Food Impaction Research Articles

Endoscopic diagnosis and management of eosinophilic esophagitis.

Eosinophilic esophagitis is a chronic allergic inflammatory disease, and its incidence and prevalence have recently increased. Eosinophilic esophagitis has not become a rare disease; thus, knowledge for diagnosing it is needed in current clinical practice. The adequate management of endoscopic procedures is particularly important for the diagnosis and evaluation of inflammatory activity and therapeutic responses. The therapeutic options for eosinophilic esophagitis include anti-acid drugs such as proton pump inhibitors, potassium-competitive acid blockers, swallowed topical corticosteroids, biologics, and dietary elimination therapies. Moreover, endoscopic esophageal dilation is a therapeutic option for fibrotic strictures due to eosinophilic esophagitis to improve obstructive symptoms, such as dysphagia and food impaction. In this review, we describe the endoscopic characteristics of eosinophilic esophagitis, including an endoscopic reference score and an optimal biopsy protocol to diagnose and evaluate the therapeutic response. We also describe a current therapeutic management of eosinophilic esophagitis.

Ventral pallidal GABAergic neurons drive consumption in male, but not female rats.

Food intake is controlled by multiple converging signals: hormonal signals that provide information about energy homeostasis, but also hedonic and motivational aspects of food and food cues that can drive non-homeostatic or "hedonic" feeding. The ventral pallidum (VP) is a brain region implicated in the hedonic and motivational impact of food and foods cues, as well as consumption of rewards. Disinhibition of VP neurons has been shown to generate intense hyperphagia, or overconsumption. While VP gamma-Aminobutyric acidergic (GABA) neurons have been implicated in cue-elicited reward seeking and motivation, the role of these neurons in the hyperphagia resulting from VP activation remains unclear. Here, we used Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) to activate VP GABA neurons in non-restricted male and female rats during chow and sucrose consumption. We found that activation of VP GABA neurons increases consumption of chow and sucrose in male rats, but not female rats. Together, these findings suggest that activation of VP GABA neurons can stimulate consumption of routine or highly palatable rewards selectively in male rats.Significance statement The ventral pallidum has been implicated bidirectionally in consumption of both standard food and highly palatable rewards, but the specific neural subpopulations involved have not been identified. Here we chemogenetically excited GABAergic ventral pallidal neurons and tested consumption of standard chow and a sweet sucrose solution. We found that chemogenetic excitation of these neurons stimulated consumption of both rewards but did so specifically in male rats. These results suggest that GABAergic ventral pallidal neurons can drive overconsumption of foods in male rats, but not female rats, raising important questions about the role of ventral pallidum in consumption in females, who have been understudied in this domain.

Population pharmacokinetics of cannabidiol and the impact of food and formulation on systemic exposure in children with drug-resistant developmental and epileptic encephalopathies.

Identifying factors influencing cannabidiol (CBD) exposure can optimize treatment efficacy and safety. We aimed to describe the population pharmacokinetics of CBD in children with drug-resistant developmental and epileptic encephalopathies (DEEs) and assess the influence of environmental, pharmacological, and clinical characteristics on CBD systemic exposure. Data from two pharmacokinetic studies of patients aged 2-18 years with DEEs were included (N = 48 patients). Serial blood samples were collected during maintenance treatment, before and after the morning dose, and up to 6 h after a dose of a purified CBD oil formulation, with or without a normocaloric breakfast. CBD plasma concentrations were also available following administration of a CBD-enriched formulation. Samples were quantified using a validated liquid chromatography/tandem mass spectrometry assay. A CBD population pharmacokinetic model was developed using nonlinear mixed-effects modeling. The effects of formulation, concomitant food intake, and demographic, clinical, and pharmacological factors on CBD pharmacokinetics were evaluated. Simulated maximum plasma concentration (Cmax) and area under the concentration-time curve between 0 and 12 h (AUC0-12) were calculated. A one-compartment model with transit compartments and first-order elimination best described CBD pharmacokinetics. Mean values for CBD apparent clearance (CL/F) and volume of distribution (V/F) were 143.5 L/h and 1892.4 L, respectively. Weight was allometrically scaled for V/F and CL/F, sex was associated with V/F, and both formulation and food condition were associated with F (relative bioavailability). CBD Cmax increased by 41% and AUC0-12 by 45% when CBD was administered with food compared to fasting. Dose-normalized AUC0-12 was approximately 50% lower with CBD-enriched oil compared to purified CBD. In the present study, we described the effects of food and formulation on CBD exposure in children with DEEs. Increased CBD exposure with food intake and significant changes in drug exposure when switching between CBD formulations should be considered in patient management.

Testing the effect of ecolabels on the environmental impact of food purchases in worksite cafeterias: a randomised controlled trial

BackgroundReducing the environmental impact of foods consumed is important for meeting climate goals. We aimed to conduct a randomised controlled trial to test whether ecolabels reduce the environmental impact of food selected in worksite cafeterias, alone or in combination with increased availability of more sustainable meal options.MethodsWorksite cafeterias (n = 96) were randomised to one of three study groups, with 54 included for final analysis. One group was intended to increase the availability of meat-free options, but no change was implemented. Therefore, this group was treated as part of the control, creating two groups: (1) control (no ecolabels) (n = 35), and (2) ecolabels (n = 19). Regression analysis assessed the primary outcome of total environmental impact of hot meals sold over a 6-week period. Secondary outcome analyses explored the individual environmental indicators that composed the total environmental impact score (i.e., greenhouse gas emissions, biodiversity loss, eutrophication, and water scarcity). The mean weekly environmental impact scores of hot meal options over the full 12-week trial period were assessed using hierarchical mixed effects models.ResultsThere was no significant effect of the intervention on the environmental impact scores of meals sold (mean difference between control and intervention sites: -1.4%, 95%CI: -33.6%, + 30.8%). There was no evidence of an effect in mean weekly environmental impact score (-5.4%, 95%CI: -12.6%, + 2.5%), nor in any of the four individual environmental indicators (greenhouse gas emissions: -3.6%, 95%CI: -30.7%, 34.3%; biodiversity loss: 2.0%, 95%CI: -25.8%, 40.2%; eutrophication: -2.4%, 95%CI: -29.3%, 34.7%; water scarcity: -0.4%, 95%CI: -28.7%, 39.1%).ConclusionsEcolabels may not be an effective tool to shift consumer behaviour in worksite cafeterias towards meals with lower environmental impact.Trial registrationThe study was pre-registered prospectively on ISRCTN (https://www.isrctn.com/ISRCTN10268258; 06/01/2022).

"Now I can see it works!" Perspectives on Using a Nutrition-Focused Approach When Initiating Continuous Glucose Monitoring in People with Type 2 Diabetes: Qualitative Interview Study.

Food choices play a significant role in achieving glycemic goals and optimizing overall health for people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) can provide a comprehensive look at the impact of foods and other behaviors on glucose in real time and over the course of time. The impact of using a nutrition-focused approach (NFA) when initiating CGM in people with T2D is unknown. This study aims to understand the perspectives and behaviors of people with T2D who participated in an NFA during CGM initiation. Semistructured qualitative interviews were conducted with UNITE (Using Nutrition to Improve Time in Range) study participants. UNITE was a 2-session intervention designed to introduce and initiate CGM using an NFA in people with T2D who do not use insulin. The intervention included CGM initiation materials that emphasized the continuous glucose monitor as a tool to guide evidence-based food choices. The materials were designed to support conversation between the CGM user and diabetes care provider conducting the sessions. A rapid matrix analysis approach was designed to answer two main questions: (1) How do people who participate in an NFA during CGM initiation describe this experience? and (2) How do people who participate in an NFA during CGM initiation use CGM data to make food-related decisions, and what food-related changes do they make? Overall, 15 people completed interviews after completion of the UNITE study intervention: 87% (n=13) identified as White, 60% (n=9) identified as male, mean age of 64 (SD 7.4) years, mean T2D duration of 7.5 (SD 3.8) years, and mean hemoglobin A1c level of 7.5% (SD 0.4%). Participants fluently discussed glycemic metrics such as time in range (percent time with glucose 70-180 mg/dL) and reported regularly using real-time and retrospective CGM data. Participants liked the simplicity of the intervention materials (eg, images and messaging), which demonstrated how to use CGM data to learn the glycemic impact of food choices and suggested how to adjust food choices for improved glycemia. Participants reported that CGM data impacted how they thought about food, and most participants made changes because of seeing these data. Many of the reported changes aligned with evidence-based guidance for a healthy lifestyle, including prioritizing nonstarchy vegetables, reducing foods with added sugar, or walking more; however, some people reported behavior changes, such as skipping or delaying meals to stay in the target glucose range. A few participants reported that the CGM amplified negative feelings about food or eating. Participants agreed that pairing nutrition information with CGM initiation instructions was helpful for their diabetes care. In general, the NFA during CGM initiation was well received and led to positive changes in food choices and behaviors during a 2-month intervention.

Eosinophilic Esophagitis-Related Food Impaction: Distinct Demographics, Interventions, and Promising Predictive Models.

Eosinophilic esophagitis (EoE) is an increasingly common cause of food impaction. This study aims to provide a nationwide analysis of food impaction in patients with or without EoE diagnosis, concentrating on patient demographics, interventions, outcomes, and development of predictive machine-learning models. A retrospective assessment was conducted using Nationwide Emergency Department Sample data from January 1, 2018, to December 31, 2019. We compared patients with food impaction with an associated EoE diagnosis to those without EoE and derived machine-learning models to predict EoE using International Classification of Diseases codes at discharge for identification. Of 286,886,714 emergency department visits, 146,084 were for food impaction, with 7093 cases coinciding with an EoE diagnosis (4.9%). Patients with EoE were more commonly young men with fewer overall comorbidities but higher incidences of obesity, asthma, gastritis, and allergic rhinitis. A significantly larger proportion in the EoE group (89.6%) underwent esophagogastroduodenoscopy compared to the non-EoE group (51.1%; P < 0.001) and had a higher rate of biopsy during esophagogastroduodenoscopy in the emergency department (54.9% vs 13.4%; P < 0.001). Our machine-learning models, incorporating patient demographics, hospital attributes, and comorbidities, had a sensitivity of 86.1% and an area under the receiver operating characteristic curve of 0.828. This nationwide study demonstrates that EoE in food impaction is associated with specific patient demographics, comorbidities, and elevated interventions. Our machine-learning models hold promise as screening tools for EoE, aiding medical practitioners in determining the need for biopsy.

Histoire naturelle des allergies alimentaires non IgE-médiées

Non-IgE-mediated food allergies are adverse immune reactions to certain food allergens that are specific for a given individual, but do not involve specific serum IgE antibodies. They mainly affect infants and young children. They include allergic proctocolitis, food protein-induced enterocolis syndrome (FPIES), allergic enteropathy, aspecific digestive dysmotility (e.g., severe reflux, constipation) and certain eosinophilic oesophagitis (EoE) responding to the avoidance diet. The most common allergen involved is cow's milk, but other foods may be responsible, particularly in breast-fed infants, although this is rare. The main symptoms are haematochezia in allergic proctocolitis, acute vomiting with pallor and hypotonia in FPIES, stunted growth and chronic diarrhoea in allergic enteropathy, and reflux with feeding difficulties in infantile EoE. Eviction-reintroduction of the suspected allergen is used as a diagnostic test in allergic proctocolitis and enteropathy. In FPIES, there is a clinical definition. For EoE, histological analysis of oesophageal biopsies makes the diagnosis after elimination of differential diagnoses. Treatment involves avoiding the allergen responsible until tolerance is acquired. With the exception of EoE, the course of the disease is favourable in the first 2–3 years of life. There is a risk of developing functional intestinal disorders and atopic diseases. EoE is a chronic disease, with possible cases of remission in paediatrics. The main complications are oesophageal stenosis, food impaction and oesophageal perforation.

The Use of Omics in Untangling the Effect of Lifestyle Factors in Pregnancy and Gestational Diabetes: A Systematic Review.

To synthesise the evidence from clinical trials and observational studies using omics techniques to investigate the impact of diet and lifestyle factors on metabolite profile in pregnancy, and in the prevention and management of gestational diabetes mellitus (GDM). A systematic literature search was performed using PubMed, Ovid, CINAHL, and Web of Science databases in October 2023 and updated in September 2024. Inclusion criteria were randomised controlled trials (RCT) or non-RCTs in pregnant women with or without GDM, that measured diet and lifestyle factors, and which applied post-transcriptional omics approaches. Risk of bias was assessed using the ROBINS-I for non-RCTs and ROB-2 tool for RCTs. The results of all studies are narratively synthesised. Of 6293 studies identified, eight observational studies and three RCTs comprising 2639 pregnant women were included. Three studies reported on changes in diet-related metabolic phenotypes during pregnancy; however, the impact of certain foods on the metabolome and risk for GDM was less clear. Compared with women without GDM, women with GDM had a worse deterioration in metabolites, including saturated fatty acids, branched chain amino acids and purine degradation metabolites. There is limited evidence that conventional dietary treatment for GDM may modify the metabolome in women with GDM. Metabolome profiles in pregnancy may be altered by certain dietary choices; however, it is inconclusive whether improved diet related metabolite profiles have a beneficial impact in the prevention or management of GDM. High quality studies with larger sample sizes are needed to better understand the role that maternal nutrition plays in modulating the maternal metabolome, not only for a healthy pregnancy but also for the prevention and management of GDM.

Radiographic and endoscopic management of unintentional versus intentional foreign body ingestion

Background and Objectives: Foreign body (FB) ingestion is a condition managed with esophagogastroduodenoscopy (EGD). This study compared the differences in demographics, utilization of imaging, endoscopic findings, and clinical outcomes between patients with unintentional versus intentional FB ingestion. Methods: Adult patients with FB ingestion, including food impactions, were included at a large tertiary academic medical system between 2010 and 2021 in this retrospective case series. Patients with unintentional ingestion of FBs (Group A) were compared to patients with intentional ingestion of FBs (Group B). Results: A total of 479 patients were included: 397 patients in Group A (83%) and 82 patients in Group B (17%). In Group A, 221 patients (56%) underwent imaging compared to 79 patients (96%) in Group B (P &lt; 0.001). A FB was visible on imaging in 73 patients in Group A (34%) and 70 in Group B (89%) (P &lt; 0.001). Group A patients more frequently underwent EGD after routine business hours (6 PM–7 AM) (40% vs. 27%, P = 0.03), and less frequently had ingested FBs identified on EGD (74% vs. 85%, P = 0.04). Excluding food impactions from Group A, imaging was utilized less frequently in Group A (80%) compared to Group B patients (96%) for evaluation of true FB ingestion (P = 0.016). Additionally, true FBs were visible on imaging less frequently in Group A (59%) than in Group B (87%) (P = 0.002). Conclusion: Unintentional FB ingestion patients were less likely to undergo imaging or to have FBs identified on imaging or EGD; They were more likely to undergo EGDs after routine business hours. Further investigation of the role of imaging in unintentional FB ingestion is needed to decrease unneeded emergent endoscopy for patients with FBs that are no longer easily reachable by EGD.

Effect of Consuming Papaya Leaves, Almond Milk, Green Beans, Moringa Leaves, Ajwa Dates, Soy Milk, and Fennel Leaves on Breast Milk Production in Postpartum Mothers

Exclusive breastfeeding rates are often low due to suboptimal breast milk production, which impedes infants' nutritional needs. This issue is frequently attributed to poor maternal nutrition, unbalanced diets, and irregular food consumption. Breast milk production relies on hormonal changes, notably the dominance of prolactin over progesterone and estrogen during childbirth. To address this, a study was conducted to evaluate the impact of specific foods boiled papaya leaves, almond milk, green beans, moringa leaves, ajwa dates, soy milk, and fennel leaves—on breast milk production. Employing a quasi-experimental design with a one-group pretest-posttest approach, the study involved 56 postpartum mothers whose milk production was substandard. These participants were selected in March 2023 using purposive non-probability sampling. A paired t-test was performed for bivariate analysis. Results indicated a significant improvement in milk production, with a p-value of 0.000, demonstrating that the consumption of these foods positively affects lactation. Consequently, it is recommended that breastfeeding mothers incorporate these foods into their diet to enhance milk production and support exclusive breastfeeding. Regular consumption of these specific foods can help meet infants' nutritional needs more effectively.

Impact Of Classical Yoga Therapy And Naturopathy Neutraceutical Functional Supplementary Food On Cortisol And Pitsburg Sleep Quality Index Among Middle-Aged Men With Insomnia: Randomized Control Trail

To fulfill the objectives of the Random Group Experimental Design, 120 adults experiencing insomnia issues volunteered from Chennai city. Among them, 90 individuals underwent screening, from which 45 were randomly selected using the Random Sampling technique, falling within the age range of 35 to 50 years. These participants were then divided into two groups: an Experimental Group and a Control Group, each comprising 15 subjects. Over a period of 12 weeks, the Experimental Group received training sessions six days a week, lasting up to an hour each morning, while the Control Group engaged in active rest. Both groups underwent pre-test and post-test evaluations before and after the training sessions, during which their scores on the Pittsburgh Sleep Quality Index (PSQI) and cortisol levels were measured. The significance of differences among the groups was determined using the 't' test. Results indicated a decrease in both PSQI scores and cortisol levels among participants in the Experimental Group, who engaged in Classical Yoga therapy practices and consumed Naturopathy supplementary food. Consequently, the hypothesis was accepted with a confidence level of 0.05. The study concludes that Classical Yoga therapy practices along with Naturopathy supplementary food contribute to reducing PSQI scores and cortisol levels in adults suffering from insomnia.

Eosinophilic oesophagitis in adults: from symptoms to therapeutic options.

Eosinophilic oesophagitis (EoE) is a chronic and progressive immune-mediated condition, typically affecting young atopic male adults and potentially leads to organ dysfunction and fibrosis. The clinical spectrum widely varies -from non-troublesome dysphagia to food impaction- and hence the rate of misdiagnosis and diagnostic delay are high, especially when presenting with minor symptoms, such as heartburn and acid regurgitation. There have been several major therapeutic breakthroughs for the management of EoE in recent years. Highly effective conventional agents with oesophagus-specific formulations (i.e. orodispersible budesonide) and a biological agent (i.e. dupilumab) now have a formal indication. Oesophageal dilation may be indicated in case of strictures, which are more common in longstanding and untreated disease. Therefore, the early diagnosis of this disorder and specialist referral is if of great importance. The evaluation of alarm signs and typical presentation patterns should allow a more straightforward recognition. The emergency and internal medicine doctors should actively be involved in this process and take part to the multidisciplinary care of patients with EoE, to allow better patient care and clinical outcomes.

Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient

Background: Lichen planus (LP) is a chronic inflammatory disease that can present with significant morbidity, particularly in children. Erosive lichen planus (ELP), its rare destructive subtype, can be particularly difficult to diagnose and manage. We present a rare pediatric case of ELP with multisite involvement and discuss the differential diagnosis. Case Presentation: A 12-year-old boy presented with painful erosions and ulcers on the lateral tongue and dystrophic nails. His six-year history of tongue and nail lesions prompted several comprehensive examinations. Laboratory tests did not reveal any abnormalities. Histopathological examination of the tongue lesions was representative of ELP. Line-field confocal optical coherence tomography (LC-OCT) examination of the tongue lesions showed features that strongly correlated with histopathology. The patient was later hospitalized due to dysphagia and esophageal food impaction, during which esophageal ELP was confirmed. The patient was initially managed with topical corticosteroids. He was later started on systemic therapy in the form of methotrexate and low-dose naltrexone to address his symptoms and disease presentation. Conclusions: This case highlights the complexities of diagnosis and management of ELP in pediatric patients. A multidisciplinary approach and regular follow-up are necessary to manage symptoms, prevent complications, and improve quality of life.

Balancing Nutritional and Environmental Sustainability Through the Evaluation of the Water Footprint of the Recommended Italian, Spanish, and American Diets

Background/Objectives: The water footprint (WF) provides information on the impact of individual foods on water consumption, but to better direct food production toward water saving, we need to understand how to reduce the WF of our diets while keeping it healthy. In this study, we compared the WF of healthy diets based on national food-based dietary guidelines with the aim of highlighting changes in dietary patterns that could reduce water requirements without compromising nutritional adequacy. Methods: Three 2000 kcal/day dietary patterns were elaborated following the Italian, Spanish, and American dietary guidelines, and their total, green, blue, and grey WFs were calculated. Results: The Italian dietary pattern showed the lowest total WF (2806 L per capita/day), with the American and Spanish patterns being 8% and 10.5% higher, respectively. The food groups contributed differently to the total WF. In the USA, animal foods were the main contributor (56% versus 41% in Spain and 38% in Italy). The contribution of plant foods was higher in Italy (61%) than in Spain (54%) and the USA (38%). The distribution of the total WF between WFgreen, WFblue, and WFgrey was similar across the dietary patterns. Within each food group, and mainly in the animal-origin food group, the type of product significantly modulated the WF. Conclusions: Different diets can be equally nutritionally sustainable but have different impacts on environmental sustainability. The comparison of their WFs can be the starting point to promote dialogue between nutritionists, operators in the environmental sector, and the agri-food industry to ensure a healthy and balanced approach.

An anti-junk food ad from a sports commercial break reduced junk food consumption inclinations, yet junk food ads had minimal to no impact.

In Australia, there are concerns that unrestricted junk food advertising during sports broadcasts increases short-term junk food consumption among viewers. Therefore, the present study aimed to estimate the impact of junk food and anti-junk food advertising on consumption inclinations. We conducted a content analysis across a sample (N = 16) of Australian Football League (AFL) and National Rugby League (NRL) matches to determine the prevalence of junk food and anti-junk food advertising video clips. We also exposed participants (N = 428) to a single randomly selected junk food advertisement or a single anti-junk food advertisement and measured the immediate impact on craving and consumption intentions for both healthy weight and high body mass index (BMI) participants. Junk food and anti-junk food advertising video clips comprised 10.85% and .003% of all advertisements across the broadcasts, respectively. For both healthy and overweight participants, junk food advertisement exposure did not increase immediate craving or consumption intentions. However, decreases were observed in craving and consumption intentions following an anti-junk food advertisement. Junk food advertising prevalence across national sports was high. Junk food advertisements did not increase immediate inclinations to consume junk food, but an anti-junk food advertisement was effective in reducing immediate craving and consumption intentions, particularly for healthy BMI participants. SO WHAT?: Given the potential efficacy of health promotion adverts, governments should consider investing in a higher frequency of health messages during broadcasts that are known to readily promote junk food, such as national sports.

A Phase 1, Open-Label, Randomized, Two-Part Study in Healthy Adult Volunteers to Evaluate the Bioavailability of the Maribavir Powder for Oral Suspension, as Well as Food Effect and Impact of Rabeprazole.

The relative bioavailability and impact of food and the proton pump inhibitor rabeprazole on the pharmacokinetics of a maribavir powder-for-oral-suspension formulation was investigated in a Phase 1 open-label study in healthy adult volunteers. A single 200-mg maribavir dose was administered as the commercial tablet (Treatment A), powder formulation (Treatment B), or powder formulation with a high-fat/high-calorie meal (Treatment C) in Part 1, and as the powder formulation alone (Treatment D) or following administration of rabeprazole 20mg once daily for 5 days (Treatment E) in Part 2. Maribavir maximum plasma concentration following Treatment B was 18% lower versus Treatment A, whereas the area under the concentration-time curve (AUC) from time 0 to the last quantifiable concentration or infinity were similar. Maribavir maximum plasma concentration, AUC from time 0 to the last quantifiable concentration, and AUC from time 0 to infinity were reduced by 42%, 18%, and 18% (Treatment C vs Treatment B), and by 51%, 30%, and 11% (Treatment E vs Treatment D), respectively. A clinically significant reduction in maribavir exposure is not expected when maribavir powder formulation is taken with food or proton pump inhibitors. Participants assessed the powder for oral suspension as easy to swallow and having an acceptable taste/texture. Safety profiles for maribavir formulations in this study were consistent with those previously published.

The effect of complementary foods on the colonic microbiota of weaning infants: a systematic review.

The transition from breastmilk to solid foods (weaning) is a decisive stage for the development of the colonic microbiota. However, little is known about how complementary foods influence the composition and function of the colonic microbiota in infants. This systematic review collected evidence of the effect of individual foods on the fecal microbiota of weaning infants (4-12 months old) using five databases: PubMed, CENTRAL, Scopus, Web of Science, and ScienceDirect. A total of 3625 records were examined, and seven randomized clinical trials met the review's eligibility criteria. Altogether, 983 participants were enrolled, and plant-based foods, meats, and dairy products were used as interventions. Wholegrain cereal increased the fecal abundance of the order Bacteroidales in the two included studies. Pureed beef increased the fecal abundances of the genus Bacteroides and the Clostridium XIVa group, as well as microbial richness in two of the three included studies. However, the conclusions of this review are limited by the small number of studies included. No conclusions could be drawn about the impact of complementary foods on fecal metabolites. Further clinical trials assessing the effect of dietary interventions on both fecal microbial composition and function are needed to fill this knowledge gap in infant nutrition.

Progress of the study on factors related to orthodontic treatment and the formation of black triangles

Black triangles can be formed due to the defect or absence of the gingival papilla, which increases the risks of food impaction, caries, and periodontal disease, and affects the esthetics of anterior teeth. The incidence of black triangles after orthodontic treatment is from 38% to 58%. The formation of black triangles is influenced by patient-related factors and factors related to orthodontic treatment. This article discusses the factors related to orthodontic treatment and the formation of interdental black triangles and provides reference for preventing the formation of this problem.

Development and Validation of the PICK-UP-STRICS Score to Predict Fibrostenosis in Patients with EoE Prior to Endoscopy.

Predicting fibrostenotic complications prior to endoscopy in eosinophilic esophagitis (EoE) is challenging and esophageal strictures and narrowing are commonly missed on endoscopy. To develop and validate a score to predict fibrostenosis in EoE patients prior to endoscopy. We leveraged a large database of newly diagnosed EoE patients. Fibrostenosis was defined as esophageal stricture, luminal narrowing, or dilation performed during the diagnostic endoscopy. Patients were randomly divided into a development and validation set. We compared features between patients with and without fibrostenosis to inform the initial model and assess predictive ability, as measured by area under curve (AUC). We tested the model in the independent validation set and generated a score to predict low, medium and high fibrostenosis risk. In 655 newly diagnosed EoE patients in the development set, fibrostenosis was associated with age ≥ 18years (OR 10.64; 95% CI 5.61-20.17), symptoms for ≥ 5years prior to diagnosis (OR 2.07; 1.32-3.24), dysphagia (OR 3.72; 1.68-8.22), food impaction (OR 1.68; 1.07-2.62), and lack of abdominal pain (OR 0.28; 0.14-0.60). The model predicted fibrostenosis (AUC = 0.841). In the validation set (n = 654), AUC was preserved (0.831). A scoring system was generated, with scores of ≤ 2 being low risk (< 10% chance of stricture), 2.5-4.5 medium risk (10-50% stricture), and 5-6 high risk (> 50%). We developed and validated the PICK-UP-STRICS score to increase suspicion and detection of fibrostenotic disease in EoE using readily available clinical features prior to endoscopy. This score may guide clinical decisions on the need of endoscopic dilation.

Long-Term Outcomes of Ceramic Veneers Restorations: A Comprehensive Analysis of Clinical and Patient-Reported Metrics.

This study aimed to evaluate the clinical performance of ceramic veneers after 9-10 years, assess patient-reported outcomes, and examine their associations. Thirty patients with ceramic veneers aged 9-10 years were recalled for a clinical examination. Each participant completed a questionnaire on satisfaction and oral health-related quality of life, specifically using the Oral Impact on Daily Performance (OIDP) scale. The chi-square or Fisher exact test was used to assess the associations between tooth position and professional evaluations of veneer success and individual items. Consistency between professional evaluations of the veneers and patient-reported outcomes was evaluated using Weight Kappa. A total of 30 patients with 233 veneers participated in the study. Clinical evaluations deemed 9.87% (n = 23) of veneers as successful, 79.40% (n = 185) as surviving with complications, and 10.73% (n = 25) as a failure. The most common complications were marginal adaptation, gingival inflammation, and marginal discoloration. The participants were most frequently dissatisfied with the function of the veneers, food impaction, and cleaning difficulties. The OIDP assessment indicated that problems on daily activities such as cleaning, eating, and sleeping were predominantly affected. There were significant consistencies between certain clinical performance attributes and patient-reported outcomes. The survival rate of ceramic veneers was 89.3% after 9-10 years of follow-up. Among these, 79.4% had survived with complications such as material defects, secondary caries, and gingival problems. Given the discrepancies between patient-reported outcomes and clinical evaluations, further investigations into patient perception are needed alongside traditional clinical assessments. Educating patients about the potential complications associated with veneer restoration, especially specific to tooth location, is essential. Additionally, advising patients on proper oral hygiene practices is recommended to minimize the risk of gingival inflammation to enhance the longevity of the restoration.