Assessment of dietary nutrients that influence perception of intra-oesophageal acid reflux events in patients with gastro-oesophageal reflux disease.

BACKGROUND: Gastro-oesophageal reflux disease symptoms are most commonly reported postprandially, suggesting that some diet components are likely to induce symptoms more than others. AIMS: To determine which of the various dietary nutrients is a strong predictive factor for symptom generation in association with an acid reflux event. METHODS: Subjects with typical heartburn symptoms were evaluated by the gastro-oesophageal reflux disease Symptom Checklist, demographics questionnaire, upper endoscopy and pH testing. During the pH study, patients completed a detailed 24-h dietary intake record. This included time of meals, description of food components and the amount and type of food preparation. RESULTS: Fifty gastro-oesophageal reflux disease patients completed all stages of the study. A total of 112 (78%) symptoms were considered as sensed reflux event. Body mass index did not correlate with having perceived reflux. Patients who consumed more cholesterol, saturated fatty acids and had more percentage calories from fat were significantly more likely to experience a perceived reflux event. Regression analysis and beta-coefficient were specifically significant for cholesterol. CONCLUSION: Of all dietary nutrients, cholesterol enhances the most the perception of intra-oesophageal acid reflux events in patients with gastro-oesophageal reflux disease.

Reproducibility and relative validity of a questionnaire to assess intake of black tea polyphenols in epidemiological studies.

Epidemiological studies suggest that tea drinking may reduce the risk of cardiovascular diseases and cancers. Although tea is an important source of antioxidant phytochemicals, variation in preparation techniques may translate to variation in antioxidant capacity. However, most large-scale epidemiological studies use regular food frequency questionnaires to estimate tea intake, and nationally available nutrient analysis databases do not include levels of black tea polyphenols. The Arizona Tea Questionnaire (ATQ) was designed as a tool for collecting more complete dietary tea consumption information, and a database was developed after analyzing 40 black tea samples (brewed, instant, and sun tea) for polyphenols. This study assesses the reliability and relative validity of the ATQ and polyphenol database. Relative validity of estimates of black tea consumption was tested by comparing the ATQ with the traditional Arizona Food Frequency Questionnaire and four days of food records. The ATQ was tested for reproducibility of estimates of black (hot and iced) tea consumption and levels of black tea polyphenol intake. Correlations between two measures of intake taken 2 months apart ranged from 0.72 for black hot tea to 0.86 for black sun tea. Mean intakes (range) of total flavonoids for black tea consumers were 80.8 (3.0-588.0) mg/day at the first ATQ and 102.4 (4.5-802.3) mg/day at the second ATQ (r = 0.83, P < 0.001). The ATQ provided highly reproducible estimates of both total tea consumption and individual tea polyphenol intake. This instrument may be a useful tool in studies of the associations between tea consumption, tea polyphenols intake, and risk for chronic disease.

Reliability and validity of a self-administered food frequency questionnaire in a chemoprevention trial of adenoma recurrence.

Various chemoprevention trials have assessed dietary intake by means of food frequency questionnaires. However, it is important to assess the degree to which such questionnaires can measure diet. We conducted reproducibility and validity analyses of our Arizona Food Frequency Questionnaire (AFFQ) in our recently completed, randomized, Phase III chemoprevention trial testing the effects of a wheat bran fiber supplement on colorectal adenoma recurrence. A total of 139 individuals provided a baseline and year 1 AFFQ and a set of 4-day dietary records collected over a period of 1 month. The reproducibility analyses of the AFFQ administered 1 year apart showed a mean intraclass correlation of 0.54 for unadjusted nutrients and 0.48 for energy-adjusted nutrients. The relative validity of the AFFQ, as compared with the average of the 4-day diet records, showed a mean deattenuated correlation of 0.49 (range, 0.22-0.65) for the baseline AFFQ and 0.49 (range, 0.25-0.67) for the year 1 AFFQ. When data from both AFFQs were combined and compared with the diet records, there was a slight improvement in the overall deattenuated correlations (mean, 0.56; range, 0.33-0.71). The correlations we observed for macro- and micronutrient intake were within the overall range of those reported in the literature. Reliability and validity studies of dietary instruments are feasible in the setting of a chemoprevention trial and should be conducted when the instrument's performance has not been previously assessed in the target population.

Pastoral care in a critical care setting.

Healing the whole person-mind, body, spirit-cannot be forgotten in this world of critical care and high-technology medicine. It is the chaplain, one of many on the multidisciplinary care team, who is a reminder of this most important focus.

Environmental barriers in dental office infection control.

The emphasis of this article is to explain the utility of incorporating disposable, single-use environmental-surface infection control barriers into dental office infection control programs. Use of barriers in dental operatories and x-ray rooms can increase infection control effectiveness, reduce operatory turn-around time between patients, and actually reduce office time and expenses associated with infection control. This article is not intended to be a cookbook on how to do it, but rather a guide to the understanding of why dentists should consider using disposable barriers in place of chemical disinfectants wherever possible. Understanding the barrier concept will enable readers to problem-solve their own facility's needs and to select appropriate materials on their own.

Avoiding cross-contamination in prosthodontics.

Reduction of the potential for cross-contamination in prosthodontics may be accomplished in the following ways: 1. Use surface covers such as clear plastic wraps or bags over instruments like face-bow, articulators, and torch handles. 2. Disinfect surfaces with chemical agents such as 1% iodine surgical scrub in 70% isopropyl alcohol in a ratio of 1:2 to 1:20. 3. Use unit-doses of petroleum jelly, impression materials, waxes, indelible pencils, etc. 4. Use mechanical sterilization to sterilize prosthodontic instruments as "set ups" not commonly thought compatible with the mechanical sterilization process (wood-handled knives, spatulas, Boley gauges, bite forks, impression trays, metal rulers, and acrylic resin burs). 5. Use chemical disinfectants such as Cidex, 2% glutaraldehyde; iodophor solution, 1% stock iodine diluted to 0.5% to 0.05% in 70% isopropyl alcohol; and 5.25% sodium hypochlorite diluted to 0.5% to 0.05% with tap water to disinfect removable partial denture frameworks, acrylic resin impression trays, immediate dentures, and mold and shade guide teeth. 6. Use a mask and latex disposable examination gloves during all patient contact. Efficient application of these recommendations will reduce the potential for disease transmission during the delivery of health care.