Supplemental material for Burden of impaired sleep quality on work productivity in functional dyspepsia

<p>Supplemental Material for Burden of impaired sleep quality on work productivity in functional dyspepsia by Juntaro Matsuzaki, Hidekazu Suzuki, Koji Togawa, Tsuyoshi Yamane, Hideki Mori, Takahiro Komori, Tatsuhiro Masaoka and Takanori Kanai in United European Gastroenterology Journal</p

Computer-Aided Prediction of Long-Term Prognosis of Patients with Ulcerative Colitis after Cytoapheresis Therapy

<div><p>Cytoapheresis (CAP) therapy is widely used in ulcerative colitis (UC) patients with moderate to severe activity in Japan. The aim of this study is to predict the need of operation after CAP therapy of UC patients on an individual level using an artificial neural network system (ANN). Ninety UC patients with moderate to severe activity were treated with CAP. Data on the patients’ demographics, medication, clinical activity index (CAI) and efficacy of CAP were collected. Clinical data were divided into training data group and validation data group and analyzed using ANN to predict individual outcomes. The sensitivity and specificity of predictive expression by ANN were 0.96 and 0.97, respectively. Events of admission, operation, and use of immunomodulator, and efficacy of CAP were significantly correlated to the outcome. Requirement of operation after CAP therapy was successfully predicted by using ANN. This newly established ANN strategy would be used as powerful support of physicians in the clinical practice.</p></div

Receiver operating characteristic (ROC) curve analysis using fasting gastric juice pH as a predictor of hiatal hernia.

<p>At a cut-off value of 2.1, gastric juice pH exhibited 49.1% sensitivity and 69.7% specificity for predicting hiatal hernia, and area under the curve (AUC) of 0.592 (95% CI 0.515–0.670, <i>p</i><0.05).</p

Association between Increased Gastric Juice Acidity and Sliding Hiatal Hernia Development in Humans

<div><p>Objectives</p><p>Several clinical factors; overweight, male gender and increasing age, have been implicated as the etiology of hiatal hernia. Esophageal shortening due to acid perfusion in the lower esophagus has been suggested as the etiological mechanism. However, little is known about the correlation between gastric acidity and sliding hiatus hernia formation. This study examined whether increased gastric acid secretion is associated with an endoscopic diagnosis of hiatal hernia.</p><p>Methods</p><p>A total of 286 consecutive asymptomatic patients (64 were diagnosed as having a hiatal hernia) who underwent upper gastrointestinal endoscopy were studied. Clinical findings including fasting gastric juice pH as an indicator of acid secretion, age, sex, body mass index, and <i>Helicobacter pylori</i> infection status determined by both <i>Helicobacter pylori</i> serology and pepsinogen status, were evaluated to identify predictors in subjects with hiatal hernia.</p><p>Results</p><p>Male gender, obesity with a body mass index >25, and fasting gastric juice pH were significantly different between subjects with and without hiatal hernia. The cut-off point of fasting gastric juice pH determined by receiver operating curve analysis was 2.1. Multivariate regression analyses using these variables, and age, which is known to be associated with hiatal hernia, revealed that increased gastric acid secretion with fasting gastric juice pH <2.1 (OR = 2.60, 95% CI: 1.38–4.90) was independently associated with hiatal hernia. Moreover, previously reported risk factors including male gender (OR = 2.32, 95% CI: 1.23–4.35), body mass index >25 (OR = 3.49, 95% CI: 1.77–6.91) and age >65 years (OR = 1.86, 95% CI: 1.00–3.45), were also significantly associated with hiatal hernia.</p><p>Conclusions</p><p>This study suggests that increased gastric acid secretion independently induces the development of hiatal hernia in humans. These results are in accordance with the previously reported hypothesis that high gastric acid itself induces hiatal hernia development.</p></div

Association of Visceral Fat Area, Smoking, and Alcohol Consumption with Reflux Esophagitis and Barrett's Esophagus in Japan

<div><p>Background</p><p>Central obesity has been suggested as a risk factor for gastroesophageal reflux disease. The aim of this study was to evaluate the association of visceral fat area and other lifestyle factors with reflux esophagitis or Barrett’s esophagus in Japanese population.</p><p>Methods</p><p>Individuals who received thorough medical examinations including the measurement of visceral fat area by abdominal computed tomography were enrolled. Factors associated with the presence of reflux esophagitis, the severity of reflux esophagitis, or the presence of Barrett’s esophagus were determined using multivariable logistic regression models.</p><p>Results</p><p>A total of 2608 individuals were eligible for the analyses. Visceral fat area was associated with the presence of reflux esophagitis both in men (odds ratio, 1.21 per 50 cm²; 95% confident interval, 1.01 to 1.46) and women (odds ratio, 2.31 per 50 cm²; 95% confident interval, 1.57 to 3.40). Current smoking and serum levels of triglyceride were also associated with the presence of reflux esophagitis in men. However, significant association between visceral fat area and the severity of reflux esophagitis or the presence of Barrett’s esophagus was not shown. In men, excessive alcohol consumption on a drinking day, but not the frequency of alcohol drinking, was associated with both the severity of reflux esophagitis (odds ratio, 2.13; 95% confident interval, 1.03 to 4.41) and the presence of Barrett’s esophagus (odds ratio, 1.71; 95% confident interval, 1.14 to 2.56).</p><p>Conclusion</p><p>Visceral fat area was independently associated with the presence of reflux esophagitis, but not with the presence of Barrett’s esophagus. On the other hand, quantity of alcohol consumption could play a role in the development of severe reflux esophagitis and Barrett’s esophagus in Japanese population.</p></div

Differences between participants with and without reflux esophagitis.

<p>Differences between participants with and without reflux esophagitis.</p

Flow diagram of study populations.

<p>Flow diagram of study populations.</p

Characteristics of the subjects with and without hiatal hernia and univariate analysis of risk factors for hiatal hernia.

<p>Characteristics of the subjects with and without hiatal hernia and univariate analysis of risk factors for hiatal hernia.</p

The sensitivity and specificity provided by ANN.

<p>The sensitivity and specificity provided by ANN.</p

The sensitivity and specificity provided by ANN.

<p>The sensitivity and specificity provided by ANN.</p