WTS database

Title	Pub Year	Author	SearchLink Sort descending
Determination of polycyclic aromatic hydrocarbons in waters by ultrasound-assisted emulsification-microextraction and gas chromatography-mass spectrometry	2010	Selcuk University, Department of Environmental Engineering, Campus, 42031 Konya, Turkey. sozcan@selcuk.edu.tr	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Analytica Chimica Acta Periodical, Abbrev. Anal.Chim.Acta Pub Date Free Form 30-Apr Volume 665 Issue 2 Start Page 193 Other Pages 199 Notes CI: Copyright 2010; JID: 0370534; 2009/11/24 [received]; 2010/03/23 [revised]; 2010/03/23 [accepted]; 2010/03/29 [aheadofprint]; ppublish Place of Publication Netherlands ISSN/ISBN 1873-4324; 0003-2670 Accession Number PMID: 20417330 Language eng SubFile Journal Article DOI 10.1016/j.aca.2010.03.047 [doi] Output Language Unknown(0) PMID 20417330 Abstract An ultrasound-assisted emulsification-microextraction (USAEME) procedure was developed for the extraction of US EPA 16 polycyclic aromatic hydrocarbons (PAHs) in 10 mL of water samples, with subsequent determination by gas chromatography-mass spectrometry (GC-MS). After determination of the most suitable solvent and solvent volume, several other parameters (i.e., extraction time, centrifugation time and ionic strength of the sample) were optimized using a 2(3) factorial experimental design. Limits of detection ranged from 0.001 to 0.036 microg L(-1). The developed procedure was applied to fortified distilled water with different fortification levels (0.5, 2 and 5 microg L(-1)). Recoveries were over 92% and relative standard deviations of the recoveries were below 8%. The efficiency of the USAEME was compared with traditional liquid-liquid extraction (LLE) and solid-phase extraction on real water samples (i.e., tap water, well water and surface (lake) water as well as domestic and industrial wastewaters). The USAEME showed comparable efficiencies especially with LLE. The developed USAEME was demonstrated to be robust, viable, simple, rapid and easy to use for the determination of PAHs in water samples by GC-MS. Descriptors Links Book Title Database Publisher Elsevier B.V Data Source Authors Ozcan,S., Tor,A., Aydin,M. E. Original/Translated Title URL Date of Electronic 20100329 PMCID Editors
Patent foramen ovale and decompression illness in divers	2010	Seksjon for pediatri, Institutt for klinisk medisin, Universitetet i Bergen, Norway.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke Periodical, Abbrev. Tidsskr.Nor.Laegeforen. Pub Date Free Form 22-Apr Volume 130 Issue 8 Start Page 834 Other Pages 838 Notes JID: 0413423; RF: 41; ppublish Place of Publication Norway ISSN/ISBN 0807-7096; 0029-2001 Accession Number PMID: 20418929 Language nor SubFile English Abstract; Journal Article; Review; IM DOI 10.4045/tidsskr.09.0377 [doi] Output Language Unknown(0) PMID 20418929 Abstract BACKGROUND: About 25 % of the population has patent foramen ovale, and the condition has been assumed to be a causal factor in decompressive illness. Transcatheter closure is possible and is associated with a relatively low risk, but it has not been clarified whether there is an indication for assessment and treatment of the condition in divers. The present study explored a possible relationship between a patent foramen ovale and the risk for decompression illness in divers, if there are categories of divers that should be screened for the condition and what advice should be given to divers with this condition. MATERIAL AND METHODS: The review is based on literature identified through a search in Pubmed and the authors' long clinical experience in the field. RESULTS: The risk of decompression illness for divers with a persistent foramen ovale is about five times higher than that in divers without this condition, but the absolute risk for decompression illness is only 2.5 after 10,000 dives. A causal association has not been shown between patent foramen ovale and decompression illness. Even if closure of patent foramen ovale may be done with relatively small risk, the usefulness of the procedure has not been documented in divers. INTERPRETATION: We do not recommend screening for patent foramen ovale in divers because the absolute risk of decompression illness is small and transcatheter closure is only indicated after decompression illness in some occupational divers. Descriptors Decompression Sickness/etiology, Diving/injuries, Echocardiography, Transesophageal, Foramen Ovale, Patent/complications/diagnosis/therapy, Humans, Occupational Health, Risk Factors Links Book Title Database Publisher Data Source Authors Sivertsen,W., Risberg,J., Norgard,G. Original/Translated Title Apent foramen ovale og trykkfallssyke hos dykkere URL Date of Electronic PMCID Editors
Water pipe (shisha) smoking among male students of medical colleges in the eastern region of Saudi Arabia	2010	Family and Community Medicine Department, College of Medicine, King Faisal University, Dammam, Saudi Arabia. aztaha@hotmail.com	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Annals of Saudi medicine Periodical, Abbrev. Ann.Saudi Med. Pub Date Free Form May-Jun Volume 30 Issue 3 Start Page 222 Other Pages 226 Notes LR: 20151119; JID: 8507355; CIN: Ann Saudi Med. 2011 Jan-Feb;31(1):94-5. PMID: 21245608; CIN: Ann Saudi Med. 2010 Jul-Aug;30(4):330; author reply 330. PMID: 20622355; CIN: Ann Saudi Med. 2010 Nov-Dec;30(6):493-4; author reply 494. PMID: 21060162; OID: NLM Place of Publication Saudi Arabia ISSN/ISBN 0975-4466; 0256-4947 Accession Number PMID: 20427939 Language eng SubFile Journal Article; IM DOI 10.4103/0256-4947.62838 [doi] Output Language Unknown(0) PMID 20427939 Abstract BACKGROUND AND OBJECTIVES: Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking. METHODS: This cross-sectional study included 500 male students of three colleges (medicine, applied medical sciences and dentistry). Data were collected from 371 students using a self-administered questionnaire. RESULTS: The overall prevalence of shisha smoking was 12.6% (8.6% shisha only and 4.0% both shisha and cigarettes). Thirty students (63.8%) started shisha smoking at ages of 16 to 18 years. Seven students (15%) smoked shisha daily. Cafiotas or restaurants were the favorite places for smoking (70.2% of students). There was a high prevalence of shisha smoking among students whose mothers had a secondary (19.1%) and higher (53.3%) education. CONCLUSIONS: There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended. Descriptors Confidence Intervals, Cross-Sectional Studies, Geography, Health Behavior, Health Knowledge, Attitudes, Practice, Humans, Male, Prevalence, Risk Factors, Risk-Taking, Saudi Arabia/epidemiology, Schools, Medical, Smoking/epidemiology, Students, Dental, Students, Medical, Surveys and Questionnaires Links Book Title Database Publisher Data Source Authors Taha,A. Z., Sabra,A. A., Al-Mustafa,Z. Z., Al-Awami,H. R., Al-Khalaf,M. A., Al-Momen,M. M. Original/Translated Title URL Date of Electronic PMCID PMC2886873 Editors
Analysis of the gastrointestinal symptoms of uninvestigated dyspepsia and irritable bowel syndrome	2009	Department of Endoscopic Center, Hyogo College of Medicine, Nishinomiya, Japan.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Gut and liver Periodical, Abbrev. Gut Liver Pub Date Free Form Sep Volume 3 Issue 3 Start Page 192 Other Pages 196 Notes LR: 20131113; JID: 101316452; OID: NLM: PMC2852717; OTO: NOTNLM; 2009/05/28 [received]; 2009/07/05 [accepted]; 2009/09/30 [epublish]; ppublish Place of Publication Korea (South) ISSN/ISBN 2005-1212; 1976-2283 Accession Number PMID: 20431745 Language eng SubFile Journal Article DOI 10.5009/gnl.2009.3.3.192 [doi] Output Language Unknown(0) PMID 20431745 Abstract BACKGROUND/AIMS: Epidemiological studies suggest that there is a considerable overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS). The aim of this study was to examine concurrent gastrointestinal symptoms in FD and IBS. METHODS: A total of 186 college students filled out a questionnaire regarding whether they had uninvestigated dyspepsia (UD, FD without endoscopic examination) and IBS based on Rome-II criteria. Gastrointestinal symptoms were measured using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. RESULTS: A total of 181 students (98 males, mean age 24.6 years) completed both questionnaires. The prevalence of UD, IBS, and UD+IBS overlap was 12 (6.7%), 40 (22.1%), and 8 (4.4%), respectively. A significant UD+IBS overlap was observed (66.7% IBS in UD, 20.0% UD in IBS). Reflux scores of GSRS in either UD or IBS were significantly greater than in those without. Gastroesophageal reflux disease (GERD), defined as weekly occurring moderate symptoms of heartburn and/or acid regurgitation and evaluated using the GSRS, was found in 16 (8.8%) of the subjects. The prevalence of IBS was significantly higher in GERD patients than in non-GERD patients (50.0% vs 19.4%). CONCLUSIONS: The considerable overlap not only between UD and IBS, but also between GERD and IBS, suggests the involvement of common pathophysiological disturbances in the two conditions. Descriptors Dyspepsia, Gastroesophageal reflux, Gastrointestinal symptom rating scale, Irritable bowel syndrome, Overlap Links Book Title Database Publisher Data Source Authors Hori,K., Matsumoto,T., Miwa,H. Original/Translated Title URL Date of Electronic 20090930 PMCID PMC2852717 Editors
Extreme and acquiescence bias in a bi-ethnic population	2010	School of Public Health, Faculty of Social Welfare and Health Studies, University of Haifa, Israel. ornaepel@research.haifa.ac.il	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full European journal of public health Periodical, Abbrev. Eur.J.Public Health Pub Date Free Form Oct Volume 20 Issue 5 Start Page 543 Other Pages 548 Notes LR: 20151119; JID: 9204966; 2010/05/03 [aheadofprint]; ppublish Place of Publication England ISSN/ISBN 1464-360X; 1101-1262 Accession Number PMID: 20439322 Language eng SubFile Comparative Study; Journal Article; IM DOI 10.1093/eurpub/ckq052 [doi] Output Language Unknown(0) PMID 20439322 Abstract BACKGROUND: Extreme and acquiescence biases are the tendency to give a positive or extreme answer regardless of the 'true' answer. These biases may compromise comparisons of attitudes regarding health between population groups. The aim of the study was to measure the extent of extreme and acquiescence biases and identify factors associated with them in two ethnic groups: Jews and Arabs in Israel. METHODS: A random telephone survey was conducted during 2006, interviewing 2322 Jews and 809 Arabs. Three attitude questions were presented twice with opposite wording to measure extreme and acquiescence biases in these two groups. RESULTS: Extreme bias ranged from 2 to 14% among Jews and from 6 to 29% among Arabs, depending on the question. Acquiescence bias ranged from 2 to 10% among Jews and 5-19% among Arabs. The less educated respondents gave more extreme biased responses for all items. The older respondents gave more extreme answers for two out of the three questions tested. After adjusting for age and education the odds ratio (OR) of giving more extreme biased answers was higher among Arabs compared with Jews for all three questions [OR = 2.49, confidence interval (CI) = 1.87, 3.31; OR = 2.33, CI = 1.75, 3.10; and OR = 2.94, CI = 1.83-4.71, respectively, for each question]. CONCLUSIONS: Levels of response biases are higher in the Arab minority population compared with the majority Jewish population and depended on the subject, age and education. Descriptors Adult, Arabs/psychology/statistics & numerical data, Bias (Epidemiology), Confidence Intervals, Cross-Sectional Studies, Disclosure, Female, Health Knowledge, Attitudes, Practice, Humans, Interviews as Topic, Israel, Jews/psychology/statistics & numerical data, Male, Middle Aged, Odds Ratio, Oral Hygiene/psychology, Population Surveillance, Prejudice, Smoking/ethnology, Socioeconomic Factors, Surveys and Questionnaires Links Book Title Database Publisher Data Source Authors Baron-Epel,O., Kaplan,G., Weinstein,R., Green,M. S. Original/Translated Title URL Date of Electronic 20100503 PMCID Editors
Sensitive determination of 2,4,6-trichloroanisole in water samples by ultrasound assisted emulsification microextraction prior to gas chromatography-tandem mass spectrometry analysis	2010	Grupo de Investigacion y Desarrollo en Quimica Analitica (QUIANID) (LISAMEN, CCT CONICET - Mendoza), Av. Ruiz Leal S/N, Parque General San Martin, Mendoza, Argentina.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Talanta Periodical, Abbrev. Talanta Pub Date Free Form 15-Jun Volume 81 Issue 5-Apr Start Page 1536 Other Pages 1541 Notes LR: 20131121; JID: 2984816R; 0 (2,4,6-trichloroanisole); 0 (Anisoles); 0 (Emulsifying Agents); 0 (Phosphates); 0 (Water Pollutants, Chemical); 7V31YC746X (Chloroform); 2009/10/27 [received]; 2010/02/24 [revised]; 2010/02/25 [accepted]; 2010/03/06 [aheadof Place of Publication England ISSN/ISBN 1873-3573; 0039-9140 Accession Number PMID: 20441935 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM DOI 10.1016/j.talanta.2010.02.065 [doi] Output Language Unknown(0) PMID 20441935 Abstract A novel application of an ultrasound assisted emulsification microextraction (USAEME) technique is proposed for the extraction and preconcentration of 2,4,6-trichloroanisole (2,4,6-TCA) from water samples prior to its determination by gas chromatography-tandem mass spectrometry (GC-MS/MS). USAEME employs a non-polar high-density solvent (extractant solvent), which forms an oil-in-water emulsion (O/W) in the aqueous sample bulk assisted by ultrasonic radiation. Several factors including, solvent type and volume, extraction time, extraction temperature, shaking mode and matrix modifiers were studied and optimized over the relative recovery of the target analyte. An aliquot of 5mL water sample was conditioned by adding 150microL 6.15molL(-1) sodium chloride and 300microL 0.05molL(-1) phosphate buffer (pH 6), and finally extracted with 40microL chloroform by using USAEME technique. Under the optimal experimental conditions 2,4,6-TCA was quantitatively extracted achieving an enrichment factor (EF) of 555. The detection limit (LOD), calculated as three times the signal-to-noise ratio (S/N), was 0.2ngL(-1) and the RSD was 6.3% (n=5) when 1ngL(-1) 2,4,6-TCA standard mixture was analyzed. The coefficients of estimation of the calibration curves obtained following the proposed methodology was >or=0.997 and the linear working range was 1-5000ngL(-1). Finally, the proposed technique was successfully applied for extraction and determination of the 2,4,6-TCA in water samples. Recovery studies lead values >or=94%, which showed a successfully robustness of the analytical methodology for determination of nanogram per liter of 2,4,6-TCA in water samples. Descriptors Analytic Sample Preparation Methods/methods, Anisoles/analysis, Calibration, Chloroform/chemistry, Chromatography, Gas/methods, Emulsifying Agents/chemistry, Mass Spectrometry/methods, Phosphates/chemistry, Reproducibility of Results, Sensitivity and Specificity, Tandem Mass Spectrometry/methods, Temperature, Ultrasonics, Water Pollutants, Chemical/analysis, Water Purification Links Book Title Database Publisher Data Source Authors Fontana,A. R., Altamirano,J. C. Original/Translated Title URL Date of Electronic 20100306 PMCID Editors
Water-pipe smoking among North American youths	2010	University of Montreal, Department of Social and Preventive Medicine, 3875 St Urbain, Montreal, Quebec H2W 1V1, Canada.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Pediatrics Periodical, Abbrev. Pediatrics Pub Date Free Form Jun Volume 125 Issue 6 Start Page 1184 Other Pages 1189 Notes LR: 20131121; JID: 0376422; 059QF0KO0R (Water); 2010/05/10 [aheadofprint]; ppublish Place of Publication United States ISSN/ISBN 1098-4275; 0031-4005 Accession Number PMID: 20457679 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; AIM; IM DOI 10.1542/peds.2009-2335 [doi] Output Language Unknown(0) PMID 20457679 Abstract OBJECTIVES: The objectives of this analysis were to identify the sociodemographic characteristics of water-pipe users in a North American context and to describe concurrent psychoactive substance use. METHODS: Data on sociodemographic characteristics, water-pipe smoking, and use of other psychoactive substances were collected in 2007 through mailed self-report questionnaires completed by 871 young adults, 18 to 24 years of age, who were participating in the Nicotine Dependence in Teens Study, a longitudinal investigation of the natural history of nicotine dependence among adolescents in Montreal, Canada. Independent sociodemographic correlates of water-pipe use were identified in multivariate logistic regression analyses. RESULTS: Previous-year water-pipe use was reported by 23% of participants. Younger age, male gender, speaking English, not living with parents, and higher household income independently increased the odds of water-pipe use. Water-pipe use was markedly higher among participants who had smoked cigarettes, had used other tobacco products, had drunk alcohol, had engaged in binge drinking, had smoked marijuana, or had used other illicit drugs in the previous year. CONCLUSIONS: Water-pipe users may represent an advantaged group of young people with the leisure time, resources, and opportunity to use water-pipes. Evidence-based public health and policy interventions are required to equip the public to make informed decisions about water-pipe use. Descriptors Adolescent, Adolescent Behavior, Alcohol Drinking/epidemiology, Female, Health Behavior, Humans, Leisure Activities, Male, Public Health, Quebec/epidemiology, Smoking/epidemiology/trends, Substance-Related Disorders/epidemiology, Tobacco Use Disorder/epidemiology, Water Links Book Title Database Publisher Data Source Authors Dugas,E., Tremblay,M., Low,N. C., Cournoyer,D., O'Loughlin,J. Original/Translated Title URL Date of Electronic 20100510 PMCID Editors
Carboxyhaemoglobin levels in water-pipe and cigarette smokers	2010	Lung Unit, Department of Internal Medicine, Steve Biko Academic Hospital, School of Medicine, University of Pretoria. theronansa@gmail.com	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde Periodical, Abbrev. S.Afr.Med.J. Pub Date Free Form 29-Jan Volume 100 Issue 2 Start Page 122 Other Pages 124 Notes LR: 20140912; JID: 0404520; 059QF0KO0R (Water); 142M471B3J (Carbon Dioxide); 9061-29-4 (Carboxyhemoglobin); 2009/04/29 [received]; 2009/07/10 [accepted]; epublish Place of Publication South Africa ISSN/ISBN 0256-9574 Accession Number PMID: 20459918 Language eng SubFile Comparative Study; Controlled Clinical Trial; Journal Article; IM DOI Output Language Unknown(0) PMID 20459918 Abstract Water-pipe smoking is growing in popularity, especially among young people, because of the social nature of the smoking session and the assumption that the effects are less harmful than those of cigarette smoking. It has however been shown that a single water-pipe smoking session produces a 24-hour urinary cotinine level equivalent to smoking 10 cigarettes per day. AIM: We aimed to measure carboxyhaemoglogin (COHb) blood levels before and after water-pipe and cigarette smoking sessions. METHOD: Self-confessed smokers older than 18 years (N=30) volunteered to smoke a water-pipe or a cigarette and have their blood COHb levels measured under controlled conditions. RESULTS: Mean baseline COHb levels were 2.9% for the 15 cigarette smokers and 1.0% for the 15 water-pipe smokers. Levels increased by a mean of 481.7% in water-pipe smokers as opposed to 39.9% in cigarette smokers. CONCLUSION: The study demonstrated that water-pipe smokers had significantly higher increases in blood COHb levels than cigarette smokers during a single smoking session. Descriptors Administration, Inhalation, Adult, Carbon Dioxide/metabolism, Carboxyhemoglobin/metabolism, Cohort Studies, Equipment Design, Female, Humans, Male, Nebulizers and Vaporizers, Smoking/blood, South Africa, Tobacco/metabolism, Water, Young Adult Links Book Title Database Publisher Data Source Authors Theron,A., Schultz,C., Ker,J. A., Falzone,N. Original/Translated Title URL Date of Electronic 20100129 PMCID Editors
The association between current low-dose oral contraceptive pills and periodontal health: a matched-case-control study	2010	Faculty of Dentistry at the Shahid Sadoughi University of Medical Sciences in Yazd, Iran.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full The journal of contemporary dental practice Periodical, Abbrev. J.Contemp.Dent.Pract. Pub Date Free Form 1-May Volume 11 Issue 3 Start Page 33 Other Pages 40 Notes LR: 20151119; JID: 101090552; 0 (Contraceptives, Oral); epublish Place of Publication United States ISSN/ISBN 1526-3711; 1526-3711 Accession Number PMID: 20461322 Language eng SubFile Comparative Study; Journal Article; D; IM DOI 1526-3711-686 [pii] Output Language Unknown(0) PMID 20461322 Abstract AIM: This study assessed the influence of current oral contraceptive pills on periodontal health in young females. METHODS AND MATERIALS: Seventy women ranging in age from 17 to 35 years (mean 24 years) had a comprehensive periodontal examination. Their current and previous oral contraceptive pill use was assessed by a questionnaire. A periodontal assessment was performed that included recording the following: plaque index, gingival index, probing depth, and attachment level at six sites per tooth. The periodontal health of women taking birth control pills for at least two years was compared to that of women not taking an oral contraceptive. The control and test groups were matched for socioeconomic status, age, oral habits, occupation, and educational levels. RESULTS: Although there was no difference in plaque index levels between the two groups, current oral contraceptive pill users had higher levels of gingival inflammation and bleeding on probing. However, no significant differences were found regarding mean probing depths and attachment loss between the two groups. CONCLUSION: As birth control policies are advocated by most countries, and because oral contraceptives are the most widely used method for birth control, a need exists to assess the effects of oral contraceptives on the periodontal health of young women. Although additional studies are needed to better understand the mechanism of OC-induced gingivitis, female patients should be informed of the oral and periodontal side effects of OCs and the need for meticulous home care and compliance with periodontal maintenance. Descriptors Adolescent, Adult, Age Factors, Case-Control Studies, Contraceptives, Oral/therapeutic use, Dental Plaque Index, Educational Status, Female, Gingival Hemorrhage/classification, Gingivitis/classification, Humans, Occupations, Periodontal Attachment Loss/classification, Periodontal Diseases/classification/etiology, Periodontal Index, Periodontal Pocket/classification, Periodontium/drug effects, Social Class, Surveys and Questionnaires, Time Factors, Young Adult Links Book Title Database Publisher Data Source Authors Haerian-Ardakani,A., Moeintaghavi,A., Talebi-Ardakani,M. R., Sohrabi,K., Bahmani,S., Dargahi,M. Original/Translated Title URL Date of Electronic 20100501 PMCID Editors
Meta-analyses of the effect of symptoms of gastroesophageal reflux on the risk of Barrett's esophagus	2010	Michigan Institute for Clinical and Health Research, Ann Arbor, Michigan, USA.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full The American Journal of Gastroenterology Periodical, Abbrev. Am.J.Gastroenterol. Pub Date Free Form Aug Volume 105 Issue 8 Start Page 1729, 1730 Other Pages 7; quiz 1738 Notes LR: 20141203; GR: K23 DK079291/DK/NIDDK NIH HHS/United States; GR: K23 DK079291/DK/NIDDK NIH HHS/United States; GR: K23 DK079291-04/DK/NIDDK NIH HHS/United States; JID: 0421030; RF: 52; NIHMS217992; OID: NLM: NIHMS217992; OID: NLM: PMC2916949; 2010/05/18 Place of Publication United States ISSN/ISBN 1572-0241; 0002-9270 Accession Number PMID: 20485283 Language eng SubFile Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review; IM DOI 10.1038/ajg.2010.194 [doi] Output Language Unknown(0) PMID 20485283 Abstract OBJECTIVES: Esophageal adenocarcinoma (EAC) is a devastating disease that has risen in incidence over the past several decades. Barrett's esophagus (BE) is an associated premalignant lesion. Current preventative efforts rely on endoscopic screening of individuals with gastroesophageal reflux disease (GERD) symptoms and surveillance endoscopy for those with BE. However, some recent studies have found a high prevalence of BE in patients without GERD, and others have found little or no association with GERD. We hypothesized that studies of higher-quality design show weaker associations of GERD with BE, and that GERD is only weakly associated with short-segment Barrett's esophagus (SSBE). METHODS: We performed a systematic literature search in multiple online electronic databases regardless of language. Eligible studies required visualization of columnar mucosa and histological confirmation of intestinal metaplasia, and GERD symptoms ascertained by questionnaire or interview. The highest-quality sampling design was defined a priori by both cases and controls identified among unselected research volunteers ("research design") rather than by patients selected for endoscopy for clinical indications ("clinical design"), which introduces selection and ascertainment bias. A priori, heterogeneity was defined by Cochrane's Q P<0.20 and the inconsistency index (I(2); 25% low, 50% moderate, and 75% high). Heterogeneity of results can reflect significant differences in study design or effect modification by strata of outcomes. RESULTS: Systematic review identified 13,392 citations. Evaluation identified 108 potentially relevant journal articles, of which 26 met eligibility. Of these, 14 studies identified cases of BE and controls based on clinical indication ("clinical design"), and 6 used the "research design." The remaining six studies identified cases of BE from patients undergoing endoscopy for clinical indication and controls among patients without known BE ("cases clinical/controls research"). The summary odds ratio (OR) for the association of GERD with BE from all studies was 2.90 (95% confidence interval (CI), 1.86-4.54), but the results were very heterogeneous (P=0.0001; I(2)=89%). When stratified by BE length and sampling design, the studies with clinical design showed substantial, but heterogeneous, associations with SSBE (OR, 2.38; 95% CI, 1.21-4.70; P=0.02; I(2)=62%), and stronger and homogeneous association with long-segment BE (LSBE; fixed effects OR, 2.96; 95% CI, 1.69-5.19; P=0.25; I(2)=25%). In the research study design, stratifying by length of BE resolved the heterogeneity and showed a strong association between GERD and LSBE (fixed effects OR, 4.92; 95% CI, 2.01-12.0; P=0.30; I(2)=19%) and no association with SSBE (fixed effects OR, 1.15; 95% CI, 0.763-1.73; P=0.84; I(2)=0%). Funnel plots showed potential evidence for bias against dissemination of small negative studies. CONCLUSIONS: In the highest-quality studies, GERD symptoms are not associated with SSBE, but increased the odds of LSBE by fivefold. GERD symptoms can serve as a reliable predictor of LSBE, but not SSBE. If SSBE is considered worthy of identification, then current screening practices do not select patients at risk for endoscopy, and alternative methods of selection for screening need to be developed. Descriptors Barrett Esophagus/etiology/pathology/prevention & control, Esophagoscopy, Gastroesophageal Reflux/complications/pathology, Humans, Precancerous Conditions/etiology/pathology/prevention & control, Risk Links Book Title Database Publisher Data Source Authors Taylor,J. B., Rubenstein,J. H. Original/Translated Title URL Date of Electronic 20100518 PMCID PMC2916949 Editors

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