Esophageal Acidification During Nocturnal Acid-breakthrough with Ilaprazole Versus Omeprazole in Gastroesophageal Reflux Disease.

Esophageal Acidification During Nocturnal Acid-breakthrough with Ilaprazole Versus Omeprazole in Gastroesophageal Reflux Disease.

J Neurogastroenterol Motil. 2016 Sep 1;

Authors: Karyampudi A, Ghoshal UC, Singh R, Verma A, Misra A, Saraswat VA

Abstract
Background/Aims: Though nocturnal acid-breakthrough (NAB) is common in gastroesophageal reflux disease (GERD) patients, its clinical importance results from esophageal acidification, which has been shown to be uncommon. Ilaprazole, a long-acting proton pump inhibitor, may cause NAB infrequently. Accordingly, we studied prospectively, (1) frequency and degree of esophageal acidification during NAB, and (2) frequency and severity of NAB while on ilaprazole versus omeprazole.
Methods: Fifty-eight consecutive patients with GERD on once daily ilaprazole, 10 mg (n = 28) or omeprazole, 20 mg (n = 30) for > one month underwent 24-hour impedance-pH monitoring prospectively. NAB was defined as intra-gastric pH < 4 for > one hour during night and esophageal acidification as pH < 4 for any duration. Nocturnal symptoms (heartburn, regurgitation, and chest pain) were also recorded.
Results: Of 58 patients (age 35.5 [inter-quartile range 26.5-46.0] years, 38 (65.5%) male), 42 (72.4%) had NAB. Though patients with NAB had lower nocturnal intra-gastric pH than without (2.8 [1.9- 4.1] vs 5.7 [4.6-6.8], P < 0.001), frequency and duration of nocturnal esophageal acidification (17/42 vs 4/16, P = 0.36 and 0.0 [0.0-1.0] vs 0.0 [0.0-0.3] minutes, P = 0.26, respectively) and symptoms were comparable (13/42 vs 6/16, P = 0.75). Though ilaprazole was associated with less NABs (1 [range 1-2, n = 19] vs 1 [range 1-3, n = 23], P = 0.01) than omeprazole, frequency, duration, and mean intra-gastric pH during NAB were comparable (19/28 vs 23/30, P = 0.56; 117 [0-315] vs 159 [69-287] minutes, P = 0.5; 1.02 [0.7-1.4] vs 1.04 [0.44-1.3], P = 0.62, respectively).
Conclusions: Though NAB was common while on proton pump inhibitor, esophageal acidification was uncommon. Frequency and severity of NAB were comparable among patients on ilaprazole and omeprazole except for lesser number of NABs.

PMID: 27585842 [PubMed - as supplied by publisher]

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Pylephlebitis: Through These Portals Pass Bad Bugs

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Role of Iron and Copper in the Pathogenesis of Parkinson’s Disease

Abstract

Parkinson's disease (PD) is an old age disorder of basal ganglia which involves oligomerization of α-synuclein protein and formation of intercellular inclusions known as "Lewy bodies" in substantia nigra and caudate nuclei in brain which is progressive in nature. It is second most prevalent neurodegenerative disorder characterized by tremor at rest, muscle rigidity, slowness of movement (bradykinesia, akinesia), and changes in posture (instability). Both excess and deficiency in levels of transition metals (especially iron, copper) can be detrimental to the central nervous system. Abnormalities in iron (Fe) and copper (Cu) metabolism have been reported to produce oxidative stress which is one of the major cause in pathogenesis of PD. In the present study 35 PD patients and 33 controls of Northern Indian population were included and serum levels of Fe, Cu and ceruloplasmin (Cp) were measured. Serum Fe (p < 0.01) and Cu (p < 0.01) levels were found to be significantly decreased in PD, whereas there was no significant change in Cp levels in PD patients as compared to controls. These results suggest the existence of a defect in iron which over the time, may hasten the entry of iron into the brain and decrease iron in the extracellular compartment in PD patients.

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Incidence rate for breast cancer in Japanese in Japan and in the United States from the Cancer Incidence in Five Continents.

Incidence rate for breast cancer in Japanese in Japan and in the United States from the Cancer Incidence in Five Continents.

Jpn J Clin Oncol. 2016 Sep;46(9):883

Authors: Katanoda K, Hori M

PMID: 27585802 [PubMed - in process]

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Grid-Independent Descriptors (GRIND) analysis and SAR Guided Molecular Docking Studies to Probe Selectivity Profiles of Inhibitors of Multidrug Resistance Transporters ABCB1 and ABCG2.

Grid-Independent Descriptors (GRIND) analysis and SAR Guided Molecular Docking Studies to Probe Selectivity Profiles of Inhibitors of Multidrug Resistance Transporters ABCB1 and ABCG2.

Curr Cancer Drug Targets. 2016 Aug 31;

Authors: Shafi T, Jabeen I

Abstract
ATP-binding cassette (ABC) transporters, P-glycoprotein (P-gp, ABCB1) and breast cancer resistance protein (BCRP/ABCG2) are major determinant of pharmacokinetic, safety and efficacy profiles of drugs thereby effluxing a broad range of endogenous substances across the plasma membrane. Overexpression of these transporters in various tumors is also implicated in the development of multidrug resistance (MDR) and thus, hampers the success of cancer chemotherapy. Modulators of these efflux transporters in combination with chemotherapeutics could be a promising concept to increase the effective intracellular concentration of anticancer drugs. However, broad and overlapped specificity for substrates and modulators of ABCB1 and ABCG2, merely induce toxicity and unwanted drug-drug interactions and thus, lead to late-stage failure of drugs. Therefore, it is of great importance to identify specific 3D structural requirements for selective inhibition of ABCB1 and ABCG2 transport function. Towards this goal, GRID Independent Molecular Descriptor (GRIND) models of selective inhibitors of both transporters have been developed, using their most probable binding conformations obtained from molecular docking protocol. Our results demonstrated a dominant role of molecular shape and different H-bonding patterns in drug-ABCB1/ABCG2 selective interactions. Moreover, distinct distances of different pharmacophoric features from steric hot spots of the molecules provided a strong basis of selectivity for both transporters. Additionally, our results suggested the presence of two H-bond donors at a distance of 8.4-8.8 A° in selective modulators of ABCG2.

PMID: 27585695 [PubMed - as supplied by publisher]

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Three-dimensional cone-beam CT sialography in non tumor salivary pathologies: Procedure and results.

Three-dimensional cone-beam CT sialography in non tumor salivary pathologies: Procedure and results.

Dentomaxillofac Radiol. 2016 Sep 2;:20150431

Authors: Bertin H, Bonnet R, Delemazure AS, Mourrain-Langlois E, Mercier J, Corre P

Abstract
OBJECTIVE: Non-tumor salivary diseases are common. Imaging studies are essential for their diagnosis and before undergoing an endoscopic or surgical treatment. In this study we aimed at presenting our procedure and results obtained with three dimensional cone-beam CT (3D-CBCT) sialography for non-tumor salivary gland diseases.
METHODS: Patients with parotid or submandibular salivary symptoms were examined by 3D-CBCT sialography. They received an intraductal injection of 0.5mL of water-soluble contrast medium maintained in the gland, followed by the examination in a NewTom wide-field CBCT device. Images were processed with multiplanar and three-dimensional reconstructions.
RESULTS: A ductal exploration could be performed until the fourth divisions. The main lesions found were stones, stenosis, dilatations and "dead tree" appearance of the ductal system. No side effects of the catheterization or the iodin contrast was reported, nor tissue damages related to the contrast keeping technique.
CONCLUSION: 3D-CBCT sialography seems to represent a reliable non invasive diagnostic tool for the ductal salivary diseases. More studies are needed to assess the value of 3D-CBCT sialography compared to conventional imaging.

PMID: 27588734 [PubMed - as supplied by publisher]

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Exploring Current Sensory Enhancement Practices Within Videofluoroscopic Swallow Study (VFSS) Clinics.

Exploring Current Sensory Enhancement Practices Within Videofluoroscopic Swallow Study (VFSS) Clinics.

Dysphagia. 2016 Sep 1;

Authors: Turkington L, Nund RL, Ward EC, Farrell A

Abstract
Whilst some research evidence supports the potential benefits of sensory enhancement strategies (SES) in dysphagia management, there is limited understanding of how SES are used in clinical services and the influencing drivers involved in selection during instrumental assessment. SES include modification of temperature, flavour, texture, chemesthetic qualities and bolus size of food/fluid. This study aimed to explore the use of SES within Australian Videofluoroscopic Swallow Study (VFSS) clinics providing adult services, via a qualitative methodology. Maximum variation sampling was used to select a cross section of speech-language pathologists (SLPs) with a range of experience working within 16 VFSS clinics across metropolitan and regional settings to participate in semi-structured, focus group or individual teleconference interviews. Content analysis of interview transcripts was conducted, with four themes emerging as influencing drivers of SES use, including: Patient factors influence SES use; Clinician factors influence SES use; Trials of SES require planning and organisation, and; Organisational barriers impact on SES use. These four themes were all connected through a single integrative theme: Extensive variations of SES procedures exist across clinical settings. Findings indicate that achieving alignment of clinical purpose and implementation of practices amongst VFSS clinicians will be complex given current diversity in SES use. Organisational issues and clinician training need to be addressed, and more research is needed to provide a stronger evidence base to inform clinical practice in this emerging area of dysphagia management.

PMID: 27586878 [PubMed - as supplied by publisher]

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