Gastroesophageal reflux disease and obesity.

Gastroesophageal reflux disease (GERD) is a common condition, with multifactorial pathogenesis, affecting up to 40% of the population. Obesity is also common. Obesity and GERD are clearly related, both from a prevalence and causality association.

Gastroesophageal reflux disease and obesity.

Although the balance of epidemiologic data supports a relationship between obesity and gastroesophageal reflux disease (GERD), it is difficult to establish true cause and effect. However, results of several studies show that the frequency and severity of GERD symptoms and complications may be higher in obese patients, including an increase in the presence of hiatal hernia. Additionally, findings of a recent meta-analysis demonstrate a statistically significant increase in the risk for GERD symptoms, erosive esophagitis, and esophageal adenocarcinoma in obese patients.

Transforming growth factor-beta suppresses nonmetastatic colon cancer through Smad4 and adaptor protein ELF at an early stage of tumorigenesis.

Although transforming growth factor-beta (TGF-beta) is both a suppressor and promoter of tumorigenesis, its contribution to early tumor suppression and staging remains largely unknown. In search of the mechanism of early tumor suppression, we identified the adaptor protein ELF, a beta-spectrin from stem/progenitor cells committed to foregut lineage. ELF activates and modulates Smad4 activation of TGF-beta to confer cell polarity, to maintain cell architecture, and to inhibit epithelial-to-mesenchymal transition.

Factors associated with failure of metronidazole in Clostridium difficile-associated disease.

Goal: To identify patients likely to fail metronidazole as initial treatment of C. difficile infection.

Background: For moderate to severe Clostridium difficile-associated diarrhea, metronidazole is the drug of choice for treatment.