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Li Q, Duan H, Wang Q, Dong P, Zhou X, Sun K, Tang F, Wang X, Lin L, Long Y, Sun X, Tao L. Analyzing the correlation between gastroesophageal reflux disease and anxiety and depression based on ordered logistic regression. Sci Rep 2024; 14:6594. [PMID: 38503861 PMCID: PMC10951219 DOI: 10.1038/s41598-024-57101-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
Numerous studies have indicated a connection between psychiatric symptoms, specifically anxiety and depression, and gastroesophageal reflux. However, the precise nature of the link between the severity of gastroesophageal reflux disease and the severity of anxiety and depression remains uncertain. Here, we gathered 24-h pH monitoring data and baseline patient information from a cohort of 518 individuals. Additionally, we evaluated their psychological well-being using the Hospital Anxiety and Depression Scale. The relationship between baseline characteristics and varying degrees of anxiety, depression, and gastroesophageal reflux disease (GERD) was assessed using R software version 4.1.3 and logistic regression models. The findings indicate a statistically significant variation in anxiety levels based on gender, as well as a significant disparity in depression groups when considering age and literacy levels. Kruskal-Wallis test analysis revealed a significant positive correlation between the severity of anxiety and depression and the 24-h pH monitoring results in our patient cohort. As the anxiety and depression levels increased, the rank mean for each examination result also increased. Logistic regression modeling analysis showed that a higher anxiety level was associated with a higher level of GERD. In the presence of mild anxiety, there is a statistically significant association with a higher incidence of GERD with an odds ratio (OR) of 2.64 (95% CI 1.50, 4.64). Similarly, the moderately severe anxiety group also exhibits a causal relationship with an increased GERD incidence, with an OR of 6.84 (95% CI 3.92, 12.17). Additionally, moderate to severe depression is associated with a higher incidence of GERD, with an OR of 2.32 (95% CI 1.23, 4.37). The prevalence of GERD was greater among males compared to females (OR 2.29, 95% CI 1.51-3.49). Additionally, an elevated body mass index (BMI) demonstrated a positive correlation with the susceptibility to GERD (OR 1.07, 95% CI 1.01-1.14). Increasing age may promote the occurrence of GERD in patients. These findings may help to provide a better basis for psychological or pharmacological interventions for GERD patients with psychosomatic symptoms in the future, and provide a reference basis for clinical treatment of the disease.
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Affiliation(s)
- Qian Li
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Hui Duan
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Qiong Wang
- The Third People's Hospital of Chengdu, Chengdu, China.
| | - Peiwen Dong
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xinxu Zhou
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Kaidi Sun
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Feng Tang
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xinxin Wang
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Lin Lin
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Yanchan Long
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xiaobin Sun
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Lan Tao
- The Third People's Hospital of Chengdu, Chengdu, China
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Zamani M, Alizadeh-Tabari S, Chan WW, Talley NJ. Association Between Anxiety/Depression and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2023; 118:2133-2143. [PMID: 37463429 DOI: 10.14309/ajg.0000000000002411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION An association between gastroesophageal reflux disease (GERD) and common psychiatric conditions, most notably anxiety and depression, has been reported. However, the magnitude of this association is poorly understood. Therefore, we aimed to systematically assess this issue. METHODS We comprehensively searched multiple bibliographic databases (Embase, PubMed, Scopus, and Web of Science) from inception to May 15, 2023. We retrieved observational studies that reported the prevalence of anxiety and/or depressive symptoms diagnosed by validated questionnaires in ≥100 adults (aged 18 years or older) with GERD. We also included cohort studies that explored the risk of incident GERD in subjects with anxiety/depression vice versa scenario. Finally, we included Mendelian randomization studies that assessed the cause-and-effect relationship between anxiety/depression and GERD. The extracted data were combined using a random-effects model. RESULTS In total, 36 eligible studies were included. The pooled prevalences of anxiety and depressive symptoms were 34.4% (95% confidence interval [CI] 24.7-44.2; I2 = 99.4%) and 24.2% (95% CI 19.9-28.5; I2 = 98.8%) in subjects with GERD based on 30 studies, respectively. Both anxiety and depressive symptoms were more common in subjects with GERD compared with those in healthy controls (odds ratio = 4.46 [95% CI 1.94-10.25] and odds ratio = 2.56 [95% CI 1.11-5.87], respectively). According to 3 cohort studies, subjects with GERD were at an increased risk of developing anxiety/depression and vice versa. Finally, 3 Mendelian randomization studies showed that genetic liability to these mood disorders is linked to an increased risk of developing GERD and vice versa. DISCUSSION Up to 1 in 3 subjects with GERD experience anxiety and depression. There is likely a bidirectional causal relationship between anxiety/depression and GERD.
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Affiliation(s)
- Mohammad Zamani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Alizadeh-Tabari
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Walter W Chan
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicholas J Talley
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Sawada A, Sifrim D, Fujiwara Y. Esophageal Reflux Hypersensitivity: A Comprehensive Review. Gut Liver 2023; 17:831-842. [PMID: 36588526 PMCID: PMC10651372 DOI: 10.5009/gnl220373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/01/2022] [Accepted: 10/18/2022] [Indexed: 01/03/2023] Open
Abstract
Reflux hypersensitivity (RH) is one of the phenotypes of gastroesophageal reflux disease. The latest Rome IV defines RH as a condition with typical reflux symptoms and positive reflux-symptom association despite normal acid exposure. Subsequently, the Lyon consensus proposed detailed cutoff values for the criteria on the basis of experts' consensus. Rome IV brought a clear-cut perspective into the pathophysiology of gastroesophageal reflux disease and the importance of esophageal hypersensitivity. This perspective can be supported by the fact that other functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia often overlap with RH. Although several possible pathophysiological mechanisms of esophageal hypersensitivity have been identified, there is still unmet medical needs in terms of treatment for this condition. This review summarizes the current knowledge regarding RH.
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Affiliation(s)
- Akinari Sawada
- Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Daniel Sifrim
- Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Weeks I, Abber SR, Thomas JJ, Calabrese S, Kuo B, Staller K, Murray HB. The Intersection of Disorders of Gut-Brain Interaction With Avoidant/Restrictive Food Intake Disorder. J Clin Gastroenterol 2023; 57:651-662. [PMID: 37079861 PMCID: PMC10623385 DOI: 10.1097/mcg.0000000000001853] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
High rates of overlap exist between disorders of gut-brain interaction (DGBI) and eating disorders, for which common interventions conceptually conflict. There is particularly increasing recognition of eating disorders not centered on shape/weight concerns, specifically avoidant/restrictive food intake disorder (ARFID) in gastroenterology treatment settings. The significant comorbidity between DGBI and ARFID highlights its importance, with 13% to 40% of DGBI patients meeting full criteria for or having clinically significant symptoms of ARFID. Notably, exclusion diets may put some patients at risk for developing ARFID and continued food avoidance may perpetuate preexisting ARFID symptoms. In this review, we introduce the provider and researcher to ARFID and describe the possible risk and maintenance pathways between ARFID and DGBI. As DGBI treatment recommendations may put some patients at risk for developing ARFID, we offer recommendations for practical treatment management including evidence-based diet treatments, treatment risk counseling, and routine diet monitoring. When implemented thoughtfully, DGBI and ARFID treatments can be complementary rather than conflicting.
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Affiliation(s)
- Imani Weeks
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
| | - Sophie R. Abber
- Department of Psychology, Florida State University, Tallahassee, FL
| | - Jennifer J. Thomas
- Harvard Medical School, Boston, MA
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Samantha Calabrese
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA
| | - Braden Kuo
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Kyle Staller
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Helen Burton Murray
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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Carle-Toulemonde G, Goutte J, Do-Quang-Cantagrel N, Mouchabac S, Joly C, Garcin B. Overall comorbidities in functional neurological disorder: A narrative review. L'ENCEPHALE 2023:S0013-7006(23)00086-6. [PMID: 37414721 DOI: 10.1016/j.encep.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION The importance to assess and include the frequent comorbidities in the personalised care management plan of patients with functional neurological disorders (FND) has arisen through the years. FND patients are not only complaining from motor and/or sensory symptoms. They also report some non-specific symptoms that participate to the burden of FND. In this narrative review, we aim to better describe these comorbidities in terms of prevalence, clinical characteristics and their variability depending on the subtype of FND. METHODS The literature was searched for on Medline and PubMed. The search was narrowed to articles between 2000 and 2022. RESULTS Fatigue is the most common symptom reported in relation to FND (from 47 to 93%), followed by cognitive symptoms (from 80 to 85%). Psychiatric disorders are reported in 40 to 100% FND patients, depending on the FND subtype (functional motor disorder [FMD], functional dissociative seizures [FDS]…) but also on the type of psychiatric disorder (anxiety disorders being the most frequent, followed by mood disorders and neurodevelopmental disorders). Stress factors such as childhood trauma exposure (emotional neglect and physical abuse predominantly) have also been identified in up to 75% of FND patients, along with maladaptive coping strategies. Organic disorders are commonly reported in FND, such as neurological disorders (including epilepsy in FDS [20%] and FMD in Parkinson's Disease [7%]). Somatic symptom disorders including chronic pain syndromes are frequently associated to FND (about 50%). To be noted, recent data also suggest a high comorbidity between FND and hypermobile Ehlers Danlos Syndrome (about 55%). CONCLUSION Put together, this narrative review highlights the high burden of FND patients, not only due to somatosensory alterations but also by considering the frequent comorbidities reported. Thus, such comorbidities must be taken into consideration when defining the FND personalised care management strategy for the patients.
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Affiliation(s)
| | - Julie Goutte
- Internal Medicine Department, Saint-Etienne University Hospital, Saint-Priest-en-Jarez, France
| | | | - Stéphane Mouchabac
- Sorbonne University, Department of Psychiatry, AP-HP, Saint-Antoine University Hospital, Paris, France
| | - Charlotte Joly
- Neurology Department, Assistance Publique-Hôpitaux de Paris, AP-HP Avicenne University Hospital, Bobigny, France
| | - Béatrice Garcin
- Neurology Department, Assistance Publique-Hôpitaux de Paris, AP-HP Avicenne University Hospital, Bobigny, France
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Taft TH, Carlson DA, Marchese SH, Pandolfino JE. Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases. Neurogastroenterol Motil 2023; 35:e14540. [PMID: 36703507 PMCID: PMC10133015 DOI: 10.1111/nmo.14540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Diagnosis and management of chronic esophageal disease requires the use of potentially traumatic medical procedures, performed with or without sedation. Medical trauma and post-traumatic stress (PTS) are emerging as important considerations in patients with digestive illness. To date, no study assesses medical PTS from procedures in patients with esophageal disease. METHODS Adult patients with achalasia, eosinophilic esophagitis, gastroesophageal reflux disease, or functional esophageal disease at a university-based gastroenterology clinic completed: Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Gastroesophageal Disease Questionnaire, Brief Esophageal Dysphagia Questionnaire, Northwestern Esophageal Quality of Life scale (HRQoL), NIH-PROMIS Depression scale, and a study-specific questionnaire about esophageal procedures (endoscopy with sedation; functional lumen imaging probe (FLIP) with sedation; high-resolution manometry (HRM); wireless pH testing; or 24-h pH-impedance testing). KEY RESULTS Half of 149 participants reported at least one traumatic procedure, with HRM most often cited. Only 2.7% met the cutoff for PTS on PCL-5. This increased to 7.1% for patients with a traumatic procedure combined with experiencing intense fear. Rates of moderate-severe PTS ranged from 7.4%-12% for all patients and 14%-29% for those with a traumatic procedure with fear. Medical PTS was associated with poorer HRQoL, and increased esophageal symptoms, depression, and hypervigilance and symptom anxiety. CONCLUSIONS & INFERENCES Preliminary evidence suggests medical PTS affects few patients with esophageal disease. However traumatic procedures, most often associated with HRM, significantly increase PTS symptoms. The potential impacts of medical PTS on esophageal patient assessment and outcomes are considerable and warrants further study.
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Affiliation(s)
- Tiffany H Taft
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dustin A Carlson
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sara H Marchese
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John E Pandolfino
- Division of Gastroenterology & Hepatology Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Sun W, Kang X, Zhao N, Dong X, Li S, Zhang G, Liu G, Yang Y, Zheng C, Yu G, Shuai L, Feng Z. Study on dysphagia from 2012 to 2021: A bibliometric analysis via CiteSpace. Front Neurol 2022; 13:1015546. [PMID: 36588913 PMCID: PMC9797971 DOI: 10.3389/fneur.2022.1015546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives This study aims to review the documents on dysphagia, summarize the research direction, analyze the research hot spots and frontiers, report the research trends, and provide new ideas for future development in the field via CiteSpace. Methods We retrieved articles on dysphagia published between 2012 and 2021 from the Web of Science Core Collection database. We downloaded the entire data and utilized CiteSpace version 5.8.R3 (64-bit) to analyze the number of publications annually, cited journals, countries, institutions, authors, cited authors, cited references, and keywords. We visualized the data with a knowledge map, collaborative network analysis, cluster analysis, and strongest citation burst analysis. Results We obtained 14,007 papers with a continually increasing trend over time. The most productive country and institute in this field were the United States (4,308) and Northwestern University (236), respectively. Dysphagia (5,062) and Laryngoscope (2,812) were the most productive journals, Elizabeth Ward had the highest number of publications (84), and Logeman et al.'s article (centrality: 0.02) was the most referenced. The most common keywords were dysphagia, management, quality of life, deglutition disorder, diagnosis, aspiration, prevalence, children, outcome, and oropharyngeal dysphagia. Conclusion This study analyzed the current literature on dysphagia via CiteSpace and identified its research hot spots and frontiers. The prevalent global trends in dysphagia research and the growing public awareness about healthcare and quality of life suggest that research on dysphagia will gain popularity with further breakthroughs.
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Affiliation(s)
- Weiming Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China,*Correspondence: Weiming Sun
| | - Xizhen Kang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Na Zhao
- Department of Rehabilitation Medicine, Jiangxi Provincial People's Hospital, Nanchang, China
| | - Xiangli Dong
- Jiangxi Medical College, Nanchang University, Nanchang, China,Department of Psychosomatic Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shilin Li
- Department of Rehabilitation Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Gaoning Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Guanxiu Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yang Yang
- School of Life Science, Nanchang University, Nanchang, China
| | - Chafeng Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Guohua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Lang Shuai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China,Lang Shuai
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China,Zhen Feng
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Computer assisted identification of stress, anxiety, depression (SAD) in students: A state-of-the-art review. Med Eng Phys 2022; 110:103900. [PMID: 36273998 DOI: 10.1016/j.medengphy.2022.103900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/09/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022]
Abstract
Stress, depression, and anxiety are a person's physiological states that emerge from various body features such as speech, body language, eye contact, facial expression, etc. Physiological emotion is a part of human life and is associated with psychological activities. Sad emotion is relatable to negative thoughts and recognized in three stages containing stress, anxiety, and depression. These stages of Physiological emotion show various common and distinguished symptoms. The present study explores stress, depression, and anxiety symptoms in student life. The study reviews the psychological features generated through various body parts to identify psychological activities. Environmental factors, including a daily routine, greatly trigger psychological activities. The psychological disorder may affect mental and physical health adversely. The correct recognition of such disorder is expensive and time-consuming as it requires accurate datasets of symptoms. In the present study, an attempt has been made to investigate the effectiveness of computerized automated techniques that include machine learning algorithms for identifying stress, anxiety, and depression mental disorder. The proposed paper reviews the machine learning-based algorithms applied over datasets containing questionnaires, audio, video, etc., to recognize sad details. During the review process, the proposed study found that artificial intelligence and machine learning techniques are well recommended and widely utilized in most of the existing literature for measuring psychological disorders. The various machine learning-based algorithms are applied over datasets containing questionnaires, audio, video, etc., to recognize sad details. There has been continuous monitoring for the body symptoms established in the various existing literature to identify psychological states. The present review reveals the study of excellence and competence of machine learning techniques in detecting psychological disorders' stress, depression, and anxiety parameters. This paper shows a systematic review of some existing computer vision-based models with their merits and demerits.
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Sun Y, Cao X, Cao D, Cui Y, Su K, Jia Z, Wu Y, Jiang J. Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease. Front Nutr 2022; 9:1009122. [PMID: 36386930 PMCID: PMC9663808 DOI: 10.3389/fnut.2022.1009122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/17/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Gastro-oesophageal reflux disease (GORD) is a common gastrointestinal dysfunction that significantly affects the quality of daily life, and health interventions are challenging to prevent the risk of GORD. In this study, we used Mendelian randomization framework to genetically determine the causal associations between multifaceted modifiable factors and the risk of GORD. MATERIALS AND METHODS Sixty-six exposures with available instrumental variables (IVs) across 6 modifiable pathways were included in the univariable MR analysis (UVMR). Summary-level genome-wide association studies (GWAS) datasets for GORD were retrieved from the Neale Lab (GORD Neale , Ncases = 29975, Ncontrols = 390556) and FinnGen (GORD Finn , Ncases = 13141, Ncontrols = 89695). Using the METAL software, meta-analysis for single nucleotide polymorphisms (SNPs) from GORD Neale and GORD Finn was conducted with an inverse variance weighted (IVW) fixed-effect model. Moreover, we leveraged partition around medoids (PAM) clustering algorithm to cluster genetic correlation subtypes, whose hub exposures were conditioned for multivariable MR (MVMR) analyses. P-values were adjusted with Bonferroni multiple comparisons. RESULTS Significant causal associations were identified between 26 exposures (15 risk exposures and 11 protective exposures) and the risk of GORD. Among them, 13 risk exposures [lifetime smoking, cigarette consumption, insomnia, short sleep, leisure sedentary behavior (TV watching), body mass index (BMI), body fat percentage, whole body fat mass, visceral adipose tissue, waist circumference, hip circumference, major depressive disorder, and anxious feeling], and 10 protective exposures (leisure sedentary behavior (computer use), sitting height, hand grip strength (left and right), birth weight, life satisfaction, positive affect, income, educational attainment, and intelligence) showed novel significant causal associations with the risk of GORD. Moreover, 13 exposures still demonstrated independent associations with the risk of GORD following MVMR analyses conditioned for hub exposures (educational attainment, smoking initiation and BMI). In addition, 12 exposures showed suggestive causal associations with the risk of GORD. CONCLUSION This study systematically elucidated the modifiable factors causally associated with the risk of GORD from multifaceted perspectives, which provided implications for prevention and treatment of GORD.
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Affiliation(s)
- Yuanlin Sun
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xueyuan Cao
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Donghui Cao
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yingnan Cui
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Kaisheng Su
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zhifang Jia
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yanhua Wu
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jing Jiang
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, Jilin, China,*Correspondence: Jing Jiang,
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Li Y, Duan Z. Updates in interaction of gastroesophageal reflux disease and extragastroesophageal digestive diseases. Expert Rev Gastroenterol Hepatol 2022; 16:1053-1063. [PMID: 35860994 DOI: 10.1080/17474124.2022.2056018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Gastroesophageal reflux disease (GERD) is one of the common chronic diseases with prevalence increasing in the last decades. Because of its prevalence and chronicity, GERD affects the quality of life and increases health-care costs. Gastroesophageal diseases leading to GERD have been thoroughly studied, while extragastroesophageal digestive diseases (EGEDDs) may coexist with GERD and affect the occurrence and persistence of GERD symptoms and therapeutic effect. AREAS COVERED In this review, we aim to summarize the EGEDDs correlated with GERD and explore the potential mechanisms of this interaction. EXPERT OPINION Individuals with troublesome GERD symptoms may have some common gastroesophageal etiologies, but EGEDDs may also overlap and impact on the progression of GERD, which are often ignored in clinic. The lesions in the small intestine, colon, and hepatobiliary tract as well as functional bowel disorders had positive or negative associations with GERD through potential mechanisms. These diseases aggravate GERD symptoms, increase the esophageal acid burden, cause esophageal hypersensitivity, and finally affect the response to therapy in GERD patients. Therefore, it is necessary to clear the interaction between GERD and EGEDDs and their mechanisms.
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Affiliation(s)
- Yanqiu Li
- Second Gastroenterology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhijun Duan
- Second Gastroenterology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Jones MP, Shah A, Walker MM, Koloski NA, Holtmann G, Talley NJ. Overlap of heartburn, functional dyspepsia, and irritable bowel syndrome in a population sample: Prevalence, temporal stability, and associated comorbidities. Neurogastroenterol Motil 2022; 34:e14349. [PMID: 35293084 DOI: 10.1111/nmo.14349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/02/2022] [Accepted: 02/22/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Co-occurring (overlapping) irritable bowel syndrome (IBS), functional dyspepsia (FD), and heartburn has been observed. However, whether it is a distinct entity has not been established, nor what clinical, demographic, lifestyle, and psychological traits are associated with it. This study sought to estimate the prevalence and temporal stability of this overlap and to identify features specific to it in order to gain some insights into the potential etiopathogenesis. METHODS Two waves of a survey to a population-representative sample were conducted 3 years apart, recruiting 1312 individuals for this study. The chance-expected probability of complete overlap (CO) was calculated and compared with the observed CO. A range of demographic, lifestyle factors, medical diagnoses, sleep quality, and psychological distress were tested to identify predictors of overlap using logistic regression. KEY RESULTS CO was observed in 2.1% (95% confidence interval 1.9, 3.7) of the sample and was closely replicated in wave 2 at 2.0%. The observed CO was greater than expected by chance (0.2%) to a statistically significant extent (p < 0.001). Overlap between IBS subtypes, FD subtypes, and heartburn was also elevated above chance expectation. Individuals with CO were separately differentiated from others with respect to elevated rates of self-reported medically diagnosed asthma, elevated psychological distress score, and elevated impact on sleep quality. The discrimination provided by these factors was further independent of age and sex. CONCLUSIONS AND INFERENCES Overlap between IBS, FD, and heartburn (GERD) appears to be a distinct entity that has a profile including psychological morbidity, sleep disturbance, and elevated rates of atopy.
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Affiliation(s)
- Michael P Jones
- School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Ayesha Shah
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI), Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Marjorie M Walker
- College of Health, Medicine and Well Being, University of Newcastle, Newcastle, New South Wales, Australia
| | - Natasha A Koloski
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI), Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,College of Health, Medicine and Well Being, University of Newcastle, Newcastle, New South Wales, Australia
| | - Gerald Holtmann
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI), Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Nicholas J Talley
- College of Health, Medicine and Well Being, University of Newcastle, Newcastle, New South Wales, Australia
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12
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Hu W, Kong X, Wang H, Li Y, Luo Y. Ischemic stroke and intestinal flora: an insight into brain-gut axis. Eur J Med Res 2022; 27:73. [PMID: 35614480 PMCID: PMC9131669 DOI: 10.1186/s40001-022-00691-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/21/2022] [Indexed: 11/10/2022] Open
Abstract
Stroke is a type of cerebrovascular disease that significantly endangers human health and lowers quality of life. This understandably places a heavy burden on society and families. In recent years, intestinal flora has attracted increasing attention from scholars worldwide, and its association with ischemic stroke is becoming a hot topic of research amongst researchers in field of stroke. After suffering from a stroke, intestinal microbial dysbiosis leads to increased intestinal permeability and activation of the intestinal immune system, which in turn leads to ectopic intestinal bacteria and pro-inflammatory cells that enter brain tissue through the damaged blood-brain barrier. This exacerbates ischemia-reperfusion injury. Interestingly, after a stroke, some metabolites produced by the intestinal flora attenuate ischemia-reperfusion injury by suppressing the post-stroke inflammatory response and promotes the repair of neurological function. Here we elucidate the changes in gut flora after occurrence of a stroke and highlight the immunomodulatory processes of the post-stroke gut flora.
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Affiliation(s)
- Wenjie Hu
- Department of Biological Science, Jining Medical University, Rizhao, Shandong, China.,Institute of Neuroregeneration & Neurorehabilitation, Qingdao University, Qingdao, Shandong, China
| | - Xiangyi Kong
- Institute of Neuroregeneration & Neurorehabilitation, Qingdao University, Qingdao, Shandong, China
| | - Hui Wang
- Institute of Neuroregeneration & Neurorehabilitation, Qingdao University, Qingdao, Shandong, China
| | - Yunqing Li
- Department of Pathogenic Biology, Jining Medical University, Jining, Shandong, China
| | - Yimin Luo
- Department of Biological Science, Jining Medical University, Rizhao, Shandong, China.
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