Prolonged large bowel transit increases serum deoxycholic acid: a risk factor for octreotide induced gallstones

BACKGROUNDTreatment of acromegaly with octreotide increases the proportion of deoxycholic acid in, and the cholesterol saturation of, bile and induces the formation of gallstones. Prolongation of intestinal transit has been proposed as the mechanism for the increase in the proportion of deoxycholic acid in bile.AIMSTo study the effects of octreotide on intestinal transit in acromegalic patients during octreotide treatment, and to examine the relation between intestinal transit and bile acid composition in fasting serum.METHODSMouth to caecum and large bowel transit times, and the proportion of deoxycholic acid in fasting serum were measured in non-acromegalic controls, acromegalic patients untreated with octreotide, acromegalics on long term octreotide, and patients with simple constipation. Intestinal transit and the proportion of deoxycholic acid were compared in acromegalic patients before and during octreotide.RESULTSAcromegalics untreated with octreotide had longer mouth to caecum and large bowel transit times than controls. Intestinal transit was further prolonged by chronic octreotide treatment. There were significant linear relations between large bowel transit time and the proportion of deoxycholic acid in the total, conjugated, and unconjugated fractions of fasting serum.CONCLUSIONSThese data support the hypothesis that, by prolonging large bowel transit, octreotide increases the proportion of deoxycholic acid in fasting serum (and, by implication, in bile) and thereby the risk of gallstone formation.

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Intestinal transit, deoxycholic acid and the cholesterol saturation of bile--three inter-related factors.

Gut ◽

10.1136/gut.27.5.550 ◽

1986 ◽

Vol 27 (5) ◽

pp. 550-558 ◽

Cited By ~ 105

Author(s):

S N Marcus ◽

K W Heaton

Keyword(s):

Deoxycholic Acid ◽

Intestinal Transit ◽

Related Factors ◽

Cholesterol Saturation

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The effect of Testa Triticum Tricum on intestinal transit, deoxycholic acid metabolism and the cholesterol saturation of bile

Scandinavian Journal of Gastroenterology ◽

10.3109/00365528709095884 ◽

1987 ◽

Vol 22 (sup129) ◽

pp. 200-204

Author(s):

S. N. Marcus

Keyword(s):

Acid Metabolism ◽

Deoxycholic Acid ◽

Intestinal Transit ◽

Cholesterol Saturation

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Hydrogeological responses in tropical mountainous springs

Memorias del I Congreso Internacional de Ciencias Exactas y Naturales ◽

10.15359/cicen.1.37 ◽

2019 ◽

Author(s):

Ricardo Sánchez-Murillo

Keyword(s):

Costa Rica ◽

Isotope Composition ◽

Central Valley ◽

Distribution Functions ◽

Geochemical Composition ◽

Transit Times ◽

Management Plans ◽

Best Fit ◽

Term Data

This study presents a hydrogeochemical analysis of spring responses (2013-2017) in the tropical mountainous region of the Central Valley of Costa Rica. The isotopic distribution of δ18O and δ2H in rainfall resulted in a highly significant meteoric water line: δ2H = 7.93×δ18O + 10.37 (r2=0.97). Rainfall isotope composition exhibited a strong dependent seasonality. The isotopic variation (δ18O) of two springs within the Barva aquifer was simulated using the FlowPC program to determine mean transit times (MTTs). Exponential-piston and dispersion distribution functions provided the best-fit to the observed isotopic composition at Flores and Sacramento springs, respectively. MTTs corresponded to 1.23±0.03 (Sacramento) and 1.42±0.04 (Flores) years. The greater MTT was represented by a homogeneous geochemical composition at Flores, whereas the smaller MTT at Sacramento is reflected in a more variable geochemical response. The results may be used to enhance modelling efforts in central Costa Rica, whereby scarcity of long-term data limits water resources management plans.

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Faculty Opinions recommendation of Preoperative octreotide treatment of acromegaly: long-term results of a randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718421945.793511696 ◽

2015 ◽

Author(s):

Niki Karavitaki ◽

Georgia Ntali

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Long Term Results ◽

Octreotide Treatment ◽

Randomised Controlled

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One-Year Age Increment and Sex Differences in the Relationship between Long-Term Exposure to PM 2.5 and Fasting Plasma Glucose Levels in Chinese Children and Adolescents Aged 6-17 Years: Exploring an Independent Risk Factor and Precise Intervention Time Clues

SSRN Electronic Journal ◽

10.2139/ssrn.3416701 ◽

2019 ◽

Author(s):

Mao Wang ◽

Lijuan Gong ◽

Aili Jiang ◽

Yinglin Wu ◽

Ruijie Wang ◽

...

Keyword(s):

Sex Differences ◽

Risk Factor ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Independent Risk Factor ◽

Glucose Levels ◽

One Year ◽

The Relationship ◽

Chinese Children And Adolescents

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Shades between Black and Green Investment: Balance or Imbalance?

Sustainability ◽

10.3390/su13095024 ◽

2021 ◽

Vol 13 (9) ◽

pp. 5024

Author(s):

Vítor Manuel de Sousa Gabriel ◽

María Mar Miralles-Quirós ◽

José Luis Miralles-Quirós

Keyword(s):

Risk Factor ◽

Oil Prices ◽

Oil Price ◽

Short Term ◽

Environmental Indices ◽

Long Run ◽

Green Investment ◽

Bounds Test

This paper analyses the links established between environmental indices and the oil price adopting a double perspective, long-term and short-term relationships. For that purpose, we employ the Bounds Test and bivariate conditional heteroscedasticity models. In the long run, the pattern of behaviour of environmental indices clearly differed from that of the oil prices, and it was not possible to identify cointegrating vectors. In the short-term, it was possible to conclude that, in contemporaneous terms, the variables studied tended to follow similar paths. When the lag of the oil price variable was considered, the impacts produced on the stock market sectors were partially of a negative nature, which allows us to suppose that this variable plays the role of a risk factor for environmental investment.

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Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

European Heart Journal ◽

10.1093/ehjci/ehaa946.2961 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

H Wienbergen ◽

A Fach ◽

S Meyer ◽

J Schmucker ◽

R Osteresch ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Risk Factor ◽

Prevention Program ◽

Study Endpoint ◽

Funding Source ◽

Risk Factor Control ◽

One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after >24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p<0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p<0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p<0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after >24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

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Atrial Fibrillation and Mortality in the Oldest Old after Surgery for Hip Fractures

Gerontology ◽

10.1159/000513450 ◽

2021 ◽

pp. 1-7

Author(s):

Amit Frenkel ◽

Vladimir Zeldetz ◽

Roni Gat ◽

Yair Binyamin ◽

Asaf Acker ◽

...

Keyword(s):

Atrial Fibrillation ◽

Risk Factor ◽

Hip Fractures ◽

Retrospective Cohort ◽

Primary Outcome ◽

Oldest Old ◽

Postoperative Mortality ◽

Patient Characteristics ◽

One Year

Introduction: One-year mortality following hip fractures increases steeply with age, from 2% in the 60- to 69-year-old population up to 28% in the oldest old (older than 90 years). Of the various factors that contribute to hip fractures, atrial fibrillation (AF) is an independent risk factor at any age. Objective: The objective of this study was to assess the association of AF with mortality among the oldest old with hip fractures. Method: This is a retrospective cohort study of 701 persons above age 90 years who underwent orthopedic repair for a hip fracture during 2000–2018. Of them, 218 (31%) had AF at hospital admission. The primary outcome was survival following surgery. We compared patient characteristics and 30-day, 180-day, 1-year, and 3-year survival between patients with and without AF. Results: The adjusted odds ratio for 30-day postoperative mortality for those with AF versus without AF group was 1.03 (95% confidence interval [CI] 0.63–1.66). Survival estimates were higher among those without AF than with AF at 180 days postoperative: 0.85 (95% CI 0.82–0.89) versus 0.68 (95% CI 0.61–0.74), p < 0.001; at 1 year postoperative: 0.68 (95% CI 0.63–0.72) versus 0.48 (95% CI 0.42–0.55), p < 0.001; and at 3 years postoperative: 0.47 (95% CI 0.42–0.52) versus 0.28 (95% CI 0.27–0.34), p < 0.001. Conclusions: Among individuals aged >90 years, operated for hip fractures, mortality was similar for those with and without AF at 30 days postoperative. However, the survival curves diverged sharply after 180 days. Our findings suggest that AF is not an immediate surgical risk factor, but rather confers increased long-term risk in this population.

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