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Modulation of the oxidative plasmatic state in gastroesophageal reflux disease with the addition of rich water molecular hydrogen: A new biological vision.
Franceschelli, S, Gatta, DMP, Pesce, M, Ferrone, A, Di Martino, G, Di Nicola, M, De Lutiis, MA, Vitacolonna, E, Patruno, A, Grilli, A, et al
Journal of cellular and molecular medicine. 2018;(5):2750-2759
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Abstract
Gastroesophageal reflux disease (GERD), a clinical condition characterized by reflux of gastroduodenal contents in the oesophagus, has proved to demonstrate a strong link between oxidative stress and the development of GERD. Proton pump inhibitors (PPIs) have been universally accepted as first-line therapy for management of GERD. The potential benefits of electrolysed reduced water (ERW), rich in molecular hydrogen, in improving symptoms and systemic oxidative stress associated with GERD was assessed. The study was performed on 84 GERD patients undergoing control treatment (PPI + tap water) or experimental treatment (PPI + ERW) for 3 months. These patients were subjected to the GERD-Health Related Quality of Life Questionnaire as well as derivatives reactive oxigen metabolites (d-ROMs) test, biological antioxidant potential (BAP) test, superoxide anion, nitric oxide and malondialdehyde assays, which were all performed as a proxy for the oxidative/nitrosative stress and the antioxidant potential status. Spearman's correlation coefficient was used to evaluate the correlation between scores and laboratory parameters. Overall results demonstrated that an optimal oxidative balance can be restored and GERD symptoms can be reduced rapidly via the integration of ERW in GERD patients. The relative variation of heartburn and regurgitation score was significantly correlated with laboratory parameters. Thus, in the selected patients, combination treatment with PPI and ERW improves the cellular redox state leading to the improvement of the quality of life as demonstrated by the correlation analysis between laboratory parameters and GERD symptoms.
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Lactulose Breath Test Gas Production in Childhood IBS Is Associated With Intestinal Transit and Bowel Movement Frequency.
Chumpitazi, BP, Weidler, EM, Shulman, RJ
Journal of pediatric gastroenterology and nutrition. 2017;(4):541-545
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Abstract
OBJECTIVES In adults with irritable bowel syndrome (IBS), bacterial gas production (colonic fermentation) is related to both symptom generation and intestinal transit. Whether gas production affects symptom generation, psychosocial distress, or intestinal transit in childhood IBS is unknown. METHODS Children (ages 7-17 years) with pediatric Rome III IBS completed validated psychosocial questionnaires and a 2-week daily diary capturing pain and stooling characteristics. Stool form determined IBS subtype. Subjects then completed a 3-hour lactulose breath test for measurement of total breath hydrogen and methane production. Carmine red was used to determine whole intestinal transit time. RESULTS A total of 87 children (mean age 13 ± 2.6 [standard deviation] years) were enrolled, of whom 50 (57.5%) were girls. All children produced hydrogen and 51 (58.6%) produced methane. Hydrogen and methane production did not correlate with either abdominal pain frequency/severity or psychosocial distress. Hydrogen and methane production did not differ significantly by IBS subtype. Methane production correlated positively with whole intestinal transit time (r = 0.31, P < 0.005) and inversely with bowel movement frequency (r = -0.245, P < 0.05). Methane production (threshold 3 ppm) as a marker for identifying IBS-C had a sensitivity of 60% and specificity of 42.9%. CONCLUSIONS Lactulose breath test total methane production may serve as a biomarker of whole intestinal transit time and bowel movement frequency in children with IBS. In children with IBS, lactulose breath test hydrogen and methane production did not, however, correlate with abdominal pain, IBS subtype, or psychosocial distress.
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Effect of dietary turmeric on breath hydrogen.
Shimouchi, A, Nose, K, Takaoka, M, Hayashi, H, Kondo, T
Digestive diseases and sciences. 2009;(8):1725-9
Abstract
Turmeric is widely used in Indian cuisine. The main constituents of turmeric are curcumin and its analogues, which are well-known antioxidant compounds. In the present study, we hypothesized that turmeric in curry might increase bowel motility and activate hydrogen-producing bacterial flora in the colon, thereby increasing the concentration of breath hydrogen. Eight healthy subjects fasted for 12 h and ingested curry and rice with or without turmeric (turmeric knockout curry). Breath-hydrogen concentrations were analyzed every 15 min for 6 h by gas chromatography with a semiconductor detector. Curry with turmeric significantly increased the area under the curve of breath hydrogen and shortened small-bowel transit time, compared with curry not containing turmeric. These results suggested that dietary turmeric activated bowel motility and carbohydrate colonic fermentation.
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Interobserver and within-subject variances of T2-relaxation time and 1H-metabolite ratios in the normal hippocampus.
Højrup, S, Jensen, FT, Hokland, S, Simonsen, C, Christensen, T, Frøkiaer, J, Pedersen, M
Journal of neuroradiology = Journal de neuroradiologie. 2007;(3):198-204
Abstract
PURPOSE To investigate the magnetic resonance (MR) reproducibility of normal hippocampal volume (HV), temporal lobe volume (TLV), transversal relaxation time (T(2)) and (1)H-MR spectroscopy ((1)H-MRS) metabolite ratios. MATERIALS AND METHODS Two sets of HV, TLV, T(2) and MR spectroscopic metabolite signal ratios were determined in 27 healthy volunteers. HV and TLV were measured with a T(1)-weighted MR sequence; whereas T(2) measurements were performed with conventional spin-echo (CSE) and fast spin-echo (FSE) MR imaging sequences. The interobserver and within-subject variances of T(2) measurements were estimated. RESULTS Estimated right and left HV coefficients of variation (CV)=0.13. FSE T(2) measurements showed no significant differences in the interobserver (CV=0.02) and within-subject variances (CV=0.02). Measurements showed no differences in the interobserver (CV=0.02) and within-subject (CV=0.04) variances for the CSE T(2) of the right and left hippocampi. Metabolite ratios between N-acetyl aspartate (NAA) and creatine (Cr), choline (Cho) and creatine, and NAA and choline plus creatine (Cho + Cr) for the right hippocampus were 2.29+/-0.19, 1.52+/-0.14 and 0.91+/-0.05, respectively. Metabolite ratios for the left hippocampus were 2.18+/-0.10, 1.48+/-0.10 and 0.88+/-0.06, respectively. CONCLUSIONS HV, TLV, T(2) and (1)H MRS metabolite ratio measurements showed fair reproducibility with small CVs, and no differences in the interobserver and within-subject variances, including no differences between right and left TLV, and in the right and left T(2).
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Inulin is an ideal substrate for a hydrogen breath test to measure the orocaecal transit time.
Geboes, KP, Luypaerts, A, Rutgeerts, P, Verbeke, K
Alimentary pharmacology & therapeutics. 2003;(7):721-9
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Abstract
BACKGROUND A better substrate is needed for a hydrogen breath test to measure the orocaecal transit time. The currently used substrate, lactulose, accelerates the orocaecal transit time by increasing the osmolality of the gut contents. The recently developed lactose 13C-ureide breath test is reliable, but a hydrogen breath test is preferred, as it allows the simultaneous investigation of the digestion and absorption of nutrients by means of 13C-labelled compounds. METHODS The usefulness of different types of inulin as a substrate for a hydrogen breath test was studied. Raftilin HP (>99% inulin with a degree of polymerization of between 5 and 60 and <0.5% glucose, fructose and sucrose) was further evaluated and compared with lactulose with regard to its effects on gastric emptying and the digestion of protein and lipids. RESULTS A good correlation was found between the orocaecal transit times using Raftilin HP (338 min; interquartile range, 300-383 min) and lactose 13C-ureide (353 min; interquartile range, 285-375 min) (r=0.85; P<0.001). The administration of 5 or 10 g Raftilin HP had no influence on the orocaecal transit time, whereas lactulose significantly shortened the orocaecal transit time. Neither inulin nor lactulose had a significant influence on gastric emptying or protein or lipid assimilation. CONCLUSION Raftilin HP is an ideal substrate for a hydrogen breath test to measure the orocaecal transit time.
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Short duration exercise increases breath hydrogen excretion after lactulose ingestion: description of a new phenomenon.
Ehrenpreis, ED, Swamy, RS, Zaitman, D, Noth, I
The American journal of gastroenterology. 2002;(11):2798-802
Abstract
OBJECTIVE There is limited information on the effect of exercise on colonic function. Beneficial effects have been described, including prevention of colon cancer. In the present study, we demonstrate that short duration exercise results in enhancement of breath hydrogen excretion after consumption of lactulose. METHODS Twelve normal volunteers who performed regular exercise were recruited. Each study subject underwent four study sessions (two resting and two exercise) after consumption of 10 g of crystalline lactulose. Colonic hydrogen production was measured in mid-expiratory breath samples obtained at baseline and frequent intervals to 420 min. Exercise sessions consisted of 5 min on a treadmill at a 20% incline at 10 km/h. This was performed 180 min after lactulose ingestion in the two exercise sessions. RESULTS A characteristic pattern in the hydrogen concentration versus time curves was seen after exercises, consisting of an initial decrease then an increase in concentration above baseline for up to 3 h. Mean area under the curve from 0 to 420 min for resting studies was 5,156 +/- 2,621 ppm/min and was 7,051 +/- 2,447 ppm/min for exercise studies, p < 0.05 (37% increase). Mean area under the curve from 180 to 420 min was 2,808 +/- 1,592 ppm/min for resting studies and 4,543 +/- 1,729 for exercise studies, p < 0.005 (62% increase). CONCLUSION This study demonstrates that exercise potentially enhances the metabolism of lactulose by colonic bacteria. The authors postulate that this effect is due to stirring of the colonic contents. The described phenomenon may explain, in part, the beneficial effects of exercise on colonic mucosa.
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Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal transport kinetics in children.
Schmitt, CP, Haraldsson, B, Doetschmann, R, Zimmering, M, Greiner, C, Böswald, M, Klaus, G, Passlick-Deetjen, J, Schaefer, F
Kidney international. 2002;(4):1527-36
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Abstract
BACKGROUND Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). METHODS Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m2, dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. RESULTS While intraperitoneal pH was constant at 7.41 +/- 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 +/- 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the transport of urea, potassium, beta2-microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. CONCLUSION The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
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Factors affecting renal hydrogen ion excretion capacity in healthy children.
Manz, F, Wentz, A, Lange, S
Pediatric nephrology (Berlin, Germany). 2001;(5):443-5
Abstract
In 560 healthy German children and adolescents aged 2.8-22.0 years from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study, the relationship between urine pH and renal net acid excretion (mmol/day/1.73 m2) was analysed. A quadratic model showed the best fit (r2 = 0.608). Using logistic regression analysis three parameters (urinary phosphorus excretion, total protein intake and urinary ratio of potassium and sodium) had a significant effect on renal hydrogen ion excretion capacity characterised by the probability of high or low net acid excretion with respect to the urine pH value. Urinary osmolality, in contrast to what has been seen in a previous experimental study with low birth weight infants, along with sex and age had no significant independent effects on renal net acid excretion with respect to the urine pH value over the range of osmolalities observed. In healthy children and adolescents a low fluid intake with high urinary osmolality does not at least substantially decrease the renal capacity of hydrogen ion excretion.
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Variations in colonic H2 and CO2 production as a cause of inadequate diagnosis of carbohydrate maldigestion in breath tests.
Koetse, HA, Vonk, RJ, Pasterkamp, S, Pal, J, de Bruijn, S, Stellaard, F
Scandinavian journal of gastroenterology. 2000;(6):607-11
Abstract
BACKGROUND Lactose maldigestion is usually diagnosed by means of the H2 breath test. When 13C-lactose is used as substrate, a 13CO2 breath test can be performed simultaneously. In an earlier publication we described the relation between both the H2 and 13CO2 exhalation in breath and the measured intestinal lactase activity after consumption of 13C-lactose. We found a discrepancy between both breath test results in 36% of the cases. To investigate the possible cause of these incongruous breath test results, we studied gas production from carbohydrate in the colon, using 13C-lactulose as a non-absorbable substrate. METHODS Experiments were performed in 21 subjects, by applying 5 different doses of 13C-lactulose. Repeatability studies were performed in six of these subjects, using 10 g substrate (three tests with 1-week intervals). RESULTS Both the H2 and the 13CO2 excretion in breath varied strongly interindividually and intraindividually after consumption of 13C-lactulose. In both cases no dose-response relation was observed. A significant positive linear relationship was found between H2 and 13CO exhalation (r = 0.45, P < 0.005). Extrapolation of these results to 13C-lactose breath tests indicates that the colonic contribution of 13CO2 production to the total 13CO2 excretion in breath varies but is on the average large enough to cause false-negative 13CO2 breath test results. CONCLUSIONS Excretion in breath of 13CO2 produced in the colon during a 13C-lactulose breath test correlates with the breath H2 excretion. This could explain the occurrence of false-negative 13CO2 lactose breath tests when colonic gas production is high and false-negative lactose H2 breath test results when gas production is low. It can also explain the improved sensitivity of the combined H2/13CO2 lactose breath test compared with both breath tests alone.