Efeito da adição de partículas bioativas ao gel clareador dental / Efeito da adição de partículas bioativas ao gel clareador dental

O estudo avaliou o efeito da adição de partículas bioativas ao gel clareador (peróxido de hidrogênio 35%, técnica de consultório), quanto ao clareamento e sobre a estrutura dental, além da resistência à desmineralização. O objetivo da primeira parte do estudo foi avaliar géis, com diferentes partículas bioativas e concentrações, para o potencial clareador e às alterações da estrutura dental. O objetivo da segunda parte foi avaliar géis, com diferentes partículas bioativas e concentrações, perante a suscetibilidade do esmalte ao protocolo cariogênico e ao desgaste dental erosivo. Espécimes de incisivos bovinos foram avaliados na primeira parte por análise da cor, microdureza Knoop e rugosidade. Os grupos foram controle negativo (CN), controle comercial (CCWhiteness HP), controle experimental (CE-gel sem partícula), controle positivo (CPsolução de peróxido), e os grupos experimentais onde as partículas bioativas S-PRG e 45S5 foram utilizadas nas concentrações de 5, 10, 15 e 20 %. Na segunda parte foram avaliados por microradiografia para a alteração da densidade mineral e profundidade da lesão perante o protocolo cariogênico e pela perfilometria para o desgaste dental erosivo. Os grupos foram CN, CC, CE, controle fluoreto (CF), e os grupos experimentais onde as partículas bioativas S-PRG e 45S5 foram utilizados nas concentrações de 15 e 20 % apenas. Os dados foram analisados estatisticamente para verificar a diferença entre os grupos (α=5%). Para a mudança de cor (∆E*00) foi observada diferença apenas para o fator partícula, S-PRG-3,37(0,48)a e 45S5-3,67(0,76)b. Todos os grupos experimentais foram estatisticamente iguais o CP e diferentes do CN. Para a microdureza (KNH%) foi observada diferença para a interação dos fatores, sendo o S-PRG 20% o grupo com maior aumento da microdureza. Todos os grupos experimentais foram diferentes e maiores que CP, CC e CE. Não foram observadas diferenças de rugosidade entre os grupos. Para a alteração da densidade mineral foi observada diferença para a interação dos fatores e tempo. Os grupos S-PRG 15% e 20% foram os grupos que apresentaram a menor alteração da densidade mineral em todos os tempos testados. Aos 14 e 21 dias o SPRG 20% foi diferente do CN e semelhante ao CF. Para a profundidade da lesão foram observadas diferenças estatísticas para o fator partícula e tempo, S-PRG206,8(59,2)a e 45S5 230,0(63,7)b, 7 dias-148,9(19,7)a, 14 dias-217,7(22,5)b e 21 dias288,7(30,7)c. Aos 14 e 21 dias o S-PRG 20% foi diferente do CN e semelhante ao CF. Para o desgaste foi observada diferença apenas para o tempo, 5 dias-1,2(0,2)a e 10 dias-2,3(0,3)b. Conclui-se que: a adição de partículas bioativas não reduziu a efetividade clareadora, contribuiu para o aumento da microdureza e não alterou a rugosidade. Além disso, o grupo S-PRG com 20% teve suscetibilidade à desmineralização por cárie semelhante ao grupo controle fluoreto e nenhum grupo alterou a suscetibilidade ao desgaste dental erosivo (AU)

The study evaluated the consequences of bioparticle addition on tooth bleaching gel (hydrogen peroxide 35%, in-office technique), for its bleaching effect and changes on tooth structure, also for resistance against demineralization. The aim of the first part of the study was to evaluate bleaching gels containing different bioactive particles and concentrations over the bleaching potential and possible dental structural changes. The objective of the second part was to evaluate bleaching gels containing different bioactive particles and concentrations to assess enamel susceptibility to cariogenic and erosive tooth wear protocols after bleaching treatments. Bovine incisors specimens were used in the first part for analysis of color, Knoop microhardness and roughness. The groups were negative control (NC), commercial control (CCWhiteness HP), experimental control (EC-gel without particles), positive control (PCperoxide solution), and experimental groups were the bioactive particles S-PRG and 45S5 used in concentrations of 5, 10, 15, and 20 %. In the second part, specimens were evaluated using advanced transverse microradiography to assess the change in mineral density and lesion depth in response to the cariogenic protocol, and profilometry to measure wear in response to the erosive tooth wear protocol. The groups were NC, CC, EC, fluoride control (FC), and experimental groups were the bioactive particles S-PRG and 45S5 used only in concentrations of 15 and 20 %. The data were statistically analyzed to verify the differences between the groups (α=5%). For the color change (∆E*00), a difference was observed only for particle, S-PRG3,37(0,48)a and 45S5-3,67(0,76)b. All experimental groups were statistically similar to PC and different from NC. For the microhardness (KNH%), difference was observed for factors interaction, S-PRG 20% was the group with higher hardness increase. All experimental groups were different and higher than PC, CC, and EC. No roughness differences were observed between groups. For the mineral density alteration differences were observed for factors interaction and time. S-PRG 15% and 20% presented the lower mineral density change for all measurements times. On 14 and 21 days S-PRG 20% was different from NC and similar to FC. For lesion depth differences were observed for factor particle and time, S-PRG-206,8(59,2)a and 45S5- 230,0(63,7)b, 7 days-148,9(19,7)a, 14 days-217,7(22,5)b and 21 days-288,7(30,7)c. On 14 and 21 days S-PRG 20% was different from NC and similar to FC. For wear the only difference was for time, 5 days-1,2(0,2)a and 10 days-2,3(0,3)b. It was concluded that the addition of bioactive particles did not reduce the bleaching effectiveness, it contributed to microhardness increase and did not change roughness. Furthermore, the S-PRG group with 20% susceptibility to cariogenic demineralization was similar to the fluoride control group, and no group showed a change in susceptibility to erosive tooth wear (AU)

Can the combination of proanthocyanidin and vitamin E or palm oil effectively protect enamel against in vitro erosive and abrasive challenges?

Abstract Objectives This study aimed to assess the effect of proanthocyanidin, palm oil and vitamin E against erosive and erosive+abrasive challenges in vitro after enamel pellicle formation in situ. Methodology Bovine enamel blocks (n=84) were obtained and divided into the following treatment groups: negative control (NC) - deionized water; positive control (PC) - SnCl2/NaF/AmF-containing solution; palm oil (PO); 2% proanthocyanidin (P2); vitamin E (VitE); 2% proanthocyanidin+palm oil (P2PO); and 2% proanthocyanidin+vitamin E (P2VitE). For 5 days, one half of the sample from each group was subjected to erosion and the other half was subjected to erosion+abrasion. The acquired enamel pellicle (AEP) was pre-formed in situ for 30 minutes. The specimens were then treated in vitro with solutions (500 µl, 30s for each group). Subsequently, the blocks were left in the oral cavity for another hour to obtain the modified AEP. The blocks were immersed in 0.5% citric acid (pH=2.5) for 90s, 4×/day. AEP formation and treatment were carried out before the first and third erosive challenges, and after these challenges, abrasive cycles (15s) were performed on half of the samples. Enamel wear was quantified by profilometry and data were analyzed by two-way ANOVA and Tukey's test (p<0.05). Results All groups showed higher wear when exposed to erosion+abrasion than when exposed to erosion alone (p=0.0001). PO, P2VitE, P2, and P2PO showed enamel wear similar to the PC group, but only PC, PO and P2VitE differed from the NC group. The other groups behaved similarly to NC. Conclusion It was concluded that the combination of proanthocyanidin and vitamin E was effective in reducing wear in the face of in vitro erosive and erosive+abrasive challenges.

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion

Abstract This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey's test; and Ra, by 2-way ANOVA, repeated measures, and Tukey's test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Resumo Este estudo avaliou o efeito da Fitoesfingosina (PHS) e da vitrocerâmica bioativa (Biosilicato) sobre o esmalte dental em termos de alteração de cor (ΔE), microdureza (KHN) e rugosidade superficial, quando submetido a desafio erosivo (DE). Sessenta espécimes de dentes bovinos (6×6×2mm) foram obtidos. Foram realizadas leituras de cor inicial (Easyshade, VITA), microdureza (HMV-2, Shimadzu) e rugosidade superfícial (SJ-201P, Mitutoyo). Os espécimes foram separados em grupos de acordo com os tratamentos: PHS, Biosilicato a 10%, PHS+Biosilicato a 10%, e saliva artificial (controle). Em seguida, foram submetidos a DE com Coca-Cola por 2 min. Esse ciclo foi repetido 4 vezes/dia por 15 dias. Entre os ciclos, as amostras foram mantidas em saliva artificial (2 h/37°C). Após os ciclos diários, os espécimes também foram armazenados em saliva artificial a 37ºC. Foram realizadas leituras finais de cor, microdureza e rugosidade superficial. Os dados de cor e microdureza foram analisados ​​por ANOVA de uma via, teste de Tukey; e dados de rugosidade superficial, por ANOVA de duas vias, teste de Tukey (p<.05). A maior ΔE ocorreu em Saliva+DE (p<.05). Grupos tratados com PHS apresentaram menor alteração de cor do que Saliva+DE (p<.05). Biosilicate+DE demonstrou valores intermediários, similar (p>.05) aos outros grupos, exceto Saliva+DE. Todos os grupos presentaram média acima dos limites 50:50% de perceptibilidade (50:50%LP) e aceitabilidade (50:50%LA) exceto o controle que demonstrou média acima do 50:50%LA mas abaixo do 50:50%LP. Biosilicate+DE mostrou maior microdureza realativa do que Saliva+DE (p<.05), mas similar a PHS+DE e PHS+Biosilicato+DE. A rugosidade de superfície do esmalte aumentou para todos os grupos, exceto para o controle que presentou a menor alteração (p<.05). O Biosilicato apode prevenir perda mineral do esmalte indizido pela erosão melhor que a saliva. O PHS associado ou não ao Biosilicato demonstrou melhor estabilidade de cor que a saliva.

Clinical characteristics and management strategies of late bleeding after laparoscopic pancreaticoduodenectomy / 中华肝胆外科杂志

Objective:To study the clinical characteristics and management strategies of late bleeding after laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 58 patients with post-pancreaticoduodenectomy hemorrhage (PPH) admitted to the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from March 2018 to March 2022 were retrospectively analyzed, including 42 males and 16 females, aged (61.88±11.02) years old. According to the occurrence of intra-abdominal erosion factors (e.g., pancreatic fistula, biliary fistula, gastrointestinal anastomotic fistula, intra-abdominal abscess), patients were divided into the erosion group ( n=42) and non-erosion group ( n=16). All patients underwent standard lymphadenectomy. Clinical data including the PPH time-point, occurrence of rebleeding, and treatment outcomes were accessed. The management strategies of PPH in the two groups of patients were analyzed. Results:The PPH time-point in the erosion group and non-erosion patients was 8.00 (5.00, 19.25) d and 21.50 (12.75, 26.75) d, respectively ( P=0.001). PPH can occurred within one month after surgery in both erosion and non-erosion groups. In the erosion group, 31 cases (73.81%, 31/42) were treated by re-operation, two (4.76%, 2/42) by interventional radiology and nine (21.43%, 9/42) with conservative protocol, respectively. In the non-erosion group, five cases (31.25%, 5/16) were treated by re-operation, seven (43.75%, 7/16) by interventional radiology and four (25.00%, 4/16) with conservative protocol, respectively. The incidence of re-bleeding is higher in the erosion group [47.6% (20/42) vs 12.5% (2/16), P<0.05]. Clinical manifestations, sites and severity of bleeding, and treatment outcomes were also different in the erosion and non-erosion groups (all P<0.05). Conclusions:The occurrence of intra-abdominal erosion factors can affect the clinical characteristics and treatment strategy of late bleeding after laparoscopic pancreaticoduodenectomy. Surgery remains the treatment of choice for post-pancreaticoduodenectomy hemorrhage either as an urgent or last resort.

Characteristics of reflux and manifestation under probe-based confocal laser endoscopy in patients with endoscopic negative heartburn / 中华消化内镜杂志

Objective:To study reflux characteristics of patients with endoscopic negative heartburn and their manifestation under probe-based confocal laser endoscopy (pCLE) based on the Rome Ⅳ standard.Methods:Thirty-six endoscopic negative outpatients with typical heartburn at the Department of Gastroenterology of the Second Affiliated Hospital of Baotou Medical College from September 2020 to March 2021 were included, and underwent 24-hour multichannel intraluminal impedance-pH monitor and pCLE. According to Rome Ⅳ diagnostic process, patients were divided into non-erosive reflux disease (NERD) group ( n=16), reflux hypersensitivity (RH) group ( n=8) and functional heartburn (FH) group ( n=12). The Gerd-Q scale score, 24-hour pH monitoring results and microstructure changes under pCLE were compared among the three groups. Results:There was no significant difference in the total score, positive symptom score, negative symptom score or positive influence score of Gerd-Q scale among the three groups ( P>0.05). DeMeester score [28.45 (20.08, 34.53)] and acid reflux times (24.88±9.05) in the NERD group were significantly higher than those in the RH group [7.30 (3.90, 11.38), P<0.001; 13.63±5.76, P=0.003] and FH group [6.90 (4.80, 9.73), P<0.001; 7.42±8.32, P<0.001]. But there was no significant difference between the RH group and the FH group ( P>0.05). The diameter of intra-papillary capillary loop (IPCL) (18.68±2.12 μm) and dilation of intercellular space (3.95±0.97 μm) in the NERD group were significantly higher than those in the RH group (13.91±1.99 μm, P<0.001; 2.97±0.55 μm, P=0.006) and FH group (13.83±2.00 μm, P<0.001; 2.31±0.54 μm, P<0.001), but there was no significant difference between the RH group and the FH group ( P>0.05). The number of IPCL in the NERD group, RH group and FH group were 2.0 (1.00, 2.75), 2.0 (1.00, 2.75) and 1.5 (1.00, 2.00), respectively with no significant difference ( P=0.697). Conclusion:Gerd-Q scale is not suitable for differential diagnosis of patients with endoscopic negative heartburn. Compared with functional esophageal diseases (RH and FH), acid reflux and mucosal microstructure changes are of more important pathogenic significance in NERD.

Clinical effect of compound phellodendron gargle with total glucosides of paeony capsule in the treatment of erosive oral lichen planus / 药学实践与服务

Objective To observe the short-term clinical effect of compound phellodendron gargle combined with the total glucosides of paeony (TGP) in the treatment of erosive oral lichen planus (OLP). Methods 62 patients were divided into observation group and control group through a designed parallel randomized controlled study. All the patients used the total glucosides of paeony capsule , the patients in the observation group also used the compound phellodendron gargle. The pain condition, the healing condition of face, and the treatment effective in both group were evaluated through physical signs and VAS scores evaluations by SPSS 22.0, which could further evaluate the short-term clinical efficacy of compound phellodendron. Results After 30 days, the scores of VAS and physical signs of each group are much better than before. And the scores of VAS and treatment effective of observation group were significantly better than those of the other control groups (P<0.05). Conclusion The application of phellodendron gargle with total glucosides of paeony capsule could improve the treatment effect of OLP patients and reduce the oral pain , which could be used widely in clinical practice.

Effects of different toothpaste formulations on erosive tooth wear prevention: systematic review / Efeitos de diferentes dentifrícios na prevenção do desgaste dentário erosivo: revisão sistemática de literatura

Objective: erosive tooth wear is a multifactorial condition that results in loss of dental hard tissue, caused by a chemical and mechanical process. This paper aims to carry out a systematic review presenting the effects of different toothpaste formulations on the loss of dental enamel surface in vitro. Material and Methods: the searches were performed in the databases PubMed, Web of Science, LILACS and Scielo. Articles published from 2010 to 2020 were filtered, without language restriction. Articles that included abrasion and erosion protocols were searched, as they were more similar to clinical reality, since toothpaste is applied through tooth brushing. The searches with descriptors and free terms on the topic resulted in 992 articles, however only 12 were within the search criteria. Results: the selected studies appointed that association of conventional fluorides (NaF) with metallic fluorides can be a promising strategy for the reduction of surface loss by erosive tooth wear. Toothpastes containing sodium fluoride, as well as tin without chitosan, showed a reduction in surface loss, considered sufficient for individuals with medium exposure to acids. In children's toothpastes, the one containing sodium fluoride showed a reduction in surface loss when compared to non-fluoride dentifrices. Conclusion: different protocols may result in less or greater loss of enamel surface, and methodological differences should be considered. To clarify the effects of dentifrices on erosive tooth wear, other properties of dentifrices should be investigated. (AU)

Objetivo: o desgaste erosivo é uma condição multifatorial que resulta em perda de tecido duro dentário, causado por um processo químico e mecânico. Este trabalho tem como objetivo realizar uma revisão sistemática de literatura apresentando os efeitos de diferentes formulações de dentifrícios na perda de superfície de esmalte dentário in vitro. Material e Métodos: a busca foi realizada nas bases de dados PubMed, Web of Science, LILACS e Scielo. Foram filtrados artigos publicados no intervalo de 2010 a 2020, sem restrição de idioma. Buscou-se artigos que incluíssem protocolos de abrasão e erosão, por mais se assemelhar a realidade clínica, uma vez que o dentifrício é aplicado através da escovação dentária. A busca com descritores e termos livres sobre o tema encontrou 992 artigos, entretanto somente 12 estavam dentro dos critérios da pesquisa. Resultados: os estudos selecionados apontaram que associação dos fluoretos convencionais (NaF) com os metálicos pode ser uma estratégia promissora para a redução de perda de superfície pelo desgaste dentário erosivo. Dentifrícios contendo fluoreto de sódio, assim como estanho sem quitosana, apresentaram redução na perda de superfície, sendo considerada suficiente para indivíduos com exposição média aos ácidos. Em dentifrícios infantis, aquele que continha fluoreto de sódio apresentou uma redução de perda de superfície quando comparado com dentifrícios sem fluoreto. Conclusão:diferentes protocolos podem resultar em menor ou maior perda de superfície de esmalte e as diferenças (AU)

Role of PPI and importance of anti-reflux agents in the treatment of NERD

Background: Esomeprazole, an S-isomer of omeprazole, is a much more potent acid inhibitor than most other currently available PPIs and gives excellent results. Therefore, it is a first-line drug for acid-related diseases like NonErosive Reflux Disease (NERD). Yet, patients demand faster onset and response. Aim : To establish the role of esomeprazole and the importance of anti-reflux agents like a combination of two antacids (calcium carbonate and sodium bicarbonate) and alginate in treating NERD. Conclusion: Esomeprazole therapy shows potential efficacy in the continuous maintenance treatment of the NERD. However, it is suggested that to improve the efficiency of esomeprazole for the treatment of NERD; we can supplement the drug with antacids (sodium bicarbonate and calcium carbonate) and alginates.

Development of a sodium fluoride and stannous chloride-containing gel for treatment of dental erosion

Resumo Este estudo desenvolveu e testou géis experimentais contendo íons fluoreto (F-) e estanho (Sn2+) para o controle da erosão dentária. Os espécimes polidos, de esmalte e dentina, foram previamente erodidos (solução de ácido cítrico a 1%, 10 min) e alocados aleatoriamente em 5 grupos (n = 10): Placebo - gel de hidroxipropilmetilcelulose (HMC); F + Sn + HMC - 7.500 ppm F- / 15.000 ppm Sn2+; F + HMC - 7.500 ppm F-; Gel de flúor fosfato acidulado comercial (12.300 ppm F-); e Controle - sem tratamento. Após o tratamento (aplicado por 60 s), os espécimes foram submetidos a uma ciclagem de erosão-remineralização (5 min em solução de ácido cítrico a 0,3%, 60 min em saliva artificial, 4 × / dia, 20 dias). A perda de superfície (SL, em µm) foi determinada após o 5º, 10º e 20º dias de ciclagem (α = 0,05). Para o esmalte, após 5 e 10 dias, o F + Sn + HMC apresentou a menor PS, não diferindo do gel comercial. Após 20 dias, não foram encontradas diferenças entre os grupos comercial, F + HMC e F + Sn + HMC. O placebo não diferiu do controle em nenhum momento, e ambos os grupos apresentaram a maior PS, comparado aos demais grupos. Para dentina, no 5º dia , F + Sn + HMC, F + HMC e comercial não diferiram significativamente, apresentando menor PS que o grupo controle e placebo. No 10º dia, F+Sn+HMC e comercial apresentaram a menor PS comparado ao grupo controle e placebo. No 20º dia, apenas o gel comercial apresentou PS menor que o controle e o placebo. Assim, o gel experimental F + Sn + HMC foi capaz de controlar a progressão da erosão dentária.

Abstract: This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished specimens were eroded (1% citric acid solution, 10 min) and randomly allocated into 5 groups (n=10): Placebo - Hydroxypropyl Methylcellulose (HMC) gel; F+Sn+HMC - 7,500 ppm F- / 15,000 ppm Sn2+; F+HMC - 7,500 ppm F-; Commercial acidulated phosphate fluoride gel (12,300 ppm F-); and Control - no treatment. After treatment (applied for 60 s), specimens underwent an erosion-remineralization cycling (5 min in 0.3% citric acid solution, 60 min in artificial saliva, 4×/day, 20 days). Surface loss (SL, in µm) was determined after the 5th, 10th and 20th days of cycling (α=0.05). For enamel, after 5 and 10 days, F+Sn+HMC presented the lowest SL, which did not differ from the commercial gel. After 20 days, no differences were found between commercial, F+HMC, and F+Sn+HMC groups. Placebo did not differ from the control at any time points, and both groups presented the highest SL when compared to the other groups. For dentin, on the 5th day, F+Sn+HMC, F+HMC and commercial did not differ significantly, showing lower SL than the control and the placebo. On the 10th day, F+Sn+HMC and commercial presented the lowest SL compared to control and placebo. After 20 days, only the commercial gel showed lower SL than the control and placebo. Thus, the experimental F+Sn+HMC gel was able to control the progression of tooth erosion.

Clinical significance of ineffective esophageal motility in non-erosive acid reflux diseases / 中华消化内镜杂志

Objective:To investigate the role of ineffective esophageal motility (IEM) in non-erosive acid reflux related diseases, and the influence of the fourth edition Chicago classification (CC v4.0) on the diagnosis of IEM.Methods:From January 2018 to January 2020, 63 patients with acid reflux related symptoms who underwent gastroscopy and showed no abnormal changes in esophageal mucosa or structure, and underwent high resolution esophageal manometry (HRM) and 24-hour esophageal pH monitoring in the Department of Gastroenterology of Beijing Friendship Hospital were included in the case-control study. According to the HRM results, the third edition Chicago classification standard (CC v3.0) and CC v4.0 were used to divided patients into IEM group and normal dynamic group. The HRM results, 24-hour esophageal pH monitoring results and final diagnosis of the two groups under the two editions of Chicago classification standard were mainly compared and analyzed.Results:Among the 63 patients, there were 14 cases of non-erosive gastroesophageal reflux disease (NERD), 19 cases of reflux hypersensitivity (RH), and 30 cases of functional heartburn (FH). When using CC v3.0, there were 20 cases in the IEM group, including 9 cases of NERD, 5 cases of RH and 6 cases of FH, and 43 cases in the normal dynamic group, including 5 cases of NERD, 14 cases of RH and 24 cases of FH. When using CC v4.0, there were 16 cases in the IEM group, including 7 cases of NERD, 4 cases of RH and 5 cases of FH, and 47 cases in the normal dynamic group, including 7 cases of NERD, 15 cases of RH and 25 cases of FH. When using CC v3.0, compared with the normal dynamic group, the acid exposure time (AET) of the IEM group was significantly higher [3.45 (1.55, 6.40)% VS 1.20 (0.40, 2.30)%, Z=-2.940, P=0.003], the DeMeester score was also significantly higher [13.8 (5.8, 21.4) VS 5.3 (2.9, 10.0), Z=-2.851, P=0.004], the lower esophageal sphincter pressure (LESP) [10.15 (7.52, 13.65) mmHg (1 mmHg=0.133 kPa) VS 15.40 (11.20, 21.60) mmHg, Z=-3.241, P=0.001], 4-second integrated relaxation pressure (4sIRP) (3.79±0.57 mmHg VS 6.05±0.50 mmHg, t=2.727, P=0.008), and distal contraction integral (DCI) [334.65 (208.25, 438.92) mmHg·s·cm VS 1 258.70 (919.00, 1 750.10) mmHg·s·cm, Z=-6.305, P<0.001] were significantly lower than those of the normal dynamic group. When using CC v4.0, AET and Demeester scores in the IEM group were also significantly higher than those in the normal dynamic group (both P<0.05), and LESP, 4sIRP and DCI were also significantly lower than those in the normal dynamic group (all P<0.05). In addition, upper esophageal sphincter pressure was significantly lower than that in normal dynamic group [34.60 (21.50, 48.05) mmHg VS 49.67 (36.75, 61.10) mmHg, Z=-2.140, P=0.032]. Conclusion:IEM is associated with impaired anti-reflux barrier function and esophageal acid exposure in patients with non-erosive acid reflux related diseases. Compared with CC v3.0, CC v4.0 can reduce the heterogeneity of IEM patients to some extent.

Comparison of esophageal motility and reflux characteristics of patients with endoscopic-negative heartburn based on the Lyon Consensus / 西安交通大学学报(医学版)

【Objective】 To explore the characteristics of esophageal motility and reflux of endoscopic-negative heartburn patients based on the Lyon Consensus Diagnostic Criteria and discuss the differential diagnosis value of the mean nocturnal baseline impedance （MNBI） and the postreflux swallow-induced peristaltic wave （PSPW） index for reflux hypersensitivity （RH） and functional heartburn （FH） patients. 【Methods】 We enrolled 132 patients with heartburn as the main symptom who visited the Gastroenterology Department of our hospital from January 2017 to June 2021， including 24 in the non-erosive reflux disease （NERD） group， 24 in the RH group， and 84 in the FH group. All the patients completed gastroscopy， esophageal high-resolution manometry and 24h-pH impedance monitoring. We analyzed and compared the related indexes of esophageal motility and reflux. The receiver operating characteristic （ROC） curve was used to analyze the esophageal proximal MNBI， distal MNBI， and PSPW indexes for the differential diagnosis of RH and FH. 【Results】 The lower esophageal sphincter （LES） average resting pressure， LES residual pressure and intact relaxation pressure （IRP） in NERD were lower than those in RH and FH （P0.05）. When the proximal MNBI， distal MNBI， and PSPW indexes were used alone respectively to diagnose RH， the area under the ROC curve was 0.480， 0.810， 0.682， respectively， with the sensitivities being 87.5%， 100% and 91.7%， and the specificities being 26.2%， 66.7% and 51.2%， respectively. 【Conclusion】 NERD patients have obvious abnormal esophageal dynamics， mainly manifested as LES relaxation， which further aggravates the pathological acid reflux， while patients with RH and FH are mainly exposed to physiological acid or non-acid reflux. In patients with endoscopic negative heartburn， distal MNBI value can improve the clinical diagnosis rate of RH and help distinguish RH from FH.

Desgaste erosivo en preescolares de 5 años de Montevideo­Uruguay: primer estudio poblacional / Erosive tooth wear in 5 -year- old preschool children of Montevideo­Uruguay: first population study / Desgaste erosivo em preescolares de 5 anos de MontevideoUruguai: primer estudo populacional

Objetivo: determinar prevalencia, extensión, severidad y distribución del desgaste erosivo (DE) en preescolares de Montevideo. Metodología: estudio transversal de base poblacional, muestra representativa de centros educativos públicos y privados. Fueron indagados aspectos sociodemográficos, biológicos y de comportamiento con un cuestionario auto-reportado por padres/responsables. Los exámenes fueron realizados por dos operadores Kappa ≥ 0,7. DE fue registrado con el índice O´Brien modificado, reportándose porcentaje y promedio; intervalo de confianza (IC) 95%. Se realizaron análisis de asociación con sexo y nivel socioeconómico. Resultados: se examinaron 614 preescolares. Prevalencia: 57,6% (IC95%: 52,7-62,5). Extensión: 4,8 (IC95%: 4,3-5,3). DE severo: 8,2% (IC95%: 5,5-10,9) Las superficies más afectadas fueron palatino de incisivos superiores. Los preescolares de nivel socioeconómico alto presentaron mayor DE que los de nivel bajo; 73,1% (IC95%:61,9-84,2) y 48,4% (IC95%:39,2-57,7) respectivamente (p≤0,01). Conclusiones: la prevalencia y extensión del DE fue alta. Estos datos pueden contribuir en la modificación de medidas que apunten a controlar la prevalencia de DE.

Aims: assess the prevalence, extent,severity, and distribution of erosive tooth wear (ETW) in preschoolers of Montevideo. Methods: cross-sectional populationbased study of representative sample of public and private educational centers. Sociodemographic, biological, and behavioral aspects were investigated with a self-reported questionnaire to parents /guardians. The examinations were performed by two examiners (Kappa ≥ 0.7). The ETW was registered with modified O´Brien index, reported in percentage and average, confidence interval (CI) 95%. Analysis of association with sex and socioeconomic level were carried out.Results: 614 preschoolers were examined. Prevalence: 57.6% [95%CI=52.7-62.5]. Severe ETW: 8.2% [95%CI 5.5-10.9]. ETW extension: 4.8 [95%CI=4.3-5.3]. The most affected surfaces were palatal upper incisors. Preschoolers of high socioeconomic level presented higher ETW than those of low level; 73.1% (95% CI: 61.9-84.2) and 48.4% (95% CI: 39.2-57.7) respectively (p≤0.01). Conclusion: ETW prevalence and extent was high. These data can contribute to the modification of measures that aim to control ETW prevalence.

Objetivo: determinar prevalência, extensão, severidade e distribuição do desgaste erosivo (DE) em pré-escolares de Montevidéu. Metodologia: estudo transversal de base populacional, amostra representativa de centros educacionais públicos e privados. Aspetos sociodemográficos, biológicos e comportamentais foram investigados por meio de questionário autorreferência pelos pais/responsáveis. Os exames foram realizados por dois operadores Kappa ≥ 0,7. DE foi registado com o Índice O´Brien modificado, relatando porcentagem e média; intervalo de confiança (IC) 95%. Foi realizada análise de associação com sexo e nível socioeconômico. Resultados: 614 pré-escolares foram examinados. Prevalência: 57,6% (IC95%: 52,7-62,5). Extensão: 4,8 (IC 95%: 4,3-5,3). DE grave: 8,2% (IC 95%: 5,5-10,9). As superfícies mais afetadas foram palatinas dos incisivos superiores. Pré-escolares de alto nível socioeconômico apresentaram maior DE que os de baixo nível; 73,1% (IC 95%: 61,9-84,2) e 48,4% (IC 95%: 39,2-57,7) respetivamente (p≤0,01). Conclusões: a prevalência e extensão da DE foi alta. Esses dados podem contribuir em la modificação de medidas que visam controlar a prevalência de DE.

Collagen cross-linking agents + dimethyl sulfoxide improving the adhesive properties of erosive lesion dentin

Abstract To investigate the effect of the dimethyl sulfoxide combined with cross-linking agents on microtensile bond strength, silver nitrate penetration and in situ degree of conversion analysis of adhesives to the erosive dentin treatment with Cola-based soft drink. One hundred and sixty-six molars were assigned to 20 groups: (1) Treatment: Sound dentin; Erosive dentin; Erosive dentin treated with primer of dimethyl sulfoxide; Erosive dentin treated with DMSO primer containing proanthocyanidin and rivoflavin; (2) Adhesive systems: iBond Universal and Scotchbond Universal; and (3) adhesive strategy: etch-and-rinse or self-etch strategy. After restoration, specimens were sectioned into sticks to be tested. The data from microtensile bond strength (MPa), silver nitrate penetration (%) and in situ degree of conversion (%) were analyzed by (three- and two-factor ANOVA; Tukey's test α=5%). The application of dimethyl sulfoxide combined of not with cross-linkers improved all properties evaluated when compared to only erosive dentin treatment with Cola-based soft drink. However, only when dimethyl sulfoxide was combined to cross-linkers, the values of the microtensile bond strength, silver nitrate penetration and in situ degree of conversion in erosive dentin treatment with Cola-based soft drink was similar to sound dentin, for both adhesives and adhesive strategies. The application of dimethyl sulfoxide combined with the collagen cross-linking agent contributed to increasing the bond strength and degree of conversion in erosive lesion dentin, at the same time that significantly reduction of nanoleakage in this substrate.

Resumo Este estudo investigou o efeito do dimetil sulfóxido combinado a agentes de reticulação de colágeno na resistência de união à microtração, infiltração de nitrato de prata e análise do grau de conversão por Micro-Raman de sistemas adesivos universais para a dentina erosionada por refrigerante a base de Cola. Cento e sessenta molares foram divididos em 20 grupos: (1) Tratamento: Dentina sadia; Dentina erosionada; Dentina erosionada tratada com primer de dimetil sulfóxido; Dentina erosionada tratada com primer contendo 6,5% de proantocianidina e; Dentina erosionada tratada com primer contendo 0,1% de rivoflavina; (2) Sistemas adesivos: iBond Universal e Scotchbond Universal; e (3) estratégia adesiva: estratégia condicionamento e lavagem ou autocondicionate. Após a restauração, os espécimes foram seccionados em palitos e testados. Os dados dos três testes foram analisados estatisticamente (ANOVA de 2 e 3 fatores e teste de Tukey; α = 5%). A aplicação de dimetil sulfóxido combinado ou não agentes de reticulação de colágeno melhorou todas as propriedades avaliadas quando comparado a dentina erosionada. Entretanto, apenas quando o dimetil sulfóxido foi combinado com agentes de reticulação de colágeno, os valores de adesão a dentina, infiltração de nitrato de prata e grau de conversão em dentina erosionada foi semelhante a dentina sadia, para os dois adesivos e estratégias adesivas. A aplicação de dimetil sulfóxido combinado com agentes de reticulação de colágeno contribuiu para aumentar a resistência de união e o grau de conversão dentro da camada híbrida na dentina erodida, ao mesmo tempo que reduziu significativamente a nanoinfiltração neste substrato.

Avaliação da microbiota intestinal em adultos com esofagite erosiva / Assessment of the intestinal microbiota in adults with erosive esophagitis

ABSTRACT BACKGROUND: The intestinal microbiota influences the appropriate function of the gastrointestinal tract. Intestinal dysbiosis may be associated with a higher risk of esophageal lesions, mainly due to changes in gastroesophageal motility patterns, elevation of intra-abdominal pressure, and increased frequency of transient relaxation of the lower esophageal sphincter. OBJECTIVE: The aim of this study was to evaluate the intestinal microbiota in individuals with erosive esophagitis and in healthy individuals using metagenomics. METHODS: A total of 22 fecal samples from adults aged between 18 and 60 years were included. Eleven individuals had esophagitis (eight men and three women) and 11 were healthy controls (10 men and one woman). The individuals were instructed to collect and store fecal material into a tube containing guanidine solution. The DNA of the microbiota was extracted from each fecal samples and PCR amplification was performed using primers for the V4 region of the 16S rRNA gene. The amplicons were sequenced using the Ion Torrent PGM platform and the data were analyzed using the QIIME™ software version 1.8. Statistical analyses were performed using the Mann-Whitney non-parametric test and the ANOSIM non-parametric method based on distance matrix. RESULTS: The alpha-diversity and beta-diversity indices were similar between the two groups, without statistically significant differences. There was no statistically significant difference in the phylum level. However, a statistically significant difference was observed in the abundance of the family Clostridiaceae (0.3% vs 2.0%, P=0.032) and in the genus Faecaliumbacterium (10.5% vs 4.5%, P=0.045) between healthy controls and esophagitis patients. CONCLUSION: The findings suggest that reduced abundance of the genus Faecaliumbacterium and greater abundance of the family Clostridiaceae may be risk factors for the development of erosive esophagitis. Intervention in the composition of the intestinal microbiota should be considered as an adjunct to current therapeutic strategies for this clinical condition.

RESUMO CONTEXTO: A doença do refluxo gastroesofágico (DRGE) é uma das enfermidades mais comuns na prática clínica e possui fisiopatologia multifatorial. Disbiose da microbiota intestinal pode ter influência em mecanismos envolvidos nesta doença, como mudanças nos padrões motores gastrointestinais, elevação da pressão intra-abdominal e aumento da frequência de relaxamentos transitórios do esfíncter esofágico inferior. Contudo, a avaliação da microbiota intestinal, neste contexto, ainda é pouco documentada. OBJETIVO: Este estudo avaliou a microbiota bacteriana intestinal, em indivíduos com doença do refluxo gastroesofágico erosivo e em indivíduos saudáveis, utilizando técnicas de metagenômica. MÉTODOS: Estudo incluiu amostras fecais de 22 adultos, com idades entre 18 e 60 anos: 11 com esofagite erosiva (oito homens e três mulheres) e 11 controles saudáveis (dez homens e uma mulher). Os pacientes foram orientados a coletar e armazenar o material fecal em tubo contendo solução de guanidina. O DNA da microbiota foi extraído das amostras de fezes e amplificação por PCR foi realizada usando iniciadores para a região V4 do gene 16S rRNA. Os amplicons foram seqüenciados usando a plataforma Ion PGM Torrent e os dados foram analisados usando o software QIIME™ versão 1.8 (Quantitative Insights Into Microbial Ecology). Análise de estatística foi realizada utilizando-se o teste não paramétrico de Mann-Whitney e o teste ANOSIM, método não paramétrico baseado em matriz de distância. RESULTADOS: Os índices de alfa-diversidade e beta-diversidade foram semelhantes entre os dois grupos, sem diferença estatisticamente significante. Não houve diferença estatisticamente significante no nível de filo, classe e ordem. Entretanto, observou-se diferença estatisticamente significante na abundância da família Clostridiaceae (0,3% vs 2,0%, P=0,032) e no gênero Faecaliumbacterium (10,5% vs 4,5%, P=0,045) entre controles saudáveis e pacientes com DRGE erosiva, respectivamente. CONCLUSÃO: Os achados sugerem que menor abundância do gênero Faecaliumbacterium e maior abundância da família Clostridiaceae, nos pacientes com DRGE, podem influenciar na fisiopatologia desta doença.

Estimativa da erosão hídrica do solo pelo modelo Water Erosion Prediction Project na Sub-Bacia do Córrego do Gigante, sul de Minas Gerais / Estimated water soil erosion by the Water Erosion Prediction Project model in the Gigante Stream Basin, Minas Gerais, Brazil

RESUMO Objetivou-se, no presente trabalho, monitorar e identificar precipitações erosivas e as perdas de solo (PSs) por meio de parcelas experimentais instaladas na Sub-Bacia do Córrego do Gigante, calibrar o modelo Water Erosion Prediction Project (WEPP) em sua versão encosta, tendo como base os resultados obtidos nas parcelas, e aplicá-lo na área da sub-bacia, para estimativa das PSs por erosão hídrica. O regime pluvial no período de estudo apresentou elevado grau de erosividade e de concentração, pois 57,3% dos eventos foram erosivos, dos quais, os quatro de maior magnitude, participaram com 47,2% da erosividade anual. As áreas contempladas pelas interações entre classe de solo, declividade (D) e uso de solo, nas parcelas experimentais, totalizaram 174,32 ha (50% da área da sub-bacia), cujos valores obtidos resultaram em PS média ponderada de 0,623 t ha-1 ano-1, e foram referência no ajuste do modelo WEPP na versão encosta, com estimativa de 0,651 t ha-1 ano-1. A aplicação do modelo sobre uma superfície com 93,0% de abrangência da sub-bacia resultou em uma estimativa de 0,802 t ha-1 ano-1 para a taxa de PS. As áreas de solo exposto, embora participando com apenas 7,9% da área da sub-bacia, produziram 85,1% das PSs estimadas, o que, por outro lado, reflete a influência positiva da cobertura vegetal na diminuição da erosão hídrica. Simulando a implantação de cobertura sob a forma de campo/pastagem e/ou reflorestamento, nas áreas de solo descoberto, as taxas de PS na sub-bacia reduziriam significativamente para 0,215 t ha-1 ano-1.

ABSTRACT The objective of the present work was to monitor and identify erosive precipitations and monitor soil losses through experimental plots installed in the Córrego do Gigante sub-basin, to calibrate the Water Erosion Prediction Project (WEPP) model, in its slope version, based on the results obtained in the plots, and apply it to the sub-basin area to estimate soil losses due to water erosion. The rainfall regime during the study period showed high degrees of erosivity and concentration, since 57% of the events were erosive, of which, the four most erosive events corresponded to 47.2% of the annual erosivity. The areas covered by the interactions between soil class, slope, and land use, in the experimental plots, totaled 174.32 ha (50% of the sub-basin area), whose values obtained resulted in a weighted average loss of 0.623 t ha-1 year-1, which were a reference in the adjustment of the WEPP model in the hillside version, with an estimate of 0.651 t ha-1 year-1. The application of the model on a surface with 93.0% coverage of the sub-basin resulted in an estimate of 0.802 t ha-1 year-1 for the soil loss rate. The exposed soil areas, although accounting for only 7.9% of the sub-basin area, produced 85.1% of the estimated soil losses, which, on the other hand, reflects the positive influence of vegetation cover in the decrease of water erosion. Simulating the implementation of cover in the form of field/pasture and/or reforestation in the areas of bare soil significantly reduced the rates of soil losses in the sub-basin to 0.215 t ha-1 year-1.

Etiology and current treatment status of 277 patients with chronic atrophic gastritis and erosion in Beijing area / 中华消化杂志

Objective:To preliminarily understand the living habits, medication taking and treatment status including the therapeutic regimen, compliance and short-term efficacy of patients with chronic atrophic gastritis and erosion in Beijing area.Methods:From April to September in 2019 at Peking Union Medical College Hospital, Peking University Third Hospital and Peking University Shougang Hospital, the outpatients with chronic atrophic gastritis and erosion diagnosed with endoscopy within two weeks before visiting were prospectively included in this non-interventional observation study. Chi square test was used for statistical analysis.Results:A total of 277 patients with chronic atrophic gastritis and erosion had complete follow-up data, of which male patients accounted for 49.8% (138/277). The common initial symptoms of patients with chronic atrophic gastritis and erosion included acid reflux, abdominal distension, epigastric pain and postprandial distension, which accounted for 60.3% (167/277), 59.6% (165/277) , 58.8% (163/277) and 52.3% (145/277), respectively. For treatment, 36.8% (102/277) of the patients only received lifestyle instruction without medication. Among the patients with medication treatment, the short-term efficacy of gastric mucosal protectants+ proton pump inhibitor+ gastro-kinetic agent for abnominal distension, postprandial distention, acid reflux and nausea was highest as compared with other therapeutic regimen, and the differences were statistically significant ( χ2=25.18, 19.49, 13.75, 8.84, all P<0.05). Conclusions:Chronic gastritis with erosion may be caused by a combination of multiple factors, and the symptoms of which lack specific. If necessary, gastroscopy may help the diagnosis. Individualized treatment strategies based on the symptoms of patients is needed for treatment.

A Survey on Knowledge and Practices in Erosive Tooth Wear Among Dental Practitioners in Kuantan, Pahang: A Preliminary Study

@#Introduction: Erosive tooth wear (ETW) is an emerging dental condition worldwide. However, most dental practitioners overlooked the early stages of the condition due to vague clinical appearance of tooth surface loss. Therefore, this study was aimed to determine the knowledge of ETW and treatment given amongst dental professionals in private clinics in Kuantan, Pahang. Method: Several private dental clinics in Kuantan, Pahang, involved in this cross-sectional study. Dental practitioners were volunteering to participate in this research. A validated self-administered questionnaire was distributed, and a descriptive analysis was conducted. Results: The overall response rate was 75%. Results revealed that most participants obtained a structured education on ETW (79.2%). Through continuous dental education, about half of the participants learnt further. All participants agreed that carbonated drink caused ETW, and most reported that gastroesophageal reflux diseases and pickles had related to the ETW. The majority of participants favoured case note (79%) with regards to ETW records. Nevertheless, 40.9% and 36.4% are recorded at the tooth surface and individual level, respectively. Surprisingly, 79% of them did not know about special scores when assessing ETW. Most participants prefer to give instruction on oral hygiene and diet counselling as preventive measures, but the use of fluoride was not given priority. 77% have not ever referred the case to a dental specialist and preferred to treat the patient on their own. Conclusion: ETW knowledge among recruited PDPs is adequate; however, no specific indices were used for ETW scoring and insufficient treatment strategies..

Comparison of Effects of Different Courses of Proton Pump Inhibitors in Treatment of Erosive Esophagitis / 胃肠病学

Background: Gastroesophageal reflux disease (GERD) is a commonly seen disease of digestive system, and its prevalence is increasing year by year. Xinjiang is located in the northwestern part of China and is a multi-ethnic region. The diets consumed are mainly meat, sweet food and strong tea, and the incidence of GERD is high in Xinjiang. Aims: To compare the efficacy of 4-week and 8-week courses of proton pump inhibitors (PPI) in the treatment of mild erosive esophagitis (EE) and to explore the factors influencing the efficacy of PPI. Methods: A total of 151 LA-A/B grade EE patients from November 2020 to February 2021 at General Hospital of Xinjiang Military Region were recruited, and grading of gastroesophageal reflux disease questionnaire (GerdQ), STOP-Bang questionnaire, Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), self-rating depression scale (SDS) were performed. Patients received 40 mg qd esomeprazole for 8 weeks. The factors influencing the efficacy of PPI were analyzed. Results: No significant difference in symptom remission rate was found between 4-week and 8-week courses of PPI (74.1% vs. 81.3%, P=0.163). Multivariate analysis results showed that high risk of obstructive sleep apnea-hypopnea syndrome (OSAHS) and presence of hiatal hernia were the factors influencing the efficacy of 4-week course of PPI (P<0.05) and presence of hiatal hernia was the factor influencing the efficacy of 8-week course of PPI (P<0.05). Conclusions: Symptom remission rates are similar between 4-week and 8-week courses of PPI for mild EE. The presence of hiatal hernia and high risk of OSAHS can increase the difficulty and prolong the course of PPI in the treatment of EE.

The Acidity of Non-alcoholic Beverages in Australia: Risk of Dental Erosion

Introduction: Extrinsic acids play a key role in the etiology of dental erosion (DE), particularly acidic beverages. Of the factorsconsidered, pH appears to be the most significant influencing a beverage’s ability to cause DE. This study tested the pH andsubsequent erosive potential of non-alcoholic beverages commercially available in Australia.Purpose: Internationally, the consumption of non-alcoholic beverages is increasing. Regional differences in beverage availabilityand manufacturing processes may alter beverage pH. To date, little research outside of the United States has been conductedinvestigating the erosive potential of non-alcoholic beverages. This information should serve as a resource to professionals tofacilitate dietary counseling and identify potentially acidic beverages that have not been previously identified in the literature.Methods: A total of 177 commercially available non-alcoholic beverages were purchased from a supermarket in Orange,Australia, and their pH tested in triplicate at room temperature, using a temperature calibrated benchtop pH meter and probe.Beverages were classified by beverage type and subsequent erosive potential. The mean and median pH of beverage typeswas taken where appropriate.Results: As high as, 93.8% of the beverages had a potential to cause DE. These included 34 (19.2%) extremely erosive(pH < 3), 114 (64.4%) erosive (3 ≤ pH < 4), and 18 (10.2%) minimally erosive beverages (4 ≤ pH ≤ 5.5). Only 11 beverages(6.2%) were unlikely to be erosive (pH > 5.5).Conclusions: Of the beverages tested, most beverages (93.8%) had the potential to cause some degree of DE. The resultsprovided could serve as a resource to health professionals to facilitate dietary counseling and healthy dietary decisions amongconsumers

Esophageal pH-impedance monitoring of reflux patterns in non-erosive reflux disease, reflux hypersensitivity and functional heartburn / 南方医科大学学报

OBJECTIVE@#To analyze the differences in reflux patterns in 24-hour esophageal pH-impedance monitoring in patients with non-erosive reflux disease (NERD), reflux hypersensitivity (RH) and functional heartburn (FH) and explore the possible mechanism of symptoms in patients with heartburn and negative endoscopic findings.@*METHODS@#Seventy-nine patients with heartburn as the main symptoms but negative endoscopic findings, including 35 with NERD, 16 with RH and 28 with FH, were enrolled in this study.All the patients underwent 24-h esophageal pH-impedance monitoring and esophagogastroscopy, and the results were compared among the 3 groups.@*RESULTS@#Acid reflux episode was significantly increased and weakly alkaline reflux episode was significantly decreased in NERD group in comparison with RH group and FH group (@*CONCLUSIONS@#Patients with NERD, RH and FH had different reflux patterns.Acid reflux is predominant in the NERD, while weakly alkaline reflux is significantly increased RH and FH.In patients with normal esophageal acid exposure but without symptoms or without recorded symptoms during esophageal pH-impedance monitoring, analysis of the total reflux episode, mixed reflux episode, proximal acid reflux episode and percentage can help in the differential diagnosis between RH and FH.