Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that affects approximately 10% of the population. Diet triggers symptoms in the vast majority of individuals with IBS. ...In view of this, there has been a focus on the role of diet in IBS. The diets currently being headlined for IBS include (i) traditional dietary advice, (ii) the low fermentable oligo‐, di‐, mono‐ saccharides and polyols (FODMAPs) diet and (iii) the gluten‐free diet (GFD). Although traditional dietary advice is considered as the first‐line dietary therapy, its evidence base is variable, with a few randomized controlled trials (RCTs) exploring the efficacy of this approach, other than for fibre. There are now a growing number of RCTs demonstrating the efficacy of the low FODMAP diet in the short‐term, with some emerging data on the long‐term ‘adapted’ low FODMAP diet. There are also several RCTs showing the benefits of a GFD in IBS; however, this concept is hampered with uncertainty as to the mechanism of action. Nevertheless, all of these dietary therapies are viable options for individuals with IBS, with the dietitian and patient engagement at the forefront of achieving success. However, future pragmatic studies are needed to clarify the comparative efficacy and convenience of implementing these various diets into routine life. Moreover, it is imperative to better delineate the concern that restrictive diets – such as the low FODMAP and GFD – may promote nutritional inadequacies, disordered eating behaviours, and lead to detrimental alterations to the gut microbiota.
We have conducted a spectroscopic survey of 78 starbursting infrared-luminous galaxies at redshifts up to z = 0.5. We use moderate-resolution spectroscopy of the Na I D interstellar absorption ...feature to directly probe the neutral phase of outflowing gas in these galaxies. Over half of our sample are ultraluminous infrared galaxies that are classified as starbursts; the rest have infrared luminosities in the range log(L sub(IR)/L sub( )) = 10.2-12.0. The sample selection, observations, and data reduction are described here. The absorption-line spectra of each galaxy are presented. We also discuss the theory behind absorption-line fitting in the case of a partially covered, blended absorption doublet observed at moderate-to-high resolution, a topic neglected in the literature. A detailed analysis of these data is presented in a companion paper.
Aims. Long gamma-ray bursts (LGRB) have been proposed as promising tracers of star formation owing to their association with the core-collapse of massive stars. Nonetheless, previous studies we ...carried out at z < 1 support the hypothesis that the conditions necessary for the progenitor star to produce an LGRB (e.g. low metallicity), were challenging the use of LGRBs as star-formation tracers, at least at low redshift. The goal of this work is to characterise the population of host galaxies of LGRBs at 1 < z < 2, investigate the conditions in which LGRBs form at these redshifts and assess their use as tracers of star formation. Methods. We performed a spectro-photometric analysis to determine the stellar mass, star formation rate, specific star formation rate and metallicity of the complete, unbiased host galaxy sample of the Swift/BAT6 LGRB sample at 1 < z < 2. We compared the distribution of these properties to the ones of typical star-forming galaxies from the MOSDEF and COSMOS2015 Ultra Deep surveys, within the same redshift range. Results. We find that, similarly to z < 1, LGRBs do not directly trace star formation at 1 < z < 2, and they tend to avoid high-mass, high-metallicity host galaxies. We also find evidence for an enhanced fraction of starbursts among the LGRB host sample with respect to the star-forming population of galaxies. Nonetheless we demonstrate that the driving factor ruling the LGRB efficiency is metallicity. The LGRB host distributions can be reconciled with the ones expected from galaxy surveys by imposing a metallicity upper limit of logOH ∼ 8.55. We can determine upper limits on the fraction of super-solar metallicity LGRB host galaxies of ∼20%, 10% at z < 1, 1 < z < 2, respectively. Conclusions. Metallicity rules the LGRB production efficiency, which is stifled at Z ≳ 0.7 Z⊙. Under this hypothesis we can expect LGRBs to trace star formation at z > 3, once the bulk of the star forming galaxy population are characterised by metallicities below this limit. The role played by metallicity can be explained by the conditions necessary for the progenitor star to produce an LGRB. The moderately high metallicity threshold found is in agreement with the conditions necessary to rapidly produce a fast-rotating Wolf-Rayet stars in close binary systems, and could be accommodated by single star models under chemically homogeneous mixing with very rapid rotation and weak magnetic coupling.
Aim
The aim of this study was to examine mortality in patients with both type 1 diabetes (T1D) and coeliac disease (CD).
Methods
Between 1969 and 2008, we identified individuals with CD through ...biopsy reports from all pathology departments (n = 28) in Sweden. T1D was defined as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged ≤30 years. During follow‐up, we identified 960 patients with both T1D and CD. For each individual with T1D and CD, we selected up to five subjects with T1D alone (i.e. no CD), matched for sex, age and calendar period of diagnosis, as the reference group (n = 4608). Using a stratified Cox regression analysis with CD as a time‐dependent covariate, we estimated the risk of death in patients with both T1D and CD compared with those with T1D alone.
Results
Stratifying for time since CD diagnosis, CD was not a risk factor for death in patients with T1D during the first 5 years after CD diagnosis hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.43–1.73, but thereafter the HR for mortality increased as a function of follow‐up time (5 to <10 years, HR 1.44, 95% CI 0.74–2.79; 10 to <15 years, HR 1.88, 95% CI 0.81–4.36). Having a CD diagnosis for ≥15 years was associated with a 2.80‐fold increased risk of death in individuals with T1D (95% CI 1.28–6.12).
Conclusion
A diagnosis of CD for ≥15 years increases the risk of death in patients with T1D.
To determine if the association between hyperuricaemia and poor outcomes in heart failure (HF) varies by chronic kidney disease (CKD).
Of the 2645 systolic HF patients in the Beta-Blocker Evaluation ...of Survival Trial with data on baseline serum uric acid, 1422 had hyperuricaemia (uric acid ≥6 mg/dL for women and ≥8 mg/dL for men). Propensity scores for hyperuricaemia, estimated for each patient, were used to assemble a matched cohort of 630 pairs of patients with and without hyperuricaemia who were balanced on 75 baseline characteristics. Associations of hyperuricaemia with outcomes during 25 months of median follow-up were examined in all patients and in those with and without CKD (estimated glomerular filtration rate of <60 mL/min/1.73 m(2)). Hyperuricaemia-associated hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality and HF hospitalization were 1.44 (1.12-1.85, P = 0.005) and 1.27 (1.02-1.58, P = 0.031), respectively. Hazard ratios (95% CIs) for all-cause mortality among those with and without CKD were 0.96 (0.70-1.31, P = 0.792) and 1.40 (1.08-1.82, P = 0.011), respectively (P for interaction, 0.071), and those for HF hospitalization among those with and without CKD were 0.99 (0.74-1.33, P = 0.942) and 1.49 (1.19-1.86, P = 0.001), respectively (P for interaction, 0.033).
Hyperuricaemia has a significant association with poor outcomes in HF patients without CKD but not in those with CKD, suggesting that hyperuricaemia may predict poor outcomes when it is primarily a marker of increased xanthine oxidase activity, but not when it is primarily due to impaired renal excretion of uric acid.
In cystic fibrosis (CF), pathophysiologic changes in the gastrointestinal tract lead to malnutrition and altered gut microbiome. Microbiome alterations have been linked to linear growth, gut ...inflammation and respiratory manifestations. Elucidating these gut microbiome alterations may provide insight into future nutritional management in CF.
Infants were followed for 12-months at four sites in the United States (US-CF) and Australia (AUS-CF). 16S rRNA gene sequencing was performed on longitudinal stool samples. Associations between microbial abundance and age, antibiotic prophylaxis, malnutrition, and breast feeding were evaluated using generalized linear mixed models. Taxonomic and predictive functional features were compared between groups.
Infants with CF (N = 78) were enrolled as part of a larger study. AUS-CF infants had higher mean weight-for-age z-scores than US-CF infants (p = 0.02). A subset of participants (CF N = 40, non-CF disease controls N = 10) provided stool samples for microbiome analysis. AUS-CF infants had lower stool alpha diversity compared to US-CF infants (p < 0.001). AUS-CF infants had higher relative abundance of stool Proteobacteria compared to US-CF infants which was associated with antibiotic prophylaxis (p < 0.001). Malnutrition (weight-for-age <10th percentile) was associated with depleted Lactococcus (p < 0.001). Antibiotic prophylaxis (p = 0.002) and malnutrition (p = 0.012) were linked with predicted decreased activity of metabolic pathways responsible for short chain fatty acid processing.
In infants with CF, gut microbiome composition and diversity differed between the two continents. Gut microbial diversity was not linked to growth. The relationship between malnutrition and antibiotic prophylaxis with reduced SCFA fermentation could have implications for gut health and function and warrants additional investigation.
Background: Diminutive and flat colorectal lesions can be difficult to detect using conventional colonoscopic techniques. Previous data have suggested that pan-chromoscopy may improve detection ...rates. No randomised control trial has been performed examining detection rates of such lesions while controlling for extubation time and lavage effect. Aim: We conducted a randomised controlled trial of pan-colonic chromoscopic colonoscopy for the detection of diminutive and flat colorectal lesions while controlling for extubation time and lavage effect. Methods: Consecutive patients attending for routine colonoscopy were randomised to either pan-chromoscopy using 0.5% indigo carmine (IC) or targeted chromoscopy (control group). A minimum diagnostic extubation time was set at eight minutes with controls undergoing a matched volume of saline wash. Results: A total of 260 patients were randomised; 132 controls and 128 to pan-colonic chromoscopy. Extubation times did not differ significantly between the control (median 15 minutes (range 8–41)) and chromoscopy (median 17 minutes (range 8–39)) groups. The volume of IC used in the pan-chromoscopy group (median 68 ml (range 65–90)) and normal saline used in the control group (69 ml (range 60–93)) did not differ significantly. There was a statistically significant difference between the groups regarding the total number of adenomas detected (p<0.05) with significantly more diminutive (<4 mm) adenomas detected in the pan-chromoscopy group (p = 0.03). Pan-chromoscopy diagnosed more diminutive and flat lesions in the right colon compared with controls (p<0.05), with more patients with multiple adenomas (>3) detected using pan-chromoscopy (p<0.01). Hyperplastic lesions were more commonly detected in the pan-chromoscopy group compared with controls (p<0.001). More hyperplastic polyps were detected in the left colon (86% rectosigmoid) using chromoscopy compared with controls. Conclusion: Chromoscopy improves the total number of adenomas detected and enhances the detection of diminutive and flat lesions. Importantly, eight diminutive lesions had foci of high grade dysplasia. Chromoscopy may benefit patients, assuming a high risk of colorectal cancer, and help in risk stratification and planning follow up colonoscopy intervals.
What is the optimal FODMAP threshold in IBS? Rej, A; Sanders, DS; Buckle, RL ...
Journal of gastroenterology and hepatology,
June 2021, 2021-Jun, 2021-06-00, 20210601, Letnik:
36, Številka:
6
Journal Article
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