational and health problem, if it is not properly managed.

Diagnosis of Helicobacter pylori Infection in Children and Adolescents in Korea

Helicobacter pylori plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma. In Korea, the guidelines for the diagnosis and treatment of H. pylori infection in adults were revised in 2013. The European Helicobacter and Microbiota Study Group and Consensus panel released the fifth edition of the Maastricht Consensus Report for the management of H. pylori infection in 2015, and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the North American Society of Paediatric Gastroenterology, Hepatology and Nutrition released the updated joint guidelines for children and adolescents in 2016. Considering these recommendations and recent progress in our research and that of other research teams, this study aimed to discuss the diagnostic strategies for H. pylori infection in children and adolescents.

Prevalence of and risk factors for equine glandular and squamous gastric disease in polo horses

The objectives of this study were to determine the prevalence rates and risk factors for equine glandular gastric disease (EGGD) and equine squamous gastric disease (ESGD) in a population of 63 polo horses in competition. The prevalence of EGGD grade ≥ 1 was 69% and EGGD ≥ 2 was 31%. The prevalence of ESGD grade ≥ 1 was 54% and grade ≥ 2 was 37%. The risk factors retained in the final multivariable models were years of experience in polo competition for EGGD grade ≥ 1 and for grade ≥ 2, with decreased experience being associated with EGGD and weekly exercise duration and non-steroidal anti-inflammatory drug (NSAID) use being associated with ESGD grade ≥ 1. Decreasing weekly exercise duration was the only risk factor associated with ESGD grade ≥ 2. Equine gastric disease was common in this population of polo horses and the amount of experience and weekly exercise duration were related to the risk of disease.

Amaranth oil reduces accumulation of 4-hydroxynonenal-histidine adducts in gastric mucosa and improves heart rate variability in duodenal peptic ulcer patients undergoing Helicobacter pylori eradication

Helicobacter pylori-induced oxidative stress in gastric mucosa (GM) is a milieu for the development of chronic gastritis, duodenal peptic ulcer (DPU), gastric cancer, and a number of extragastric diseases. Because our previous study revealed the accumulation of the protein adducts of lipid peroxidation product 4-hydroxynonenal (HNE) in GM, which persists after eradication of H. pylori, the aim of the study was to test whether Amaranth oil supplementation in addition to standard anti-Helicobacter treatment could prevent such accumulation of HNE in GM in H. pylori-positive DPU patients. Seventy-five patients were randomly split into two groups: group 1 - standard treatment (n = 39) and group 2 - standard treatment with additional supplementation of 1 ml of concentrated oil from amaranth seeds (Amaranthus cruenthus L., n = 36). Clinical analysis, including endoscopy with biopsies from antrum and corpus of the stomach were performed before and after the treatment, as was heart rate variability (HRV) recorded, as parameter of systemic, extragastric pathophysiological alterations in DPU patients. Improvement of clinical, endoscopic and histologic manifestations, and successful ulcer healing were observed in both the groups. Moreover, supplementation of amaranth oil in addition to standard anti-H. pylori treatment significantly reduced accumulation of HNE-histidine adducts in GM and increased HRV in DPU patients (p < .05). Therefore, standard treatments of DPU require additional therapeutic approaches, in accordance with integrative medicine principles, aiming to reduce persistence of oxidative stress, as was successfully done in our study by the use of amaranth oil.

Association of peptic ulcer disease with obesity, nutritional components, and blood parameters in the Korean population

Objectives

Peptic ulcer disease (PUD) is a common disorder, but whether an association exists between PUD and anthropometric indicators remains controversial. Furthermore, no studies on the association of PUD with anthropometric indices, blood parameters, and nutritional components have been reported. The aim of this study was to assess associations of anthropometrics, blood parameters, nutritional components, and lifestyle factors with PUD in the Korean population.

Methods

Data were collected from a nationally representative sample of the South Korean population using the Korea National Health and Nutrition Examination Survey. Logistic regression was used to examine associations of anthropometrics, blood parameters and nutritional components among patients with PUD.

Results

Age was the factor most strongly associated with PUD in women (p = <0.0001, odds ratio (OR) = 0.770 [0.683–0.869]) and men (p = <0.0001, OR = 0.715 [0.616–0.831]). In both crude and adjusted analyses, PUD was highly associated with weight (adjusted p = 0.0008, adjusted OR = 1.251 [95%CI: 1.098–1.426]), hip circumference (adjusted p = 0.005, adjusted OR = 1.198 [1.056–1.360]), and body mass index (adjusted p = 0.0001, adjusted OR = 1.303 [1.139–1.490]) in women and hip circumference (adjusted p = 0.0199, adjusted OR = 1.217 [1.031–1.435]) in men. PUD was significantly associated with intake of fiber (adjusted p = 0.0386, adjusted OR = 1.157 [1.008–1.328], vitamin B2 (adjusted p = 0.0477, adjusted OR = 1.155 [1.001–1.333]), sodium (adjusted p = 0.0154, adjusted OR = 1.191 [1.034–1.372]), calcium (adjusted p = 0.0079, adjusted OR = 1.243 [1.059–1.459]), and ash (adjusted p = 0.0468, adjusted OR = 1.152 [1.002–1.325] in women but not in men. None of the assessed blood parameters were associated with PUD in women, and only triglyceride level was associated with PUD in men (adjusted p = 0.0169, adjusted OR = 1.227 [1.037–1.451]).

Discussion

We found that obesity was associated with PUD in the Korean population; additionally, the association between nutritional components and PUD was greater in women than in men.