FDgard® Combination of Caraway Oil and L-Menthol for Treatment of Functional Dyspepsia

MedicalResearch.com Interview with:

William D. Chey, M.D., F.A.C.G. Director, Division of Gastroenterology Michigan Medicine Gastroenterology Clinic Ann Arbor, Michigan

Dr. Chey

William D. Chey, M.D., F.A.C.G.
Director, Division of Gastroenterology
Michigan Medicine Gastroenterology Clinic
Ann Arbor, Michigan

MedicalResearch: What is the background for this study? Would you tell us what is meant by Functional Dyspepsia?

Response: Functional dyspepsia (FD or meal-triggered indigestion) is a very common disorder affecting 11 percent – 29.2 percent of the world’s population, making it comparable in prevalence to Irritable Bowel Syndrome (IBS). However, unlike IBS, there is no FDA approved product to treat FD. Sufferers are often treated off-label with prescribed proton pump inhibitors (PPIs), histamine type-2 receptor antagonists (H2RAs), antidepressants, and prokinetics. While offering relief to a portion of FD patients, some of these have been associated with adverse events. Functional dyspepsia can have a negative effect on workplace attendance and productivity, with associated costs estimated in excess of $18 billion annually.

In functional dyspepsia, which is typically recurring, meal-triggered indigestion with no known organic cause, the normal function and sensation of the stomach and intestines are altered. FD is accompanied by symptoms such as epigastric pain or discomfort, epigastric burning, postprandial fullness, inability to finish a normal sized meal, heaviness, pressure, bloating in the upper abdomen, nausea, and belching. When doctors diagnose FD, they often identify patients as those who have these symptoms for at least three months, with symptom onset six months previously.

Caraway oil and peppermint oil have a history of helping some patients with functional dyspepsia. In multiple clinical studies, the combination of caraway oil and peppermint oil has been shown to manage FD and its accompanying symptoms, such as reducing the intensity of epigastric pain, pain frequency, dyspeptic discomfort, and the intensity of sensations of pressure, abdominal heaviness and fullness significantly better than control

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Proton-pump inhibitors (PPIs) Linked to Increased Risk of Death

MedicalResearch.com Interview with:

Ziyad Al-Aly, MD, FASNAssistant Professor of MedicineDirector of the Clinical Epidemiology CenterChief of Research and EducationDepartment of Veterans Affairs Health Care SystemSaint Louis

Dr. Ziyad Al-Aly

Ziyad Al-Aly, MD, FASN
Assistant Professor of Medicine
Director of the Clinical Epidemiology Center
Chief of Research and Education
Department of Veterans Affairs Health Care System
Saint Louis 

MedicalResearch.com: What is the background for this study?  

Response: In 2017, we published a paper showing increased risk of death associated with Proton-pump inhibitors (PPI) use. Following the publication of that 2017 paper, several key stakeholders including patients, doctors, research scientists, medical media folks, mainstream media folks, and others asked us: what do these people die from? Did you study causes of death attributable to PPI use? In the study published today, we developed a causal inference framework to answer this question.

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Calcium Channel Inhibitors (Verapamil and Diltiazem) May Be Useful in Allergic Inflammation of Esophagus

MedicalResearch.com Interview with:

Dr. Rhonda Souza, MDBaylor University Medical CenterCenter for Esophageal ResearchDallas, TX 75246

Dr. Souza

Dr. Rhonda Souza, MD
Baylor University Medical Center
Center for Esophageal Research
Dallas, TX 75246 

MedicalResearch.com: What is the background for this study?  

Response: Eosinophilic esophagitis (EoE) is a modern disorder of the esophagus caused by an allergy to certain foods. EoE causes esophageal symptoms like difficulty swallowing and heartburn and is diagnosed when biopsies of the esophagus taken during endoscopy show numerous eosinophils, which are a type of inflammatory blood cell.  There are few established treatments for EoE.

One such treatment is a diet that eliminates the offending food allergens, and another is to use steroids to reduce the number of eosinophils in the esophagus. However, the most common treatment for adults with eosinophilic esophagitis is to use proton pump inhibitors (PPIs), which block the proton pumps in stomach cells that make acid.  In earlier studies, we found that PPIs also can block proton pumps in esophageal cells.  Those proton pumps are activated by chemicals that the body produces in response to allergens including interleukin (IL)-13 or IL-4.  Il-13 and IL-4, which cause the esophagus to produce eotaxin-3, a molecule that attracts eosinophils. What remained unknown, however, was the mechanism whereby these interleukins activate proton pumps in the EoE esophagus. In our present study, we explored whether IL-4 works by increasing calcium levels in esophageal cells from EoE patients.

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Novel Lantibiotic Against C. diff Infections May Improve Lipid Profile

MedicalResearch.com Interview with:

Rajesh Kumar NV, Ph.D.Affiliation during the study:Senior Manager, Human Therapeutics Division,Intrexon Corporation, Germantown, MD, USA

Dr. Rajesh Kumar NV

Rajesh Kumar NV, Ph.D.
Affiliation during the study:
Senior Manager, Human Therapeutics Division,
Intrexon Corporation, Germantown, MD, USA
Current affiliation:
Translational Research Program Manager, Oncology Drug Discovery,
Department of Radiation Oncology and Molecular Radiation Sciences,
Johns Hopkins University School of Medicine
Baltimore, MD,  


MedicalResearch.com: What is the background for this study?

Response: Clostridium difficile is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Clostridium difficile infection is the most frequent form of colitis in hospitals and nursing homes and affects millions of patients in the United States and abroad. Clostridium difficile associated disease (CDAD) is a global public health challenge where even mild to moderate infections at times can quickly progress to a fatal disease if not treated promptly.

OG253 is a novel lantibiotic in development for the treatment of CDAD. Lantibiotics are antimicrobial peptides whose chemical structure includes a bridge maintained by the non-canonical amino acid lanthionine. The primary objective of our study was to evaluate the repeated dose toxicokinetics and any possible side effects of OG253 as enteric-coated capsules following daily oral administrations of three different doses (6.75, 27 and 108 mg/day) for a single day or seven consecutive days in both genders of rats.

An enteric-coated capsule of OG253 was formulated in an attempt to circumvent the proteolytic degradation of OG253 in the upper digestive tract and specifically deliver this lantibiotic to the distal portion of the small intestine. Continue reading

Children Swallow Jewelry, Coins, Toys and Button Batteries, Leading to 99 ER Visits a Day

MedicalResearch.com Interview with:
Danielle Orsagh-Yentis, MD
Pediatric GI Motility Fellow
Department of Gastroenterology, Hepatology and Nutrition
Nationwide Children’s Hospital
Columbus, Ohio

MedicalResearch.com: What is the background for this study?

Response: Foreign body ingestions are quite common in young children. Much of the literature and advocacy to date has focused on the harms of button battery and magnet ingestions.

We found that foreign body ingestions in children younger than 6 years of age have been increasing over the past 2 decades. This overall increase is mirrored by the rise in coin, toy, and jewelry ingestions, as well as batteries, which, when swallowed, have the potential to cause considerable harm.  Continue reading

New Probiotic Targets Harmful Intestinal Biofilm in Crohn’s Disese

MedicalResearch.com Interview with:

Professor Mahmoud A. Ghannoum, PhDDirector of the Center for Medical MycologyCase Western Reserve School of Medicine and UH

Dr. Ghannoum

Professor Mahmoud A. Ghannoum, PhD
Director of the Center for Medical Mycology
Case Western Reserve School of Medicine and UH

MedicalResearch.com: What are the main findings? 

Response: The driving force for this study was our finding that patients with Crohn’s disease had a significantly high level (or abundance) of pathogenic fungi (called Candida tropicalis) as well as bacteria (Escherichia coli, and Serratia Marcescens) compared to their non-diseased first-degree relatives. Not only were their levels high, but these organisms cooperated to form polymicrobial digestive plaque (or digestive biofilms) that aggravated the inflammatory symptoms in these patients.

Based on this we wanted to develop a probiotic that targeted these organisms and the biofilms they form. Our efforts led to the design of the novel Biohm probiotic which we tested and the results were described in our publication.

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Opioid-Induced Constipation: Can Your Hospital Afford the Financial Burden?

MedicalResearch.com Interview with:

Howard Franklin, MD, MBAVice President of Medical Affairs and StrategySalix Pharmaceuticals

Dr. Franklin

Howard Franklin, MD, MBA
Vice President of Medical Affairs and Strategy
Salix Pharmaceuticals

MedicalResearch.com: What is opioid-induced constipation?

Response: Opioid-induced constipation (OIC) is a side effect in as many as 80 percent of chronic pain patients on opioids. OIC is unlikely to improve over time without treatment and can lead to suffering and discomfort. More importantly, the insufficient treatment of OIC can have negative implications for patients, both those on opioid therapy for chronic non-cancer pain as well as advanced illness, and for hospitals. 

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Overcoming Barriers to Life-Saving Colonoscopies

MedicalResearch.com Interview with:

Dr. Michael Epstein

Dr. Michael Epstein

Dr. Michael Epstein MD
Dr. Epstein has over 30 years of experience in the field of Gastroenterology with extensive medical training as a practicing clinician, including treating patients with a range of gastroenterological conditions, such as Inflammatory Bowel Disease (IBD), Crohn’s disease, Ulcerative Colitis, Hepatology and Liver diseases.

Dr. Epstein is also the founder and principle physician at Digestive Disorders Associates and is the president of the Maryland Diagnostic and Therapeutic Endo Center, both in Annapolis, Maryland. He is board certified by the American Board of Internal Medicine with a sub-specialty in Gastroenterology. He is a fellow of the American Gastroenterology Association and the American College of Gastroenterology, and a member of the Society of Gastrointestinal Surgeons. 

MedicalResearch.com: What is the importance of colonoscopy

Response: We lose more people to colon cancer each year than who have died in the Vietnam WarI believe that colon cancer has become a public health issue and there is a great need to increase public awareness around screening.

It is so important for patients to take part in routine screenings as the symptoms of colon cancer are often silent. Sadly, often times people do not know they have colon cancer until the cancer is in an advanced state.

A colonoscopy is important because it is the only test that can currently detect and treat this type of cancer that is also one of the leading killers in the United States. Not only can we often detect pre-cancerous polyps, but we can often remove these polyps during the procedure.  Continue reading

Low Sugar Diet Reduced Liver Fat and Inflammation

MedicalResearch.com Interview with:

Miriam Vos, MD, MSPH Assistant professor of Pediatrics Emory University School of Medicine Physician on staff, Children’s Healthcare of Atlanta

Dr. Vos

Miriam Vos, MD, MSPH
Associate Professor of Pediatrics and Director
Pediatric Fatty Liver Program
Emory and Children’s Healthcare of Atlanta

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Fatty liver disease has quickly become a common problem in children and adolescents, affecting an estimated 7 million children in the U.S.  This study resulted from our previous research demonstrating that fructose increases cardiometabolic risk factors in children with NAFLD in addition to other research that had demonstrated associations between NAFLD and sugar.    Continue reading

Changing Attitudes Toward Liver Transplant for Alcohol-Associated Liver Disease

MedicalResearch.com Interview with:

Norah Terrault, MD MPH Professor, Gastroenterology Department of Medicine University of California San Francisco

Prof. Terrault

Norah Terrault, MD MPH
Professor, Gastroenterology
Department of Medicine
University of California San Francisco

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Rates of liver transplantation (LT) for alcohol-associated liver disease (ALD) are rising such that ALD recently became the most common reason for LT in the United States. Although some assume that the increase in LT for ALD is because LT for hepatitis C has declined since the advent of antiviral therapy, little research has been done to formally investigate this hypothesis, or other reasons for the increase.

This national registry study used the United Network for Organ Sharing database and included over 32,000 liver transplant recipients, including 9,438 patients with ALD. The main findings are that

1) liver transplantation for ALD has doubled in the past 15 years, but only 48% of the increase in LT for ALD can be explained by declining LT for hepatitis C;

2) Many liver transplantation centers require patients to be abstinent at least 6 months to be eligible for LT for alcohol-associated liver disease, but this is changing – our trends analysis strongly suggest that shifting attitudes of transplant providers to allow earlier LT for ALD are an important part of the increase in LT for ALD, and are variable across different geographic regions;

3) Late post- liver transplantation survival after 5-years is 11% lower for alcohol-associated liver disease (vs. non-ALD).  

MedicalResearch.com: What should readers take away from your report?

Response: Changing attitudes regarding liver transplantation for acute alcoholic hepatitis may be having broad effects on LT for alcohol-associated liver disease, as more LT providers believe that it is justified to pursue earlier LT for ALD. As attitudes continue to change with more data to suggest that early LT for ALD can be undertaken with acceptable outcomes, we may see further increases in liver transplantation for ALD in future years. Since attitudes are provider-specific, and there is no national transplant policy for LT eligibility in terms of pre-LT abstinence requirements, this study suggests that variable policies and provider attitudes may be leading to inequity in healthcare access for alcohol-associated liver disease patients in need of liver transplantation.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Given the significant increase in liver transplantation for alcohol-associated liver disease, which was different across regions, there would be value in a national policy to guide the management of LT for ALD. It is unclear why late survival for ALD is inferior for non-ALD, but other studies have shown recurrent alcohol use, malignancy, and infections to be important causes of late death after liver transplantation — these should be specifically investigated in future studies of liver transplantation for ALD.

No disclosures

Citation: 

Lee BP, Vittinghoff E, Dodge JL, Cullaro G, Terrault NA. National Trends and Long-term Outcomes of Liver Transplant for Alcohol-Associated Liver Disease in the United States. JAMA Intern Med. Published online January 22, 2019. doi:10.1001/jamainternmed.2018.6536

Jan 22, 2019 @ 10:34 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Ulcerative colitis: Fecal Microbiota Transplantation Can Induce Remission

MedicalResearch.com Interview with:

Samuel P. Costello MBBS Inflammatory Bowel Disease Service, Department of Gastroenterology, The Queen Elizabeth Hospital Australia

Dr. Costello

Samuel P. Costello MBBS
Inflammatory Bowel Disease Service,
Department of Gastroenterology
The Queen Elizabeth Hospital
Australia

MedicalResearch.com: What is the background for this study?

Response: Ulcerative colitis (UC) is an inflammatory bowel disease that has high rates of persistent or relapsing symptoms despite available therapies. Many of these therapies also have the potential for unacceptable side effects including allergy, intolerance, serious infection and malignancy due to long-term immunosuppression. It is for these reasons that new therapies for Ulcerative colitis are required; particularly therapies that target novel pathways and are not immune suppressing.

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Toilet Stools May Make Going to the Bathroom Easier

MedicalResearch.com Interview with:

Dr. Peter Stanich MD Assistant Professor of Gastroenterology, Hepatology and Nutrition The Ohio State University Wexner Medical Center and College of Medicine

Dr. Stanich

Dr. Peter Stanich MD
Assistant Professor of Gastroenterology, Hepatology and Nutrition
The Ohio State University Wexner Medical Center
and College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: We knew of toilet stools from popular culture and wanted to study this in a scientific way. This is something that patients, family and friends always ask about and we wanted to start the process of assessing it more rigorously to see if they are beneficial.  Continue reading

Normal Intestinal Microbiome Enhances Intestinal Barrier

MedicalResearch.com Interview with:

Dr. Venkatakrishna R Jala, PhD Assistant Professor James Graham Brown Cancer Center Department of Microbiology and Immunology University of Louisville

Dr. Jala

Dr. Venkatakrishna R Jala, PhD
Assistant Professor
James Graham Brown Cancer Center
Department of Microbiology and Immunology
University of Louisville

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Humans evolved along with their gut microbiota and adapted their physiological activities to help each other. Along with consumption of healthy diets, humans must harbor the appropriate microbiota to convert the foods into available components called metabolites. These microbial metabolites play a critical role in preserving homeostasis, the development of immune systems and preventing adverse events both systemically and locally. Despite the availability of large metagenomics (bacterial sequence) data, and its associations with disease conditions, the functional dynamics of microbiota (good vs bad) in human health or diseases are yet to be defined. The host’s indigenous gut microbiota and its metabolites have emerged as key factors that greatly influence human health and disease, including inflammatory bowel diseases (IBD). IBD patients suffer from leaky gut and increased inflammation.

The current study demonstrates that a microbial metabolite derived from ellagitannin/ellagic acid rich diets (e.g., pomegranate, berries) called ‘urolithin A’ and its synthetic analogue significantly enhance gut barrier function in addition to blocking the unwarranted inflammation in IBD animal models.  Continue reading

Probiotics Found Unhelpful in Kids With Outpatient Diarrhea

Stephen Freedman MDCM, MSc Alberta Children's Hospital Foundation Professor in Child Health and Wellness Sections of Pediatric Emergency Medicine and Gastroenterology Alberta Children's Hospital & Research Institute University of Calgary Calgary, AB

Dr. Freedman

MedicalResearch.com Interview with:
Stephen Freedman MDCM, MSc
Alberta Children’s Hospital Foundation Professor in Child Health and Wellness
Sections of Pediatric Emergency Medicine and Gastroenterology
Alberta Children’s Hospital & Research Institute
University of Calgary
Calgary, AB

 MedicalResearch.com: What is the background for this study?

Response: Vomiting and diarrhea remain extremely common diseases in children and are the most common reason children are brought for emergency department care in North America.  While we have options to reduce vomiting there historically has been little physicians can offer to reduce the severity of the diarrhea.

Probiotics have recently emerged as an option with some early evidence of benefit in clinical trials but the studies performed to date have been small and few little research has been conducted in North America in outpatient or emergency department children.

The one study to date that was performed in a US emergency department did not find probiotic use to be beneficial.  Given the increasing importance of clarifying this issue we undertook this study.

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Can a Low-Gluten Diet Improve Your Health (even if you don’t have celiac disease)?

MedicalResearch.com Interview with:

Professor Oluf Pedersen Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen

Dr. Pedersen

Professor Oluf Pedersen
Novo Nordisk Foundation Center for Basic Metabolic Research
University of Copenhagen

MedicalResearch.com: What is the background for this study?

Response: We focused our study on healthy people due to the world-wide bottom-up movement among healthy adults to live gluten-free or on a low-gluten diet.

Therefore, we undertook a randomised, controlled, cross-over trial involving 60 middle-aged healthy Danish adults with two eight week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day).

The two diets were balanced in number of calories and nutrients including the same total amount of dietary fibres. However, the composition of fibres differed markedly between the two diets.

When the low-gluten trend started years back the trend was without any scientific evidence for health benefits. Now we bring pieces of evidence that a low-gluten diet in healthy people may be related to improved intestinal wellbeing due to changes in the intestinal microbiota which to our surprise is NOT induced by gluten itself but by the concomitant change in the type of dietary fibres linked to a low-gluten intake.

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Fecal Transplantation May Stabilize Microbiome in Premature Infants

MedicalResearch.com Interview with:

Thomas Thymann PhD DVM MSc Department of Veterinary and Animal Sciences Comparative Pediatrics and Nutrition Faculty of Health and Medical Sciences University of Copenhagen Frederiksberg, Denmark

Prof. Thymann

Thomas Thymann PhD DVM MSc
Department of Veterinary and Animal Sciences
Comparative Pediatrics and Nutrition
Faculty of Health and Medical Sciences
University of Copenhagen
Frederiksberg, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infants that are born preterm are at risk of developing a severe and life threatening intestinal disease referred to as necrotizing enterocolitis (NEC). This condition is known to be under influence of several factors including the microorganisms that start to colonize the intestine immediately after birth.

We wanted to see whether fecal matter collected from healthy 10-day old piglets, would benefit the pattern of early colonization, and prevent NEC.

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CDC Identifies Most Serious Norovirus Strains

MedicalResearch.com Interview with:
"Day 19: Norovirus (stomach flu) visits our home." by Loren Kerns is licensed under CC BY 2.0Rachel M. Burke, PhD, MPH
Epidemiologist, Viral Gastroenteritis Branch
Centers for Disease Control and Prevention
Atlanta, GA 30329

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Noroviruses are the leading cause of vomiting and diarrhea from acute gastroenteritis (inflammation of the stomach or intestines) among people of all ages in the United States. Each year in the United States, norovirus illness is responsible for an estimated 19 to 21 million cases of acute gastroenteritis, and contributes to 56,000 to 71,000 hospitalizations and 570 to 800 deaths, mostly among children and the elderly.

CDC linked information from two different surveillance systems to analyze 3,747 norovirus outbreaks reported by health departments from 2009 to 2016. Our study provides a comprehensive description of norovirus outbreaks from the epidemiology and laboratory perspectives, using the National Outbreak Reporting System (NORS) and CaliciNet, respectively. 

Norovirus outbreaks caused by GII.4 strains occurred more often in healthcare settings, affected older adults, and caused more severe illness, leading to hospitalization or death.

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Crohn’s Disease: Single Capsule Antibiotic Combined Demonstrates Clinical Benefit

MedicalResearch.com Interview with:
RedHill BiopharmaDror Ben-Asher
Co-Founder, Chairman & CEO
RedHill Biopharma Ltd.

MedicalResearch.com: Your presentation at United European Gastroenterology Week (UEGW) covered top-line data from your recently completed Phase 3 study of RHB-104 in Crohn’s disease. Can you please briefly remind us of the background for this study and what results you previously announced?

Response: Crohn’s disease is a devastating gastrointestinal disorder that affects millions of people worldwide. Crohn’s is a chronic relapsing disorder that plagues people throughout their lives with a variety of symptoms including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The existing treatments for Crohn’s disease leave a lot to be desired – they are only partially effective in the long-term control of Crohn’s and are associated with serious side effects. In addition, the existing therapies only target treating the symptomatic inflammation associated with Crohn’s.

We began developing RHB-104 with the MAP hypothesis in mind, a theory that suggests Crohn’s is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP), in susceptible patients. RHB-104 is a patent-protected orally-administered combination of three antibiotics (clarithromycin, clofazimine and rifabutin) in a single oral capsule that has demonstrated its potential to benefit Crohn’s patients.

When we announced top-line results from the MAP US study, our Phase 3 trial of RHB-104 in patients with moderate to severe Crohn’s disease, we showed that RHB-104 demonstrated a significant clinical benefit to patients versus placebo control. Patients treated with RHB-104 showed significant increase in remission at 26-weeks post treatment initiation in addition to being generally safe and well tolerated. Continue reading

The Appendix May Play Role in Initiation of Parkinson’s Disease

MedicalResearch.com Interview with:

Viviane Labrie, Ph.D. Assistant Professor, Center for Neurodegenerative Science Van Andel Research Institute Grand Rapids, Michigan

Dr. Labrie

Viviane Labrie, Ph.D.
Assistant Professor
Center for Neurodegenerative Science
Van Andel Research Institute
Grand Rapids, Michigan

MedicalResearch.com: What is the background for this study?

Response: Our lab has an interest in the early events and initiation of neurodegenerative diseases. Parkinson’s disease for a long time was thought to be a movement disorder driven by the destruction of dopamine neurons in a specific area of the brain, the substantia nigra. In the last 10 years it has become evident that Parkinson’s disease is not just a movement disorder but hosts a whole range of non-motor systems. One of the most common non-motor symptoms in Parkinson’s patients is issues with the gastrointestinal (GI) tract. GI symptoms often occur early in Parkinson’s disease; for many patients, GI symptoms precede the onset of motor symptoms by as many as 2 decades. Moreover, the GI is not only involved in the early signs of Parkinson’s but has been proposed to be a place in the body where Parkinson’s disease begins.

The hallmark pathology of Parkinson’s disease in the brain is Lewy bodies, which contains a clumped form of a protein called alpha-synuclein. There is evidence that Parkinson’s disease pathology, this clumped alpha-synuclein protein, is detectable in the GI tract, even many years before the onset of Parkinson’s motor symptoms. Clumped alpha-synuclein is also capable of traveling across nerve cells. There is evidence that clumped alpha-synuclein can travel up the nerve that connects the GI tract to the brain and enter the brain. This could be disastrous because clumped alpha-synuclein can seed and spread in the brain, which has neurotoxic effects and can eventually lead to Parkinson’s disease. In fact, in the brain of Parkinson’s patients, one of the first places where alpha-synuclein clumps are detected is at the terminal where the gut nerve connects to the brain, and this pathology advances from this point to other brain areas as the disease progresses.

This intriguing connection of the GI tract to the early processes of Parkinson’s disease had us interested in trying to understand how the gut could be involved in triggering Parkinson’s. But the GI tract is a very big place, and we first asked ourselves, where should we look to better understand GI involvement in Parkinson’s disease? Continue reading

Psoriasis Patients More Likely To Have Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Psoriasis

Psoriasis

Prof Ching-Chi Chi, MD, MMS, DPhil 
Department of Dermatology
Chang Gung Memorial Hospital, Linkou
Guishan Dist, Taoyuan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies have shown common genotypes, clinical course, and immunological features shared by psoriasis and inflammatory bowel disease.

However, the relationship between psoriasis and inflammatory bowel disease was largely unclear.

In this study, we found when compared to the general population, psoriatic patients are more likely to have concomitant inflammatory bowel disease.  Continue reading

Cannabis Improved Symptoms, but Not Inflammation of Crohn’s Disease

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

Timna Naftali MD
Specialist in Gastroenterology
Meir Hospital and Kupat Holim Clinic,
Tel Aviv University, Israel

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In previous studies we could see that Crohn’s patients improve symptoms when taking cannabis but we did not have good data about actual inflammation.

So, in this study we added a colonoscopy to see if we can detect any change in inflammation. We also wanted to find a better mode of consuming cannabis, other than smoking.

MedicalResearch.com: What should readers take away from your report?

 Response: The take home massage would be that cannabis may help the patients feel better, but is not a replacement of conventional medical therapy. It should be used as an adjuvant to other treatments in appropriate cases.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Regarding future research, there are many points that should be addressed:

  • Cannabis in laboratory trials does have an anti-inflammatory effect. We have to find a way of translating this effect to clinical treatment
  • What is the best way of administering cannabis? (We certainly do not want to recommend smoking)
  • What is the best dose/combination?
  • What are the long term effects?
  • Which patients, if any, will benefit most?

Citation:

UEG 2018 abstract:
https://live.ueg.eu/week/
Cannabis induces clinical response but no endoscopic response in Crohn’s disease patients

Oct 22, 2018 @ 9:18 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Text Messages Improved Colonoscopy Adherence

MedicalResearch.com Interview with:

Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania

Dr. Mahmud

Nadim Mahmud, MD, MS, MPH
Hospital of the University of Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process.

We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence. 

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Education Using VR Can Encourage Patients To Get Colon Cancer Screening

MedicalResearch.com Interview with:

Nathaniel Ernstoff, MD University of Miami

Dr. Ernstoff

Nathaniel Ernstoff, MD
University of Miami

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening.

This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer.

Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study’s completion.

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Recreational Cannabis Linked to Acute Pancreatitis

MedicalResearch.com Interview with:
Tarek Alansari, MD Metropolitan HospitalTarek Alansari, MD
Metropolitan Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cannabis is the most frequently consumed recreational drug in the world. The use of cannabis is becoming increasingly accepted by the general public in the United States. The estimates of the prevalence of cannabis use in the United States is about 9.5% in the adult population and the prevalence of dependence or abuse approaches 2.9%. Those under the age of 35 years are the most frequent consumers. According to Business Insider as of June 2018, recreational cannabis is legal in 9 states and medical cannabis is legal in 30 states. Recent surveys show that about 35 million Americans are frequent cannabis users.

Aiming for symptomatic relief, some patients with different gastrointestinal disorders have turned to cannabis without fully understanding the effect of its use for their individual condition.
Biliary tract disease, ethanol abuse, infections, autoimmunity, and genetics are well known causes of acute pancreatitis. However, medication-induced pancreatitis remains a less common etiology. In about 20% of cases of acute pancreatitis despite of the great improvement in genetic testing and imaging modalities, the workup still fails to reveal an etiology. These cases are labeled idiopathic.

Cannabis use is emerging as a rare, possibly overlooked cause of acute pancreatitis with few cases reported in the literature. In the United States, only 5 cases of cannabis – induced acute pancreatitis (AP) have been reported till September 2017. The review of literature revealed that only 26 cases of cannabis-induced AP have been reported worldwide. Continue reading

More Patients With Bariatric Surgery Admitted for Gallstone-Related Biliary Disease

MedicalResearch.com Interview with:

Violeta Popov, MD PhD FACG Assistant Professor of Medicine Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan) Division of Gastroenterology NYU Langone Medical Center 

Dr. Popov

Violeta Popov, MD PhD FACG
Assistant Professor of Medicine
Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan)
Division of Gastroenterology
NYU Langone Medical Center 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Bariatric surgery is the most effective method currently available for durable weight loss. In the first few months after surgery, patients typically experience significant weight loss. Rapid weight reduction though can lead to the development of gallstones and biliary disease, described in up to 40% of post-bariatric patients. To avoid these complications, the gallbladder was removed during open bariatric procedures in the past. However, with the advent of laparoscopic surgery, concomitant cholecystectomy with bariatric surgery is no longer performed for many reasons.  The aim of is study is to assess if biliary diseases such as acute pancreatitis, acute cholecystitis, acute cholangitis, and cholecystectomy have increased with this change in practice. This is a retrospective cohort analysis of the National Inpatient Sample (NIS), the largest publicly available inpatient database in the United States of nonfederal institutions, with approximately 1000 hospitals participating and information on over 7 million inpatient admissions.

We found that from 2006 to 2014 there has been an approximately 10-fold increase in hospital admissions for biliary diseases, as well as similar increase in cholecystectomies, in patients who have a history of bariatric surgery. There was no significant change in admissions in patients without bariatric surgery between 2006 and 2014 admitted for the same biliary diseases.  Continue reading

Obesity Linked to Alarming Risk in Gastric and Colon Cancers in Young Adults

MedicalResearch.com Interview with:

Hisham Hussan, M.D. Assistant Professor of Clinical Medicine Director, Obesity and Bariatric Endoscopy Section Division of Gastroenterology, Hepatology, and Nutrition Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus, OH 43210

Dr. Hussan

Hisham Hussan, M.D.
Assistant Professor of Clinical Medicine
Director, Obesity and Bariatric Endoscopy Section
Division of Gastroenterology, Hepatology, and Nutrition
Department of Internal Medicine
The Ohio State University Wexner Medical Center
Columbus, OH 43210

MedicalResearch.com: What is the background for this study?

Response: Obesity, a major healthcare burden, is an established risk factor for many gastrointestinal cancers. With obesity being on the rise, we inspected whether obesity related gastrointestinal cancers are increasing in different age groups, and relation to obesity.

MedicalResearch.com: What are the main findings? 

Response: We identify an alarming increase in incidence of gastric and colorectal cancers in young adults (less than 50 years of age) between 2002-2013.

This was paralleled by an uptrend in obese patients undergoing surgeries for these cancers during the same period. 

MedicalResearch.com: What should readers take away from your report?

Response: Our results suggest, for the first time, a contributing role of obesity in the etiology as well as the increasing incidence of gastric and colorectal cancers in young adults. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: More studies are needed to investigate the interplay of epigenetics factors such as young-onset obesity and western diet in relation to risk of adults developing colorectal and gastric cancers at an earlier age. Also public policies are needed to counter obesity and the rising incidence of gastric and colorectal cancer in this young high risk group.

MedicalResearch.com: Is there anything else you would like to add?

Response: My main career focus is translational and clinical research at the interface of energy balance, the microbiome and gastrointestinal cancer.

We have no financial disclosers or conflict of interest.

Citation:

 ACG18 abstract:

Rising, Age‐Specific, Trends of Obesity‐Related Gastrointestinal Cancers Correspond With Increasing Cancer Resections in Obese Patients: A 2002‐2013 National Analysis Using the SEER and NIS Databases

Oct 9, 2018 @ 11:58 am

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Gut Microbiome Can Be Restored in Cancer Patients with Fecal Transplantation

MedicalResearch.com Interview with:

Joao Xavier PhD Associate Faculty Member | Computational & Systems Biology Memorial Sloan Kettering Cancer Center New York, NY 10065

Dr. Joao Xavier

Joao Xavier PhD
Associate Faculty Member | Computational & Systems Biology
Memorial Sloan Kettering Cancer Center
New York, NY 10065 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our team at Memorial Sloan Kettering has been investigating the intestinal microbiota of patients receiving bone marrow transplantations for more than eight years now. We have found through several studies that these patients lose important healthy bacteria from their microbiota, and that these losses are mostly caused by the antibiotics given as prophylaxis or to treat infections.

We also found that the drastic changes in the microbiota composition, especially the intestinal dominations by bacteria such as Enterococcus, increase the risk of transplant-related complications and lowered patient survival.

We aimed to determine the feasibility of autologous microbiota transplant (auto-FMT) as a way to reconstitute lost bacteria. This randomized study found that indeed auto-FMT could reconstitute important microbial groups to patients.  Continue reading

H. pylori Link to Stomach Cancer Strengthened

MedicalResearch.com Interview with:

Nina R. Salama. PhD Member Human Biology Division Member Public Health Sciences Division Affiliate Member Basic Sciences Division Dr. Penny E. Petersen Memorial Chair for Lymphoma Research  Director of Molecular and Cellular Biology (MCB) Graduate Program Fred Hutchinson Cancer Research Center

Dr. Salama

Nina R. Salama. PhD
Member Human Biology Division
Member Public Health Sciences Division
Affiliate Member Basic Sciences Division
Dr. Penny E. Petersen Memorial Chair for Lymphoma Research
Director of Molecular and Cellular Biology (MCB) Graduate Program
Fred Hutchinson Cancer Research Center 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We wanted to better understand why certain patients infected with H. pylori developed stomach cancer and how we could better identify them. H. pylori is one of the strongest risk factors for stomach cancer, but how much it predisposes individuals to gastric cancer varies around the world.

Working closely with colleagues from Zhengzhou University, we ran tests on 49 samples from China and found that 91 percent of patients infected with the EPIYA D gene variant of H. pylori also had stomach cancer. Continue reading

Vaccines Against Rotavirus Gastroenteritis Decreased Infections Even in Unvaccinated Kids

MedicalResearch.com Interview with:

Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics

Dr. Chuanxi Fu

Chuanxi Fu, MD.PhD.
Professor of Epidemiology, School of Public Health
Zhejiang Chinese Medical University
Associate editor, Human Vaccines & Immunotherapeutics 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated.

In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage.  Continue reading

Crohn’s Disease: Positive Findings from Phase III Study of Antibiotic Combination

MedicalResearch.com Interview with:
RedHill Biopharma LtdMr. Gilead Raday, MPhil, MSc
Chief Operating Officer
RedHill Biopharma Ltd

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Crohn’s disease?  How common is it and whom does it affect? 

Response: Crohn’s disease (CD) is a chronic, relapsing inflammatory gastrointestinal disorder characterized by a variety of symptoms, including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The underlying cause of Crohn’s is unknown; however, CD is believed to arise secondary to genetic and environmental stimuli. More than 1.5 million people suffer from CD globally and it is prevalent in the U.S., affecting more than 200 people per 100,000.

The current standard of care for Crohn’s disease is limited to anti-inflammatories, immuno-suppressants and biologics that treat auto-immune disorders. These therapies target symptomatic improvement in the inflammation associated with CD, are widely considered to be of limited efficacy in the long term, and are associated with numerous side effects. This speaks to the great unmet need for an effective therapy for this debilitating disease.

Additionally, there is no current therapy that treats the suspected underlying cause of Crohn’s disease. We have developed RHB-104 with the MAP hypothesis in mind, which posits that Crohn’s disease is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP). This is similar to peptic ulcer disease, a condition that was initially associated with stress, smoking, NSAIDs and other behavioral factors, yet was found to be caused by H. pylori bacterial infection in the 1980s, revolutionizing the field of ulcer treatment. Validation of this theory would revolutionize how Crohn’s disease is viewed and treated by the medical community and RHB-104 is the only therapy in development targeting MAP infection.  Continue reading