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Ardalan ZS, Livingstone KM, Polzella L, Avakian J, Rohani F, Sparrow MP, Gibson PR, Yao CK. Perceived dietary intolerances, habitual intake and diet quality of patients with an ileoanal pouch: Associations with pouch phenotype (and behaviour). Clin Nutr 2023; 42:2095-2108. [PMID: 37748240 DOI: 10.1016/j.clnu.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/24/2023] [Accepted: 07/23/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND AND AIMS Ileoanal pouch patients frequently attribute pouch-related symptoms and pouchitis with diet. We aimed to assess perceived food intolerance and habitual dietary intake and their relationship with pouch indication, symptoms and current or history of pouchitis. METHODS In this cross-sectional study, patients with an ileoanal pouch completed a dietary intolerance and a food frequency questionnaire, that specifically quantifies habitual intake of FODMAPs. Perceived dietary intolerance rates, nutrient intake and diet quality, and their differences based on pouch indication, symptom, and current or history of pouchitis were assessed. Associations between intolerances and intake, and between dietary intake with pouchitis risk were analysed using univariable and multivariable regression analysis. RESULTS Of the 58 (10 FAP and 48 UC) patients with complete data, 81% of UC and 80% of FAP patients reported dietary intolerances. Overall diet quality was good. Differences in dietary intake were limited to a few food groups. Patients with a history of pouchitis had a lower intake of fruits (p = 0.03) and nuts (p = 0.004). Patients with current pouchitis had a lower intake of nuts (p = 0.02). On multivariable logistic regression, intake of dietary fibre was associated negatively [OR 0.68(95%CI:0.51-0.92)] and of non-digestible oligosaccharides positively with pouchitis history [OR 5.5(95% CI:1.04-29.1)]. CONCLUSIONS In patients with an ileoanal pouch, perceived dietary intolerances are common but had minimal impact on nutritional adequacy and diet quality. Negative associations of the intakes of fruits, nuts and dietary fibre and positive association with non-digestible oligosaccharides with a history of pouchitis require further study to inform dietary recommendations.
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Affiliation(s)
- Zaid S Ardalan
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia.
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Louise Polzella
- Department of Nutrition and Dietetics, Monash University, Victoria, Australia
| | - Julia Avakian
- Department of Nutrition and Dietetics, Monash University, Victoria, Australia
| | - Faran Rohani
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia
| | - Miles P Sparrow
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia
| | - Peter R Gibson
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia
| | - Chu K Yao
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia
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Feng X, Shi Y, Zhou Z, Ji Z, Zhou W, Chen S, Mao J. Alleviation of loperamide-induced constipation with sticky rice fermented huangjiu by the regulation of serum neurotransmitters and gut microbiota. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:692-704. [PMID: 36121332 DOI: 10.1002/jsfa.12181] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 08/09/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Huangjiu is an important component of traditional fermented food. It is produced by cereal fermentation. Sticky rice fermented huangjiu is an abundant source of polysaccharides, oligosaccharides, proteins, amino acids, and flavor compounds (POPAF), and it has been used as a dietary supplement and pharmaceutical ingredient. The purpose of this study is to explore the alleviation of constipation using sticky rice fermented huangjiu, with the aim of providing a basis for the nutritional treatment of constipation. RESULTS Sticky rice fermented huangjiu was more effective in the alleviation of constipation than same concentration of ethanol treatment on serum neurotransmitters, gut microbiota, and intestinal metabolites in this 17 days constipation mouse model. Compared with ethanol treatment, the administration of sticky rice fermented huangjiu to constipated mice increased gastrointestinal motility. It alleviated the decrease in motilin (27.94%), substance P (13.85%), gastrin (63.46%), 5-hydroxytryptamine (4.55%), and short-chain fatty acid (19.80%) levels, and alleviated the increase in somatostatin levels (9.54%). Furthermore, the administration of sticky rice fermented huangjiu regulated the microbiota-mediated gut ecology through alterations in the characteristic taxa. CONCLUSION The results reveal that sticky rice fermented huangjiu may alleviate loperamide-induced constipation by the regulation of serum neurotransmitters and gut microbiota. These findings reveal that huangjiu is endowed with many functional components by cereal fermentation, and the bioactive substances in huangjiu can be separated and applied for medical treatment or diet therapy in the future. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Xinjing Feng
- National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Ying Shi
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Zhilei Zhou
- National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- Shaoxing Key Laboratory of Traditional Fermentation Food and Human Heath, Jiangnan University (Shaoxing) Industrial Technology Research Institute, Shaoxing, China
| | - Zhongwei Ji
- National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- Shaoxing Key Laboratory of Traditional Fermentation Food and Human Heath, Jiangnan University (Shaoxing) Industrial Technology Research Institute, Shaoxing, China
| | - Weibiao Zhou
- Shaoxing Key Laboratory of Traditional Fermentation Food and Human Heath, Jiangnan University (Shaoxing) Industrial Technology Research Institute, Shaoxing, China
- Department of Food science and technology, National University of Singapore, Singapore, Singapore
| | - Shuguang Chen
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Jian Mao
- National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- Shaoxing Key Laboratory of Traditional Fermentation Food and Human Heath, Jiangnan University (Shaoxing) Industrial Technology Research Institute, Shaoxing, China
- National Engineering Research Center of Chinese Rice Wine, Zhejiang Guyuelongshan Shaoxing Wine CO., Ltd, Shaoxing, China
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Comparison of Gastric Emptying Time after the Ingestion of Whisky with Isocalorically Adjusted Glucose Solution. J Nutr Metab 2022; 2022:6137230. [PMID: 35734752 PMCID: PMC9209003 DOI: 10.1155/2022/6137230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/03/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Previous studies have shown that the liquid gastric emptying mainly depended on energy content, regardless of compositional differences. But the gastric emptying of alcoholic beverages remains unclear. Therefore, we performed the present study to compare gastric emptying times between whisky mixed with water and glucose solution with uniform energy contents and volumes. As a crossover study, 10 healthy male volunteers ingested one of 3 test solutions with a uniform volume of 150 ml, i.e., whisky with water-containing whisky 30 ml (67 kcal), sugar water containing glucose 16.8 g (67 kcal), and water (0 kcal), and the gastric emptying time of each beverage was then assessed by ultrasound measurements of the gastric antral cross-sectional area. The gastric emptying pattern of whisky with water was faster than that of isocaloric sugar water, but slower than that of water. Each antral cross-sectional area 20, 30, and 40 min after the ingestion of sugar water was significantly larger than that of whisky with water. Antral cross-sectional areas 10 and 20 min after the ingestion of water were significantly smaller than those of whisky with water. In conclusion, the gastric emptying time of whisky would be faster than that of isocaloric glucose solution and slower than that of water. Unlike the other beverages, the gastric emptying time of alcohol drinks does not purely depend on the energy content because alcohol itself has no calorie before absorption. This study is registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000034443).
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Chen Y, Chen C, Ouyang Z, Duan C, Liu J, Hou X, Bai T. Prevalence and beverage-related risk factors of gastroesophageal reflux disease: An original study in Chinese college freshmen, a systemic review and meta-analysis. Neurogastroenterol Motil 2022; 34:e14266. [PMID: 34585480 DOI: 10.1111/nmo.14266] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/06/2021] [Accepted: 08/30/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Beverage-drinking behavior could be a potential risk factor for gastroesophageal reflux disease (GERD) in young populations. However, GERD prevalence in this population has not been investigated, and beverage consumption's association with GERD remains inconclusive. This study aimed to evaluate the prevalence and beverage-related risk factors of GERD among Chinese college freshmen and in youth around the world. METHODS A cross-sectional survey was conducted in Chinese college freshmen in September 2019 using random cluster sampling method. Participants completed questionnaires on demographic information, food intake frequency, and GER symptoms. Multivariate logistic regression models were applied to assess the association between beverages and GERD. Studies were retrieved from multiple databases for systemic review. The prevalence of GERD in young populations and beverage-related risk factors were pooled using random-effect models. KEY RESULTS Based on the 3345 individuals who completed the questionnaires, GERD prevalence in Chinese college freshmen is 5.1%. Multivariate analysis showed students who drink green tea daily, and those who drink coffee regularly were more likely to develop GERD compared with those who never drink tea or coffee. The pooled prevalence of GERD in young populations is 18.0%, and frequent alcohol consumption is positively associated with GERD in general population. CONCLUSIONS AND INFERENCES The prevalence of GERD in Chinese college freshmen is significantly lower than that in worldwide youth populations. Alcohol, green tea, and coffee consumption could be potential risk factors for GERD. Future large-scale epidemiological studies are warranted for reliable identification of beverage-related risk factors for GERD in young populations.
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Affiliation(s)
- Youli Chen
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Can Chen
- Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Ouyang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaofan Duan
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinsong Liu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Meza V, Arnold J, Díaz LA, Ayala Valverde M, Idalsoaga F, Ayares G, Devuni D, Arab JP. Alcohol Consumption: Medical Implications, the Liver and Beyond. Alcohol Alcohol 2022; 57:283-291. [PMID: 35333295 DOI: 10.1093/alcalc/agac013] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/25/2022] [Accepted: 02/16/2022] [Indexed: 12/12/2022] Open
Abstract
Alcohol consumption represents a major factor of morbidity and mortality, with a wide range of adverse medical implications that practically affect every organ system. It is the fifth major cause of deaths in men and women and causes up to 139 million disability-adjusted life years. Solid evidence places the risk as undoubtedly correlated to the length of time and amount of alcohol consumption. While alcohol-related liver disease represents one of the most studied and well-known consequences of alcohol use, the term itself embodies a wide spectrum of progressive disease stages that are responsible for almost half of the liver-related mortality worldwide. We discuss the staged alcohol-related fatty liver, alcohol-related steatohepatitis and, finally, fibrosis and cirrhosis, which ultimately may end up in a hepatocellular carcinoma. Other comorbidities such as acute and chronic pancreatitis; central nervous system; cardiovascular, respiratory and endocrine system; renal disease; urological pathologies; type 2 diabetes mellitus and even infectious diseases are reviewed in their relation to alcohol consumption. This article reviews the impact of alcohol use on different systems and organs, summarizing available evidence regarding its medical implications. It examines current basic and clinical data regarding mechanisms to highlight factors and processes that may be targetable to improve patient outcomes. Although alcohol use is a part of many cultural and social practices, as healthcare providers we must identify populations at high risk of alcohol abuse, educate patients about the potential alcohol-related harm and provide appropriate treatment.
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Affiliation(s)
- Víctor Meza
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | | | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Deepika Devuni
- Division of Gastroenterology, Department of Medicine, UMass Chan Medical School l, Worcester, MA 01655, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
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Ye Y, Yin Y, Huh SY, Almansa C, Bennett D, Camilleri M. Epidemiology, Etiology, and Treatment of Gastroparesis: Real-World Evidence From a Large US National Claims Database. Gastroenterology 2022; 162:109-121.e5. [PMID: 34624355 DOI: 10.1053/j.gastro.2021.09.064] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Although gastroparesis carries a considerable health care and patient burden, associated epidemiological data are limited. To provide new real-world evidence for gastroparesis, we estimated disease prevalence, and investigated patient demographics and disease etiology in a large US claims database. METHODS This retrospective, cross-sectional analysis used de-identified, longitudinal patient-level enrollment and billing data for adults from the Optum Clinformatics Data Mart database, a large US national administrative health insurance claims database. Prevalence was age-, sex-, and geographical region-standardized using the 2018 US census. Descriptive analyses of demographic and clinical variables and underlying disease etiologies were performed. RESULTS The overall standardized prevalence of gastroparesis was 267.7 (95% confidence interval [CI] 264.8-270.7) per 100,000 US adults, whereas prevalence of "definite" gastroparesis (individuals diagnosed within 3 months of gastric emptying scintigraphy testing with persistent symptoms for more than 3 months) was 21.5 (95% CI 20.6-22.4) per 100,000 persons. Patients with gastroparesis had an overall Charlson Comorbidity Index score of 4.2, indicating substantial comorbidity burden. The most frequently documented comorbidities were chronic pulmonary disease (46.4%), diabetes with chronic complication (37.3%), and peripheral vascular disease (30.4%). Patients most commonly had a diabetic etiology (57.4%; type 1, 5.7% and type 2, 51.7%), followed by postsurgical (15.0%), drug-induced (11.8%), and idiopathic (11.3%) etiologies. CONCLUSIONS New evidence is provided regarding the prevalence, patient demographics, and etiology of gastroparesis in the US general population. Wider availability of reliable objective gastric emptying measures and further education of medical professionals in recognizing and diagnosing gastroparesis would benefit future studies and improve understanding of disease epidemiology.
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Affiliation(s)
- Yizhou Ye
- Global Evidence and Outcomes, Takeda Development Center Americas, Inc., Cambridge, Massachusetts
| | - Yu Yin
- Safety and Health Value Statistics, Takeda Development Center Americas, Inc., Cambridge, Massachusetts
| | - Susanna Y Huh
- Clinical Science, Takeda Development Center Americas, Inc., Cambridge, Massachusetts
| | - Cristina Almansa
- Clinical Science, Takeda Development Center Americas, Inc., Cambridge, Massachusetts
| | - Dimitri Bennett
- Global Evidence and Outcomes, Takeda Development Center Americas, Inc., Cambridge, Massachusetts; Perelman School of Medicine, Adjunct, University of Pennsylvania, Philadelphia, Pennsylvania.
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Intraoperative Endoscopy in Transient Adult Jejunojejunal Intussusception. Case Rep Gastrointest Med 2021; 2021:3718089. [PMID: 34336311 PMCID: PMC8289613 DOI: 10.1155/2021/3718089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
Despite improvements in imaging modalities, causative lead points in adult intussusception may be difficult to diagnose. Such lead points can be malignant, causing recurrence or metastases if left unresected. We describe a case of transient adult jejunojejunal intussusception, in which intraoperative endoscopy was used to confirm the absence of a lead point. A 39-year-old woman with a history of laparoscopic oophorectomy presented with epigastric pain, nausea, and vomiting. Contrast computed tomography revealed jejunojejunal intussusception, with no visible lead point. Spontaneous reduction was confirmed during exploratory laparoscopy. After lysis of adhesions, intraoperative peroral jejunoscopy was performed with the surgeons' assistance. Endoscopy confirmed the absence of tumor, and bowel resection was avoided. No recurrence has been observed during 24 months of follow-up. Intraoperative endoscopy may provide additional reassurance for the absence of a lead point in cases where preoperative enteroscopy cannot be performed and no lead points can be identified on imaging.
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Gonzalez Z, Herlihy D, Phan C, Diaz J, Dominguez K, McCallum R. Alcohol and gastric motility: pathophysiological and therapeutic implications. J Investig Med 2020; 68:965-971. [PMID: 32447287 DOI: 10.1136/jim-2020-001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 01/16/2023]
Abstract
Alcohol has been associated with alterations in gastric motility. The literature identifies that various factors play a role in alcohol's effect on gastric emptying including differences in alcohol concentration, osmolarity, caloric content, amino acids as well as different processing techniques (fermentation vs distillation). Additionally, chronic alcohol consumption has been shown to alter the myenteric nitrergic system resulting in impaired gastrointestinal motor function, and it also has an inhibitory effect on the release of several neurotransmitters that play a key role in gastrointestinal motility, including acetylcholine. Whether social or limited intake of alcohol could have a therapeutic role has not been apparent. Serendipitously, we have identified a therapeutic role for alcohol with a meal in the entity of dumping syndrome (DS) where there is postprandial rapid emptying of voluminous and hyperosmolar gastric contents into the small bowel. In the clinical setting of DS attributed to impaired vagal nerve function, there was normalization of gastric emptying and resolution of accompanying symptoms when drinking a glass of wine before and during meals. We propose that alcohol's anticholinergic effect was augmented in the setting of vagal nerve denervation resulting in slowing of gastric emptying and in alleviation of symptoms of early DS. This review article provides an in-depth analysis of the published literature on alcohol and gastric motility focusing on the accumulated knowledge that may have clinical application and relevance.
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Affiliation(s)
- Zorisadday Gonzalez
- Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Daniel Herlihy
- Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Cong Phan
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | - Jesus Diaz
- Nuclear Medicine, University Medical Center of El Paso, El Paso, Texas, USA
| | - Kenneth Dominguez
- Nuclear Medicine, University Medical Center of El Paso, El Paso, Texas, USA
| | - Richard McCallum
- Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
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Moss MJ, Fisher JA, Kenny TA, Palmer AC, Thompson JA, Wolfer H, Hendrickson RG. Salicylate toxicity after undetectable serum salicylate concentration: a retrospective cohort study. Clin Toxicol (Phila) 2018; 57:137-140. [PMID: 30306804 DOI: 10.1080/15563650.2018.1502442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Salicylates are usually rapidly absorbed and quickly measurable in serum. An undetectable serum salicylate concentration ([ASA]) may occur early after ingestion and may be interpreted as evidence of non-exposure and not repeated. Although cases of delayed salicylate detection are reported rarely, the risk factors associated with this phenomenon are not known. RESEARCH QUESTION What factors are associated with an early undetectable [ASA] in salicylate poisoning? METHODS Records from a single regional poison center were searched from 2002 to 2016 for cases of salicylate toxicity treated with bicarbonate and [ASA] > 30 mg/dL. Cases were excluded if initial [ASA] was obtained >4 h after presentation. Case information, serial [ASA], and outcomes were recorded and compared between groups. RESULTS A total of 313 records met all criteria with 11 initially undetectable [ASA] (3.5%) and 302 detectable [ASA] (96.5%). Time of first [ASA] occurred sooner in the undetectable [ASA] group (89 vs. 137 min, p = 0.011) while time to peak [ASA] was longer (640 vs. 321 min, p < .001). The longest interval between ingestion and undetectable [ASA] was 225 min. Peak [ASA] and reported mean ingested dose were similar in both groups (45 vs. 50 mg/dL, p = NS; 19.7 g vs. 32.9 g, p = NS). Coingestion of agents that delay gastric emptying were similar in both groups (18% [2/11] vs. 25% [76/302], p = NS, chi-square). Hemodialysis was performed in 9% (1/11) of undetectable [ASA] patients and 5.6% (17/302) of detectable [ASA] patients (p = NS, chi-square). A single death occurred in the entire cohort in a patient with an initially detectable [ASA]. DISCUSSION In this series, a small but significant proportion (3.5%) of patients who developed [ASA] > 30 mg/dL had an initially undetectable [ASA]. Those with an undetectable [ASA] were measured earlier after ingestion with a longer time to peak [ASA]. However, neither coingestion of agents prolonging gastric emptying nor reported dose ingested was different between groups. Formulation was infrequently recorded but one undetectable [ASA] did ingest a non-enteric coated product. Limitations include the small number of patients with undetectable [ASA], use of single poison center data and partial data on co-ingestants and aspirin formulation. CONCLUSIONS [ASA] may be undetectable early after an overdose and need for serial [ASA] in the evaluation of salicylate ingestion should be further explored. Additional research is needed to determine any causative factors and the optimal timing of [ASA] measurements.
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Affiliation(s)
- Michael J Moss
- a Oregon Poison Center , Portland , OR , USA.,b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
| | - J Ashton Fisher
- b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
| | - Tara A Kenny
- b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
| | - Allison C Palmer
- b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
| | - John A Thompson
- b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
| | - Hannah Wolfer
- b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
| | - Robert G Hendrickson
- a Oregon Poison Center , Portland , OR , USA.,b Department of Emergency Medicine , Oregon Health & Science University , Portland , OR , USA
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Wang F, Li G, Ning J, Chen L, Xu H, Kong X, Bu J, Zhao W, Li Z, Wang X, Li X, Ma J. Alcohol accumulation promotes esophagitis via pyroptosis activation. Int J Biol Sci 2018; 14:1245-1255. [PMID: 30123073 PMCID: PMC6097477 DOI: 10.7150/ijbs.24347] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 06/12/2018] [Indexed: 02/07/2023] Open
Abstract
Gastroesophageal reflux impairs the mucosal barrier in the distal esophagus, allowing chronic exposure of the squamous epithelium to multitudinous stimulations and inducing chronic inflammation. Esophagitis is a response to inflammation of the esophageal squamous mucosa. Our study clarified that alcohol accumulation could aggravate the progress of esophagitis by inducing pyroptosis; however, Ac-YVAD-CMK, an inhibitor of caspase-1, could effectively suppress the expression of IL-1β and IL-18 both in vivo and in vitro, reducing the inflammatory response, which is promised to be an agent to inhibit the progression of esophagitis. Additionally, caspase-1-derived pyroptosis is involved in esophageal cancer.
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Affiliation(s)
- Fengjiao Wang
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
| | - Gang Li
- Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China
| | - Jinfeng Ning
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
| | - Lantao Chen
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
| | - Hai Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
| | - Xianglong Kong
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
| | - Jianlong Bu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
| | - Weiwei Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin, 150086, China
| | - Zhengtian Li
- Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Xiuyun Wang
- Department of Abdominal Ultrasound, First Hospital of Harbin Medical University, Harbin, 150001, China
| | - Xiaoguang Li
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Jianqun Ma
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150001, China
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Associations between obstructive sleep apnea severity and endoscopically proven gastroesophageal reflux disease. Sleep Breath 2017; 22:85-90. [DOI: 10.1007/s11325-017-1533-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 06/21/2017] [Accepted: 06/27/2017] [Indexed: 12/11/2022]
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