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Gastric emptying, postprandial blood pressure, glycaemia and splanchnic flow in Parkinson's disease

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World Journal of Gastroenterology 2016年第20期22卷 4860-4867页

作者： laurence G Trahair Thomas E Kimber Katerina Flabouris Michael Horowitz karen l jones Discipline of Medicine The University of Adelaide NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health The University of Adelaide Neurology Unit Royal Adelaide Hospital

AIM: To determine gastric emptying, blood pressure, mesenteric artery blood flow, and blood glucose responses to oral glucose in Parkinson’s ***: Twenty-one subjects (13 M, 8 F; age 64.2 ± 1.6 years) with mild to moderate Parkinson’s disease (Hoehn and Yahr score 1.4 ± 0.1, duration of known disease 6.3 ± 0.9 years) consumed a 75 g glucose drink, labelled with 20 MBq 99mTc-calcium phytate. Gastric emptying was quantified with scintigraphy, blood pressure and heart rate with an automated device, superior mesenteric artery blood flow by Doppler ultrasonography and blood glucose by glucometer for 180 min. Autonomic nerve function was evaluated with cardiovascular reflex tests and upper gastrointestinal symptoms by ***: The mean gastric half-emptying time was 106 ± 9.1 min, gastric emptying was abnormally delayed in 3 subjects (14%). Systolic and diastolic blood pressure fell (P lood flow and blood glucose (P llowing the drink. Three subjects (14%) had definite autonomic neuropathy and 8 (38%) had postprandial hypotension. There were no significant relationships between changes in blood pressure, heart rate or mesenteric artery blood flow with gastric emptying. Gastric emptying was related to the score for autonomic nerve function (R = 0.55, P lationship between the blood glucose at t = 30 min (R = -0.52, P le the blood glucose at t = 180 min was related directly (R = 0.49, P ld to moderate Parkinson’s disease, gastric emptying is related to autonomic dysfunction and a determinant of the glycaemic response to oral glucose.

关键词： Gastric emptying Hypotension Parkinson’ s disease Blood pressure Glucose

Inter-relationships between gastric emptying and glycaemia:Implications for clinical practice

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World Journal of Diabetes 2023年第5期14卷 447-459页

作者： Tejaswini Arunachala Murthy Marianne Chapman karen l jones Michael Horowitz Chinmay S Marathe Adelaide Medical School University of AdelaideAdelaide 5000SAAustralia Intensive Care Unit Royal Adelaide HospitalAdelaide 5000SAAustralia NHMRC Centre of Clinical Research Excellence in Nutritional Physiology Interventions and OutcomesUniversity of AdelaideAdelaide 5000SAAustralia Endocrine and Metabolic Unit Royal Adelaide HospitalAdelaide 5000SAAustralia

Gastric emptying(GE)exhibits a wide inter-individual variation and is a major determinant of postprandial glycaemia in health and diabetes;the rise in blood glucose following oral carbohydrate is greater when GE is relatively more rapid and more sustained when glucose tolerance is ***,GE is influenced by the acute glycaemic environment acute hyperglycaemia slows,while acute hypoglycaemia accelerates *** GE(gastroparesis)occurs frequently in diabetes and critical *** diabetes,this poses challenges for management,particularly in hospitalised individuals and/or those using *** critical illness it compromises the delivery of nutrition and increases the risk of regurgitation and aspiration with consequent lung dysfunction and ventilator *** advances in knowledge relating to GE,which is now recognised as a major determinant of the magnitude of the rise in blood glucose after a meal in both health and diabetes and,the impact of acute glycaemic environment on the rate of GE have been made and the use of gut-based therapies such as glucagon-like peptide-1 receptor agonists,which may profoundly impact GE,in the management of type 2 diabetes,has become *** necessitates an increased understanding of the complex inter-relationships of GE with glycaemia,its implications in hospitalised patients and the relevance of dysglycaemia and its management,particularly in critical *** approaches to management of gastroparesis to achieve more personalised diabetes care,relevant to clinical practice,is *** studies focusing on the interactions of medications affecting GE and the glycaemic environment in hospitalised patients,are required.

关键词： Glycaemia Gastric emptying Clinical practice Glucagon-like peptide-1

Development of innovative tools for investigation of nutrient-gut interaction

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World Journal of Gastroenterology 2020年第25期26卷 3562-3576页

作者： Wei-Kun Huang Cong Xie Richard l Young Jiang-Bo Zhao Heike Ebendorff-Heidepriem karen l jones Christopher K Rayner Tong-Zhi Wu Adelaide Medical School Centre of Research Excellence in Translating Nutritional Science to Good Healththe University of AdelaideAdelaideSA 5005Australia Institute for Photonics and Advanced Sensing School of Physical SciencesUniversity of AdelaideAdelaideSA 5005Australia The ARC Centre of Excellence for Nanoscale BioPhotonics AdelaideSA 5005Australia Diabetes Nutrition and Gut HealthLifelong HealthSouth Australia Health and Medical Research InstituteAdelaideSA 5005Australia Department of Gastroenterology and Hepatology Royal Adelaide HospitalAdelaideSA 5000Australia Department of Endocrinology Zhongda HospitalInstitute of DiabetesSchool of MedicineSoutheast UniversityNanjing 210009Jiangsu ProvinceChina

The gastrointestinal tract is the key interface between the ingesta and the human *** is wide recognition that the gastrointestinal response to nutrients or bioactive compounds,particularly the secretion of numerous hormones,is critical to the regulation of appetite,body weight and blood *** concept has led to an increasing focus on“gut-based”strategies for the management of metabolic disorders,including type 2 diabetes and *** the underlying mechanisms and downstream effects of nutrient-gut interactions is fundamental to effective translation of this knowledge to clinical *** this end,an array of research tools and platforms have been developed to better understand the mechanisms of gut hormone secretion from enteroendocrine *** review discusses the evolution of in vitro and in vivo models and the integration of innovative techniques that will ultimately enable the development of novel therapies for metabolic diseases.

关键词： Nutrient-gut interaction Metabolic disorders Incretin hormones Enteroendocrine cells Enteroids Intestinal intubation Intestine-on-a-chip

Upper gastrointestinal function and glycemic control in diabetes mellitus

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World Journal of Gastroenterology 2006年第35期12卷 5611-5621页

作者： Reawika Chaikomin Christopher K Rayner karen l jones Michael Horowitz University of Adelaide Department of Medi-cine Royal Adelaide Hospital North Terrace Adelaide South Australia 5000 Australia

Recent evidence has highlighted the impact of glycemic control on the incidence and progression of diabetic micro- and macrovascular complications, and on cardiovascular risk in the non-diabetic population. Postprandial blood glucose concentrations make a major contribution to overall glycemic control, and are determined in part by upper gastrointestinal function. Conversely, poor glycemic control has an acute, reversible effect on gastrointestinal motility. Insights into the mechanisms by which the gut contributes to glycemia have given rise to a number of novel dietary and pharmacological strategies designed to lower postprandial blood glucose concentrations.

关键词： Blood glucose Diabetes mellitus Gastric Emptying Gastrointestinal motility Hyperglycemia

Management of critically ill patients with type 2 diabetes:The need for personalised therapy

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World Journal of Diabetes 2015年第5期6卷 693-706页

作者： Palash Kar karen l jones Michael Horowitz Adam M Deane Discipline of Acute Care Medicine Level 5Eleanor Harrald BuildingUniversity of Adelaide Intensive Care Unit Level 4Emergency Services BuildingRoyal Adelaide Hospital Centre for Research Excellence University of Adelaide Discipline of Medicine Level 6Eleanor Harrald BuildingUniversity of Adelaide

Critical illness in patients with pre-existing diabetes frequently causes deterioration in glycaemic *** the prevalence of diabetes in patients admitted to hospital and intensive care units,the ideal management of hyperglycaemia in these groups is *** are data that suggest that acute hyperglycaemia in critically ill patients without diabetes is associated with increased mortality and *** insulin to keep blood glucose concentrations l/l is accepted as standard of care in this ***,preliminary data have recently been reported that suggest that chronic hyperglycaemia may result in conditioning,which protects these patients against damage mediated by acute ***,acute glucose-lowering to l/l in patients with diabetes with inadequate glycaemic control prior to their critical illness appears to have the capacity to cause *** review focuses on glycaemic control in critically ill patients with type 2 diabetes,the potential for harm from glucose-lowering and the rationale for personalised therapy.

关键词： Diabetes Critically ill Intensive care Management Personalised therapy

Nutrient stimulation of mesenteric blood flow-implications for older critically ill patients

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World Journal of Critical Care Medicine 2017年第1期6卷 28-36页

作者： Thu AN Nguyen Yasmine Ali Abdelhamid liza K Phillips leeanne S Chapple Michael Horowitz karen l jones Adam M Deane Discipline of Acute Care Medicine University of Adelaide National Health and Medical Research Council Centre for Research Excellence in Translating Nutritional Science to Good Health Endocrine and Metabolic Unit Royal Adelaide Hospital Discipline of Medicine University of Adelaide Intensive Care Unit Royal Melbourne Hospital University of Melbourne

Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons(aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death. In older critically ill patients, the administration of enteral nutrition acutely increases mesenteric blood flow, but whether this pathophysiological response is protective, or precipitates mesenteric ischaemia, is unknown. There are an increasing number of older patients surviving admission to intensive care units, who are likely to be at increased risk of postprandial hypotension, both during, and after, their stay in hospital. In this review, we describe the prevalence, impact and mechanisms of postprandial hypotension in older people and provide an overview of the impact of postprandial hypotension on feeding prescriptions in older critically ill patients. Finally, we provide evidence that postprandial hypotension is likely to be an unrecognised problem in older survivors of critical illness and discuss potential options for management.

关键词： Postprandial hypotension Enteral nutrition Critical care Aged Mesenteric ischaemia

Weight regain after intragastric balloon for pre-surgical weight loss

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2040-2046页

作者： Danielle Abbitt Kevin Choy Alexandra Kovar Teresa S jones Krzysztof J Wikiel Edward l jones Department of Surgery University of ColoradoAuroraCO 80045United States Department of Surgery Rocky Mountain Regional Veteran Affairs Medical CenterAuroraCO 80045United States

BACKGROUND Over one-third of Americans carry the diagnosis of obesity,many also with obesity-related *** can place patients at increased risk of operative and postoperative *** intragastric balloon has been shown to aid in minor weight loss,however its weight recidivism in patients requiring short interval weight loss has not been well *** To evaluate weight loss,ability to undergo successful elective surgery after intragastric balloon placement,and weight management after balloon *** This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective *** outcomes including weight loss,duration of balloon placement,successful elective surgery,weight regain postballoon and post-procedure complications were *** criteria included those with balloon in place at time of *** Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective *** patients were required to participate in a 12-month weight management program to be eligible for balloon *** surgeries included incisional hernia repair,umbilical hernia repair,inguinal hernia repair,and knee and hip *** average age at placement was 53 years±11 years,majority(91%)were *** average duration of intragastric balloon therapy was 186 days±41 *** average weight loss was 14.0 kg±7.4 kg and with an average percent excess body weight loss of 30.0%(7.9%-73.6%).Over half of the patients(52.0%)achieved the goal of 30-50 lbs(14-22 kg)weight ***-one patients(64%)underwent their intended elective surgery,2 patients(6%)deferred surgery due to symptom relief with weight loss ***-one of the patients(64%)have documented weights in 3 months after balloon removal,in these patients the majority(76%)gained weight after balloon *** pat

关键词： Intragastric balloon Weight loss Obesity Bariatric Body mass index

Are there sex-based disparities in cataract surgery?

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International Journal of Ophthalmology(English edition) 2024年第1期17卷 137-143页

作者： Matthew D.Geiger Anne M.lynch Alan G.Palestine Nathan C.Grove karen l.Christopher Richard S.Davidson Michael J.Taravella Naresh Mandava Jennifer l.Patnaik Department of Ophthalmology University of Colorado School of MedicineAuroraCO 80045USA

AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract ***:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of *** collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the ***:A total of 11977 eyes from 7253 patients were included in the *** comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for *** had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer *** were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/***:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for ***,observed surgical complicatio

关键词： cataract surgery sex-based disparity phacoemulsification outcomes

Dual ecological and socio-cultural fragmentation induced by hydropower dams: Case studies from the Greater Himalayan region of India

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Zoological Research(Diversity and Conservation) 2024年第2期1卷 117-120页

作者： Garima Gupta Rahul Kotiyal Isabel l.jones Biological and Environmental Sciences University of StirlingScotland FK94LAUK Baramasa.in Narrating Himalaya 248001India

Climate change and biodiversity loss are pressing global challenges(Pörtner et al.,2021).However,as global energy demand continues to increase(IEA,2021),nations face significant challenges to decarbonization and reaching“net zero”due to trade-offs between the often-competing needs of renewable energy generation and biodiversity *** example,hydropower generates renewable energy(Gibson et al.,2017),yet there are well-documented and severe consequences of dam development for biodiversity(e.g.,Zarfl et al.,2019)and people(e.g.,Bisht,2009)due to reservoir creation and disruption of river *** such potentially damaging ecological and social trade-offs,hydropower currently contributes 70%of global renewable energy and there are at least 3700 large dams planned or under construction globally(Zhang&Gu,2023).

关键词： reservoir consequences globally