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Beas R, Altamirano-Farfan E, Izquierdo-Veraza D, Norwood DA, Riva-Moscoso A, Godoy A, Montalvan-Sanchez EE, Ramirez M, Guifarro DA, Kitchin E, Fischer M, Kurada S. Prevalence of celiac disease in systemic lupus erythematosus, sjogren syndrome and systemic sclerosis: A systematic review and meta-analysis. Dig Liver Dis 2024:S1590-8658(24)00316-5. [PMID: 38584032 DOI: 10.1016/j.dld.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Celiac disease (CeD) is an immune-mediated disorder affecting the small bowel, associated with genetic factors and increasing global prevalence. AIM This study explores the association between CeD, Systemic Lupus Erythematosus (SLE), primary Sjogren syndrome (pSS), and Systemic Sclerosis (SSc). METHODS A systematic review and meta-analysis were conducted following PRISMA guidelines. Searches across multiple databases yielded 2728 articles, with 15 studies selected. Data extraction included study characteristics, prevalence of CeD and CeD antibodies in SLE, pSS, and SSc. Quality assessment utilized the Newcastle-Ottawa Scale. RESULTS The meta-analysis revealed a pooled prevalence of biopsy-proven CeD in SLE, pSS, and SSc of approximately 3%. Seroprevalence of any CeD antibody in SLE, pSS, and SSc ranged from 3% to 10%. Notably, pSS exhibited the highest prevalence at 5.59%. High heterogeneity was observed in seroprevalence across autoimmune conditions. Quality assessment indicated robust methodological quality in the selected studies. CONCLUSION This study highlights a significantly higher prevalence of CeD, especially pSS, compared to the general population. The findings underscore the importance of recognizing elevated CeD antibodies in patients with SLE, pSS and SSc emphasizing the need for early detection and comprehensive care for gastrointestinal symptoms in these conditions.
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Affiliation(s)
- Renato Beas
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | | | | | - Dalton A Norwood
- Division of Preventive Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Ambar Godoy
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Mirian Ramirez
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel A Guifarro
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Emily Kitchin
- Division of Rheumatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Monika Fischer
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Satya Kurada
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA
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Norwood DA, Dominguez LB, Paredes AA, Montalvan-Sanchez E, Murillo AR, Dougherty MK, Palsson OS, Dominguez RL, Morgan DR. Correction to: Prevalence and Associated Dietary Factors of Rome IV Functional Gastrointestinal Disorders in Rural Western Honduras. Dig Dis Sci 2024:10.1007/s10620-024-08404-x. [PMID: 38564149 DOI: 10.1007/s10620-024-08404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Dalton A Norwood
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Lucia B Dominguez
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Andrea A Paredes
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Eleazar Montalvan-Sanchez
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Aida Rodriguez Murillo
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Michael K Dougherty
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, 4182, Bioinformatics, 130 Mason Farm RD, Chapel Hill, NC, 27599-6134, USA
| | - Olafur S Palsson
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, 4182, Bioinformatics, 130 Mason Farm RD, Chapel Hill, NC, 27599-6134, USA
- Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina School of Medicine, 130 Mason Farm Road, CB# 7080, Chapel Hill, NC, 27599, USA
| | - Ricardo L Dominguez
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Douglas R Morgan
- Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham (UAB), 373 Boshell Building, 1720 2 Avenue South, Birmingham, AL, 35294-0012, USA.
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Vashi B, Norwood DA, Sullivan R, Hegazy Y, Sánchez-Luna SA, Ajayi-Fox P, Ahmed AM, Baig KRKK, Peter S, Mulki R. Social determinants of health influencing the adherence to post-endoscopic mucosal resection surveillance. Clin Res Hepatol Gastroenterol 2024; 48:102301. [PMID: 38355006 DOI: 10.1016/j.clinre.2024.102301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND AND AIMS Colorectal cancer (CRC) is a global health challenge, particularly in Alabama, where the incidence rates exceed national averages. This study investigated the factors influencing adherence to post-endoscopic mucosal resection (EMR) colonoscopies, focusing on travel distance and socioeconomic status. This study aimed to provide evidence-based insights to improve patient care in CRC management. METHODS This retrospective study in a tertiary care referral center analyzed 465 patients who underwent EMR. The data included demographics, clinical details, and travel-related variables. Descriptive statistics, logistic regression, and spatial analysis were used to assess the factors affecting adherence. RESULTS Of 465 patients, 36.6 % had adequate follow-up, 21.8 % had inadequate follow-up, and 41.6 % were lost to follow-up. Noteworthy demographic variations were observed, with median ages differing across adherence groups. Traveled distances showcased compelling insights, indicating a median distance of 22.2 miles for adequate follow-up, 15.7 miles for inadequate follow-up, and 31.6 miles for the lost-to-follow-up group (p<0.001). Longer travel distances were associated with better adherence. Longer travel distances from the hospital were associated with significantly lower odds of inadequate follow-up: 10-25 miles OR:0.29, 25-85 miles OR:0.35, and >80 miles OR:0.24 compared to the first quartile (<10 miles). Socioeconomic factors, particularly educational attainment, significantly influenced the follow-up rates. CONCLUSIONS This study revealed suboptimal post-EMR follow-up rates and underscored the impact of travel distance and socioeconomic factors. Targeted interventions addressing distance-related barriers can enhance treatment adherence and ensure timely CRC surveillance after EMR. Further research is needed in diverse healthcare settings.
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Affiliation(s)
- Bijal Vashi
- Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Dalton A Norwood
- Division of Preventive Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Rebecca Sullivan
- Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Yassmin Hegazy
- Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Sergio A Sánchez-Luna
- Division of Gastroenterology, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Patricia Ajayi-Fox
- Division of Gastroenterology, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Ali M Ahmed
- Division of Gastroenterology, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Kondal R Kyanam Kabir Baig
- Division of Gastroenterology, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Shajan Peter
- Division of Gastroenterology, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States
| | - Ramzi Mulki
- Division of Gastroenterology, Heersink School of Medicine, The University of Alabama at Birmingham, AL 35205, United States.
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Montalvan-Sanchez EE, Norwood DA, Dougherty M, Beas R, Guranizo-Ortiz M, Ramirez-Rojas M, Morgan DR, Imperiale TF. Colorectal Cancer Screening Programs in Latin America: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e2354256. [PMID: 38300621 PMCID: PMC10835514 DOI: 10.1001/jamanetworkopen.2023.54256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
Importance Colorectal cancer (CRC) is a leading cause of cancer-related mortality globally, with increasing incidence and mortality in Latin America. CRC screening programs can reduce disease burden, but information on screening programs in Latin America is limited. Objective To describe characteristics (eg, type of program, uptake, neoplastic yield) of CRC screening programs in Latin America. Data Sources PubMed, Ovid MEDLINE, EMBASE, Cochrane, PsycINFO, Web of Science Core Collection, LILACS, and SciELO were searched from inception to February 2023. Relevant references from bibliographies, conference proceedings, and gray literature were considered. The search strategy included English, Spanish, and Portuguese terms. Study Selection Included were studies of CRC screening programs in Latin America using fecal immunochemical test (FIT) or colonoscopy as the primary screening method. Four reviewers independently assessed study eligibility based on titles, with review of abstracts and full texts as needed. Data Extraction and Synthesis Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed for data abstraction and quality assessment. Descriptive information was extracted, and data were pooled using a random-effects model. Main outcomes and Measures Program performance indicators included rates of participation and FIT positivity, adenoma detection rate (ADR), advanced adenoma detection rate (AADR), CRC detection rate, and colonoscopy quality indicators. Results There were 17 studies included from upper middle-income and high-income countries in Latin America with a total of 123 929 participants. Thirteen studies used FIT as the initial screening method, whereas 4 used screening colonoscopy. The participation rate in FIT-based programs was 85.8% (95% CI, 78.5%-91.4%). FIT positivity rates were 15.2% (95% CI, 9.6%-21.8%) for the 50-ng/mL threshold and 9.7% (95% CI, 6.8%-13.0%) for the 100-ng/mL threshold. For FIT-based studies, the pooled ADR was 39.0% (95% CI, 29.3%-49.2%) and CRC detection rate was 4.9% (95% CI, 2.6%-7.9%); for screening colonoscopy-based studies, the pooled ADR was 19.9% (95% CI, 15.5%-24.8%) and CRC detection rate was 0.4% (95% CI, 0.1%-0.8%). Conclusions and Relevance This systematic review and meta-analysis suggests that CRC screening in upper middle-income countries in Latin America is feasible, detecting rates of neoplasia comparable with those of high-income regions. Population-based screening programs should be developed or enhanced in these settings. There is a knowledge gap regarding feasibility and yield of screening programs in lower middle-income countries.
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Affiliation(s)
| | - Dalton A. Norwood
- Division of Preventive Medicine, The University of Alabama at Birmingham, Birmingham
| | - Michael Dougherty
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill
- UNC Rex Digestive Healthcare, Raleigh, North Carolina
| | - Renato Beas
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | | | | | - Douglas R. Morgan
- Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham
| | - Thomas F. Imperiale
- Division of Gastroenterology and Hepatology, Indiana University, Indianapolis
- Regenstrief Institute, Indianapolis, Indiana
- The Indiana University Simon Cancer Center, Indianapolis
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Locke J, Norwood DA, Forrister N, Ahmed AM, Aryan M, Oster R, Reddy S, Kabir Baig KK, Peter S. Safety and efficacy of direct percutaneous endoscopic jejunostomy tube placement compared with surgical jejunostomy: a tertiary care analysis. Gastrointest Endosc 2023:S0016-5107(23)03157-7. [PMID: 38103750 DOI: 10.1016/j.gie.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND AND AIMS Jejunostomy tube placements provides enteral access for feeding in eligible patients who cannot meet their nutritional needs by mouth. They can be surgically placed laparoscopically (lap-J) or with the use of a conventional open laparotomy approach (open-J). Recently, direct percutaneous endoscopic jejunostomy (DPEJ) has emerged as an alternative owing to its low cost and shorter recovery times. We sought to retrospectively compare the procedural success rates and adverse events of these methods. METHODS Patients were identified by querying our health system patient database and the departmental database of patients who underwent DPEJ. The patients were divided into 3 cohorts based on the procedure: DPEJ, lap-J, or open-J. Patient age and body mass index, procedural success rate, and adverse event rate were compared among the 3 groups. RESULTS A total of 201 patients met inclusion criteria (65 DPEJ, 111 lap-J, and 25 open-J). Procedural success rates were similar among the 3 groups (DPEJ 96.9%, lap-J 99.1%, open-J 100%; P = .702). Rates of infection and bleeding were also similar among the 3 groups. There were no cases of GI perforation. Tube dysfunction for any reason that required complete removal or replacement within 90 days occurred more often in the surgical groups than in the DPEJ group (DPEJ 0%, lap-J 35.1%, open-J 40.0%; P < .001). This was driven largely by increased rates of tube clogging and tube dislodgement in the surgical groups. CONCLUSIONS DPEJ is a safe and effective alternative to surgical jejunostomy in eligible patients and may be associated with decreased adverse event rates at 90 days.
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Affiliation(s)
- John Locke
- Division of Internal Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Dalton A Norwood
- Division of Preventive Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Nicholas Forrister
- Division of Internal Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Ali M Ahmed
- Division of Gastroenterology and Hepatology, University of Alabama, Birmingham, Alabama, USA
| | - Mahmoud Aryan
- Division of Internal Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Robert Oster
- Division of Preventive Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Sushanth Reddy
- Division of Surgical Oncology, University of Alabama, Birmingham, Alabama, USA
| | | | - Shajan Peter
- Division of Gastroenterology and Hepatology, University of Alabama, Birmingham, Alabama, USA
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6
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Rifkin SB, Miller AK, Montalvan-Sanchez EE, Norwood DA, Martinez E, Waterboer T, Beasley TM, Dominguez RL, Williams SM, Morgan DR. Wood cookstove use is associated with gastric cancer in Central America and mediated by host genetics. Sci Rep 2023; 13:16515. [PMID: 37783717 PMCID: PMC10545771 DOI: 10.1038/s41598-023-42973-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023] Open
Abstract
Biomass cookstove food preparation is linked to aero-digestive cancers, mediated by ingested and inhaled carcinogens (e.g., heterocyclic amines, and polycyclic aromatic hydrocarbons). We investigated the association between gastric adenocarcinoma, wood cookstove use, H. pylori CagA infection and risk modification by variants in genes that metabolize and affect the internal dose of carcinogens. We conducted a population-based, case-control study (814 incident cases, 1049 controls) in rural Honduras, a high-incidence region with a homogeneous diet and endemic H. pylori infection, primarily with the high-risk CagA genotype. We investigated factors including wood cookstove use, H. pylori CagA serostatus, and 15 variants from 7 metabolizing genes, and the interactions between wood stove use and the genetic variants. Male sex (OR 2.0, 1.6-2.6), age (OR 1.04, 1.03-1.05), wood cookstove use (OR 2.3, 1.6-3.3), and CagA serostatus (OR 3.5, 2.4-5.1) and two SNPs in CYP1B1 (rs1800440 and rs1056836) were independently associated with gastric cancer in multivariate analysis. In the final multivariate model, a highly significant interaction (OR 3.1, 1.2-7.8) was noted between wood cookstove use and the rs1800440 metabolizing genotype, highlighting an important gene-environment interaction. Lifetime wood cookstove use associates with gastric cancer risk in the high-incidence regions of Central America, and the association is dependent on the rs1800440 genotype in CYP1B1. H. pylori CagA infection, wood cookstove use and the rs1800440 genotype, all of which are highly prevalent, informs who is at greatest risk from biomass cookstove use.
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Affiliation(s)
- Samara B Rifkin
- Department of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Anna K Miller
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Eleazar E Montalvan-Sanchez
- Hospital de Occidente, Ministry of Health, Santa Rosa de Copan, Copan, Honduras
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dalton A Norwood
- Hospital de Occidente, Ministry of Health, Santa Rosa de Copan, Copan, Honduras
- Division of Preventive Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Mark Beasley
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Ricardo L Dominguez
- Hospital de Occidente, Ministry of Health, Santa Rosa de Copan, Copan, Honduras
| | - Scott M Williams
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
- Department of Population and Quantitative Health Sciences and Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Douglas R Morgan
- Medicine and Epidemiology, UAB Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.
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Montalvan-Sanchez E, Chambergo-Michilot D, Rodriguez-Murillo AA, Brooks AE, Palacios-Argenal D, Rivera-Pineda S, Ordonez-Montes J, Estevez-Ramirez R, Riva-Moscoso A, Norwood DA, Calderon-Rodriguez A, Pineda-SanMartin E, Giron R, Rivera-Corrales L, Carcamo-Murillo B, Garner O. High-Dose vs. Low-Dose Dexamethasone in Patients With COVID-19: A Cohort Study in Rural Central America. J Acute Med 2023; 13:36-40. [PMID: 37089670 PMCID: PMC10116034 DOI: 10.6705/j.jacme.202303_13(1).0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/27/2022] [Accepted: 10/08/2022] [Indexed: 04/25/2023]
Abstract
To compare the clinical outcomes of a low dose dexamethasone strategy vs. a high-dose dexamethasone strategy in hypoxemic COVID-19 patients. A retrospective observational study comparing low-dose (8 mg) and high-dose dexamethasone (24 mg) of COVID-19 patients admitted from September 1, 2020 to October 31, 2020 in a hospital in Honduras. We included 81 patients with confirmed COVID-19 who required oxygen therapy. The mean age was similar between groups (57.49 vs. 56.95 years). There were more male patients in the group of 24 mg ( p = 0.01). Besides, patients on the 24 mg dose had more prevalence of hypertension ( p = 0.052). More patients in the 24 mg group had a higher rate of invasive mechanical ventilation (15.00% vs. 2.56%, p = 0.058). When evaluating the association between the high dose group and outcomes, we find no significant association with mortality, nosocomial infections, high flow mask, invasive mechanical ventilation, or the need for vasopressors. We find no significant differences in the Kaplan-Meier analysis regarding the survival (log-rank p -value = 0.315). We did not find significant differences between the use of 24 mg and 8 mg of dexamethasone in hypoxemic COVID-19 patients.
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Affiliation(s)
| | | | | | - Alexandra E Brooks
- Indiana University School of Medicine Department of Medicine Indianapolis, IN USA
| | | | - Shery Rivera-Pineda
- Universidad Nacional Autónoma de Honduras Departamento de Medicina Tegucigalpa Honduras
| | - Jose Ordonez-Montes
- Universidad Nacional Autónoma de Honduras Departamento de Medicina Tegucigalpa Honduras
| | - Rosa Estevez-Ramirez
- Universidad Nacional Autónoma de Honduras Departamento de Medicina Tegucigalpa Honduras
| | - Adrian Riva-Moscoso
- Universidad Peruana de Ciencias Aplicadas Departamento de Medicina Surco Peru
| | - Dalton A Norwood
- The University of Alabama at Birmingham Department of Preventive Medicine Birmingham, AL USA
| | | | | | - Roberto Giron
- Universidad Nacional Autónoma de Honduras Departamento de Medicina Tegucigalpa Honduras
| | - Luis Rivera-Corrales
- Universidad Nacional Autónoma de Honduras Departamento de Medicina Tegucigalpa Honduras
| | | | - Orlando Garner
- Texas Tech University Health Sciences Center Pulmonology and Critical Care Medicine Permian Basin, TX USA
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Abstract
Gastric adenocarcinoma (GC) is the fourth leading cause of global cancer mortality, and the leading infection-associated cancer. Helicobacter pylori is the dominant risk factor for GC and classified as an IARC class I carcinogen. Surveillance of gastric premalignant conditions is now indicated in high-risk patients. Upper endoscopy is the gold standard for GC diagnosis, and image-enhanced endoscopy increases the detection of gastric premalignant conditions and early gastric cancer (EGC). Clinical staging is crucial for treatment approach, defining early gastric cancer, operable locoregional disease, and advanced GC. Endoscopic submucosal dissection is the treatment of choice for most EGC. Targeted therapies are rapidly evolving, based on biomarkers including MSI/dMMR, HER2, and PD-L1. These advancements in surveillance, diagnostic and therapeutic strategies are expected to improve GC survival rates in the near term.
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Affiliation(s)
- Dalton A Norwood
- UAB Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; Western Honduras Gastric Cancer Prevention Initiative, Copan Region Ministry of Health, Sala de Endoscopia, Calle 1 S, Hospital Regional de Occidente, Santa Rosa de Copán 41101, Honduras
| | - Eleazar E Montalvan
- Western Honduras Gastric Cancer Prevention Initiative, Copan Region Ministry of Health, Sala de Endoscopia, Calle 1 S, Hospital Regional de Occidente, Santa Rosa de Copán 41101, Honduras; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ricardo L Dominguez
- Western Honduras Gastric Cancer Prevention Initiative, Copan Region Ministry of Health, Sala de Endoscopia, Calle 1 S, Hospital Regional de Occidente, Santa Rosa de Copán 41101, Honduras
| | - Douglas R Morgan
- UAB Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Norwood DA, Dominguez LB, Paredes AA, Montalvan EE, Rodriguez Murillo A, Dougherty MK, Palsson OS, Dominguez RL, Morgan DR. Prevalence and Associated Dietary Factors of Rome IV Functional Gastrointestinal Disorders in Rural Western Honduras. Dig Dis Sci 2021; 66:3086-3095. [PMID: 33089482 DOI: 10.1007/s10620-020-06639-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The literature is limited regarding the prevalence of functional gastrointestinal disorders (FGIDs) in Central America, and the role of dietary factors. METHODS The Rome IV diagnostic questionnaire and National Cancer Institute Diet History questionnaire were administered in one-on-one interviews to a distributed cross section of the general adult population of Western Honduras. Our aim was to estimate prevalence of common FGIDs and symptoms and their relationships to dietary habits. RESULTS In total, 815 subjects were interviewed, of whom 151 fulfilled criteria for an FGID (18.5%). Gastroduodenal FGIDs were noted in 9.4%, with epigastric pain syndrome (EPS) more common than postprandial distress syndrome, 8.5% versus 1.6%. Among bowel disorders, functional abdominal bloating (FAB) was most prevalent (6.3%), followed by irritable bowel syndrome (3.6%), functional diarrhea (FDr; 3.4%), and functional constipation (1.1%). A significant inverse association was noted between regular bean intake and any FGID (OR 0.41, 95% CI 0.27-0.63), driven by IBS and FDr. Vegetable consumption was associated with lower prevalence of functional diarrhea (OR 0.12; 95% CI 0.04-0.35) and any diarrheal disorder (OR 0.11; 95% CI 0.04-0.31). Subjects with a median daily intake of ≥ 4 corn tortillas had 1.75 (95% CI 1.22-2.50) times the odds of having any FGID. CONCLUSIONS FGIDs were common in this rural low-resource setting in Central America, with an intriguing distribution of specific FGIDs. EPS and FAB were common, but IBS was not. Local dietary factors were associated with specific FGIDs, suggesting that diet may play a role in global variations of FGIDs.
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Affiliation(s)
- Dalton A Norwood
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Lucia B Dominguez
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Andrea A Paredes
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Eleazar E Montalvan
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Aida Rodriguez Murillo
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Michael K Dougherty
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, 4182, Bioinformatics, 130 Mason Farm RD, Chapel Hill, NC, 27599-6134, USA
| | - Olafur S Palsson
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, 4182, Bioinformatics, 130 Mason Farm RD, Chapel Hill, NC, 27599-6134, USA
- Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina School of Medicine, 130 Mason Farm Road, CB# 7080, Chapel Hill, NC, 27599, USA
| | - Ricardo L Dominguez
- Western Honduras Gastric Cancer Prevention Initiative, Western Regional Hospital, Hospital de Occidente, Avenida Solidaridad, 41101, Santa Rosa de Copan, Honduras
| | - Douglas R Morgan
- Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham (UAB), 373 Boshell Building, 1720 2nd Avenue South, Birmingham, AL, 35294-0012, USA.
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Ulrich MP, Christensen DR, Coyne SR, Craw PD, Henchal EA, Sakai SH, Swenson D, Tholath J, Tsai J, Weir AF, Norwood DA. Evaluation of the Cepheid GeneXpert system for detecting Bacillus anthracis. J Appl Microbiol 2006; 100:1011-6. [PMID: 16630001 DOI: 10.1111/j.1365-2672.2006.02810.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The Cepheid GeneXpert is a four-site, automated sample preparation and real-time PCR detection system. In this study, the capability of the GeneXpert to isolate and detect nucleic acid from Bacillus anthracis Ames spores was assessed. METHODS AND RESULTS A four-plex, dried-down bead cartridge containing PCR reagents specific for the pXO1 and pXO2 plasmids as well as sample processing and inhibition controls was evaluated. For B. anthracis Ames spores harbouring pXO1 and pXO2, samples containing 68 CFU per ml (148 spores per ml) were positive in all four replicates. A limited cross-reactivity panel, which included closely related Bacillus species, was also tested to determine the specificity of the pXO1 and pXO2 assays. No cross-reactivity occurred. Further, B. anthracis Sterne spore samples were analysed to compare results when processed using the GeneXpert to those run directly on the Cepheid SmartCycler without sample processing. The GeneXpert detection capability was three logs lower than the SmartCycler indicating the benefit of incorporating a nucleic acid extraction procedure. CONCLUSIONS This study demonstrates that the GeneXpert is a rapid and reliable system for simultaneously detecting the B. anthracis virulence plasmids pXO1 and pXO2. SIGNIFICANCE AND IMPACT OF THE STUDY The GeneXpert is the only platform currently available that is capable of both nucleic acid purification and real-time PCR detection enclosed within a single system. Further, all sample manipulations are automated, thus reducing errors associated with manual processing.
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Affiliation(s)
- M P Ulrich
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702-5011, USA
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Gibb TR, Norwood DA, Woollen N, Henchal EA. Development and evaluation of a fluorogenic 5' nuclease assay to detect and differentiate between Ebola virus subtypes Zaire and Sudan. J Clin Microbiol 2001; 39:4125-30. [PMID: 11682540 PMCID: PMC88497 DOI: 10.1128/jcm.39.11.4125-4130.2001] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2001] [Accepted: 08/19/2001] [Indexed: 11/20/2022] Open
Abstract
The ability to rapidly recognize Ebola virus infections is critical to quickly limit further spread of the disease. A rapid, sensitive, and specific laboratory diagnostic test is needed to confirm outbreaks of Ebola virus infection and to distinguish it from other diseases that can cause similar clinical symptoms. A one-tube reverse transcription-PCR assay for the identification of Ebola virus subtype Zaire (Ebola Zaire) and Ebola virus subtype Sudan (Ebola Sudan) was developed and evaluated by using the ABI PRISM 7700 sequence detection system. This assay uses one common primer set and two differentially labeled fluorescent probes to simultaneously detect and differentiate these two subtypes of Ebola virus. The sensitivity of the primer set was comparable to that of previously designed primer sets, as determined by limit-of-detection experiments. This assay is unique in its ability to simultaneously detect and differentiate Ebola Zaire and Ebola Sudan. In addition, this assay is compatible with emerging rapid nucleic acid analysis platforms and therefore may prove to be a very useful diagnostic tool for the control and management of future outbreaks.
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Affiliation(s)
- T R Gibb
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702-5011, USA.
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Abstract
The ability to rapidly recognize Marburg virus infections is critical to quickly institute proper barrier nursing precautions and limit further spread of the disease. A rapid, sensitive, and specific laboratory diagnostic test is necessary to confirm outbreaks of Marburg virus and to distinguish it from other diseases that can present with similar clinical symptoms. A one-tube reverse transcriptase-polymerase chain reaction (RT-PCR) assay for the identification of Marburg virus was developed and evaluated using the ABI PRISM 7700 Sequence Detection System and TaqMan chemistry. The sensitivity and specificity of the newly designed primer/probe set (MBGGP3) was evaluated. MBGGP3 was equivalent to or 10-100-fold more sensitive than previously designed primer sets as determined by limit of detection experiments. In addition, the MBGGP3 assay was able to detect all strains of Marburg virus tested, but gave negative results with other haemorrhagic fever and genetically related viruses. The results of this study indicate that the MBGGP3 primer/probe set is both sensitive and specific. In addition, this assay is compatible with emerging rapid nucleic acid analysis platforms and therefore may prove to be a useful diagnostic tool for the control and management of future outbreaks.
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Affiliation(s)
- T R Gibb
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702-5011, USA
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Abstract
Clostridium difficile is a causative agent in antibiotically induced diarrhea and pseudomembraneous colitis. The ability of strains of C. difficile to cause disease depends upon the presence of two toxin genes and their corresponding proteins, designated toxin A and toxin B. Previous studies conducted in this laboratory indicated that toxigenic strains of C. difficile possess both toxin genes, whereas non-toxigenic strains do not. Likewise, the studies showed that toxigenic and non-toxigenic strains of C. difficile differ significantly in chromosomal organization by ribotype analysis. Therefore, the chromosomal organization of a reference strain was investigated. Pulsed field gel electrophoresis was utilized to generate a physical map of the chromosome of the toxigenic Clostridium difficile strain ATCC 43594. Restriction digestions of whole chromosomes with the enzymes NruI and SacII generated consistent macrofragment profiles. NruI digestion resulted in 14 discernible bands containing 16 fragments of DNA. SacII digestions resulted in 14 discernible bands containing 15 fragments of DNA. Restriction digestions with both SacII and NruI resulted in 21 discernible bands containing 31 fragments of DNA. Probing of single and double digests with an extensive set of NruI and SacII single- and double-digest bands clarified the location of individual fragments in relation to one another, resulting in a restriction map of the chromosome. PCR-generated probes of five loci of C. difficile were used to map the location of seven genes on the chromosome. Finally, the addition of all fragments from NruI, SacII and NruI/SacII digestions resulted in an approximate chromosome size of 4.4 Mb.
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Affiliation(s)
- D A Norwood
- Department of Biological Sciences, Lehigh University, Bethlehem, PA 18015, USA
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Abstract
We report the physical mapping of the toxin A and B genes to the bacterial chromosome of Clostridium difficile ATCC 43594 by pulsed-field gel electrophoresis. Single and double digestions with restriction endonucleases NruI and SacII allowed localization of the toxin genes to a specific 577-kb fragment and estimation of genome size to be approximately 3.8 megabases. This effort represents the initial step in the construction of a physical map of the whole genome.
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Affiliation(s)
- D A Norwood
- Department of Biological Sciences, Lehigh University, Bethlehem, Pennsylvania 18015, USA.
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