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Miranda O, Fan P, Qi X, Wang H, Brannock MD, Kosten T, Ryan ND, Kirisci L, Wang L. Prediction of adverse events risk in patients with comorbid post-traumatic stress disorder and alcohol use disorder using electronic medical records by deep learning models. Drug Alcohol Depend 2024; 255:111066. [PMID: 38217979 PMCID: PMC10853953 DOI: 10.1016/j.drugalcdep.2023.111066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Identifying co-occurring mental disorders and elevated risk is vital for optimization of healthcare processes. In this study, we will use DeepBiomarker2, an updated version of our deep learning model to predict the adverse events among patients with comorbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD), a high-risk population. METHODS We analyzed electronic medical records of 5565 patients from University of Pittsburgh Medical Center to predict adverse events (opioid use disorder, suicide related events, depression, and death) within 3 months at any encounter after the diagnosis of PTSD+AUD by using DeepBiomarker2. We integrated multimodal information including: lab tests, medications, co-morbidities, individual and neighborhood level social determinants of health (SDoH), psychotherapy and veteran data. RESULTS DeepBiomarker2 achieved an area under the receiver operator curve (AUROC) of 0.94 on the prediction of adverse events among those PTSD+AUD patients. Medications such as vilazodone, dronabinol, tenofovir, suvorexant, modafinil, and lamivudine showed potential for risk reduction. SDoH parameters such as cognitive behavioral therapy and trauma focused psychotherapy lowered risk while active veteran status, income segregation, limited access to parks and greenery, low Gini index, limited English-speaking capacity, and younger patients increased risk. CONCLUSIONS Our improved version of DeepBiomarker2 demonstrated its capability of predicting multiple adverse event risk with high accuracy and identifying potential risk and beneficial factors.
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Affiliation(s)
- Oshin Miranda
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Peihao Fan
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Xiguang Qi
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Haohan Wang
- School of Information Sciences at the University of Illinois Urbana-Champaign, Champaign, IL 61820, USA
| | | | - Thomas Kosten
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA
| | - Neal David Ryan
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Levent Kirisci
- University of Pittsburgh School of Pharmacy, Pittsburgh, PA 15213, USA
| | - LiRong Wang
- Computational Chemical Genomics Screening Center, Department of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Cordoba Torres IT, Fouda EA, Reinhardt ME, Souki FG. Perioperative Concerns in the Patient with History of Alcohol Use. Adv Anesth 2023; 41:163-178. [PMID: 38251616 DOI: 10.1016/j.aan.2023.06.004] [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] [Indexed: 01/23/2024]
Abstract
Alcohol use is common in patients presenting for surgery and can result in significant physiologic changes and postoperative complications. Anesthesia providers must be aware of the potential risks associated with alcohol consumption and take steps to minimize them. Perioperative management includes assessing patients for alcohol use, providing alcohol cessation interventions, adjusting the anesthetic plan according to the patient's alcohol use history, providing appropriate pain management strategies, and closely monitoring patients during and after surgery for signs of alcohol withdrawal.
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Affiliation(s)
- Ivet T Cordoba Torres
- Department of Anesthesia, Jackson Memorial Hospital, University of Miami, 1611 Northwest 12th Avenue, DTC 318, Miami, FL, 33136, USA
| | - Eslam A Fouda
- Department of Anesthesia, Jackson Memorial Hospital, University of Miami, 1611 Northwest 12th Avenue, DTC 318, Miami, FL, 33136, USA
| | | | - Fouad G Souki
- Department of Anesthesia, Jackson Memorial Hospital, University of Miami, 1611 Northwest 12th Avenue, DTC 318, Miami, FL, 33136, USA.
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Miranda O, Fan P, Qi X, Wang H, Brannock MD, Kosten T, Ryan ND, Kirisci L, Wang L. Prediction of Adverse Events Risk in Patients with Comorbid Post- Traumatic Stress Disorder and Alcohol Use Disorder Using Electronic Medical Records by Deep Learning Models. RESEARCH SQUARE 2023:rs.3.rs-3299369. [PMID: 37790550 PMCID: PMC10543461 DOI: 10.21203/rs.3.rs-3299369/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background Prediction of high-risk events in mental disorder patients is crucial. In our previous study, we developed a deep learning model: DeepBiomarker by using electronic medical records (EMR) to predict suicide related event (SRE) risk in post-traumatic stress disorder (PTSD) patients. Methods We applied DeepBiomarker2 through data integration of multimodal information: lab test, medication, co-morbidities, and social determinants of health. We analyzed EMRs of 5,565 patients from University of Pittsburgh Medical Center with a diagnosis of PTSD and alcohol use disorder (AUD) on risk of developing an adverse event (opioid use disorder, SREs, depression and death). Results DeepBiomarker2 predicted whether a PTSD + AUD patient will have a diagnosis of any adverse events (SREs, opioid use disorder, depression, death) within 3 months with area under the receiver operator curve (AUROC) of 0.94. We found piroxicam, vilazodone, dronabinol, tenofovir, suvorexant, empagliflozin, famciclovir, veramyst, amantadine, sulfasalazine, and lamivudine to have potential to reduce risk. Conclusions DeepBiomarker2 can predict multiple adverse event risk with high accuracy and identify potential risk and beneficial factors. Our results offer suggestions for personalized interventions in a variety of clinical and diverse populations.
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Speksnijder CM, Ortiz-Comino L, de Haan AFJ, Fernández-Lao C, de Bree R, Merkx MAW. Swallowing after Oral Oncological Treatment: A Five-Year Prospective Study. Cancers (Basel) 2023; 15:4371. [PMID: 37686646 PMCID: PMC10486578 DOI: 10.3390/cancers15174371] [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: 07/30/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Swallowing rehabilitation in curative treated patients with oral cancer is still a challenge. Different factors may influence these patients' swallowing function. The aim of this study was to identify factors associated with swallowing function up to 5 years after cancer treatment. METHODS Swallowing duration and frequency of 5 mL water and 15 mL applesauce were measured in 123 patients treated for oral cancer. Mixed model analyses were performed to identify associated factors. RESULTS Age influenced all measured swallowing outcomes. Assessment moment, gender, tumor location, maximum tongue force, and tactile sensory function of the tongue were associated with both water and applesauce swallowing duration, tumor classification was associated with water swallowing duration, and alcohol consumption was associated with applesauce swallowing duration. Assessment moment, cancer treatment, maximum tongue force, and tactile sensory function of the tongue were associated with water and applesauce swallowing frequency. CONCLUSION Patients who are older at diagnosis, women, and patients who regularly consume alcohol before their treatment may have poorer swallow functioning after curative oral cancer treatment. Patients that fit these criteria should have their swallowing evaluated during clinical follow-ups and sent to swallowing therapy when needed. During this therapy, optimizing tongue function needs attention to maintain an optimal swallowing function.
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Affiliation(s)
- Caroline M. Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Cancer Center, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Lucía Ortiz-Comino
- Department of Physical Therapy, University of Granada, 18071 Granada, Spain
| | - Anton F. J. de Haan
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | | | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Cancer Center, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Matthias A. W. Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Dutch Comprehensive Cancer Centre, 3501 DB Utrecht, The Netherlands
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Belete M, Tesfaye W, Akalu Y, Adane A, Yeshaw Y. Gastroesophageal reflux disease symptoms and associated factors among university students in Amhara region, Ethiopia, 2021: a cross-sectional study. BMC Gastroenterol 2023; 23:130. [PMID: 37076820 PMCID: PMC10116815 DOI: 10.1186/s12876-023-02758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/06/2023] [Indexed: 04/21/2023] Open
Abstract
INTRODUCTION Gastroesophageal reflux disease (GERD) symptom is a relapsing chronic medical condition resulting from the reflux of gastric acid contents into the esophagus and throat or mouth. It interferes with social functioning, sleep, productivity, and quality of life. Despite this, the magnitude of GERD symptoms is not known in Ethiopia. Therefore, this study was conducted to determine the prevalence and associated factors of GERD symptoms among university students in the Amhara national regional state. METHODS An institutional-based cross-sectional study was employed in Amhara national regional state Universities, from April 1, 2021, to May 1, 2021. Eight hundred and forty-six students were included in the study. A stratified multistage sampling technique was employed. Data were collected by using a pretested self-administered questionnaire. Data were entered via Epi Data version 4.6.0.5 and analyzed by SPSS version-26 software. The bivariable and multivariable binary logistic regression analyses were used to determine the associated factors of GERD symptoms. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated. Variables having a p-value of ≤ 0.05 were considered statistically significant. RESULTS The prevalence of GERD symptoms in this study was 32.1% (95% CI = 28.7-35.5%). Being in the age of 20-25 years (AOR = 1.74, 95%CI = 1.03-2.94), female (AOR = 1.67, 95% CI = 1.15-2.41), use of antipain (AOR = 2.47, 95% CI = 1.65-3.69) and soft drinks (AOR = 1.58, 95% CI = 1.13-2.20) were significantly associated with higher odds of GERD symptoms. Urban dwellers had less chance of having GERD symptoms (AOR = 0.67, 95% CI = 0.48-0.94). CONCLUSION Nearly one-third of university students are affected by GERD symptoms. Age, sex, residence, use of antipain, and consumption of soft drinks were significantly associated with GERD. Reducing modifiable risk factors such as antipain use and soft drink consumption among students is advisable to decrease the disease burden.
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Affiliation(s)
- Mekonnen Belete
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Winta Tesfaye
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Adane
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Singh PK, Easwari TS. Emerging Trends and their Impacts on Peptic Ulcer Diseases: Treatments and Techniques. CURRENT DRUG THERAPY 2022. [DOI: 10.2174/1574885517666220307115813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background:
Peptic ulcer disease (PUD) is prevalent in almost all parts of the world. PUD complications are creating a major source of preventable health care expenses. The major factors responsible for the incidence of PUD and its complication have changed over the past few decades after the identification of non-steroidal inflammatory drugs (NSAIDs) and Helicobacter pylori bacterial infection along with a marked increase in the use of proton-pump inhibitors (PPIs) as drug therapy. The management of PUD has become more complex and challenging due to antimicrobial resistance.
Objective:
The objective of the study was to highlight current therapy and novel techniques used in the treatment of peptic ulcer diseases.
Methods:
An exhaustive literature search has been conducted across PubMed, Google, Scopus and Web of Science as an electronic database to add the crucial information from the relevant literature.
Results:
In the present review, we have discussed PUD and its pathophysiology. The recent trends in PUD and possible treatments with novel techniques have also been discussed. The type and presence of ulcers cannot be predicted accurately based on symptoms. The available treatment approaches for peptic ulcers based on their clinical presentation and etiology are anti-secretary therapy, endoscopy to reveal ulcers followed by drug therapy, and triple therapy for H pylori infection.
Conclusion:
Thus, the popular and effective methods are very beneficial in controlling PUD. The treatment based on diagnosis is the foremost requirement for ameliorating any disorder. In this article, the emerging techniques and development in the treatment and diagnosis of PUD have been reviewed.
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Affiliation(s)
- Pranjal Kumar Singh
- Department of Pharmaceutics, IIMT College of Medical Sciences, IIMT University, Meerut, Uttar Pradesh, India
| | - T. S. Easwari
- Department of Pharmaceutics, IIMT College of Medical Sciences, IIMT University, Meerut, Uttar Pradesh, India
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Nwokediuko SC, Adekanle O, Akere A, Olokoba A, Anyanechi C, Umar SM, Maiyaki A, Ijoma U, Obienu O, Uhunmwangho A, Ndububa D. Gastroesophageal reflux disease in a typical African population: a symptom-based multicenter study. BMC Gastroenterol 2020; 20:107. [PMID: 32293291 PMCID: PMC7157995 DOI: 10.1186/s12876-020-01261-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/02/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The prevalence of gastroesophageal reflux disease (GERD) in Africa is not known but is believed to be increasing because of demographic and epidemiologic transition. The main objectives of this study were to determine the prevalence and risk factors of GERD, and its degree of overlap with dyspepsia and irritable bowel syndrome (IBS) in Nigeria, a typical African population. METHODS This was an observational, cross-sectional and descriptive study of adult Nigerians. Diagnosis of GERD was by means of the gastroesophageal reflux disease questionnaire (GERDQ) while the diagnosis of dyspepsia and IBS was based on the Rome III criteria for the diagnosis of functional gastrointestinal disorders. The GERDQ and Rome III questionnaires for dyspepsia and IBS were merged into a composite questionnaire and administered to the study participants who were recruited with a multi-stage sampling technique. RESULTS Out of 3520 subjects who participated in the study across the country, 269 (7.6%) satisfied the diagnostic criteria for GERD, while 107 (3.0%) had GERD associated with significant impairment of quality of life. Risk factors of GERD (represented by odds ratios) were age 1.014(95% CI: 1.006-1.022), use of analgesics 1.461 (95% CI: 1.060-2.025), and use of herbs 1.318 (95% CI: 1.020-1.704). Overlap of GERD with dyspepsia and/or IBS was observed in over 50% of cases. CONCLUSIONS The prevalence of GERD in this study is 7.6%. Age, use of analgesics and use of herbs increase the risk, albeit minimally. A high degree of overlap with dyspepsia and IBS exists in Nigerian patients with GERD.
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Affiliation(s)
| | - Olusegun Adekanle
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Adegboyega Akere
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Abdulfatai Olokoba
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Chiedozie Anyanechi
- Department of Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Sabo Mustapha Umar
- Department of Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State, Nigeria
| | - Abubakar Maiyaki
- Department of Medicine, Othman Dan Fodio University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Uchenna Ijoma
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Olive Obienu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | | | - Dennis Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
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Surdea-Blaga T, Negrutiu DE, Palage M, Dumitrascu DL. Food and Gastroesophageal Reflux Disease. Curr Med Chem 2019; 26:3497-3511. [PMID: 28521699 DOI: 10.2174/0929867324666170515123807] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 02/08/2023]
Abstract
Gastroesophageal reflux disease is a chronic condition with a high prevalence in western countries. Transient lower esophageal sphincter relaxation episodes and a decreased lower esophageal sphincter pressure are the main mechanisms involved. Currently used drugs are efficient on reflux symptoms, but only as long as they are administered, because they do not modify the reflux barrier. Certain nutrients or foods are generally considered to increase the frequency of gastroesophageal reflux symptoms, therefore physicians recommend changes in diet and some patients avoid bothering foods. This review summarizes current knowledge regarding food and gastroesophageal reflux. For example, fat intake increases the perception of reflux symptoms. Regular coffee and chocolate induce gastroesophageal reflux and increase the lower esophageal exposure to acid. Spicy foods might induce heartburn, but the exact mechanism is not known. Beer and wine induce gastroesophageal reflux, mainly in the first hour after intake. For other foods, like fried food or carbonated beverages data on gastroesophageal reflux is scarce. Similarly, there are few data about the type of diet and gastroesophageal reflux. Mediterranean diet and a very low carbohydrate diet protect against reflux. Regarding diet-related practices, consistent data showed that a "short-meal-to-sleep interval" favors reflux episodes, therefore some authors recommend that dinner should be at least four hours before bedtime. All these recommendations should consider patient's weight, because several meta-analyses showed a positive association between increased body mass index and gastroesophageal reflux disease.
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Affiliation(s)
- Teodora Surdea-Blaga
- 2nd Dept. of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Farmacy, Cluj-Napoca, Romania
| | - Dana E Negrutiu
- 2nd Dept. of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Farmacy, Cluj-Napoca, Romania
| | - Mariana Palage
- Department of Therapeutic Chemistry, 'Iuliu Hatieganu' University of Medicine and Farmacy, Cluj- Napoca, Romania
| | - Dan L Dumitrascu
- 2nd Dept. of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Farmacy, Cluj-Napoca, Romania
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Watanabe M, Nakatani E, Yoshikawa H, Kanno T, Nariai Y, Yoshino A, Vieth M, Kinoshita Y, Sekine J. Oral soft tissue disorders are associated with gastroesophageal reflux disease: retrospective study. BMC Gastroenterol 2017; 17:92. [PMID: 28784097 PMCID: PMC5545853 DOI: 10.1186/s12876-017-0650-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 07/31/2017] [Indexed: 12/30/2022] Open
Abstract
Background Dental erosion (DE), one of oral hard tissue diseases, is one of the extraoesophageal symptoms defined as the Montreal Definition and Classification of gastroesophageal reflux disease (GERD). However, no study evaluated the relationship between GERD and oral soft tissues. We hypothesized that oral soft tissue disorders (OSTDs) would be related to GERD. The study aimed to investigate the association OSTDs and GERD. Methods GERD patients (105 cases), older and younger controls (25 cases each) were retrospectively examined for oral symptoms, salivary flow volume (Saxon test), swallowing function (repetitive saliva swallowing test [RSST]), teeth (decayed, missing, and filled [DMF] indices), and soft tissues (as evaluation of OSTDs, gingivitis; papillary, marginal, and attached [PMA] gingival indexes, simplified oral hygiene indices [OHI-S], and inflammatory oral mucosal regions). Clinical histories, which included body mass index [BMI], the existence of alcohol and tobacco use, and bruxism, were also investigated. A P value of <0.05 was defined as statistically significant. Results GERD patients, older and younger controls participated and aged 66.4 ± 13.0, 68.3 ± 8.2 and 28.7 ± 2.6 years old, respectively. The most common oral symptom in the GERD patients was oral dryness. Salivary flow volume and swallowing function in the GERD patients were significantly lower than in either of the controls (all P < 0.05). Inflammatory oral mucosal regions were found only in the GERD patients. The DMF indices, as a measure of dental caries, in the GERD patients were higher than in the younger controls (P < 0.001), but lower than in the older controls (P = 0.033). The PMA gingival indexes, as a measurement for gingival inflammation, and OHI-S, as a measure for oral hygiene, in the GERD patients were significantly higher than in either of the controls (all P < 0.05). Though no significant differences in BMI, the existence of alcohol and tobacco use were found, bruxism, as an exacerbation factor of periodontal disease, in the GERD patients was significantly more frequent than in either control group (P = 0.041). Conclusions OSTDs were associated with GERD, which was similar to the association between DE and GERD.
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Affiliation(s)
- Masaaki Watanabe
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Eiji Nakatani
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, 1-5-4, Minatojima minamimachi, Kobe, Hyogo, 650-0047, Japan
| | - Hiroo Yoshikawa
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yoshiki Nariai
- Department of Oral and Maxillofacial Surgery, Matsue City Hospital, 32-1 Nosira-cho, Matsue, Shimane, 690-8509, Japan
| | - Aya Yoshino
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Michael Vieth
- Pathologisches Institut Klinikum Bayreuth GmbH, Preuschwitzer Str. 101, 95445, Bayreuth, Germany
| | - Yoshikazu Kinoshita
- Department of Internal Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Joji Sekine
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
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Shinozaki S, Osawa H, Hayashi Y, Sakamoto H, Miura Y, Lefor AK, Yamamoto H. Vonoprazan treatment improves gastrointestinal symptoms in patients with gastroesophageal reflux disease. Kaohsiung J Med Sci 2017; 33:616-622. [PMID: 29132551 DOI: 10.1016/j.kjms.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/01/2017] [Accepted: 07/13/2017] [Indexed: 02/06/2023] Open
Abstract
The effects of vonoprazan, a new potassium-competitive acid blocker, on gastroesophageal reflux disease (GERD) symptom are not fully elucidated. The aim of this study is to determine the effect of vonoprazan on GERD and associated gastrointestinal symptoms. We retrospectively reviewed 88 Helicobacter pylori negative patients with GERD treated with vonoprazan 10 mg daily. Symptoms were evaluated using the Izumo scale, which reflects quality of life related to various abdominal symptoms. The rates of improvement and resolution of GERD symptoms were 86% (76/88) and 57% (50/88), respectively. Improvement and resolution in patients with erosive esophagitis was higher than in those with non-erosive reflux disease (91% vs 83%, p = 0.260 and 71% vs 47%, p = 0.025, respectively). We attempted to identify factors which predict the effects of vonoprazan. Multivariate analysis identified advanced age (≥60-year-old) (odds ratio [OR] 7.281, 95% confidence interval [CI] 2.056-25.776, p = 0.002), obesity (BMI ≥ 24) (OR 3.342, 95%CI 1.124-9.940, p = 0.030) and erosive esophagitis (OR 4.368, 95%CI 1.281-14.895, p = 0.018) as positive predictors of resolution of GERD symptoms. Alcohol use (OR 0.131, 95%CI 0.027-0.632, p = 0.011) and history of H. pylori eradication (OR 0.171, 95%CI 0.041-0.718, p = 0.015) were identified as negative predictors. Vonoprazan also improved epigastric pain (73%), postprandial distress (60%), constipation (58%) and diarrhea (52%) in patients with GERD. In conclusion, vonoprazan 10 mg daily is effective in improving GERD symptoms. Advanced age, obesity, erosive esophagitis, alcohol use and history of H. pylori eradication influence the resolution of GERD symptoms. Treatment with vonoprazan favorably affects gastrointestinal symptoms in patients with GERD.
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Affiliation(s)
- Satoshi Shinozaki
- Shinozaki Medical Clinic, Utsunomiya, Japan; Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Hiroyuki Osawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
| | - Yoshikazu Hayashi
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Hirotsugu Sakamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yoshimasa Miura
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | | | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
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Jaruvongvanich V, Sanguankeo A, Upala S. Association between Alcohol Consumption and Diverticulosis and Diverticular Bleeding: A Systematic Review and Meta-analysis. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2017; 76:211-219. [PMID: 28808610 PMCID: PMC5551275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There have been conflicting reports on the association of alcohol use and diverticular disease. We aimed to determine the odds of developing diverticular disease and diverticular bleeding in patients who consumed alcohol on a regular basis compared with those who did not. MEDLINE and PUBMED were searched up until February 2017 on observational trials, which investigated the effect of alcohol use on two outcomes of diverticular disease: diverticulosis and diverticular bleeding. Quantitative estimates (odds ratios [OR] and confidence intervals [CI]) from included studies were pooled by using a random-effects model. Heterogeneity across studies was assessed by the I2 statistic. In 6 studies including 53,644 subjects and 6 studies including 3,404 subjects, alcohol consumption on a regular basis was not associated with either diverticulosis (OR=1.99; 95% CI 0.99-4.03, I2=99%) or diverticular bleeding (OR=1.39; 95% CI 0.84-2.32, I2=45%) compared to subjects who did not consume alcohol on a regular basis, respectively. Increased odds of diverticulosis or diverticular bleeding among individuals who consume alcohol on a regular basis were not observed in these meta-analyses.
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Affiliation(s)
| | - Anawin Sanguankeo
- Department of Internal Medicine, University of Hawai'i, Honolulu, HI (VJ)
| | - Sikarin Upala
- Department of Internal Medicine, University of Hawai'i, Honolulu, HI (VJ)
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Kamani T, Penney S, Mitra I, Pothula V. The prevalence of laryngopharyngeal reflux in the English population. Eur Arch Otorhinolaryngol 2012; 269:2219-25. [PMID: 22576243 DOI: 10.1007/s00405-012-2028-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 03/23/2012] [Indexed: 12/13/2022]
Abstract
Although symptoms of laryngopharyngeal reflux (LPR) symptoms are commonly seen in the ENT clinic, their aetiology and prevalence in the population remain unknown. Lifestyle changes have been seen to be effective in symptom relief. We aimed to establish the prevalence of these symptoms and identify any associated factors. Pseudo-random sampling was performed on 2,000 adults that were sent a validated questionnaire containing the Reflux Symptom Index (RSI) and questions on their health and lifestyle. 45.8 % of the 378 responders were male. The mean RSI was 8.3. 30 % had an RSI of more than 10, of which 75 % had symptoms of gastro-oesophageal reflux disease (r = 0.646 at p = 0.01). Patients with depression and irritable bowel syndrome are more likely to have LPR symptoms. LPR symptoms are highly prevalent in the community and may be influenced significantly by the presence of gastro-oesophageal reflux, depression and irritable bowel syndrome.
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Affiliation(s)
- Tawakir Kamani
- Department of Otolaryngology Head and Neck Surgery, Queen's Medical Centre, Nottingham, UK.
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