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Duanmu Z, Ali SJV, Allen J, Cheng LK, Stommel M, Xu W. A Review of In Vitro and In Silico Swallowing Simulators: Design and Applications. IEEE Trans Biomed Eng 2024; 71:2042-2057. [PMID: 38294923 DOI: 10.1109/tbme.2024.3360893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Swallowing is a primary and complex behaviour that transports food and drink from the oral cavity, through the pharynx and oesophagus, into the stomach at an appropriate rate and speed. To understand this sophisticated behaviour, a tremendous amount of research has been carried out by utilising the in vivo approach, which is often challenging to perform, poses a risk to the subjects if interventions are undertaken and are seldom able to control for confounding factors. In contrast, in silico (computational) and in vitro (instrumental) methods offer an alternate insight into the process of the human swallowing system. However, the appropriateness of the design and application of these methods have not been formally evaluated. The purpose of this review is to investigate and evaluate the state of the art of in vitro and in silico swallowing simulators, focusing on the evaluation of their mechanical or computational designs in comparison to the corresponding swallowing mechanisms during various phases of swallowing (oral phase, pharyngeal phase and esophageal phase). Additionally, the potential of the simulators is also discussed in various areas of applications, including the study of swallowing impairments, swallowing medications, food process design and dysphagia management. We also address current limitations and recommendations for the future development of existing simulators.
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AbuDujain NM, Batais MA, Muqresh MA, Aljofan Z, Alghamdi HA, Bashmail A, Alrasheed AA, Almigbal T, Alsemairi R, Hatlebakk JG. Translation, cultural adaptation, and evaluation of the psychometric properties of the Arabic Gastroesophageal Reflux Disease Questionnaire (Ar-GerdQ). Saudi J Gastroenterol 2024:00936815-990000000-00090. [PMID: 38946632 DOI: 10.4103/sjg.sjg_61_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/28/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a common chronic digestive disease that affects people in different communities at different rates. Because of the absence of a validated Arabic tool to assess GERD symptoms, this study aimed to validate and culturally adapt the GERD questionnaire (GerdQ) tool to Arabic speakers. METHODS Patients referred for pH testing with symptoms suggestive of GERD were recruited. A cross-sectional study was conducted from March 2023 to April 2023 by administering the Arabic GERD questionnaire (Ar-GerdQ) tool on two different occasions and comparing it with the short-form leeds dyspepsia questionnaire and the Reflux Symptom Index to establish reliability and construct validity. RESULTS A total of 52 participants were included in the study. The results of the internal consistency analysis of the Ar-GerdQ indicate that the test has good reliability, with a Cronbach's alpha coefficient of 0.86 (95% CI: 0.75-0.91). Significant positive correlations with the short form leeds dyspepsia questionnaire (r = 0.59, P < 0.001, 95% CI: 0.29-0.78) and the reflux symptom index (r = 0.47, P = 0.01, 95% CI: 0.13-0.71) were demonstrated. Moreover, the intraclass correlation coefficient value was 0.60 (P < 0.001, 95% CI: 0.28-0.77), indicating a substantial level of agreement between the measurements. CONCLUSIONS Our findings indicate that the Ar-GerdQ is useful for assessing reflux disease symptoms among Arabic speakers. Effective utilization of Ar-GerdQ will reduce unnecessary endoscopic requests in primary care settings.
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Affiliation(s)
- Nasser M AbuDujain
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | | | - Ziyad Aljofan
- College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Hani A Alghamdi
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Ahmad Bashmail
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Abdullah A Alrasheed
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Turky Almigbal
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Rahaf Alsemairi
- College of Medicine, King Saud University, P.O. Box 11495, Riyadh, Saudi Arabia
| | - Jan G Hatlebakk
- Department of Clinical Medicine and Gastroenterology, Institute of Medicine, University of Bergen, Norway
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Hong W, Wang H, Yu X. Evaluation of the impact of oesophageal reflux disease on muscle fatigue. Eur J Transl Myol 2024; 34. [PMID: 38818777 DOI: 10.4081/ejtm.2024.12243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/21/2024] [Indexed: 06/01/2024] Open
Abstract
Gastroesophageal reflux disease (GERD) is a gastrointestinal tract disorder associated with regurgitation of gastric acid into the oesophagus. It can present itself as non-erosive reflux condition or erosive esophagitis. Our main objective was to evaluate the impact of oesophageal reflux disease on muscle fatigue among patients. The prospective study design was adopted using surveys performed at the South West China Medical University. All patients who were subjected to screening endoscopy at the South West China Medical University were prospectively enrolled in the study. Our study was conducted according to ethical guidelines involving animal and human subjects. Our study used Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), and the Multidimensional Fatigue Inventory (MFI) questionnaires to perform data collection on the levels of fatigue, depression, daytime hypersomnolence and anxiety. In the (HADS, Anxiety (β = 0.657, p < .001) and Depression (β = 2.927, p < .001) exhibited significant positive associations with the predicted fatigue. The Epworth Sleepiness Scale (ESS) showed no significant difference between individuals with and without reflux esophagitis (p = 0.787, power = 0.071). However, a significant difference was observed based on the presence of GERD symptoms (p = 0.003, power = 0.789), with higher mean scores for those with GERD symptoms (6.1±3.5) compared to those without (4.9±2.9). In MFI, significant differences were observed between the two groups for General and Physical Fatigue (p = 0.040, power = 0.823), Mental Fatigue (p = 0.002, power = 0.767), and MFI Total Score (p = 0.002, power = 0.981). In conclusion, GERD symptoms exhibited stronger associations with fatigue and daytime sleepiness than endoscopic findings, emphasizing the impact of symptomatic experiences on well-being.
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Affiliation(s)
- Wenming Hong
- Department of Gastroenterology, First People's Hospital of Chun'an County, Hangzhou, Zhejiang.
| | - Hao Wang
- Department of Gastroenterology, First People's Hospital of Chun'an County, Hangzhou, Zhejiang.
| | - Xuheng Yu
- Department of Gastroenterology, First People's Hospital of Chun'an County, Hangzhou, Zhejiang.
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Bin Abdulrahman KA, Alsaif AF, Almehaidib IA, Almtehe MA, Alqahtani NM, Alabdali AK. Prevalence and risk factors of gastro-esophageal reflux disease among college students at a public university in Riyadh, Saudi Arabia. J Family Med Prim Care 2024; 13:1401-1407. [PMID: 38827728 PMCID: PMC11142017 DOI: 10.4103/jfmpc.jfmpc_1715_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 06/04/2024] Open
Abstract
Background Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal disorders worldwide. It manifests when the lower esophageal sphincter malfunctions, causing the stomach's contents to reflux into the esophagus, lead to discomforting symptoms. Heartburn and regurgitation are the typical symptoms of GERD. This study aims to determine the prevalence of GERD and assess its risk factors. Materials and Methods This cross-sectional study was conducted at IMSIU, Saudi Arabia. An online survey was distributed to the students' email addresses to determine the prevalence of GERD, its related risk factors, and understanding of its symptoms. Results One thousand five hundred and thirty-three (1533) students participated in the survey. The prevalence of GERD was 34.6%. The majority (79.7%) of the respondent students had heard of GERD. Stress is believed to be a factor in developing GERD by 35.7% of students. Heartburn was the predominant symptom of GERD (76.2%). No association existed between the socio-demographic traits of those with GERD except for age and academic year. Conclusions It is imperative to raise public awareness of the disorder's characteristics and its modifiable risk factors to prevent the emergence of GERD and its complications.
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Affiliation(s)
- Khalid A. Bin Abdulrahman
- Department of Medical Education, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Abdullah F. Alsaif
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Ibrahim A. Almehaidib
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Mohammed A. Almtehe
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Nawaf M. Alqahtani
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Abdulaziz K. Alabdali
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
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Wang S, Li Z, Zhou Z, Kang M. Causal analysis of gastroesophageal reflux disease and esophageal cancer. Medicine (Baltimore) 2024; 103:e37433. [PMID: 38489737 PMCID: PMC10939529 DOI: 10.1097/md.0000000000037433] [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: 12/04/2023] [Revised: 01/01/2024] [Accepted: 02/08/2024] [Indexed: 03/17/2024] Open
Abstract
Patients with gastroesophageal reflux disease (GERD) are more likely to develop esophageal cancer (EC). However, a causal relationship between the 2 has been difficult to determine. Therefore, this study aimed to evaluate the impact of GERD on EC using the Mendelian randomization (MR) method. The causal association between GERD and EC was analyzed based on 2 publicly available genetic summary datasets for the GERD cohort (129,080 cases vs 473,524 controls) and the EC cohort (740 cases vs 372,016 controls). The causal inference was mainly evaluated by the inverse variance weighted MR. The MR-Egger regression, MR Pleiotropy Residual Sum and Outlier test, and leave-one-out test were used to confirm the sensitivity of the MR results. Possible interfering factors were excluded by multivariate MR (MVMR) analysis. We used 73 single nucleotide polymorphisms as instrumental variables. GERD was associated with increasing EC risk (odds ratio [OR], 1.001; 95% confidence interval, 1.001-1.002; P < .001), which was identified using the inverse variance weighted method. The sensitivity analysis also demonstrated similar results with the causal explanation, and major bias in genetic pleiotropy was not identified (intercept, 0.001; standard error, 0.001; P = .418). The multivariate MR analysis demonstrated the effect of GERD on EC even after excluding possible mediating factors (OR, 1.003; 95% confidence interval, 1.001-1.005; P = .012). This study confirmed that GERD has a causal effect on EC. Therefore, interventional measures are recommended to prevent EC.
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Affiliation(s)
- Shuangyue Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Tumor Radiation Therapy Clinical Medical Research Center, Nanning, Guangxi, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
| | - Zhiru Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Tumor Radiation Therapy Clinical Medical Research Center, Nanning, Guangxi, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
| | - Ziyan Zhou
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Tumor Radiation Therapy Clinical Medical Research Center, Nanning, Guangxi, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
| | - Min Kang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Tumor Radiation Therapy Clinical Medical Research Center, Nanning, Guangxi, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
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Pelzner K, Fuchs C, Petersen M, Maus M, Bruns CJ, Leers JM. Sex- and gender-specific differences in symptoms and health-related quality of life among patients with gastroesophageal reflux disease. Dis Esophagus 2024; 37:doad064. [PMID: 37963417 DOI: 10.1093/dote/doad064] [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: 02/21/2023] [Revised: 07/01/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Gastroesophageal Reflux Disease (GERD) is a common chronic gastrointestinal disorder affecting both men and women. Nonerosive reflux disease generally affects more women, whereas GERD complications such as Barrett's esophagus (BE) or esophageal cancer affect more men. The aim of this study was to evaluate sex- and gender-specific symptoms and health-related quality of life (HRQoL) among men and women with GERD. Patients with clinical signs of reflux and completion of 24-hour pH-Impedance testing at the University Hospital Cologne were included into the study. Evaluation of symptoms and HRQoL included the following validated questionnaires: GERD-Health-Related Quality of Life (GERD HRQL), Gastrointestinal Quality of Life Index (GIQLI), and Hospital Anxiety and Depression Scale (HADS). In all, 509 women and 355 men with GERD were included. Men had a significantly higher DeMeester score (60.2 ± 62.6 vs. 43 ± 49.3, P < 0.001) and a higher incidence of BE (18.6 vs. 11.2%, P = 0.006). Women demonstrated significantly higher levels of anxiety (30.9 vs. 14.5%, P = 0.001), more severely impacting symptoms (45.3 ± 11.3 vs. 49.9 ± 12.3, P < 0.001), as well as physical (14.2 ± 5.7 vs. 16.7 ± 5.6, P < 0.001) and social dysfunction (13.3 ± 4.8 vs. 14.8 ± 4.3, P = 0.002). Women further reported a lower HRQoL (85.3 ± 22.7 vs. 92.9 ± 20.8, P < 0.001). Men and women differ on biological, psychological, and sociocultural levels.
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Affiliation(s)
- Kim Pelzner
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Claudia Fuchs
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Matti Petersen
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Martin Maus
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Christiane J Bruns
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Jessica M Leers
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
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Nunes GP, Silveira TC, Marciano JVS, dos Reis-Prado AH, Ferrisse TM, dos Anjos EB, Fernandes MH. The Effect of Dexlansoprazole on Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. Int J Mol Sci 2024; 25:1247. [PMID: 38279248 PMCID: PMC10816097 DOI: 10.3390/ijms25021247] [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: 12/13/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024] Open
Abstract
This systematic review and meta-analysis evaluated the efficacy of dexlansoprazole (a proton pump inhibitor-PPI) in resolving heartburn, reflux, and other symptoms and complications resulting from gastroesophageal reflux disease (GERD). The study followed PRISMA 2020 and was registered in PROSPERO (CRD42020206513). The search strategy used MeSH and free terms appropriately adapted for each database. Only randomized clinical trials (RCTs) were included. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the certainty of evidence was rated using GRADE. Ten RCTs were included. Dexlansoprazole outperformed the placebo and other PPIs in the resolution of heartburn and reflux symptoms in patients with GERD, with benefits during and after treatment, especially in those with moderate and severe symptoms. The meta-analyses indicated that dexlansoprazole at doses of 30 and 60 mg had more 24 h heartburn-free days and nights compared to the placebo medications; no difference was reported between dexlansoprazole at doses of 30 and 60 mg in heartburn-free nights. A low bias risk and a moderate certainty of evidence were observed. This review confirms the therapeutic effect of dexlansoprazole (placebo-controlled) and its improvements in GERD symptoms compared to another PPI. However, the interpretation of the results should be carried out cautiously due to the small number of included studies and other reported limitations.
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Affiliation(s)
- Gabriel Pereira Nunes
- Department of Restorative and Preventive Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16018-805, Brazil;
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4160-007 Porto, Portugal
- Associated Laboratory for Green Chemistry—LAQV/REQUIMTE, University of Porto, 4050-453 Porto, Portugal
| | - Thayná Cerqueira Silveira
- Department of Medicine, Institute of Health Sciences (ICS), United Colleges of Northern Minas (FUNORTE), Montes Claros 39404-006, Brazil
| | - João Vítor Silveira Marciano
- Department of Medicine, Institute of Health Sciences (ICS), United Colleges of Northern Minas (FUNORTE), Montes Claros 39404-006, Brazil
| | - Alexandre Henrique dos Reis-Prado
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, Brazil
- Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48104, USA
| | - Tulio Morandin Ferrisse
- Department of Diagnosis, Surgery and Oral Medicine, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, Brazil;
| | - Evandro Barbosa dos Anjos
- Department of Medicine, Institute of Health Sciences (ICS), United Colleges of Northern Minas (FUNORTE), Montes Claros 39404-006, Brazil
| | - Maria Helena Fernandes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4160-007 Porto, Portugal
- Associated Laboratory for Green Chemistry—LAQV/REQUIMTE, University of Porto, 4050-453 Porto, Portugal
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Zhou S, Xie L, Zhou C, Zhao Y, Wang L, Ding S, Chen J, Zhu B, Su M, Shao F. Keverprazan, a novel potassium-competitive acid blocker: Single ascending dose safety, tolerability, pharmacokinetics, pharmacodynamics and food effect in healthy subjects. Eur J Pharm Sci 2023; 190:106578. [PMID: 37666458 DOI: 10.1016/j.ejps.2023.106578] [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: 04/25/2023] [Revised: 07/28/2023] [Accepted: 09/01/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Keverprazan is a novel potassium-competitive acid blocker for the treatment of acid-related diseases. AIMS To evaluate the safety, pharmacokinetics, pharmacodynamics, and food effect of single oral doses of keverprazan in healthy Chinese subjects. METHODS In the dose-escalated phase Ia trial, the first 8 subjects received keverprazan 5 mg, the others successively entered 10 mg, 20 mg, 40 mg, 60 mg groups and were randomized to receive keverprazan (n = 8), lansoprazole (LSZ) 30 mg (n = 2) or placebo (n = 2) in each dose group. The phase Ib study randomly enrolled subjects to the fasting-fed (n = 7) or fed-fasting (n = 7) groups for evaluating the food effect of keverprazan. RESULTS Twenty (35.71%) adverse events (AEs) occurred in phase Ia, including 13 (32.50%), 3 (37.50%), and 4 (50.00%) AEs in the keverprazan, placebo, and LSZ groups, respectively. Four (28.57%) AEs occurred in Phase Ib. The Tmax of keverprazan was 1.25-1.75 h. Cmax and AUC increased with the dose, and the t1/2, CL/F were 6.00-7.17 h, 88.8-198 L/h, respectively. The intragastric pH >5 holding-time ratio (HTR) increased with the dose but reached a ceiling at 20 mg. In the 30 mg LSZ and 5-60 mg keverprazan groups, the intragastric pH >5 HTRs during 24 h were 57.1%±26.4%, 7.9%±8.1%, 26.2%±22.8%, 80.2%±8.8%, 88.1%±8.6%, and 93.0%±1.7%, respectively. The geometric mean ratios (90% CI) of Cmax and AUC0-∞ of keverprazan in plasma under the fed vs. fasting state were 126.8% (109.0%-147.5%) and 134.9% (123.8%-146.9%). CONCLUSION Keverprazan is tolerable, and provides significant stable and lasting inhibition efficacy of intragastric acidity at 20 mg.
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Affiliation(s)
- Sufeng Zhou
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Lijun Xie
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Chen Zhou
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Yuqing Zhao
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Lu Wang
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Sijia Ding
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Juan Chen
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Bei Zhu
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Mei Su
- Jiangsu Carephar Pharmaceutical Co., Ltd, Nanjing 210000, China.
| | - Feng Shao
- Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China; Department of Clinical Pharmacology, Pharmacy College, Nanjing Medical University, Nanjing 211166, China.
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Abbasi A, Siddiqui SA, Ram B, Khan JUA, Sheikh K, Ali A, Raja Memon W, Rehan M, Zia Ul Haq M, Kumar Seetlani N, Akhter TS, Khoso M, Javed A, Hussain Khokhar R, Hussain Memon Z, Akbar W, Naeem M, Shaikh S, Khan Khattak A, Memon AQ, Bhatty S, Sultan O, Shani I, Maheshwary N. Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population. Cureus 2023; 15:e48994. [PMID: 38111444 PMCID: PMC10726382 DOI: 10.7759/cureus.48994] [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] [Accepted: 11/14/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND AND AIM While proton pump inhibitor (PPI) therapy has proven to be effective in managing gastroesophageal reflux disease (GERD), a notable portion of patients who experience GERD symptoms may not respond to this treatment. Research suggests that roughly 30% of individuals with a presumed GERD diagnosis may continue to experience symptoms, whether partially or completely, even when receiving PPI therapy. The aim of this study was to assess the treatment of gastrointestinal diseases with a novel potassium-competitive acid blocker (P-CAB), vonoprazan, in terms of its effectiveness and safety in the Pakistani population. METHODS This prospective, multicenter, observational study was conducted in Pakistan. This study included 1,642 patients from January 2023 to August 2023, aged 18 years, with gastrointestinal disorders. All demographic data, medical history, GERD severity assessment questionnaire (GerdQ), and laboratory parameters, including stool assessment for Helicobacter pylori (H. pylori), were observed. Patients were orally treated with vonoprazan at doses of 10 mg or 20 mg, once or twice daily. Statistical analysis was done by one-way ANOVA. RESULTS Out of 1,642 patients, 840 (51.2%) were males and 802 (48.8%) were females, with a mean age of 39.81±14.61 years. The mean GerdQ score at baseline was 20.37±15.87, 7.24±8.15 at the second week of treatment, and 3.70±6.31 at the fourth week of treatment (p<0.001). 90.74% of patients achieved H. pylori eradication. Most patients were acid regurgitation and heartburn-free for >70% of days. Most of the patients, 1,283 (78.13%), exhibited good treatment compliance. Mild adverse events were reported in 37 (2.3%) patients. CONCLUSIONS The use of vonoprazan significantly reduced the likelihood of GERD by improving symptoms and was also highly effective in the elimination of H. pylori infections. Vonoprazan was generally well tolerated.
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Affiliation(s)
| | | | - Bikha Ram
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | | | - Khalid Sheikh
- Internal Medicine, People's University of Medical and Health Sciences for Women, Nawabshah, PAK
| | - Asif Ali
- Internal Medicine, Civil Hospital Karachi, Karachi, PAK
- Medicine, Dow General Hospital/Dow University of Health Sciences, Karachi, PAK
| | - Waseem Raja Memon
- Medicine, People's University of Medical and Health Sciences for Women, Nawabshah, PAK
| | | | | | | | | | - Masood Khoso
- Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, PAK
| | - Asif Javed
- Internal Medicine, Social Security New Born & Children Hospital (MNCH), Faisalabad, PAK
| | - Riaz Hussain Khokhar
- Internal Medicine, People's University of Medical and Health Sciences for Women, Nawabshah, PAK
| | | | - Wajid Akbar
- Internal Medicine, Bacha Khan Medical College, Peshawar, PAK
| | - M Naeem
- Gastroenterology, Mardan Medical Complex, Peshawar, PAK
| | | | | | | | - Shaheen Bhatty
- Internal Medicine, Dr. Ruth K. M. Pfau Civil Hospital, Karachi, PAK
| | - Omar Sultan
- Internal Medicine, Jinnah Postgraduate Medical Center, Karachi, PAK
| | - Idress Shani
- Internal Medicine, District Head Quarters (DHQ) Hospital, Faisalabad, PAK
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Zhou S, Xie L, Zhou C, Wang L, Chen J, Ding S, Zhu B, Su M, Shao F. Keverprazan, a novel potassium-competitive acid blocker: Multiple oral doses safety, tolerability, pharmacokinetics, and pharmacodynamics in healthy subjects. Clin Transl Sci 2023; 16:1911-1922. [PMID: 37533172 PMCID: PMC10582672 DOI: 10.1111/cts.13598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/20/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
Keverprazan, a novel potassium-competitive acid blocker, was approved for treating acid-related diseases. This study aimed to analyze the safety, pharmacokinetics (PKs) and pharmacodynamics (PDs) of multiple doses of keverprazan. This was a randomized, positive-/placebo-controlled, phase Ic trial. Twenty-six healthy adults were randomized to receive 20 mg/day keverprazan (n = 8), 40 mg/day keverprazan (n = 8), placebo (n = 6), or 20 mg/day vonoprazan (n = 4) for 7 days. Safety, PK and PD assessments were conducted. In the keverprazan, vonoprazan, and placebo groups, adverse events (AEs) were reported in nine (56.25%), two (50.00%), and three (50.00%) subjects, respectively. AEs were mild except a moderate abdominal pain leading to withdraw. No serious AEs occurred. The plasma concentration-time profiles of keverprazan showed rapid absorption (median time to maximum plasma concentration of 1.25-3.0 h). The terminal half-life was 6.23 and 7.01 h for keverprazan 20 and 40 mg groups on day 7. The maximum plasma concentration was 43.1 and 93.2 ng/mL, respectively. There was no apparent accumulation of keverprazan and the major metabolite after 7-day administration. The intragastric pH greater than 5 holding time ratios (HTRs) over 24 h postdose increased from 79.1%, 84.4%, and 84.5% on day 1 to 99.0%, 97.4%, and 100.0% on day 7 in the vonoprazan 20 mg and keverprazan 20 and 40 mg groups, respectively. The intragastric pH greater than 5 HTR of keverprazan reached a plateau at 20 mg. Keverprazan is well-tolerable. A steady-state in exposure was generally reached after 7 days of treatment. A dose of 20 mg/day keverprazan can elicit a significant, stable, and long-lasting gastric acid inhibition effect.
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Affiliation(s)
- Sufeng Zhou
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Lijun Xie
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Chen Zhou
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Lu Wang
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Juan Chen
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Sijia Ding
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Bei Zhu
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Mei Su
- Jiangsu Carephar Pharmaceutical Co., Ltd.NanjingChina
| | - Feng Shao
- Phase I Clinical Trial UnitThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Department of Clinical PharmacologyPharmacy College, Nanjing Medical UniversityNanjingChina
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11
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Tran CL, Han M, Kim B, Park EY, Kim YI, Oh J. Gastroesophageal reflux disease and risk of cancer: Findings from the Korean National Health Screening Cohort. Cancer Med 2023; 12:19163-19173. [PMID: 37676071 PMCID: PMC10557881 DOI: 10.1002/cam4.6500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
AIM Little is known about the association of cancers other than esophageal adenocarcinoma with gastroesophageal reflux disease (GERD). This study aimed to examine the association between GERD and the risk of different types of cancer. METHODS A cohort study was conducted using data from the National Health Screening Cohort. We included 10,261 GERD patients and 30,783 non-GERD individuals who were matched in a 1:3 ratio by age and sex. All participants were followed-up until cancer diagnosis, death, or end of the study (December 31, 2015). Hazard ratios were calculated using the Cox proportional hazards model, adjusting for smoking and alcohol consumption, physical activity, body mass index, income, area, and Charlson Comorbidity Index. RESULTS The median follow-up time was 9.9 years. GERD was associated with an increased risk of esophageal (adjusted hazard ratios [aHR] = 3.20 [1.89-5.41]), laryngeal (aHR = 5.42 [2.68-10.96]), and thyroid cancers (aHR = 1.91 [1.55-2.34]) after controlling for all covariates. The results were consistent when examining GERD with esophagitis (K210) and without esophagitis (K219) separately. For thyroid cancer, the results were insignificant after controlling for having ever-received thyroid biopsy procedures. A dose-response relationship was found between GERD and esophageal cancer as well as laryngeal cancer, with patients with a longer duration of GERD treatment showing a stronger effect. In contrast, GERD was associated with a reduced risk of colorectal (aHR = 0.73 [0.59-0.90]), liver (aHR = 0.67 [0.51-0.89]), and pancreatic cancers (aHR = 0.43 [0.24-0.76]), which might have resulted from differences in healthcare utilization between GERD and non-GERD groups. CONCLUSION GERD was associated with an increased risk of esophageal and laryngeal cancers. Additionally, early detection and treatment of precancerous lesions among the GERD group could lead to a lower risk of colorectal, liver, and pancreatic cancers.
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Affiliation(s)
- Chi Lan Tran
- Department of Cancer Control and Population HealthGraduate School of Cancer Science and Policy, National Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
| | - Minji Han
- Department of Cancer Control and Population HealthGraduate School of Cancer Science and Policy, National Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
- Division of Cancer PreventionNational Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
- Department of Health Science and Technology, Graduate School of Convergence Science and TechnologySeoul National UniversitySeoulRepublic of Korea
| | - Byungmi Kim
- Division of Cancer PreventionNational Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
| | - Eun Young Park
- Department of Preventive MedicineKorea University College of MedicineSeoulRepublic of Korea
| | - Young Il Kim
- Center for Gastric CancerNational Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
| | - Jin‐Kyoung Oh
- Department of Cancer Control and Population HealthGraduate School of Cancer Science and Policy, National Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
- Division of Cancer PreventionNational Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
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12
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Mari A, Na'amnih W, Ghantous L, Ahmad HS, Khoury T, Muhsen K. Quality of life and severity of symptoms among patients with various degrees of reflux esophagitis: a prospective study. Sci Rep 2023; 13:13970. [PMID: 37634042 PMCID: PMC10460377 DOI: 10.1038/s41598-023-41332-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/24/2023] [Indexed: 08/28/2023] Open
Abstract
Gastro-esophageal reflux disease (GERD) can cause erosive esophagitis (EE) and compromise the quality of life (QoL). We examined differences in symptom severity and QoL according to EE severity grade. A follow-up study was conducted among GERD patients at the Nazareth Hospital in Israel. Patients underwent a baseline gastroscopy in 2014-2020 during which the EE grade was determined using the Los Angeles classification. Follow-up telephone interviews were conducted during 2019-2020 with a mean time interval of 18.9 months (SD = 14.9) after the baseline gastroscopy to assess GERD symptoms using the Reflux disease questionnaire (RDQ) and QoL using the GERD QoL questionnaire. The patients were interviewed in their native language (Arabic or Hebrew). Overall, 149 (66.4% males) patients were included; 50 had EE grades C/D and 99 had grades A/B. The mean age at baseline and follow-up was 44.6 years (SD = 15.1) and 46.2 years (SD = 14.9), respectively. Cronbach's alpha was 0.928 and 0.855 for the RDQ and QoL questionnaires, respectively. Patients with EE C/D grades had more severe symptoms than patients with EE A/B grades (P = 0.05), especially in regurgitation scores (P = 0.03). Females had more severe symptoms (overall) than males (adjusted OR = 2.34; 95% CI 1.12-4.90). Patients with the more severe esophagitis EE C/D group (adjusted OR = 1.98; 95% CI 0.93-4.24) and those who used PPIs treatment (adjusted OR = 2.19; 95% CI 0.95-5.01) reported more severe GERD symptoms. The number of schooling years was significantly associated with better QoL score (beta coefficient 1.33, P = 0.005) but not EE grade or GERD symptoms. Follow-up endoscopy conducted among 22 patients with EE grades C/D showed that 13 (59.1%) of these patients had normal endoscopic findings, 6 patients (27.3%) had a grade A EE, 1 patient (4.5%) had grade B, and 2 (9.1%) remained with grade C EE. The Arabic and Hebrew versions of the RDQ and QoL questionnaires were highly reliable. GERD symptoms severity was more profound among patients with more severe esophagitis. No significant association between EE grade and QoL; this negative result might be due to the improvement in esophagitis endoscopic findings among patients with C/D grade.
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Affiliation(s)
- Amir Mari
- Gastroenterology Department, Azrieli Faculty of Medicine, Gastroenterology and Hepatology Institute, Nazareth Hospital, Bar Ilan University, 16100, Nazareth, Israel.
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Wasef Na'amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Loay Ghantous
- Internal Medicine Department, Azrieli Faculty of Medicine, Nazareth Hospital, Bar Ilan University, Nazareth, Israel
| | - Helal Said Ahmad
- Gastroenterology Department, Azrieli Faculty of Medicine, Gastroenterology and Hepatology Institute, Nazareth Hospital, Bar Ilan University, 16100, Nazareth, Israel
| | - Tawfik Khoury
- Gastroenterology Department, Azrieli Faculty of Medicine, Gastroenterology and Hepatology Institute, Nazareth Hospital, Bar Ilan University, 16100, Nazareth, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Ku JM, Cho JH, Kim K, Kim JY, Kim JY, Kim J, Cha H, Cheon B. JP-1366: A novel and potent potassium-competitive acid blocker that is effective in the treatment of acid-related diseases. Pharmacol Res Perspect 2023; 11:e01090. [PMID: 37147903 PMCID: PMC10163344 DOI: 10.1002/prp2.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/07/2023] Open
Abstract
The global prevalence of GERD is substantially increasing each year, and GERD is a chronic disease that reduces the quality of life of patients. The efficacy of conventional drugs is diverse, and most require long-term or lifetime administration; thus, the development of more effective therapeutic agents is needed. Herein, a more effective treatment for GERD was tested. We investigated whether JP-1366 affected gastric H+/K+-ATPase activity and used the Na+/K+-ATPase assay to confirm the selectivity of H+/K+-ATPase inhibition. To clarify the mechanism of enzyme inhibition, JP-1366 and TAK-438 were analyzed by Lineweaver-Burk. Also, we investigated the effects of JP-1366 in various models involving reflux esophagitis. We found that JP-1366 mediates strong, selective, and dose-dependent inhibition of H+/K+-ATPase. We found that JP-1366 significantly suppressed gastric acid secretion in histamine-treated pylorus-ligated rats in a dose-dependent manner. Additionally, we confirmed that JP-1366 inhibited histamine-stimulated gastric acid secretion in the HPD model. JP-1366 exhibited a more than 2-fold higher inhibitory effect on esophageal injury than TAK-438 in GERD lesions and had a more potent inhibitory effect in indomethacin- or aspirin-induced gastric ulcer rat models than TAK-438. Additionally, JP-1366 inhibited gastric ulcers. These results support the possibility that JP-1366 is a good candidate drug for treating acid-related diseases.
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Affiliation(s)
- Jin Mo Ku
- Pharmacological Toxicology Laboratory, Jeil Pharmaceutical, Yongin-si, South Korea
| | - Jin Hee Cho
- Pharmacological Toxicology Laboratory, Jeil Pharmaceutical, Yongin-si, South Korea
| | - Kangjeon Kim
- Pharmacological Toxicology Laboratory, Jeil Pharmaceutical, Yongin-si, South Korea
| | - Ji Yoon Kim
- Division of New Drug Development, Jeil Pharmaceutical, Yongin-si, South Korea
| | - Jong Yup Kim
- Division of New Drug Development, Jeil Pharmaceutical, Yongin-si, South Korea
| | - John Kim
- Onconic Therapeutics Inc, Seoul, South Korea
| | - Hyunju Cha
- Onconic Therapeutics Inc, Seoul, South Korea
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14
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ARAGONA SE, CIPRANDI G. Gastric pyrosis and hyperacidity: an outstanding task in clinical practice. The positioning of a new multicomponent medical device containing sodium alginate, tamarind seed extract, and carbonates. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2023; 182. [DOI: 10.23736/s0393-3660.23.05040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
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15
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Zhou Z. Evaluation of ChatGPT's Capabilities in Medical Report Generation. Cureus 2023; 15:e37589. [PMID: 37197105 PMCID: PMC10184716 DOI: 10.7759/cureus.37589] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/19/2023] Open
Abstract
The growing demand for efficient healthcare delivery has intensified the need for technological innovations that facilitate medical professionals' decision-making processes. In this study, we investigate ChatGPT (OpenAI Incorporated, Mission District, San Francisco, United States), a state-of-the-art language model based on the GPT-4 architecture, as an effective tool for assisting healthcare professionals in writing medical reports based on real patient laboratory results. By leveraging ChatGPT's extraordinary performance across multiple medical domains, including lab result diagnostics and medical literature analysis, we aimed to streamline and enhance the medical report generation process. The generated case report presents a 31-year-old male patient with no significant past medical history who visited a clinic to establish care and seek evaluation for abdominal pain. Following routine laboratory tests, including a complete blood count, comprehensive metabolic panel, and a Helicobacter pylori breath test, ChatGPT provided tailored recommendations addressing identified concerns and abnormalities. These included lifestyle modifications, such as dietary changes, weight management, and avoiding trigger foods or behaviors; alongside medical treatment options, the patient was advised to consult a gastroenterologist for further evaluation and potential advanced treatment options. The organization and structure of this case study are derived from ChatGPT's output, using patient's actual physical information and lab results as input, without any prior knowledge. Ultimately, we will compare the generated report with suggestions from an online doctor consultation system to demonstrate the precision and reliability of ChatGPT's recommendations. Through this comparison, we aim to show that ChatGPT can produce coherent, comprehensive, and clinically relevant medical reports with a relatively high degree of accuracy and consistency.
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Affiliation(s)
- Zeyu Zhou
- Computer Science, Georgia Institute of Technology, Atlanta, USA
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16
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Dabir M, Novruzov E, Mattes-György K, Beu M, Dendl K, Antke C, Koerber SA, Röhrich M, Kratochwil C, Debus J, Haberkorn U, Giesel FL. Distinguishing Benign and Malignant Findings on [ 68 Ga]-FAPI PET/CT Based on Quantitative SUV Measurements. Mol Imaging Biol 2023; 25:324-333. [PMID: 35997853 PMCID: PMC10006041 DOI: 10.1007/s11307-022-01759-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/23/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
AIM/PURPOSE Fibroblast activation protein (FAP) is overexpressed by cancer-associated fibroblasts. However, activated fibroblasts have been shown to play a significant role also in certain benign conditions such as wound healing or chronic inflammation. Therefore, the current study aimed to identify whether FAPI uptake might differ between malignant lesions and benign conditions. MATERIAL AND METHODS We retrospectively analyzed 155 patients with various cancer types who received [68 Ga]-FAPI-04/02-PET/CT between July 2017 and March 2020. SUVmax, SUVmean, and lesion-to-background ratios (LBR) of FAPI uptake were measured in benign processes compared to malignant lesions (primary and/or 2 exemplary metastases). In addition, receiver operating characteristic (ROC) curve analysis was conducted to compare the predictive capabilities of semiquantitative PET/CT parameters. Furthermore, the sensitivity, specificity, optimal cutoff value, and 95% confidence interval (CI) were determined for each parameter. RESULTS Benign lesions exhibited significantly lower FAPI uptake compared to malignant lesions (mean SUVmax benign vs. malignant: 4.2 vs. 10.6; p < 0.001). In ROC analysis, cutoff values of these lesions (benign vs. malignant) were established based on SUVmax, SUVmean, and LBR. The SUVmax cutoff value for all lesions was 5.5 and the corresponding sensitivity, specificity, accuracy, and AUC were 78.8%, 85.1%, 82.0%, and 0.89%, respectively. CONCLUSION Our aim was to systematically analyze the pattern of FAPI uptake in benign and malignant processes. This investigation demonstrates that FAPI uptake might be useful to differentiate malignant and benign findings due to different patho-physiological origins.
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Affiliation(s)
- M Dabir
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - E Novruzov
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - K Mattes-György
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - M Beu
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - K Dendl
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.,Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - C Antke
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - S A Koerber
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - M Röhrich
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - J Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - F L Giesel
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany. .,Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.
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17
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What is the role of proton pump inhibitors consumption on the clinical presentation and severity of COVID-19 infection? ANNALES PHARMACEUTIQUES FRANÇAISES 2023; 81:210-219. [PMID: 36049543 PMCID: PMC9422333 DOI: 10.1016/j.pharma.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Proton pump inhibitors (PPI) are among the most prescribed drugs worldwide; therefore, assessing their effect on COVID-19 infection symptoms and severity is of great importance. This study was designed to evaluate the role of previous PPI consumption on the clinical presentation and severity of COVID-19. PATIENTS AND METHODS All adult COVID-19 patients were eligible in this observational cross-sectional study. The patients' demographic and clinical data, history of PPI consumption, and comorbid disease were recorded. Charlson comorbidity index (CCI) and quick COVID-19 severity index (qCSI) score were calculated for each patient. IBM SPSS version 25 was used for statistical analysis. RESULTS Totally 670 patients completed the study (PPI users=121). The average severity (qCSI) score of PPI user patients with comorbidity score of zero was significantly higher than non-users (P-value=0.001). Mortality rate was 6.6% and 3.8% in PPI-users and non-users respectively (P-value=0.117). PPI users were significantly more symptomatic compared to non-users (P-value=0.001). CONCLUSION We found that PPI users were meaningfully more symptomatic and had a higher severity (qCSI) score. Rational prescription of PPIs should be considered by physicians during and after the pandemic.
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18
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Arangia A, Marino Y, Impellizzeri D, D’Amico R, Cuzzocrea S, Di Paola R. Hydroxytyrosol and Its Potential Uses on Intestinal and Gastrointestinal Disease. Int J Mol Sci 2023; 24:ijms24043111. [PMID: 36834520 PMCID: PMC9964144 DOI: 10.3390/ijms24043111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
In recent years, the phytoconstituents of foods in the Mediterranean diet (MD) have been the subject of several studies for their beneficial effects on human health. The traditional MD is described as a diet heavy in vegetable oils, fruits, nuts, and fish. The most studied element of MD is undoubtedly olive oil due precisely to its beneficial properties that make it an object of interest. Several studies have attributed these protective effects to hydroxytyrosol (HT), the main polyphenol contained in olive oil and leaves. HT has been shown to be able to modulate the oxidative and inflammatory process in numerous chronic disorders, including intestinal and gastrointestinal pathologies. To date, there is no paper that summarizes the role of HT in these disorders. This review provides an overview of the anti-inflammatory and antioxidant proprieties of HT against intestinal and gastrointestinal diseases.
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Affiliation(s)
- Alessia Arangia
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Ylenia Marino
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Daniela Impellizzeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
- Correspondence: (D.I.); (R.D.); Tel.: +39-090-676-5208 (D.I. & R.D.)
| | - Ramona D’Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
- Correspondence: (D.I.); (R.D.); Tel.: +39-090-676-5208 (D.I. & R.D.)
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Rosanna Di Paola
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy
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19
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Zhang A, Liu W, Niu L, Zhu L, Yang L, Li X. Correlation analysis and prognostic value of miR-29a-3p expression and CYP2C19 genotypes in exfoliated cells from tongue coating of patients with gastroesophageal reflux disease. Genes Genomics 2023; 45:673-680. [PMID: 36662390 DOI: 10.1007/s13258-022-01347-5] [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: 08/03/2022] [Accepted: 11/21/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a highly prevalent and troublesome disease. Several differentially expressed microRNAs (miRNAs) have been found in GERD. OBJECTIVE This study was to analyze the correlation of miR-29a-3p expression and CYP2C19 genotypes in exfoliated cells from tongue coating of GERD patients and its prognostic value. METHODS Tongue coating specimens were collected from 130 GERD patients and 70 healthy volunteers and their clinical baseline information was recorded. miR-29a-3p expression in exfoliated cells from tongue coating was determined via RT-qPCR, and its diagnostic efficiency on GERD was evaluated via receiver operating characteristic curve. CYP2C19 genotypes and their correlation with miR-29a-3p were analyzed via polymerase chain reaction restriction fragment length polymorphism technique. The adverse events of patients were documented via 12-month follow-up. The impact of miR-29a-3p expression on the healing rate of patients was analyzed via Kaplan-Meier method. Qualification of miR-29a-3p as an independent prognostic factor of GERD patients was analyzed via multivariate Cox regression analysis. RESULTS miR-29a-3p was highly-expressed in exfoliated cells from tongue coating of GERD patients. miR-29a-3p expression had high specificity and sensitivity in diagnosing GERD. CYP2C19 genotypes in GERD patients comprised rapid metabolizers, intermedia metabolizers, and poor metabolizers. miR-29a-3p expression showed a correlation with CYP2C19 genotypes. Higher miR-29a-3p expression predicted higher cumulative incidences of adverse outcomes. Highly-expressed miR-29a-3p was an independent prognostic factor for adverse outcomes of GERD patients. CONCLUSION High expression of miR-29a-3p aided the diagnosis and predicted poor prognosis of GERD patients.
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Affiliation(s)
- Aiqing Zhang
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, Jiangsu Province, China.,Department of Gastroenterology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China
| | - Wenjuan Liu
- Department of Gastroenterology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China
| | - Lingyun Niu
- Department of Gastroenterology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China
| | - Liping Zhu
- Department of Gastroenterology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China
| | - Liuqing Yang
- Department of Gastroenterology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China
| | - Xueliang Li
- Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, Jiangsu Province, China.
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20
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Tack J, Vladimirov B, Horny I, Chong CF, Eisner J, Czerniak R, Takanami Y. Randomized clinical trial: A double-blind, proof-of-concept, phase 2 study evaluating the efficacy and safety of vonoprazan 20 or 40 mg versus esomeprazole 40 mg in patients with symptomatic gastro-esophageal reflux disease and partial response to a healing dose of a proton-pump inhibitor. Neurogastroenterol Motil 2023; 35:e14468. [PMID: 36178335 DOI: 10.1111/nmo.14468] [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: 01/25/2022] [Revised: 08/25/2022] [Accepted: 09/12/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Proton-pump inhibitors (PPIs) are cornerstone treatments for gastro-esophageal reflux disease (GERD); however, evidence suggests that most patients exhibit partial response to PPIs, suggesting the need for novel therapies that can provide an improved and sustained increase in gastric pH. AIMS This study aimed to determine the effect of vonoprazan, a novel, orally active small-molecule potassium-competitive acid blocker, versus esomeprazole, a PPI, in preventing heartburn symptoms over a 4-week treatment period in patients with GERD and a partial response to esomeprazole treatment. METHODS This randomized, double-blind, proof-of-concept, phase 2 clinical trial was conducted between 2016 and 2018 at 39 sites across Europe and designed to evaluate the efficacy and safety of vonoprazan 20 mg once daily (q.d.) and 40 mg q.d. versus esomeprazole 40 mg q.d. after 1:1:1 randomization of symptomatic patients with GERD and a partial response to a healing dose of esomeprazole. RESULTS Overall, 256 eligible patients (female, 59.4%; mean age, 52.6 years) received vonoprazan 20 mg (n = 85), vonoprazan 40 mg (n = 85), or esomeprazole 40 mg (n = 86); mean (SD) percentages of heartburn-free 24-h periods during double-blind treatment were 36.7% (33.4%), 36.5% (35.6%), and 38.4% (34.8%), respectively, with no intergroup statistical significance. Vonoprazan exposure increased proportionally from the 20-mg to 40-mg dose (mean Cmax : 23.3 ng/ml to 47.1 ng/ml, respectively). Most treatment-emergent adverse events were mild, with no deaths reported. CONCLUSIONS No statistically significant difference in efficacy and safety was observed among treatment groups, and vonoprazan was well tolerated. The trial is registered with the National Board of Health (EudraCT: 2015-001154-14) database.
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Affiliation(s)
- Jan Tack
- Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium
| | - Borislav Vladimirov
- Department of Gastroenterology, University Hospital "Queen Giovanna- ISUL", Medical University of Sofia, Sofia, Bulgaria
| | - Ivo Horny
- Department of Gastroenterology and Internal medicine, Strakonice Hospital, Czech Republic
| | - Chui Fung Chong
- Currently Hoffmann-La Roche, Formerly Takeda Development Center Asia, Basel, Switzerland
| | - Jessica Eisner
- Formerly Takeda Pharmaceuticals International Co., Takeda Pharmaceuticals International Co., Cambridge, USA
| | - Richard Czerniak
- Takeda Pharmaceuticals International Co., Cambridge, Massachusetts, USA
| | - Yohei Takanami
- Takeda Pharmaceuticals International Co., Cambridge, Massachusetts, USA
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21
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Nan L, Nam HH, Choo BK. Agastache rugosa inhibits LPS-induced by RAW264.7 cellular inflammation and ameliorates oesophageal tissue damage from acute reflux esophagitis in rats. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Brendon dos Santos C, Artioli DP, Flor Bertolini GR. Manual therapy as a management approach for gastroesophageal reflux disease: A systematic review. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Altuwaijri M. Evidence-based treatment recommendations for gastroesophageal reflux disease during pregnancy: A review. Medicine (Baltimore) 2022; 101:e30487. [PMID: 36107559 PMCID: PMC9439837 DOI: 10.1097/md.0000000000030487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Gastroesophageal reflux disease (GERD) occurs in approximately two-thirds of all pregnancies. Around 25% of pregnant women experience heartburn daily. Symptomatic GERD usually presents in the first trimester and progresses throughout pregnancy. The treatment goal is to alleviate heartburn and regurgitation without jeopardizing the pregnancy or its outcome. An English language electronic literature search of MEDLINE, EMBASE, and Cochrane Reviews was undertaken to identify randomized controlled trials, observational studies, management recommendations and reviews of GERD and its treatment during pregnancy. The search period was defined by the date of inception of each database. The treatment in a pregnant GERD patient should follow the step-up approach, starting with lifestyle modification as the first step. If heartburn is severe, medication should be started after consultation with a physician (Recommendation Grade C). The preferred choice of antacids is calcium-containing antacids (Recommendation Grade A). If symptoms persist with antacids Sucralfate can be introduced at a 1g oral tablet, 3 times daily (Recommendation Grade C). Followed by histamine-2 receptor antagonist (Recommendation Grade B). Inadequate control while on histamine-2 receptor antagonist and antacid may mandate a step-up to proton pump inhibitors along with antacids as rescue medication for breakthrough GERD (Recommendation Grade C). This article presented the treatment recommendations for pregnant women with typical GERD, based on the best available evidence.
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Affiliation(s)
- Mansour Altuwaijri
- Division of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- *Correspondence: Mansour Altuwaijri, Division of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia (e-mail: )
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24
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Polese B, Izzo L, Mancino N, Pesce M, Rurgo S, Tricarico MC, Lombardi S, De Conno B, Sarnelli G, Ritieni A. Effect of Dewaxed Coffee on Gastroesophageal Symptoms in Patients with GERD: A Randomized Pilot Study. Nutrients 2022; 14:nu14122510. [PMID: 35745239 PMCID: PMC9231412 DOI: 10.3390/nu14122510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Gastroesophageal Reflux Disease (GERD) is multifactorial pathogenesis characterized by the abnormal reflux of stomach contents into the esophagus. Symptoms are worse after the ingestion of certain foods, such as coffee. Hence, a randomized pilot study conducted on 40 Italian subjects was assessed to verify the effect of standard (SC) and dewaxed coffee (DC) consumption on gastroesophageal reflux symptoms and quality of life in patients with gastrointestinal diseases. The assessment of patient diaries highlighted a significant percentage reduction of symptoms frequency when consuming DC and a significant increase in both heartburn-free and regurgitation-free days. Consequentially, patients had a significant increase of antacid-free days during the DC assumption. Moreover, the polyphenolic profile of coffee pods was ascertained through UHPLC-Q-Orbitrap HRMS analysis. Chlorogenic acids (CGAs) were the most abundant investigated compounds with a concentration level ranging between 7.316 (DC) and 6.721 mg/g (SC). Apart from CGAs, caffeine was quantified at a concentration level of 5.691 mg/g and 11.091 for DC and SC, respectively. While still preliminary, data obtained from the present pilot study provide promising evidence for the efficacy of DC consumption in patients with GERD. Therefore, this treatment might represent a feasible way to make coffee more digestible and better tolerated.
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Affiliation(s)
- Barbara Polese
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Luana Izzo
- Food Lab, Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy; (S.L.); (A.R.)
- Correspondence: ; Tel.: +39-081-678116
| | - Nicola Mancino
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Marcella Pesce
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Sara Rurgo
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | | | - Sonia Lombardi
- Food Lab, Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy; (S.L.); (A.R.)
| | - Barbara De Conno
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Giovanni Sarnelli
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
- United Nations Educational, Scientific and Cultural Organization Chair on Health Education and Sustainable Development, University of Naples “Federico II”, 80131 Naples, Italy
| | - Alberto Ritieni
- Food Lab, Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy; (S.L.); (A.R.)
- United Nations Educational, Scientific and Cultural Organization Chair on Health Education and Sustainable Development, University of Naples “Federico II”, 80131 Naples, Italy
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25
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Mahajan R, Kulkarni R, Stoopler ET. Gastroesophageal reflux disease and oral health: A narrative review. SPECIAL CARE IN DENTISTRY 2022; 42:555-564. [PMID: 35605234 DOI: 10.1111/scd.12726] [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: 01/21/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/28/2022]
Abstract
Gastroesophageal reflux disease (GERD) is a clinical condition in which stomach contents leak backward into the esophagus. It affects millions of people worldwide and has a detrimental effect on quality of life. Heartburn and acid regurgitation are typical GERD symptoms, while atypical manifestations include noncardiac chest pain, cough and laryngitis. The oral and maxillofacial manifestations of GERD may include dental erosion, xerostomia, mucositis, aphthous like ulcerations, sour taste, burning mouth, hyperesthesia, bruxism, and/or temporomandibular disorder (TMD). This narrative review provides oral health care professionals with an update to medical aspects of GERD, recognition and management of oral and maxillofacial manifestations of the condition and provision of appropriate dental care for this patient population.
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Affiliation(s)
- Roopali Mahajan
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Roopali Kulkarni
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Eric T Stoopler
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
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26
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Huang ZP, Qiu H, Wang K, He JW, Chen H, Kong LW, Zou Y. Changes in esophagus interstitial cells of Cajal in response to acute stress. Scand J Gastroenterol 2022; 57:392-400. [PMID: 34978503 DOI: 10.1080/00365521.2021.2018490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Thoracic trauma is common, and traffic accident-related traumatic injury can cause acute stress leading to esophageal motility disorders. Interstitial cells of Cajal (ICCs) are regarded as gastrointestinal pacemaker cells. AIM This study explored the mechanism underlying changes in lower esophagus ICCs under acute stress conditions. METHODS Fifty adult rabbits, randomly divided into one healthy control and four study groups, were subjected to right chest puncture using a Hopkinson bar. Thereafter, one group was immediately subjected to lower esophagectomy, whereas the other three groups were maintained for 24, 48 and 72 h after puncture and subjected to lower esophagectomy. Immunohistochemistry was used to detect ICC distribution, morphology and density, and TUNEL assays were used to determine ICC apoptosis. Enzyme-linked immunosorbent assays (ELISAs) were used to measure cortisol, epinephrine, dopamine, IL-9, cholecystokinin (CCK) and vasoactive intestinal peptide (VIP). Western blotting and RT-PCR were performed to detect changes in SCF/c-kit and nNOS pathways. RESULTS After puncture, lung tissue was hemorrhaged, alveoli in puncture areas were destroyed, esophageal pH was decreased, and serum cortisol, epinephrine and dopamine levels increased. ICC numbers increased and apoptotic ICCs decreased in all stress groups after puncture (all p < .01). IL-9, CCK and VIP levels in lower esophagus tissue were increased after puncture (all p < .01). Moreover, SCF/c-kit and nNOS pathways were upregulated in response to stress (all p < .01). CONCLUSIONS Acute stress promotes increases in lower esophageal ICCs that might affect esophagus ICC functions and esophageal motility.
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Affiliation(s)
- Zhen-Peng Huang
- Guangzhou Institute of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Hu Qiu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jia-Wei He
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Hang Chen
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Ling-Wang Kong
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Yue Zou
- Department of Cancer Biology and Life Sciences, College of Medicine, University of Toledo, Toledo, OH, USA
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Role of Obesity, Physical Exercise, Adipose Tissue-Skeletal Muscle Crosstalk and Molecular Advances in Barrett's Esophagus and Esophageal Adenocarcinoma. Int J Mol Sci 2022; 23:ijms23073942. [PMID: 35409299 PMCID: PMC8999972 DOI: 10.3390/ijms23073942] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023] Open
Abstract
Both obesity and esophageal adenocarcinoma (EAC) rates have increased sharply in the United States and Western Europe in recent years. EAC is a classic example of obesity-related cancer where the risk of EAC increases with increasing body mass index. Pathologically altered visceral fat in obesity appears to play a key role in this process. Visceral obesity may promote EAC by directly affecting gastroesophageal reflux disease and Barrett’s esophagus (BE), as well as a less reflux-dependent effect, including the release of pro-inflammatory adipokines and insulin resistance. Deregulation of adipokine production, such as the shift to an increased amount of leptin relative to “protective” adiponectin, has been implicated in the pathogenesis of BE and EAC. This review discusses not only the epidemiology and pathophysiology of obesity in BE and EAC, but also molecular alterations at the level of mRNA and proteins associated with these esophageal pathologies and the potential role of adipokines and myokines in these disorders. Particular attention is given to discussing the possible crosstalk of adipokines and myokines during exercise. It is concluded that lifestyle interventions to increase regular physical activity could be helpful as a promising strategy for preventing the development of BE and EAC.
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Garg V, Narang P, Taneja R. Antacids revisited: review on contemporary facts and relevance for self-management. J Int Med Res 2022; 50:3000605221086457. [PMID: 35343261 PMCID: PMC8966100 DOI: 10.1177/03000605221086457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Heartburn and acid regurgitation are the typical symptoms of gastroesophageal reflux. Despite the availability of several treatment options, antacids remain the mainstay treatment for gastroesophageal reflux-related symptoms based on their efficacy, safety, and over-the-counter availability. Antacids are generally recommended for adults and children at least 12 years old, and the FDA recommends antacids as the first-line treatment for heartburn in pregnancy. This narrative review summarizes the mechanism, features, and limitations related to different antacid ingredients and techniques available to study the acid neutralization and buffering capacity of antacid formulations. Using supporting clinical evidence for different antacid ingredients, it also discusses the importance of antacids as OTC medicines and first-line therapies for heartburn, particularly in the era of the COVID-19 pandemic, in which reliance on self-care has increased. The review will also assist pharmacists and other healthcare professionals in helping individuals with heartburn to make informed self-care decisions and educating them to ensure that antacids are used in an optimal, safe, and effective manner.
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Affiliation(s)
- Vandana Garg
- Medical Innovation Director, GSK Consumer Healthcare Pte Ltd., Singapore
| | - Prashant Narang
- Medical Affairs Director, GSK Consumer Healthcare Pte Ltd., Gurugram (Haryana), India
| | - Ritu Taneja
- Senior Director, Innovation and Localization Lead, GSK Consumer Healthcare Pte Ltd., Singapore
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29
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Niknam R, Lankarani KB, Moghadami M, Taghavi SA, Zahiri L, Fallahi MJ. The association between helicobacter pylori infection and erosive gastroesophageal reflux disease; a cross-sectional study. BMC Infect Dis 2022; 22:267. [PMID: 35305563 PMCID: PMC8934462 DOI: 10.1186/s12879-022-07278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The association between H. pylori (Helicobacter pylori) infection and gastroesophageal reflux disease (GERD) is a complex and confusing subject. The aim of this study was to evaluate the association between helicobacter pylori infection and erosive gastroesophageal reflux disease. METHOD In a cross-sectional study, all patients referred for endoscopy due to dyspepsia were enrolled. The diagnosis of erosive GERD was made by endoscopy. Patients with normal esophagus were selected as comparison group. Random gastric biopsies were taken from all participants to diagnose H. pylori infection. RESULT In total, 1916 patients were included in this study, of whom 45.6% had GERD. The mean age (SD) was 42.95 (16.32). Overall, 1442 (75.3%) patients were positive for H. pylori infection. The frequency of H. pylori infection in mild GERD patients was higher than the severe GERD, but this difference was not significant (P = 0.214). Except for sociodemographic status (P < 0.001), other variables including gender, age, ethnicity, body mass index (BMI), smoking, and presence of hiatus hernia in patients had no significant association with the frequency of H. pylori infection. According to Robust Poisson regression models analysis, the association of H. pylori (PR 1.026; 95% CI 0.990-1.064; P = 0.158) and sociodemographic status were not significantly different between the two groups. But smoking, increased BMI, older age, presence of hiatus hernia, and peptic ulcer diseases were significantly associated with GERD compared with the non-GERD group. CONCLUSION In our results, there was no association between H. pylori infection and erosive GERD. Further studies are recommended.
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Affiliation(s)
- Ramin Niknam
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Alireza Taghavi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Zahiri
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Fallahi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Yang E, Kim S, Kim B, Kim B, Kim Y, Park SS, Song GS, Yu KS, Jang IJ, Lee SH. Night-time gastric acid suppression by tegoprazan compared to vonoprazan or esomeprazole. Br J Clin Pharmacol 2022; 88:3288-3296. [PMID: 35146797 PMCID: PMC9305887 DOI: 10.1111/bcp.15268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/18/2022] [Accepted: 01/26/2022] [Indexed: 11/26/2022] Open
Abstract
AIM Nocturnal acid breakthrough has been considered an unmet need of proton pump inhibitors. Tegoprazan, a novel potassium-competitive acid blocker, is expected to show improved properties for this unmet need. This study was aimed to compare night-time acid suppression by tegoprazan with that by vonoprazan or esomeprazole, and to explore the effect of CYP2C19 phenotypes on acid-suppressive effects. METHODS A randomized, open-label, three-period, six-sequence crossover study was conducted. A single oral dose of tegoprazan 50 mg, vonoprazan 20 mg or esomeprazole 40 mg was administered at night in each period. Continuous intragastric pH was monitored at baseline and after each dosing. RESULTS 16 healthy subjects (6 CYP2C19 extensive metabolizers, 5 intermediate metabolizers, 5 poor metabolizers) completed the study. After a single dose of tegoprazan, intragastric pH increased more rapidly to over 4 at approximately 1 hour compared to the other treatments, and elevated intragastric pH was maintained stably at night. Tegoprazan exhibited night-time acid suppression for slightly but not significantly longer than vonoprazan, and greater than esomeprazole; % Time pH ≥4 at night-time was 66.0%, 60.5% and 36.1% for tegoprazan, vonoprazan and esomeprazole, respectively. Night-time acid suppression by tegoprazan and vonoprazan was not dependent on CYP2C19 phenotypes, while that by esomeprazole tended to be influenced by CYP2C19 phenotypes. CONCLUSIONS Tegoprazan produced more rapid, potent and well sustained night-time acid suppression versus vonoprazan or esomeprazole when administered at night. Furthermore, tegoprazan showed no CYP2C19 phenotype dependency in acid suppression. It suggests the potential of tegoprazan, especially in preventing nocturnal acid breakthrough.
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Affiliation(s)
- Eunsol Yang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Seokuee Kim
- Division of Clinical Development, HK inno. N Corp., Seoul, Republic of Korea
| | - Bongtae Kim
- Division of Clinical Development, HK inno. N Corp., Seoul, Republic of Korea
| | - Boram Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Yechan Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Geun Seog Song
- Division of Clinical Development, HK inno. N Corp., Seoul, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Seung Hwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
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Al Ghadeer HA, Alabbad ZE, AlShaikh SB, Ahmed SU, Bu-Khamseen AA, Alhashem AT, Alhamrani AH, AlGhadeer MR, Alibrahim DA, Alkishi BM. Prevalence of Gastroesophageal Reflux Disease and Associated Risk Factors in the Eastern Region, Saudi Arabia. Cureus 2021; 13:e19599. [PMID: 34926068 PMCID: PMC8671076 DOI: 10.7759/cureus.19599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 12/12/2022] Open
Abstract
Background Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder characterized by heartburn and acid regurgitation. A higher incidence is found in Arab countries. Untreated GERD has a negative impact on individuals that interfere with daily activities and impaired quality of life. This study aims to estimate the prevalence of GERD and associated risk factors in the Eastern region, Saudi Arabia. Material & Methodology A descriptive cross-sectional study was carried out among 1517 healthy participants from the Eastern province of Saudi Arabia from May to August 2021. The sample was randomly collected through a structured self-administered questionnaire. The questionnaire was composed of questions related to sociodemographic and lifestyle characteristics as risk factors for GERD. The existence of GERD was assessed by using GERD Questionnaire (GerdQ) for diagnosing GERD, when the score is 8 or more. Results A total of 1517 participants were included in the study: 58.8% male, 41.2% female; 9% of whom were pregnant. The age of participants ranged from 18 to 58 with a mean age of 27.5 ± 11.4 years old. The existence of GERD was 20.6% among the total participants, in which their GerdQ scores were 3-7 (68.9%), 8-10 (22.1%), and 8-11 (8.5%). The higher risk groups of having GERD were pregnant women, smoker, being male, regular usage of analgesia, soft drinks, and having a family history of GERD. Conclusion This study showed the prevalence of GERD among the general population of the Eastern region, Saudi Arabia was 20.6%. Several sociodemographic and lifestyle characteristics were associated with the disease. Further studies are needed to explore the role of psychological factors in developing GERD.
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Ahmed NAF, Amer HAM, Ibrahim DA, El-Zayyadi IAEH. Prevalence of esophageal eosinophilia in patients referred for diagnostic upper gastrointestinal endoscopy. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00126-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Several conditions are associated with esophageal eosinophilia such as eosinophilic esophagitis (EoE) and gastro-esophageal reflux disease (GERD). The aim of this study was to detect the prevalence of esophageal eosinophilia in patients with upper gastrointestinal (GI) symptoms referred for diagnostic upper GI endoscopy. This study included 86 patients who underwent upper GI endoscopy and biopsies.
Results
Esophageal eosinophilia EE was found in 26 patients (30.2%): 3 patients (3.5%) had EoE and 23 patients (26.7%) had low-grade esophageal eosinophilia. The most common presenting symptoms were heart burn in 84 patients (97.7%) and upper abdominal pain in 78 patients (90.7%). Reflux esophagitis (ERD) was observed in 18.6% of patients. In histopathological examination, EoE was found in 3.5%, mild reflux esophagitis in 37.2%, and severe reflux esophagitis in 16.3%. There is statistically significant correlation between EE and male sex, hypertension, dysphagia, hiatus hernia, incompetent cardia, and fixed rings. Age, incompetent cardia, and dysphagia were statistically significant independent predictors of low-grade EE.
Conclusion
Esophageal eosinophilia EE was found in 30.2% of patients: 3.5% had eosinophilic esophagitis EoE and 26.7% had low-grade esophageal eosinophilia.
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Nam HH, Nan L, Choo BK. Anti-Inflammation and Protective Effects of Anethum graveolens L. (Dill Seeds) on Esophageal Mucosa Damages in Reflux Esophagitis-Induced Rats. Foods 2021; 10:foods10102500. [PMID: 34681549 PMCID: PMC8535990 DOI: 10.3390/foods10102500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/14/2021] [Accepted: 10/16/2021] [Indexed: 12/17/2022] Open
Abstract
Anethum graveolens L. (dill seeds) are important medicinal and functional foods in Europe and central and south Asia, often used as a seasoning in daily diets. Anethum graveolens L. seeds (AGS) are used to treat indigestion and have shown physiological activities such as those against hypoglycemia and gastroesophageal disease. This study explored the protective effects of AGS extract on mucosal damages and inflammation in reflux esophagitis rats. AGS inhibited cellular inflammation including NO production and the expression of inflammatory proteins (iNOS and COX2 etc.), cytokines (IL-1β and TNF-α) and nuclear transfer factor related to NF-κB signaling caused by LPS stimulation in vitro. Furthermore, reflux esophagitis-induced rats were used to observe the anti-inflammatory effect of AGS. Tissue staining and inflammation-related protein expression of rats with acute reflux esophagitis indicated that AGS improved this inflammatory response, such as COX-2 and TNF-α in mucosa. In conclusion, AGS have good physiological activity and the possibility of being used as a medicinal food and a functional resource for the prevention and therapy of gastroesophageal diseases.
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Affiliation(s)
- Hyeon-Hwa Nam
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si 58245, Korea;
| | - Li Nan
- Agricultural College, Yanbian University, Yanji 133002, China;
| | - Byung-Kil Choo
- Department of Crop Science & Biotechnology, Jeonbuk National University, Jeonju 54896, Korea
- Correspondence: ; Tel.: +82-63-270-2526
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Cao J, Hu Y, Jin S, Chen F, Li L, Huang H. Chronic cough caused by choledochoduodenal fistula: a case report. BMC Pulm Med 2021; 21:290. [PMID: 34507583 PMCID: PMC8434707 DOI: 10.1186/s12890-021-01658-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/02/2021] [Indexed: 12/04/2022] Open
Abstract
Background Chronic cough is characterized by cough as the only or main symptom, with a duration of more than 8 weeks and no obvious abnormality in chest X-ray examination. Its etiology is complex, including respiratory disease, digestive system disease, circulation system disease, and psychological disease. Although a set of etiological diagnosis procedures for chronic cough have been established, it is still difficult to diagnose chronic cough and there are still some patients with misdiagnosis.
Case presentation We present a case of a 54-year-old female patient who had chronic cough for 28 years. Physical examination had no positive signs and she denied any illness causing cough like tuberculosis, rhinitis. Recurrent clinic visits and symptomatic treatment didn’t improve the condition. Finally, gastroscopy identified the possible etiology of choledochoduodenal fistula that was proved by surgery. And after surgery, the patient's cough symptoms were significantly improved. Conclusion We report a rare case of chronic cough caused by choledochoduodenal fistula which demonstrates our as yet inadequate recognition of the etiology and pathogenesis. Written informed consent was obtained from the patient.
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Affiliation(s)
- Jiaofei Cao
- Department of Internal Medicine, The Second Affiliated Hospital of Medical School, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yue Hu
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shaojun Jin
- Department of Emergency, Zhuji People's Hospital of Zhejiang Province, Shaoxing, China
| | - Fei Chen
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Li Li
- Second Affiliated Hospital, School of Medicine, Zhejiang University, No.599 Yanzhou Avenue, Jiande City, Hangzhou City, 311600, Zhejiang Province, China
| | - Huaqiong Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Ong JS, Gharahkhani P, Vaughan TL, Whiteman D, Kendall BJ, MacGregor S. Assessing the genetic relationship between gastro-esophageal reflux disease and risk of COVID-19 infection. Hum Mol Genet 2021; 31:471-480. [PMID: 34553760 PMCID: PMC8522419 DOI: 10.1093/hmg/ddab253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/29/2021] [Accepted: 08/26/2021] [Indexed: 12/11/2022] Open
Abstract
Background Symptoms related with Gastro-esophageal reflux disease (GERD) were previously shown to be linked with increased risk for the 2019 coronavirus disease (COVID-19). We aim to interrogate the possibility of a shared genetic basis between GERD and COVID-19 outcomes. Methods Using published GWAS data for GERD (78 707 cases; 288 734 controls) and COVID-19 susceptibility (up to 32 494 cases; 1.5 million controls), we examined the genetic relationship between GERD and three COVID-19 outcomes: risk of developing severe COVID-19, COVID-19 hospitalization and overall COVID-19 risk. We estimated the genetic correlation between GERD and COVID-19 outcomes followed by Mendelian randomization (MR) analyses to assess genetic causality. Conditional analyses were conducted to examine whether known COVID-19 risk factors (obesity, smoking, type-II diabetes, coronary artery disease) can explain the relationship between GERD and COVID-19. Results We found small to moderate genetic correlations between GERD and COVID-19 outcomes (rg between 0.06–0.24). MR analyses revealed a OR of 1.15 (95% CI: 0.96–1.39) for severe COVID-19; 1.16 (1.01–1.34) for risk of COVID-19 hospitalization; 1.05 (0.97–1.13) for overall risk of COVID-19 per doubling of odds in developing GERD. The genetic correlation/associations between GERD and COVID-19 showed mild attenuation towards the null when obesity and smoking was adjusted for. Conclusions Susceptibility for GERD and risk of COVID-19 hospitalization were genetically correlated, with MR findings supporting a potential causal role between the two. The genetic association between GERD and COVID-19 was partially attenuated when obesity is accounted for, consistent with obesity being a major risk factor for both diseases.
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Affiliation(s)
- Jue-Sheng Ong
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Brisbane, Australia
| | - Puya Gharahkhani
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Brisbane, Australia
| | - Thomas L Vaughan
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - David Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Brisbane, Australia
| | - Bradley J Kendall
- Department of Medicine, The University of Queensland, , Herston, QLD 4006, Brisbane, Australia.,Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Brisbane, Australia
| | - Stuart MacGregor
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Brisbane, Australia
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Ortiz ADC, Fideles SOM, Pomini KT, Buchaim RL. Updates in association of gastroesophageal reflux disease and dental erosion: systematic review. Expert Rev Gastroenterol Hepatol 2021; 15:1037-1046. [PMID: 33571021 DOI: 10.1080/17474124.2021.1890030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Dental erosion occurs by dissolving dental apatite when exposed to non-bacterial acids. One of the factors that predispose to dental erosion is gastroesophageal reflux disease (GERD) due to chronic regurgitation of gastric contents to the oropharynx. Thus, in addition to other extraesophageal symptoms, individuals with GERD may have erosive dental lesions.Areas covered: The objective of this systematic review was to evaluate the association and prevalence of erosive wear in patients with GERD. The bibliographic search was performed in the Pubmed and Web of Science databases, using the descriptors 'gastroesophageal reflux disease' AND 'dental erosion', considering clinical studies recently published from 2012 to 2020.Expert opinion: GERD can be considered a risk factor for the development of erosive dental lesions, whose prevalence was significantly higher in this group. However, several other factors can be commonly associated with the prevalence and severity of dental erosion among the world population, such as dietary habits, lifestyle, abrasion and bruxism. Thus, the prevalence and distribution of erosive lesions among healthy and GERD subjects varied widely among studies, which denotes the etiological complexity of dental erosion and reinforces the importance of careful and detailed anamnesis in order to establish an accurate diagnosis.
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Affiliation(s)
- Adriana De Cássia Ortiz
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, Bauru, São Paulo, Brazil
| | - Simone Ortiz Moura Fideles
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, Bauru, São Paulo, Brazil
| | - Karina Torres Pomini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, Bauru, São Paulo, Brazil.,Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília, São Paulo, Brazil
| | - Rogério Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Alameda Dr. Octávio Pinheiro Brisolla, Bauru, São Paulo, Brazil
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Torcuato Rubio E, Martín-Masot R, Ortiz Pérez P, Serrano Nieto MJ, Díaz Ruiz J, Blasco-Alonso J, Navas-López VM. Herbst's Triad as a Manifestation of Gastroesophageal Reflux Disease. JPGN REPORTS 2021; 2:e066. [PMID: 37207055 PMCID: PMC10191475 DOI: 10.1097/pg9.0000000000000066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/17/2021] [Indexed: 05/21/2023]
Affiliation(s)
- Encarnación Torcuato Rubio
- From the Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga
| | - Rafael Martín-Masot
- From the Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga
| | - Pilar Ortiz Pérez
- From the Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga
| | | | | | - Javier Blasco-Alonso
- From the Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga
| | - Víctor Manuel Navas-López
- From the Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga
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Effect of rose oil on Gastroesophageal Reflux Disease in comparison with omeprazole: A double-blind controlled trial. Complement Ther Clin Pract 2021; 43:101361. [PMID: 33735635 DOI: 10.1016/j.ctcp.2021.101361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/05/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Gastroesophageal reflux disease (GERD) as one of the most common ailments of gastrointestinal system diminishes quality of life and impairs physical functioning and work productivity. Proton-pump inhibitors (PPIs), such as omeprazole play a more dominant role in amelioration of GERD symptoms; nonetheless, there is a growing concern about their side effects. According to traditional Persian medicine (TPM), the use of rose oil is recommended to alleviate GERD symptoms. MATERIALS AND METHODS Therefore, a randomized double-blind controlled trial was performed on 70 subjects who were randomly enrolled in two groups and received either rose oil softgel or omeprazole capsule combined with the placebo. Data were collected within 3 sessions of visit using the Mayo-gastroesophageal reflux questionnaire (GERQ). RESULTS Although, our findings showed that reflux symptoms were decreased in both groups after receiving medicine and the decrement was significant in treatment group, before and after the intervention, this decrease was not significant between two groups. CONCLUSION Given that the rose oil used in this study was produced according to the Iranian method and effective ingredients of Rosa damascena were preserved in sesame oil in production process, it seems that effectiveness of this product can be due to its tonic and enlivening properties. Consumption of rose oil soft capsule alleviates cardinal GERD symptoms similar to omeprazole. It seems that rose oil can have the same effects as PPIs in treatment of GERD but with no side effects due to its different mechanisms of action.
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Kim J, Hiura GT, Oelsner EC, Yin X, Barr RG, Smith BM, Prince MR. Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA). BMJ Open Gastroenterol 2021; 8:e000565. [PMID: 33731384 PMCID: PMC7978087 DOI: 10.1136/bmjgast-2020-000565] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/11/2020] [Accepted: 12/30/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine the prevalence, risk factors and natural history of hiatal hernia (HH) on CT in the general population. MATERIALS AND METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) acquired full-lung CT on 3200 subjects, aged 53-94 years. Three blinded observers independently determined presence/absence and type (I-IV) of HH. Associations between HH and participant characteristics were assessed via unadjusted and multivariable-adjusted relative risk regression. HH natural history was assessed compared with prior MESA CT. RESULTS Excellent interobserver agreement was found for presence (κ=0.86) and type of HH (κ=0.97). Among 316 HH identified (prevalence=9.9%), 223 (71%) were type I and 93 (29%) were type III. HH prevalence increased with age, from 2.4% in 6th decade to 16.6% in 9th decade (unadjusted prevalence ratio (PR)=1.1 (95% CI 1.04 to 1.1)). HH prevalence was greater in women (12.7%) than men (7.0%) (unadjusted PR=1.8 (95% CI 1.5 to 2.3)) and associated with proton pump inhibitor use (p<0.001). In 75 participants with HH with 10-year follow-up, median HH area increased from 9.9 cm2 to 17.9 cm2 (p=0.02) with a higher mean body mass index (BMI) in subjects with increasing HH size compared with HH decreasing in size: mean BMI=30.2±6.2 vs 26.8±7.2 (p=0.02). CONCLUSION HH on non-contrast CT is prevalent in the general population, increasing with age, female gender and BMI. Its association with proton pump inhibitor use confirms a role in gastro-oesophageal reflux disease and HH progression is associated with increased BMI. TRIAL REGISTRATION NUMBER NCT00005487.
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Affiliation(s)
- Jinhye Kim
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Grant T Hiura
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Elizabeth C Oelsner
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Department of Epidemiology, Mailman School of Pubilc Health, Columbia University, New York, NY, USA
| | - Xiaorui Yin
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - R Graham Barr
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Department of Epidemiology, Mailman School of Pubilc Health, Columbia University, New York, NY, USA
| | - Benjamin M Smith
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Martin R Prince
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA
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Manning MA, Shafa S, Mehrotra AK, Grenier RE, Levy AD. Role of Multimodality Imaging in Gastroesophageal Reflux Disease and Its Complications, with Clinical and Pathologic Correlation. Radiographics 2021; 40:44-71. [PMID: 31917657 DOI: 10.1148/rg.2020190029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Gastroesophageal reflux disease (GERD) is a common condition and impairs the quality of life for millions of patients, accounts for considerable health care spending, and is a primary risk factor for esophageal adenocarcinoma. There have been substantial advances in understanding the pathogenesis of GERD and its complications and much progress in diagnosis and management of GERD; however, these have not been comprehensively discussed in the recent radiology literature. Understanding the role of imaging in GERD and its complications is important to aid in multidisciplinary treatment of GERD. GERD results from prolonged or recurrent reflux of gastric contents into the esophagus. Common symptoms include heartburn or regurgitation. Prolonged reflux of gastric contents into the esophagus can cause erosive esophagitis. Over time, the inflammatory response related to esophagitis can lead to deposition of fibrous tissue and development of strictures. Alternatively, the esophageal mucosa can undergo metaplasia (Barrett esophagus), a precursor to dysplasia (which can lead to adenocarcinoma). Conventional barium esophagography has long been considered the primary imaging modality for the esophagus, and the fluoroscopic findings for diagnosis of GERD have been well established. Multimodality imaging has a clear role in detection and assessment of the complications of GERD, specifically reflux esophagitis and Barrett esophagus; differentiation of benign and malignant strictures; and detection, staging, and posttreatment surveillance of esophageal adenocarcinoma. Given the dramatic changes in utilization of abdominal imaging during the past 2 decades, with significantly declining volume of fluoroscopic procedures and concomitant increase in CT and MRI studies, it is crucial that modern radiologists appreciate the value of barium esophagography in the workup of GERD and recognize the key imaging features of GERD and its complications at CT and MRI.
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Affiliation(s)
- Maria A Manning
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1020, Silver Spring, MD 20910 (M.A.M.); Department of Radiology (M.A.M., A.D.L.) and Division of Gastroenterology and Hepatology (S.S.), MedStar Georgetown University Hospital, Washington, DC; the Joint Pathology Center, Silver Spring, Md (A.K.M.); and Georgetown University School of Medicine, Washington, DC (R.E.G.)
| | - Shervin Shafa
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1020, Silver Spring, MD 20910 (M.A.M.); Department of Radiology (M.A.M., A.D.L.) and Division of Gastroenterology and Hepatology (S.S.), MedStar Georgetown University Hospital, Washington, DC; the Joint Pathology Center, Silver Spring, Md (A.K.M.); and Georgetown University School of Medicine, Washington, DC (R.E.G.)
| | - Anupamjit K Mehrotra
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1020, Silver Spring, MD 20910 (M.A.M.); Department of Radiology (M.A.M., A.D.L.) and Division of Gastroenterology and Hepatology (S.S.), MedStar Georgetown University Hospital, Washington, DC; the Joint Pathology Center, Silver Spring, Md (A.K.M.); and Georgetown University School of Medicine, Washington, DC (R.E.G.)
| | - Rachel E Grenier
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1020, Silver Spring, MD 20910 (M.A.M.); Department of Radiology (M.A.M., A.D.L.) and Division of Gastroenterology and Hepatology (S.S.), MedStar Georgetown University Hospital, Washington, DC; the Joint Pathology Center, Silver Spring, Md (A.K.M.); and Georgetown University School of Medicine, Washington, DC (R.E.G.)
| | - Angela D Levy
- From the American Institute for Radiologic Pathology, 1100 Wayne Ave, Suite 1020, Silver Spring, MD 20910 (M.A.M.); Department of Radiology (M.A.M., A.D.L.) and Division of Gastroenterology and Hepatology (S.S.), MedStar Georgetown University Hospital, Washington, DC; the Joint Pathology Center, Silver Spring, Md (A.K.M.); and Georgetown University School of Medicine, Washington, DC (R.E.G.)
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Roh SS, Lee J, Shin MR, Park HJ. Comparison of Esophageal Mucosa Protective Efficacy of Evodiae Fructus and Toosendan Fructus against Duodenogastroesophageal Reflux Esophagitis. Pharmacogn Mag 2021. [DOI: 10.4103/pm.pm_277_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wang JL, Nan SS, Wang BQ, Wang C, Li ZX, Dou GX, Sun GB. Functional genetic variations of CYP2C19 promoter from patients with gastroesophageal reflux disease. Shijie Huaren Xiaohua Zazhi 2020; 28:1229-1234. [DOI: 10.11569/wcjd.v28.i24.1229] [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: 02/06/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a chronic, progressive condition, and its prevalence is increasing worldwide. The risk factors for GERD are complex and the pathogenesis of GERD has not been fully elucidated. As acid-suppressive drugs, proton pump inhibitors (PPIs) are commonly used to treat GERD; after being metabolized by CYP2C19 in the human liver, the blood concentration of PPIs gradually decreases. Previous studies have shown that CYP2C19 gene polymorphism leads to considerable individual differences of PPIs in terms of metabolic rate and efficacy.
AIM To identify potential variations in CYP2C19 promoter from patients (normal metabolizers, NMs, *1/*1) with GERD, verify the activity of promoter with variations in HEK 293T, and analyze the correlation between variations in CYP2C19 promoter and PPI treatment effect for GERD in the Chinese population.
METHODS A total of 163 patients with sporadic GERD were collected. After diagnostic treatment with PPIs, the symptom score decreased by 50%, but the symptoms did not completely disappear in the study group (n = 82). In the control group (n = 81), the symptoms completely disappeared after treatment. The CYP2C19 genotype of all patients was detected as *1/*1. The PCR and Sanger sequencing were used to identify variations in the CYP2C19 promoter. The luciferase activities of pGL3 basic-CYP2C19 promoters with or without variation were detected by dual-luciferase assay.
RESULTS Three novel heterozygous variations were identified in the CYP2C19 gene promoters isolated from three NM patients with GERD: g.94761364 T>A, g.94762112 T>A, and g.94762514 G>T. Compared to the wild type, the transcriptional activity of the CYP2C19 promoter with g.94761364 T>A was significantly increased (P = 0.034).
CONCLUSION The transcriptional activity of the CYP2C19 promoter is significantly increased in the presence of g.94761364 T>A, which may further affect the metabolism and blood concentration of PPIs. This finding provides a new insight for the medication and treatment of GERD patients in the Chinese population.
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Affiliation(s)
- Jue-Lei Wang
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
| | - Shou-Shan Nan
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
| | - Bai-Qing Wang
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
| | - Chao Wang
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
| | - Zhao-Xia Li
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
| | - Guang-Xian Dou
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
| | - Guang-Bin Sun
- Department of Gastroenterology, The Fifth Central Hospital of Tianjin, Tianjin 300450, China
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Abstract
IMPORTANCE Gastroesophageal reflux disease (GERD) is defined by recurrent and troublesome heartburn and regurgitation or GERD-specific complications and affects approximately 20% of the adult population in high-income countries. OBSERVATIONS GERD can influence patients' health-related quality of life and is associated with an increased risk of esophagitis, esophageal strictures, Barrett esophagus, and esophageal adenocarcinoma. Obesity, tobacco smoking, and genetic predisposition increase the risk of developing GERD. Typical GERD symptoms are often sufficient to determine the diagnosis, but less common symptoms and signs, such as dysphagia and chronic cough, may occur. Patients with typical GERD symptoms can be medicated empirically with a proton pump inhibitor (PPI). Among patients who do not respond to such treatment or if the diagnosis is unclear, endoscopy, esophageal manometry, and esophageal pH monitoring are recommended. Patients with GERD symptoms combined with warning symptoms of malignancy (eg, dysphagia, weight loss, bleeding) and those with other main risk factors for esophageal adenocarcinoma, such as older age, male sex, and obesity, should undergo endoscopy. Lifestyle changes, medication, and surgery are the main treatment options for GERD. Weight loss and smoking cessation are often useful. Medication with a PPI is the most common treatment, and after initial full-dose therapy, which usually is omeprazole 20 mg once daily, the aim is to use the lowest effective dose. Observational studies have suggested several adverse effects after long-term PPI, but these findings need to be confirmed before influencing clinical decision making. Surgery with laparoscopic fundoplication is an invasive treatment alternative in select patients after thorough and objective assessments, particularly if they are young and healthy. Endoscopic and less invasive surgical techniques are emerging, which may reduce the use of long-term PPI and fundoplication, but the long-term safety and efficacy remain to be scientifically established. CONCLUSIONS AND RELEVANCE The clinical management of GERD influences the lives of many individuals and is responsible for substantial consumption of health care and societal resources. Treatments include lifestyle modification, PPI medication, and laparoscopic fundoplication. New endoscopic and less invasive surgical procedures are evolving. PPI use remains the dominant treatment, but long-term therapy requires follow-up and reevaluation for potential adverse effects.
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Affiliation(s)
- John Maret-Ouda
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
- Centre for Clinical Research Sormland, Uppsala University, Eskilstuna, Sweden
| | - Sheraz R Markar
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
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Lai L, Alvarez G, Aleu A, Apping C. Cost Avoidance Analysis of Medication Conversions on the Treatment of Gastroesophageal Reflux Disease in a Medication Therapy Management Call Center: A Budgetary Perspective. J Pharm Pract 2020; 35:377-382. [PMID: 33317384 DOI: 10.1177/0897190020977764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The burden of prescription drug prices affects patients and health system, creating a need for pharmacists to use their medication expertise to recommend the most cost-effective treatment for patients. OBJECTIVE The study aimed to analyze the cost avoidance for medication conversions related to GERD from an integrated medication therapy management call center. METHODS A quasi-experimental study was conducted at a call center during a 12-month intervention. Adult patients aged ≥18 years who received highercost PPIs were included. The pharmacists provided MTM services to patients telephonically to review all aspects of the patients' medication regimen as well as conversion recommendation to lower-cost PPIs. The cost avoidance analysis and sensitivity analysis were conducted. RESULTS Of 40 eligible patients, 9 patients accepted the medication conversion, resulting in a 22.5% acceptance rate. The total cost avoidance from medication conversions was $19,937.1 per year, which equated to $2,215.2 per patient. The adjusted cost avoidance of medication conversion was estimated by assuming the patients who accepted the conversion continued taking the medication for 365 days and resulted in a total savings of $40,370.7 per year, which equated to $4,485.6 per patient. There were no significant association between the acceptance of medication conversions and patient's age(P = 0.15), gender(P = 0.73), and insurance status(P = 0.96). CONCLUSION The study results showed that the call-center MTM with medicationconversion interventions successfully demonstrated an economically advantageous impact from a budgetary perspective. Further studies should explore methods to increase acceptance of MTM services and promote awareness of the profound effect on public health and well-being.
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Affiliation(s)
- Leanne Lai
- College of Pharmacy, 69279Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Goar Alvarez
- College of Pharmacy, 69279Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Aisy Aleu
- College of Pharmacy, 69279Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Caitlan Apping
- College of Pharmacy, 69279Nova Southeastern University, Ft. Lauderdale, FL, USA
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Hou M, Hu H, Jin C, Yu X. Efficacy and Safety of Esomeprazole for the Treatment of Reflux Symptoms in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2264-2274. [PMID: 34178733 PMCID: PMC8215048 DOI: 10.18502/ijph.v49i12.4807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: We investigated the efficacy of esomeprazole for the treatment of gastroesophageal reflux disease (GERD) in a meta-analysis of clinical trials results. Methods: Medline, Embase, PubMed and Web of Science databases were systematically searched for suitable studies, and double-blind, randomized controlled trials (RCTs) were involved. A meta-analysis of RCTs was performed to analyze the efficacy of esomeprazole on clinical outcomes that associated with the severity of GERD. Results: A total of 8 clinical trials were selected in our meta-analysis (N=4495, patients with GERD). Esomeprazole treatment yielded a significant improvement in clinical signs and symptoms of GERD compared to placebo group. Funnel plot and Egger test showed there was no significant bias in the publication. Cochrane collaboration tool and Jadad scale were used to indicate that all 8 RCTs were of high quality. The results of Galbraith radial plot showed that no study was the major source of heterogeneity. Esomeprazole treatment significantly decreased the relapse rates more than that of placebo group (RR = 0.729; 95% CI: 0.670 to 0.794; P<0.001). It seems to be lower rates of heartburn (RR = 0.747; 95%CI: 0.665–0.839; P <0.001) and epigastric pain (RR = 0.795; 95%CI: 0.679–0.932; P =0.005) in esomeprazole-treated group compared with the placebo group. Moreover, serious adverse events was less likely to happen after esomeprazole therapy (RR = 1.406, 95% CI: 1.030–1.918; P =0.032). Conclusion: Compared with the control group, esomeprazole is a promising therapeutic agent that improves the management of patients with GERD.
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Affiliation(s)
- Mingxing Hou
- Department of Gastroenterology Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010058, China
| | - Haiqing Hu
- Department of Gastroenterology and Hepatology Chinese PLA General Hospital, Beijing, 100853, China
| | - Chunlu Jin
- Department of Gastroenterology and Hepatology Chinese PLA General Hospital, Beijing, 100853, China
| | - Xuemei Yu
- Department of Gastroenterology and Hepatology Chinese PLA General Hospital, Beijing, 100853, China
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Corral-Magaña O, Morgado-Carrasco D, Fustà-Novell X, Iranzo P. Penfigoide de mucosas: cuando la mucosa oral puede ser la clave para el diagnóstico de una estenosis esofágica de origen desconocido. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:792-794. [DOI: 10.1016/j.ad.2019.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 03/05/2019] [Accepted: 04/20/2019] [Indexed: 11/25/2022] Open
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Eells AC, Mackintosh C, Marks L, Marino MJ. Gastroesophageal reflux disease and head and neck cancers: A systematic review and meta-analysis. Am J Otolaryngol 2020; 41:102653. [PMID: 32841763 DOI: 10.1016/j.amjoto.2020.102653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/02/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Gastroesophageal reflux disease (GERD) has been associated with head and neck cancer (HNC), including laryngeal and pharyngeal anatomical sites. A systematic review and meta-analysis was performed to examine these associations. METHODS Articles were retrieved from the Medline, Web of Science, Scopus, and Embase databases using keywords "gastroesophageal reflux disease", "laryngopharyngeal reflux", "head and neck cancer", and associated variants. Inclusion criteria were English language publications, human subjects, and controlled studies with described development of head and neck cancer among individuals with GERD. 13 studies with a total of 39,824 patients were included. RESULTS Overall, presence of GERD was associated with an increased risk of developing HNC (OR = 1.86, 95% Confidence Interval [CI] = 1.27-2.74). This association remained significant with laryngeal cancers (OR = 1.95, 95% CI = 1.33-2.86), but not pharyngeal cancers (OR = 1.56, 95% CI = 0.86-2.83). Subgroup analyses of hypopharyngeal (OR = 2.26, 95% CI = 0.67-7.68) and oropharyngeal subsites (OR = 1.39, 95% CI = 0.51-3.84) were not statistically significant. Meta-analysis of studies that objectively assessed reflux, such as pH monitor placement, showed statistical significance (OR = 2.81, 95% CI = 1.36-5.81), while studies that used subjective reporting or chart review of GERD were not significant (OR = 1.46, 95% CI = 0.89-2.40). Association between H. pylori infection and head and neck cancers was not statistically significant (OR = 2.66, 95% CI = 0.59-11.97). CONCLUSION A diagnosis of GERD is associated with a later diagnosis of HNC, but this association is not significant for pharyngeal cancers. Associations of GERD with HNC may be specific to laryngeal cancers. LEVEL OF EVIDENCE Systematic review and meta-analysis of case control studies (3a).
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Mucous membrane pemphigoid: When the mouth can give a clue to the diagnosis of an esophageal stenosis of unknown origin. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2020.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Ma L, Li T, Liu G, Wang J, Yin Z, Kang J. Stretta radiofrequency treatment vs Toupet fundoplication for gastroesophageal reflux disease: a comparative study. BMC Gastroenterol 2020; 20:162. [PMID: 32460696 PMCID: PMC7251847 DOI: 10.1186/s12876-020-01310-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/19/2020] [Indexed: 12/11/2022] Open
Abstract
Background Outcomes of gastroesophageal reflux disease (GERD) using Toupet fundoplication (TF) and Stretta radiofrequency (SRF) have not been compared and this study was conducted to compare therapeutic efficacy of the two methods. Methods This retrospective study analyzed a total of 230 patients undergoing TF or SRF at our hospital. Baseline data, reflux symptoms, the DeMeester scores, lower esophageal sphincter (LES) pressure and adverse events were compared over 1 year period. Results A total of 226 patients were included in the study. The time and frequency of reflux and percentage of reflux time before and 12 months after therapy were not significantly different. There were significantly interactions between the therapy method and follow-up time on the DeMeester score and LES pressure. Twelve months post therapy, the DeMeester score was significantly higher in SRF than in TF group, while the LES pressure was lower. At 12 months after therapy, multivariate Cox proportional regression analysis showed that reflux frequency, the DeMeester score and LES pressure were risk factors for poor prognosis in TF group, while reflux frequency and the DeMeester score, and LES pressure were risk factors for poor prognosis in SFR group. Conclusions Compared with TF, SFR can significantly improve the esophageal pH and pressure in GERD patients without increasing the risk of poor prognosis.
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Affiliation(s)
- Lifeng Ma
- Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China
| | - Tao Li
- Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China
| | - Guochao Liu
- Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China
| | - Jianlong Wang
- Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China
| | - Zhaoqiang Yin
- Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China
| | - Jiansheng Kang
- Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China.
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Danilova DA, Bazaev AV, Gorbunova LI. [Current aspects of surgical treatment of gastro-esophageal reflux disease]. Khirurgiia (Mosk) 2020:89-94. [PMID: 32105262 DOI: 10.17116/hirurgia202002189] [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] [Indexed: 12/16/2022]
Abstract
Gastroesophageal reflux disease (GERD) is characterized by abnormal reflux of gastric content into the esophagus, pharynx, respiratory tract and oral cavity. In recent years, there has been a significant increase of the incidence of this disease, that significantly aggravates quality of life of the population. The 'gold standard' for treating GERD is anti-secretory therapy with proton pump inhibitors (PPIs). However, up to 40% of patients are unresponsive to PPIs even after dose adjustment. Advantages and disadvantages of modern surgical approaches for this pathology are reviewed. Laparoscopic fundoplication including Nissen (360°), Toupet (270°) and Dor procedures (180°) is the most common anti-reflux operation. In addition, new alternative surgical options are also discussed. For example, these are minimally invasive methods such as LINX reflux control system, electrical stimulation of the lower esophageal sphincter and transoral incisionless fundoplication (TIF). These methods are less aggressive and have less side effects. A comparative assessment of modern methods of surgical treatment of GERD is made.
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Affiliation(s)
- D A Danilova
- Privolzhsky Research Medical University of the Ministry of Health of the Russia, Nizhniy Novgorod, Russia
| | - A V Bazaev
- Privolzhsky Research Medical University of the Ministry of Health of the Russia, Nizhniy Novgorod, Russia
| | - L I Gorbunova
- Privolzhsky Research Medical University of the Ministry of Health of the Russia, Nizhniy Novgorod, Russia
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