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Advancing the Science in Gastric Pre-Neoplasia: Study Design Considerations.
Davitkov, P, Altayar, O, Shah, SC, Gawron, AJ, Mustafa, RA, Sultan, S, Morgan, DR
Gastroenterology. 2020;(3):751-759
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2.
Surveillance of Gastric Intestinal Metaplasia.
Shah, SC, Gawron, AJ, Li, D
The American journal of gastroenterology. 2020;(5):641-644
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3.
AGA Technical Review on Gastric Intestinal Metaplasia-Natural History and Clinical Outcomes.
Gawron, AJ, Shah, SC, Altayar, O, Davitkov, P, Morgan, D, Turner, K, Mustafa, RA
Gastroenterology. 2020;(3):705-731.e5
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4.
A randomized-controlled trial of arginine infusion in severe sepsis on microcirculation and metabolism.
Luiking, YC, Poeze, M, Deutz, NE
Clinical nutrition (Edinburgh, Scotland). 2020;(6):1764-1773
Abstract
BACKGROUND & AIMS Sepsis is hypothesized as an arginine deficient state, with lack of nitric oxide (NO) for adequate microcirculation and local perfusion. This study aimed to investigate if prolonged (72-h) intravenous l-arginine administration in sepsis patients improves microcirculation. Secondly, effects on arginine and protein metabolism, and organ function were studied. METHODS Critically ill patients with a diagnosis of septic shock participated in a long-term (72 h) randomized double-blind placebo-controlled parallel-group study. l-arginine-HCl (1.2 μmol kg-1 min-1; n = 9) or l-alanine (isocaloric control: 2.4 μmol kg-1 min-1; n = 9) was continuously infused. Primary study outcome was microcirculation, assessed as gastric mucosal perfusion by gastric tonometry (Pr-aCO2 gap) and skin perfusion by Laser Doppler flowmetry. Secondary endpoints were whole body (WB) arginine and protein metabolism, organ function and clinical outcomes. We measured global hemodynamics continuously for safety monitoring. Statistical analyses were performed by mixed model for repeated measures with treatment by time interaction as estimate for between-group difference. RESULTS Pr-aCO2 increased only in the l-arginine group (p = 0.006), without a significant between-group difference (p = 0.17). We found no significant differences in skin perfusion parameters. l-arginine infusion resulted in a larger increase of plasma arginine and ornithine concentrations (p < 0.01), WB (endogenous) arginine appearance (p < 0.001), WB NO synthesis (p = 0.027) and WB arginine to urea conversion (p < 0.001) than infusion of l-alanine. We found no effect on global hemodynamics, and protein metabolism by l-arginine infusion. Organ function parameters were unaffected, except for a significant difference between groups in intra-abdominal pressure over time (p = 0.029). CONCLUSIONS Prolonged intravenous l-arginine administration does not improve local perfusion and organ function despite an increase in WB NO synthesis. Administration is safe with regard to global hemodynamics, but the observed increase in Pr-aCO2 and intra-abdominal pressure warrants careful application of l-arginine infusion and further research, especially in the early stage of septic shock.
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5.
AGA Technical Review on Gastric Intestinal Metaplasia-Epidemiology and Risk Factors.
Altayar, O, Davitkov, P, Shah, SC, Gawron, AJ, Morgan, DR, Turner, K, Mustafa, RA
Gastroenterology. 2020;(3):732-744.e16
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6.
Histologic Subtyping of Gastric Intestinal Metaplasia: Overview and Considerations for Clinical Practice.
Shah, SC, Gawron, AJ, Mustafa, RA, Piazuelo, MB
Gastroenterology. 2020;(3):745-750
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7.
Update on the Diagnosis and Management of Gastric Intestinal Metaplasia in the USA.
Trieu, JA, Bilal, M, Saraireh, H, Wang, AY
Digestive diseases and sciences. 2019;(5):1079-1088
Abstract
Gastric intestinal metaplasia (GIM) is a premalignant condition that can lead to intestinal-type gastric adenocarcinoma. It is characterized by a change in the gastric mucosa to a small-intestinal phenotype. Infection with Helicobacter pylori is the most common factor associated with GIM. Although GIM is typically a histologic diagnosis, various techniques have been developed to enable the endoscopic identification of GIM. There are presently no widely accepted guidelines on screening and surveillance strategies in patients with GIM in the USA. The aim of this review is to provide an update regarding the problem, diagnosis, and management of GIM in the USA.
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8.
Magnetic Resonance Imaging Quantification of Gastrointestinal Liquid Volumes and Distribution in the Gastrointestinal Tract of Children.
Papadatou-Soulou, E, Mason, J, Parsons, C, Oates, A, Thyagarajan, M, Batchelor, HK
Molecular pharmaceutics. 2019;(9):3896-3903
Abstract
The volume and localization of fluid in the paediatric gastrointestinal tract is crucial to the design of in vitro and in silico models that predict the absorption of oral drugs administered to children. Previous studies have used magnetic resonance imaging (MRI) to quantify fluid volumes and localization in the intestines of adults; this study is the first to undertake similar analysis of pediatric participants. This study quantified the amount and distribution of fluid in fasted and fluid-fed children using MRI data captured during the routine clinical assessment. Data from 32 fasted children (aged 0-16 years) and 23 fluid-fed children (aged 8-16 years) were evaluated. The gastric volume ranged from 0 to 9 mL in the fasted and 19-423 mL in the fluid-fed state. The small intestinal volume was recorded to be 0-51 mL in the fasted and 6-91 mL in the fluid-fed state with an average number of 7.7 and 22.4 fluid pockets, respectively. The data showed significant differences in gastric volumes and the number of fluid pockets in the small intestine for age-matched fasted and fluid-fed children (p < 0.05). Both the number and the volume of pockets reported in children are much lower than those previously reported in adults. This study is the first to report intestinal volumes and localization in children and provides new information to achieve the design of biorelevant in vitro models and real values to update in silico models. The data available from both fluid-fed and fasted children show the extremes of fluid volumes that are present in the gastro-intestinal tract which is useful to understand the variability associated with drug absorption in children.
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9.
How I inspect the stomach.
Tajiri, H, Dinis-Ribeiro, M
Gastrointestinal endoscopy. 2019;(6):1106-1108
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10.
Alginate and HM-pectin in sports-drink give rise to intra-gastric gelation in vivo.
Marciani, L, Lopez-Sanchez, P, Pettersson, S, Hoad, C, Abrehart, N, Ahnoff, M, Ström, A
Food & function. 2019;(12):7892-7899
Abstract
The addition of gelling polysaccharides to sport-drinks may provide improved tolerability of drinks with high concentration of digestible carbohydrates (CHO), otherwise known to increase the risk of gastro-intestinal complaints among athletes under prolonged exercise. The physico-chemical properties of a drink containing 14 wt% of digestible CHO (0.7 : 1 fructose and maltodextrin-ratio), 0.2 wt% of HM-pectin/alginate and 0.06 wt%. sodium chloride were examined under in vitro gastric conditions using rheology and large deformation testing. The in vivo gelling behaviour of the drink was studied using magnetic resonance imaging of subjects at rest together with blood glucose measurements. The in vivo results confirm gelation of the test drink, with no gel remaining in the stomach at 60 min and blood glucose values were similar to control. The physico-chemical characterisation of the acidified test drink confirms the formation of a weak gel through which low Mw CHO can diffuse.