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Role of prokinetics in ineffective esophageal motility: A call for broader consideration and future innovations. 促胃肠动力剂在食管无效蠕动中的作用:呼吁更广泛的考虑和未来的创新。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-04 DOI: 10.1111/nmo.14961
Andrea Pasta, Francesco Calabrese, Edoardo Vincenzo Savarino, Edoardo Giovanni Giannini, Elisa Marabotto
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引用次数: 0
Cyclic vomiting syndrome: A patient/parent perspective. 周期性呕吐综合征:患者/家长的视角。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-04 DOI: 10.1111/nmo.14952
Kathleen Adams
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引用次数: 0
Third generation sequencing analysis detects significant differences in duodenal microbiome composition between functional dyspepsia patients and control subjects. 第三代测序分析检测出功能性消化不良患者和对照组之间十二指肠微生物组组成的显著差异。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-03 DOI: 10.1111/nmo.14955
Georgios Tziatzios, Emmanouil Stylianakis, Georgia Damoraki, Paraskevas Gkolfakis, Gabriela Leite, Ruchi Mathur, Mark Pimentel, Evangelos J Giamarellos-Bourboulis, Konstantinos Triantafyllou
<p><strong>Background: </strong>Functional dyspepsia (FD) is a multifactorial disorder as its development may be based on several different pathophysiological mechanisms. Interaction of gut microbiome with the host has been proposed as a potential mechanism involved in the disease's pathogenesis.</p><p><strong>Aim/methods: </strong>We aimed to characterize microbiome profiling on duodenal luminal content (DLC) of FD patients and compare it to that of controls (CG) and patients with irritable bowel syndrome (IBS). Outpatients fulfilling Rome IV criteria for FD, IBS, and control group (CG) underwent upper gastrointestinal endoscopy and 2 cc of duodenal aspirate (3rd - 4th part) was aspirated in sterile traps. Duodenal microbiome was assessed after DNA extraction and 16S gene-based sequencing on Oxford Nanopore MinION followed by EPI2ME analysis (ONT/Metrich-ore Ltd). Bioanalysis of the microbiome (alpha-, beta-diversity, comparisons of relative abundances for all taxonomic ranks) was implemented in Python. Multiple group means comparisons were performed with one-way Analysis of Variance (ANOVA) and Kruskal-Wallis test with Tuckey's and Dunn's post hoc tests respectively, in case of significance (P-value <0.05).</p><p><strong>Results: </strong>20 subjects with FD (8 females; age 49.9 ± 13.5 yrs.), 20 with IBS (14 females; age 57.6 ± 14.8 yrs.) and 10 CG (6 females; age 49.2 ± 13.8 yrs.) had their DLC analyzed. The α-diversity index of subjects with FD was significantly lower compared to controls (Shannon's index, p = 0.0218) and similar to that of patients with IBS. Principal Coordinate Analysis (PCoA) generated from species relative abundances (beta-diversity) showed no difference in the DLC profile of subjects with FD and IBS when compared to controls (p = 0.513). Compared to controls, the relative abundance (RA) of Chloroflexota phylum was lower in subjects with FD (p = 0.017) and IBS (p = 0.026), respectively. Additionally, the RA of the Rhodothermota and Thermotogota phyla was lower in FD (p = 0.017 and p = 0.018, respectively) but not in IBS patients (p = 0.15 and p = 0.06, respectively) compared to controls. Interestingly, the RA of specific taxa from Chloroflexota, Rhodothermota and Thermotogota phyla were consistently lower in subjects with FD when compared to CG but similar to IBS, during analysis of all the subsequent major ranks of taxonomy. At the class level, there were significant differences in Syntrophobacteria, Acidithiobacillia, Cytophagia and Flavobacteriia between the FD and CG groups (p < 0.05), but no such difference between FD and IBS was found. Finally, multiple significant differences at the order, family, genus and species level between the FD and CG groups were also detected. A positive relationship between the RA of Streptococcus and those from genus Granulicatella was observed both in FD (p = 0.014) and IBS (p = 0.014) patients.</p><p><strong>Conclusion & inferences: </strong>The microbiome profiling from duodenal lumin
背景:功能性消化不良(FD)是一种多因素疾病,其发病可能基于几种不同的病理生理机制。肠道微生物组与宿主的相互作用被认为是该疾病发病机制中的一个潜在机制:我们旨在分析 FD 患者十二指肠管腔内容物(DLC)的微生物组特征,并将其与对照组(CG)和肠易激综合征(IBS)患者进行比较。符合罗马IV标准的FD、肠易激综合征和对照组(CG)门诊患者接受上消化道内窥镜检查,并在无菌收集器中吸取2毫升十二指肠吸出物(第3-4部分)。在牛津纳米孔 MinION 上进行 DNA 提取和 16S 基因测序,然后进行 EPI2ME 分析(ONT/Metrich-ore Ltd)后,对十二指肠微生物组进行评估。微生物组的生物分析(α-、β-多样性、所有分类等级的相对丰度比较)由 Python 实现。多组均值比较采用单因子方差分析(ANOVA)和 Kruskal-Wallis 检验,并分别采用 Tuckey's 和 Dunn's post hoc 检验进行显著性检验(P-value 结果:对 20 名 FD 受试者(8 名女性;年龄 49.9 ± 13.5 岁)、20 名 IBS 受试者(14 名女性;年龄 57.6 ± 14.8 岁)和 10 名 CG 受试者(6 名女性;年龄 49.2 ± 13.8 岁)的 DLC 进行了分析。与对照组相比,FD 受试者的 α 多样性指数明显较低(香农指数,p = 0.0218),与肠易激综合征患者相似。根据物种相对丰度(β-多样性)生成的主坐标分析(PCoA)显示,与对照组相比,FD 和 IBS 患者的 DLC 特征没有差异(p = 0.513)。与对照组相比,FD(p = 0.017)和 IBS(p = 0.026)受试者绿藻门的相对丰度(RA)分别较低。此外,与对照组相比,FD(分别为 p = 0.017 和 p = 0.018)和 IBS(分别为 p = 0.15 和 p = 0.06)患者的红热菌门(Rhodothermota)和热菌门(Thermotogota)的丰度较低。有趣的是,在随后所有主要分类级别的分析中,与对照组相比,FD 受试者的绿藻门(Chloroflexota)、红藻门(Rhodothermota)和热藻门(Thermotogota)特定类群的RA值一直较低,但与 IBS 相似。在类别水平上,FD 组和 CG 组之间在合成细菌、酸性硫杆菌、嗜胞杆菌和黄杆菌方面存在显著差异(p 结论与推论:FD患者十二指肠腔内容物的微生物组图谱与对照组有显著差异,包括微生物区系多样性较低、微生物区系结构/组成和特定分类群不同。胃食管反流患者和肠易激综合征患者的 DLC 没有明显的类似差异。
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引用次数: 0
Respiratory-swallow patterning and oropharyngeal swallowing impairment in patients undergoing evaluation for lung transplant. 接受肺移植评估的患者的呼吸-吞咽模式和口咽吞咽功能障碍。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-02 DOI: 10.1111/nmo.14912
Kahla Graham, Erin L Reedy, Jungwha Julia Lee, Elizabeth Spencer Norton, Ambalavanan Arunachalam, Rade Tomic, Bonnie Martin-Harris

Background: Although swallowing impairment is prevalent following lung transplantation, baseline respiratory and swallowing characteristics are often overlooked. Respiratory disease processes may predispose lung transplant candidates to altered respiratory-swallow patterning and swallowing impairment.

Methods: This cross-sectional study included patients referred for a Modified Barium Swallow Study during lung transplant evaluation. Swallowing impairment was measured using the Modified Barium Swallow Impairment Profile and Penetration-Aspiration Scale. Respiratory plethysmographic signals synchronized with videofluoroscopy were analyzed to determine phase patterning, pause duration, and rate. Mixed-effects logistic regression was used to identify linkages between respiratory and swallowing measures.

Key results: Fifty patients were included and demonstrated delayed swallow initiation (49/50), oral residue (37/50), incomplete pharyngoesophageal segment opening (35/50), and esophageal retention (43/50). Airway invasion occurred infrequently (10/50). Atypical respiratory patterning was significantly associated with impairment in pharyngeal swallow initiation (OR [95% CI] = 1.76 [1.16, 2.68], p = 0.009), laryngeal elevation (OR [95% CI] = 1.45 [1.01, 2.07], p = 0.044), and laryngeal vestibular closure (OR [95% CI] = 2.57 [1.48, 4.46], p < 0.001). Increased pause duration was associated with impaired initiation (OR [95% CI] = 2.24 [1.20, 4.16], p = 0.011), laryngeal elevation (OR [95% CI] = 1.18 [1.03, 1.36], p = 0.018), laryngeal closure (OR [95% CI] = 1.28 [1.9, 1.50], p = 0.003), and tongue base retraction (OR [95% CI] = 1.33 [1.13, 1.56], p < 0.001).

Conclusions & inferences: Patients undergoing evaluation for lung transplant demonstrated impaired swallowing and phase patterning. Preliminary findings implicate the need for further evaluation of respiratory-swallow coordination and its potential role in swallowing impairment before and after lung transplantation.

背景:虽然肺移植后普遍存在吞咽障碍,但呼吸和吞咽的基线特征往往被忽视。呼吸系统疾病过程可能导致肺移植候选者的呼吸-吞咽模式改变和吞咽功能障碍:这项横断面研究包括在肺移植评估期间转诊进行改良吞咽钡检查的患者。采用改良钡吞咽功能障碍档案和穿透-吞咽量表测量吞咽功能障碍。分析了与视频荧光镜同步的呼吸胸透信号,以确定相位模式、停顿时间和速率。混合效应逻辑回归用于确定呼吸和吞咽测量之间的联系:共纳入了 50 名患者,他们的吞咽开始延迟(49/50)、口腔残留(37/50)、咽喉食管段开放不全(35/50)和食管滞留(43/50)。侵犯气道的情况很少发生(10/50)。非典型呼吸模式与咽吞咽启动障碍(OR [95% CI] = 1.76 [1.16, 2.68],p = 0.009)、喉头抬高(OR [95% CI] = 1.45 [1.01, 2.07],p = 0.044)和喉头前庭闭合(OR [95% CI] = 2.57 [1.48, 4.46],p 结论和推论:接受肺移植评估的患者显示出吞咽和相位模式受损。初步研究结果表明,有必要进一步评估呼吸-吞咽协调性及其在肺移植前后吞咽障碍中的潜在作用。
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引用次数: 0
Diabetic gastroenteropathy: Associations between gastrointestinal symptoms, motility, and extraintestinal autonomic measures. 糖尿病胃肠病:胃肠道症状、蠕动和肠道外自主神经测量之间的关联。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 DOI: 10.1111/nmo.14956
Ditte S Kornum, Christina Brock, Tina Okdahl, Davide Bertoli, Huda Kufaishi, Anne-Marie Wegeberg, Katrine L Høyer, Esben B Mark, Birgitte Brock, Christian S Hansen, Filip K Knop, Asbjørn M Drewes, Klaus Krogh

Background: Diabetic gastroenteropathy can cause significant diagnostic challenges. Still, it remains unknown if measures of extraintestinal autonomic function reflect diabetic gastroenteropathy. We aimed to assess the associations between (1) gastrointestinal symptoms and motility measures and (2) gastrointestinal symptoms/motility measures and extraintestinal autonomic markers.

Methods: We included 81 persons with type 1 or type 2 diabetes (65% female, mean age 54) with gastrointestinal symptoms and autonomic neuropathy. The Gastroparesis Cardinal Symptom Index (GCSI) and the Gastrointestinal Symptom Rating Scale (GSRS) assessed gastrointestinal symptoms. The wireless motility capsule (Smartpill™) assessed panenteric transit times and motility indices. Cardiovascular reflex tests (VAGUS™) and cardiac vagal tone (eMotion Faros) estimated cardiovascular autonomic neuropathy, while the SUDOSCAN™ evaluated sudomotor function.

Key results: Proximal gastrointestinal symptoms were positively associated with the gastric motility index (GCSI: 1.18 (1.04-1.35), p = 0.01; GSRS: 1.15 (1.03-1.29), p = 0.02; median ratio (95% CI)), while only satiety correlated with gastric emptying time (1.24 (1.03-1.49), p = 0.02). Diarrhea was associated with decreased small bowel transit time (0.93 (0.89-0.98), p = 0.005), while constipation were associated with prolonged colonic transit time (1.16 (1.03-1.31), p = 0.02). Gastrointestinal symptoms increased with the degree of abnormal cardiovascular reflex tests (GCSI: 0.67 (0.16-1.19), p = 0.03; GSRS: 0.87 (0.30-1.45), p = 0.01; mean difference (95% CI)) but not with motility measures. Cardiac vagal tone and sudomotor function were not associated with gastrointestinal markers.

Conclusions & inferences: Gastrointestinal and extraintestinal autonomic measures were not associated. However, proximal gastrointestinal symptoms were associated with the gastric motility index and cardiovascular reflex tests. Hence, the latter may contribute to evaluating whether proximal gastrointestinal symptoms are autonomically derived.

背景:糖尿病胃肠病会给诊断带来巨大挑战。然而,肠外自主神经功能的测量是否能反映糖尿病胃肠病仍是一个未知数。我们的目的是评估(1)胃肠道症状和蠕动指标与(2)胃肠道症状/蠕动指标和肠外自主神经标记物之间的关联:我们纳入了81名患有胃肠道症状和自主神经病变的1型或2型糖尿病患者(65%为女性,平均年龄54岁)。胃痉挛症状指数(GCSI)和胃肠道症状评定量表(GSRS)评估胃肠道症状。无线蠕动胶囊(Smartpill™)评估肠胃蠕动时间和蠕动指数。心血管反射测试(VAGUS™)和心脏迷走神经张力(eMotion Faros)评估心血管自律神经病变,而 SUDOSCAN™ 则评估粪便运动功能:主要结果:近端胃肠道症状与胃动力指数呈正相关(GCSI:1.18 (1.04-1.35),p = 0.01;GSRS:1.15 (1.03-1.29),p = 0.02;中位数比值(95% CI)),而只有饱腹感与胃排空时间相关(1.24 (1.03-1.49),p = 0.02)。腹泻与小肠转运时间缩短有关(0.93 (0.89-0.98),p = 0.005),而便秘与结肠转运时间延长有关(1.16 (1.03-1.31),p = 0.02)。胃肠道症状随心血管反射测试异常程度的增加而增加(GCSI:0.67 (0.16-1.19),p = 0.03;GSRS:0.87 (0.30-1.45),p = 0.01;平均差 (95% CI)),但与肠蠕动指标无关。心脏迷走神经张力和泌尿运动功能与胃肠道指标无关:结论与推论:胃肠道和肠道外的自律神经指标没有关联。然而,近端胃肠道症状与胃动力指数和心血管反射测试相关。因此,后者可能有助于评估近端胃肠道症状是否源于自律神经。
{"title":"Diabetic gastroenteropathy: Associations between gastrointestinal symptoms, motility, and extraintestinal autonomic measures.","authors":"Ditte S Kornum, Christina Brock, Tina Okdahl, Davide Bertoli, Huda Kufaishi, Anne-Marie Wegeberg, Katrine L Høyer, Esben B Mark, Birgitte Brock, Christian S Hansen, Filip K Knop, Asbjørn M Drewes, Klaus Krogh","doi":"10.1111/nmo.14956","DOIUrl":"https://doi.org/10.1111/nmo.14956","url":null,"abstract":"<p><strong>Background: </strong>Diabetic gastroenteropathy can cause significant diagnostic challenges. Still, it remains unknown if measures of extraintestinal autonomic function reflect diabetic gastroenteropathy. We aimed to assess the associations between (1) gastrointestinal symptoms and motility measures and (2) gastrointestinal symptoms/motility measures and extraintestinal autonomic markers.</p><p><strong>Methods: </strong>We included 81 persons with type 1 or type 2 diabetes (65% female, mean age 54) with gastrointestinal symptoms and autonomic neuropathy. The Gastroparesis Cardinal Symptom Index (GCSI) and the Gastrointestinal Symptom Rating Scale (GSRS) assessed gastrointestinal symptoms. The wireless motility capsule (Smartpill™) assessed panenteric transit times and motility indices. Cardiovascular reflex tests (VAGUS™) and cardiac vagal tone (eMotion Faros) estimated cardiovascular autonomic neuropathy, while the SUDOSCAN™ evaluated sudomotor function.</p><p><strong>Key results: </strong>Proximal gastrointestinal symptoms were positively associated with the gastric motility index (GCSI: 1.18 (1.04-1.35), p = 0.01; GSRS: 1.15 (1.03-1.29), p = 0.02; median ratio (95% CI)), while only satiety correlated with gastric emptying time (1.24 (1.03-1.49), p = 0.02). Diarrhea was associated with decreased small bowel transit time (0.93 (0.89-0.98), p = 0.005), while constipation were associated with prolonged colonic transit time (1.16 (1.03-1.31), p = 0.02). Gastrointestinal symptoms increased with the degree of abnormal cardiovascular reflex tests (GCSI: 0.67 (0.16-1.19), p = 0.03; GSRS: 0.87 (0.30-1.45), p = 0.01; mean difference (95% CI)) but not with motility measures. Cardiac vagal tone and sudomotor function were not associated with gastrointestinal markers.</p><p><strong>Conclusions & inferences: </strong>Gastrointestinal and extraintestinal autonomic measures were not associated. However, proximal gastrointestinal symptoms were associated with the gastric motility index and cardiovascular reflex tests. Hence, the latter may contribute to evaluating whether proximal gastrointestinal symptoms are autonomically derived.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antidiarrheal, anti-inflammatory and antioxidant effects of Anethum graveolens L. fruit extract on castor oil-induced diarrhea in rats. Anethum graveolens L. 果实提取物对蓖麻油诱发的大鼠腹泻的止泻、抗炎和抗氧化作用
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-08-08 DOI: 10.1111/nmo.14892
Chirine Brinsi, Saber Jedidi, Houcem Sammari, Houcine Selmi, Hichem Sebai

Background: Between food and medicine, nutraceuticals are widely used in human health for the prevention and treatment of various diseases. This study aims to determine the cytoprotective effects of Anethum gravelons fruit extract (AGFAE) on castor oil-induced diarrhea in rats due to its phytochemical and antioxidant properties.

Methods: Male rats were divided into six groups of six animals each: Control (C), Castor oil (CO), CO + different doses of AGFAE (50, 100, and 200 mg/kg, b.w., p.o.), and the CO + loperamide group (LOP, 10 mg/kg, b.w., p.o.).

Key results: In vitro, the chemical composition of aqueous Dill fruit extract showed strong antioxidant activity, with a high content of total polyphenols, flavonoids, and tannins. In our in vivo studies, pre-treatment with AGFAE reduced malondialdehyde and hydrogen peroxide levels and maintained normal activity of enzymatic and non-enzymatic antioxidants in the gastric and intestinal mucosa. In addition, we found that AGFAE prophylaxis improved the stability of many plasma biochemical parameters altered by castor oil intoxication, such as C-reactive protein concentrations and alkaline phosphatase activities.

Conclusions & inferences: We suggest that AGFAE phenolic compounds had significant protection against diarrhea involving several mechanisms such as reducing hypersecretion, peristaltic, inflammation, and preserving the endogenous antioxidant levels.

背景:在食品和药品之间,营养保健品被广泛用于人类健康,以预防和治疗各种疾病。本研究旨在确定芒果提取物(AGFAE)的植物化学和抗氧化特性对蓖麻油诱导的大鼠腹泻的细胞保护作用:雄性大鼠分为六组,每组六只:对照组(C)、蓖麻油组(CO)、CO + 不同剂量的 AGFAE 组(50、100 和 200 mg/kg,体重,口服)以及 CO + 洛哌丁胺组(LOP,10 mg/kg,体重,口服):主要结果:在体外,莳萝果实水提取物的化学成分显示出很强的抗氧化活性,其中含有大量的总多酚、类黄酮和单宁酸。在我们的体内研究中,AGFAE 的预处理降低了丙二醛和过氧化氢的水平,并保持了胃肠粘膜中酶和非酶抗氧化剂的正常活性。此外,我们还发现,AGFAE 预防剂改善了许多因蓖麻油中毒而改变的血浆生化指标的稳定性,如 C 反应蛋白浓度和碱性磷酸酶活性:我们认为,AGFAE酚类化合物对腹泻有显著的保护作用,这涉及多种机制,如减少高分泌、蠕动、炎症和保护内源性抗氧化剂水平。
{"title":"Antidiarrheal, anti-inflammatory and antioxidant effects of Anethum graveolens L. fruit extract on castor oil-induced diarrhea in rats.","authors":"Chirine Brinsi, Saber Jedidi, Houcem Sammari, Houcine Selmi, Hichem Sebai","doi":"10.1111/nmo.14892","DOIUrl":"10.1111/nmo.14892","url":null,"abstract":"<p><strong>Background: </strong>Between food and medicine, nutraceuticals are widely used in human health for the prevention and treatment of various diseases. This study aims to determine the cytoprotective effects of Anethum gravelons fruit extract (AGFAE) on castor oil-induced diarrhea in rats due to its phytochemical and antioxidant properties.</p><p><strong>Methods: </strong>Male rats were divided into six groups of six animals each: Control (C), Castor oil (CO), CO + different doses of AGFAE (50, 100, and 200 mg/kg, b.w., p.o.), and the CO + loperamide group (LOP, 10 mg/kg, b.w., p.o.).</p><p><strong>Key results: </strong>In vitro, the chemical composition of aqueous Dill fruit extract showed strong antioxidant activity, with a high content of total polyphenols, flavonoids, and tannins. In our in vivo studies, pre-treatment with AGFAE reduced malondialdehyde and hydrogen peroxide levels and maintained normal activity of enzymatic and non-enzymatic antioxidants in the gastric and intestinal mucosa. In addition, we found that AGFAE prophylaxis improved the stability of many plasma biochemical parameters altered by castor oil intoxication, such as C-reactive protein concentrations and alkaline phosphatase activities.</p><p><strong>Conclusions & inferences: </strong>We suggest that AGFAE phenolic compounds had significant protection against diarrhea involving several mechanisms such as reducing hypersecretion, peristaltic, inflammation, and preserving the endogenous antioxidant levels.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term, automated stool monitoring using a novel smart toilet: A feasibility study. 使用新型智能马桶对粪便进行长期自动监测:可行性研究
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 DOI: 10.1111/nmo.14954
Jin Zhou, Yuying Luo, Julia W Darcy, Kyle J Lafata, Jose R Ruiz, Sonia Grego

Background: Patients' report of bowel movement consistency is unreliable. We demonstrate the feasibility of long-term automated stool image data collection using a novel Smart Toilet and evaluate a deterministic computer-vision analytic approach to assess stool form according to the Bristol Stool Form Scale (BSFS).

Methods: Our smart toilet integrates a conventional toilet bowl with an engineered portal to image feces in a predetermined region of the plumbing post-flush. The smart toilet was installed in a workplace bathroom and used by six healthy volunteers. Images were annotated by three experts. A computer vision method based on deep learning segmentation and mathematically defined hand-crafted features was developed to quantify morphological attributes of stool from images.

Key results: 474 bowel movements images were recorded in total from six subjects over a mean period of 10 months. 3% of images were rated abnormal with stool consistency BSFS 2 and 4% were BSFS 6. Our image analysis algorithm leverages interpretable morphological features and achieves classification of abnormal stool form with 94% accuracy, 81% sensitivity and 95% specificity.

Conclusions: Our study supports the feasibility and accuracy of long-term, non-invasive automated stool form monitoring with the novel smart toilet system which can eliminate the patient burden of tracking bowel forms.

背景:患者对排便一致性的报告并不可靠。我们展示了使用新型智能马桶长期自动收集粪便图像数据的可行性,并评估了根据布里斯托尔粪便形态量表(BSFS)评估粪便形态的确定性计算机视觉分析方法:方法:我们的智能马桶将传统马桶与工程门户集成在一起,以便在冲水后对管道预定区域内的粪便进行成像。智能马桶安装在一个工作场所的卫生间内,由六名健康志愿者使用。三位专家对图像进行了标注。开发了一种基于深度学习分割和数学定义的手工创建特征的计算机视觉方法,以量化图像中粪便的形态属性:在平均 10 个月的时间里,共记录了 6 名受试者的 474 张排便图像。3%的图像被评为异常,粪便一致性为 BSFS 2,4% 为 BSFS 6。我们的图像分析算法利用了可解释的形态特征,对异常粪便形态进行了分类,准确率为 94%,灵敏度为 81%,特异性为 95%:我们的研究证实了使用新型智能马桶系统进行长期、无创自动粪便形态监测的可行性和准确性,该系统可消除患者追踪肠道形态的负担。
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引用次数: 0
Prevalence of functional diarrhea in children and adolescents. 儿童和青少年功能性腹泻的发病率。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 DOI: 10.1111/nmo.14950
Carlos Velasco-Benitez, Daniela Velasco, Amber Balda, Samantha Arrizabalo, Miguel Saps

Background: Functional diarrhea (FDr) is a common disorder in toddlers and adults. In children, the Rome criteria define FDr as a disorder of children younger than 5 years old exclusively. However, in clinical practice, school-aged children and adolescents sometimes consult for symptoms that mimic the diagnosis of FDr. We conducted a study aimed at assessing the prevalence of FDr in school-aged children and adolescents.

Methods: A cross-sectional study was conducted in children aged 8-18 years from two schools in Colombia. Children completed self-report validated questionnaires to diagnose disorders of gut-brain interaction (DGBI) per Rome IV (QPGS-IV) for their age group and the questions related to FDr from the Rome IV questionnaire for infants and toddlers.

Key results: After excluding children with organic diseases and IBS-D, 981 participants were included (female 53.8%, White 24.7%, Indigenous 10.9%, mixed race 52.6%). Of the 981 participants, 325 (33.1%) had a DGBI. Of these, 17 children (5.2%) were diagnosed with FDr (3 participants 8-12 years; 14 participants 13-18 years). FDr was more prevalent among White children compared to non-White children (mixed race, Black, and Indigenous) (p = 0.01).

Conclusion & inferences: Despite the absence of FDr in the Rome IV criteria for children and adolescents, 1.7% of children aged 8-18 years likely have FDr. This study suggests that FDr does occur in children and adolescents. If confirmed in future studies, the diagnosis of FDr should be considered for inclusion in future editions of the Rome criteria for children of all ages.

背景:功能性腹泻(FDr)是幼儿和成人的常见疾病。在儿童中,罗马标准将功能性腹泻定义为仅限于 5 岁以下儿童的疾病。然而,在临床实践中,学龄儿童和青少年有时会出现与功能性腹泻诊断相似的症状:我们对哥伦比亚两所学校 8-18 岁的儿童进行了横断面研究。儿童们填写了自我报告的有效问卷,以根据罗马IV(QPGS-IV)诊断其年龄组的肠脑互动障碍(DGBI),并回答了罗马IV婴幼儿问卷中与FDr相关的问题:主要结果:在排除患有器质性疾病和肠易激综合征(IBS-D)的儿童后,共纳入 981 名参与者(女性占 53.8%,白人占 24.7%,土著人占 10.9%,混血儿占 52.6%)。在 981 名参与者中,325 人(33.1%)患有 DGBI。其中,17 名儿童(5.2%)被诊断出患有 FDr(3 名参与者为 8-12 岁;14 名参与者为 13-18 岁)。与非白人儿童(混血儿、黑人和土著儿童)相比,FDr在白人儿童中的发病率更高(p = 0.01):本研究表明,儿童和青少年中确实存在 FDr。如果在今后的研究中得到证实,应考虑将 FDr 诊断纳入今后针对所有年龄段儿童的罗马标准版本中。
{"title":"Prevalence of functional diarrhea in children and adolescents.","authors":"Carlos Velasco-Benitez, Daniela Velasco, Amber Balda, Samantha Arrizabalo, Miguel Saps","doi":"10.1111/nmo.14950","DOIUrl":"https://doi.org/10.1111/nmo.14950","url":null,"abstract":"<p><strong>Background: </strong>Functional diarrhea (FDr) is a common disorder in toddlers and adults. In children, the Rome criteria define FDr as a disorder of children younger than 5 years old exclusively. However, in clinical practice, school-aged children and adolescents sometimes consult for symptoms that mimic the diagnosis of FDr. We conducted a study aimed at assessing the prevalence of FDr in school-aged children and adolescents.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in children aged 8-18 years from two schools in Colombia. Children completed self-report validated questionnaires to diagnose disorders of gut-brain interaction (DGBI) per Rome IV (QPGS-IV) for their age group and the questions related to FDr from the Rome IV questionnaire for infants and toddlers.</p><p><strong>Key results: </strong>After excluding children with organic diseases and IBS-D, 981 participants were included (female 53.8%, White 24.7%, Indigenous 10.9%, mixed race 52.6%). Of the 981 participants, 325 (33.1%) had a DGBI. Of these, 17 children (5.2%) were diagnosed with FDr (3 participants 8-12 years; 14 participants 13-18 years). FDr was more prevalent among White children compared to non-White children (mixed race, Black, and Indigenous) (p = 0.01).</p><p><strong>Conclusion & inferences: </strong>Despite the absence of FDr in the Rome IV criteria for children and adolescents, 1.7% of children aged 8-18 years likely have FDr. This study suggests that FDr does occur in children and adolescents. If confirmed in future studies, the diagnosis of FDr should be considered for inclusion in future editions of the Rome criteria for children of all ages.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Additional criteria on scintigraphic testing for diagnosis of rapid colonic transit in patients with chronic diarrhea. 诊断慢性腹泻患者结肠快速转运的闪烁成像测试附加标准。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-20 DOI: 10.1111/nmo.14917
Camille Lupianez-Merly, Saam Dilmaghani, Kara Jencks, Deborah Eckert, Michael Ryks, Duane Burton, Michael Camilleri

Background: Colonic transit (CT) measured by validated scintigraphy using 111In-labeled activated charcoal particles is summarized using geometric center (GC) of isotopic distribution in four colonic regions and stool at 24 and 48 h. Diagnosis of rapid CT is currently based on GC24 ≥4.4 in females and >4.7 in males, which lack sensitivity. Our aim was to evaluate, in patients with chronic diarrhea with normal CT by GC24 and GC48, the diagnostic utility of CT change (∆GC) relative to sex-matched normal values.

Methods: We evaluated two adult patient cohorts: 701 clinical patients (1994-2023) with chronic diarrhea and 76 research participants with irritable bowel syndrome with diarrhea (N = 63) or bile acid diarrhea (BAD, N = 13). Results of ∆GC were compared to 220 healthy controls' 95th percentiles (%ile) (≥2.0 females and ≥2.2 males). In the research cohort, we also analyzed (Spearman correlation) colonic ∆GC with ascending colon emptying T1/2 (AC T1/2), average stool frequency and consistency based on a daily diary, total fecal bile acid (BA) concentration, and % primary BA in a single stool sample.

Key results: Among 701 clinical patients with normal GC24, 160 (22.3%) had rapid CT based on ∆GC 95th %ile in health. Among 76 research participants, an additional 20.6% IBS-D and 23% BAD had rapid CT ∆GC. Younger age and absence of diabetes mellitus were predictive of rapid ∆GC. ∆GC significantly correlated with AC T1/2 and with fecal BA.

Conclusions & inferences: ∆GC identified an additional 21%-23% patients with rapid colonic transit among patients with diarrhea and normal GC24.

背景:通过使用 111In 标记的活性炭颗粒进行有效的闪烁扫描测量结肠转运(CT),在 24 和 48 小时内使用结肠四个区域和粪便中同位素分布的几何中心(GC)进行总结。目前,快速 CT 的诊断依据是 GC24(女性)≥4.4 和 GC24(男性)>4.7,这缺乏敏感性。我们的目的是评估在 GC24 和 GC48 CT 正常的慢性腹泻患者中,CT 变化(∆GC)相对于性别匹配正常值的诊断效用:我们评估了两组成年患者:方法:我们评估了两个成年患者队列:701 名慢性腹泻临床患者(1994-2023 年)和 76 名患有肠易激综合征伴腹泻(N = 63)或胆汁酸腹泻(BAD,N = 13)的研究参与者。∆GC的结果与220名健康对照者的第95百分位数(%ile)(女性≥2.0,男性≥2.2)进行了比较。在研究队列中,我们还分析了结肠∆GC与升结肠排空T1/2(AC T1/2)、基于每日日记的平均大便次数和稠度、粪便胆汁酸(BA)总浓度以及单次大便样本中原生胆汁酸的百分比(斯皮尔曼相关性):在 701 名 GC24 正常的临床患者中,有 160 人(22.3%)根据健康∆GC 第 95 百分位数患有快速 CT。在 76 名研究参与者中,另有 20.6% 的 IBS-D 和 23% 的 BAD 患有快速 CT ∆GC。年龄较小和无糖尿病是快速 ∆GC 的预测因素。∆ΔGC与AC T1/2和粪便BA明显相关:在腹泻和 GC24 正常的患者中,∆GC 发现了 21%-23% 的额外快速结肠转运患者。
{"title":"Additional criteria on scintigraphic testing for diagnosis of rapid colonic transit in patients with chronic diarrhea.","authors":"Camille Lupianez-Merly, Saam Dilmaghani, Kara Jencks, Deborah Eckert, Michael Ryks, Duane Burton, Michael Camilleri","doi":"10.1111/nmo.14917","DOIUrl":"10.1111/nmo.14917","url":null,"abstract":"<p><strong>Background: </strong>Colonic transit (CT) measured by validated scintigraphy using <sup>111</sup>In-labeled activated charcoal particles is summarized using geometric center (GC) of isotopic distribution in four colonic regions and stool at 24 and 48 h. Diagnosis of rapid CT is currently based on GC24 ≥4.4 in females and >4.7 in males, which lack sensitivity. Our aim was to evaluate, in patients with chronic diarrhea with normal CT by GC24 and GC48, the diagnostic utility of CT change (∆GC) relative to sex-matched normal values.</p><p><strong>Methods: </strong>We evaluated two adult patient cohorts: 701 clinical patients (1994-2023) with chronic diarrhea and 76 research participants with irritable bowel syndrome with diarrhea (N = 63) or bile acid diarrhea (BAD, N = 13). Results of ∆GC were compared to 220 healthy controls' 95th percentiles (%ile) (≥2.0 females and ≥2.2 males). In the research cohort, we also analyzed (Spearman correlation) colonic ∆GC with ascending colon emptying T<sub>1/2</sub> (AC T<sub>1/2</sub>), average stool frequency and consistency based on a daily diary, total fecal bile acid (BA) concentration, and % primary BA in a single stool sample.</p><p><strong>Key results: </strong>Among 701 clinical patients with normal GC24, 160 (22.3%) had rapid CT based on ∆GC 95th %ile in health. Among 76 research participants, an additional 20.6% IBS-D and 23% BAD had rapid CT ∆GC. Younger age and absence of diabetes mellitus were predictive of rapid ∆GC. ∆GC significantly correlated with AC T<sub>1/2</sub> and with fecal BA.</p><p><strong>Conclusions & inferences: </strong>∆GC identified an additional 21%-23% patients with rapid colonic transit among patients with diarrhea and normal GC24.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The association between salivary pepsin and gastroesophageal reflux disease: A meta-analysis. 唾液胃蛋白酶与胃食管反流病之间的关系:荟萃分析
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-02 DOI: 10.1111/nmo.14905
Fei Han, Xiangyu Li, Zhaoxiang Song, Jinlin Xie, Nan Wang, Jianning Yao

Background and purpose: The definitive diagnosis of gastroesophageal reflux disease (GERD) often requires invasive investigations like upper gastrointestinal endoscopy or reflux monitoring. We aimed to explore the relationship between salivary pepsin and GERD and its value as a non-invasive diagnostic tool.

Methods: Databases (PubMed, Web of Science, Cochran Library, and EMBASE) were searched from their inception to January 22, 2024 to explore the correlation of salivary pepsin with GERD. The meta-analysis data retrieved were summarized, including the salivary pepsin concentration, sensitivity of diagnosis (SEN), specificity of diagnosis (SPE), negative likelihood ratio, positive likelihood ratio, diagnostic odds ratio, and receiver operating characteristic (ROC) curve.

Results: The meta-analysis comparing salivary pepsin concentration in two groups (proven GERD and non-GERD) with 18 studies revealed that the proven GERD group had higher salivary pepsin concentration than the non-GERD group (SMD = 1.74 [95% CI 1.14-2.34]). The meta-analysis of salivary pepsin diagnostic value for proven GERD incorporated 23 studies. The results showed pooled SEN (0.73 [95% CI 0.66-0.80]), SPE (0.72 [95% CI 0.65-0.78]), positive likelihood ratio (2.61 [95% CI 2.02-3.39]), negative likelihood ratio (0.37 [95% CI 0.28-0.50]), diagnostic odds ratio (7.03 [95% CI 4.24-11.66]) and area under the SROC curve (0.79 [95% CI 0.75-0.82]).

Conclusion: GERD patients presented a higher salivary pepsin concentration. Salivary pepsin is both sensitive and specific in identifying GERD, making it a promising non-invasive marker for diagnosis.

背景和目的:胃食管反流病(GERD)的确诊通常需要上消化道内窥镜检查或反流监测等侵入性检查。我们旨在探讨唾液胃蛋白酶与胃食管反流病之间的关系及其作为非侵入性诊断工具的价值:方法:检索了从开始到 2024 年 1 月 22 日的数据库(PubMed、Web of Science、Cochran Library 和 EMBASE),以探讨唾液胃蛋白酶与胃食管反流病的相关性。对检索到的荟萃分析数据进行了总结,包括唾液胃蛋白酶浓度、诊断敏感性(SEN)、诊断特异性(SPE)、阴性似然比、阳性似然比、诊断几率和接收者操作特征曲线(ROC):荟萃分析比较了两组(已证实胃食管反流病和非胃食管反流病)18 项研究的唾液胃蛋白酶浓度,结果显示,已证实胃食管反流病组的唾液胃蛋白酶浓度高于非胃食管反流病组(SMD = 1.74 [95% CI 1.14-2.34])。唾液胃蛋白酶对已证实的胃食管反流病的诊断价值的荟萃分析纳入了 23 项研究。结果显示,汇总 SEN(0.73 [95% CI 0.66-0.80])、SPE(0.72 [95% CI 0.65-0.78])、阳性似然比(2.61 [95% CI 2.02-3.39])、阴性似然比(0.37 [95% CI 0.28-0.50])、诊断几率比(7.03 [95% CI 4.24-11.66])和 SROC 曲线下面积(0.79 [95% CI 0.75-0.82]):结论:胃食管反流病患者的唾液胃蛋白酶浓度较高。结论:胃食管反流病患者唾液胃蛋白酶浓度较高,唾液胃蛋白酶在识别胃食管反流病方面具有敏感性和特异性,是一种很有前途的非侵入性诊断标志物。
{"title":"The association between salivary pepsin and gastroesophageal reflux disease: A meta-analysis.","authors":"Fei Han, Xiangyu Li, Zhaoxiang Song, Jinlin Xie, Nan Wang, Jianning Yao","doi":"10.1111/nmo.14905","DOIUrl":"10.1111/nmo.14905","url":null,"abstract":"<p><strong>Background and purpose: </strong>The definitive diagnosis of gastroesophageal reflux disease (GERD) often requires invasive investigations like upper gastrointestinal endoscopy or reflux monitoring. We aimed to explore the relationship between salivary pepsin and GERD and its value as a non-invasive diagnostic tool.</p><p><strong>Methods: </strong>Databases (PubMed, Web of Science, Cochran Library, and EMBASE) were searched from their inception to January 22, 2024 to explore the correlation of salivary pepsin with GERD. The meta-analysis data retrieved were summarized, including the salivary pepsin concentration, sensitivity of diagnosis (SEN), specificity of diagnosis (SPE), negative likelihood ratio, positive likelihood ratio, diagnostic odds ratio, and receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The meta-analysis comparing salivary pepsin concentration in two groups (proven GERD and non-GERD) with 18 studies revealed that the proven GERD group had higher salivary pepsin concentration than the non-GERD group (SMD = 1.74 [95% CI 1.14-2.34]). The meta-analysis of salivary pepsin diagnostic value for proven GERD incorporated 23 studies. The results showed pooled SEN (0.73 [95% CI 0.66-0.80]), SPE (0.72 [95% CI 0.65-0.78]), positive likelihood ratio (2.61 [95% CI 2.02-3.39]), negative likelihood ratio (0.37 [95% CI 0.28-0.50]), diagnostic odds ratio (7.03 [95% CI 4.24-11.66]) and area under the SROC curve (0.79 [95% CI 0.75-0.82]).</p><p><strong>Conclusion: </strong>GERD patients presented a higher salivary pepsin concentration. Salivary pepsin is both sensitive and specific in identifying GERD, making it a promising non-invasive marker for diagnosis.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Neurogastroenterology and Motility
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