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BACKGROUND: Aspirin inhibits colorectal carcinogenesis. In a randomised double-blind placebo-controlled trial, daily soluble aspirin significantly reduced recurrence of colorectal adenomas at 1-year follow-up. In this study the results of daily intake of low-dose aspirin on polyp recurrence at 4-year follow-up are presented. METHODS: 272 patients (naive for chronic aspirin use) with colorectal adenomas were randomly assigned to treatment with lysine acetylsalicylate 160 mg/day (n=73) or 300 mg/day (n=67) or placebo (n=132) for 4 years. The primary endpoints were adenoma recurrence and adenomatous polyp burden at year 4, comparing aspirin at either dose with placebo. The same endpoints were also assessed at year 1 or 4 (last colonoscopy performed for each patient). RESULTS: At the final year 4 colonoscopy the analysis included 185 patients (55 receiving aspirin 160 mg/day, 47 aspirin 300 mg/day and 83 placebo). There was no difference in the proportion of patients with at least one recurrent adenoma between patients receiving aspirin at either dose and those treated with placebo (42/102 (41%) vs 33/83 (40%); NS) or in the adenomatous polyp burden (3.1±5.8 mm vs 3.4±6.2 mm; NS). Also, the proportion of patients with at least one advanced recurrent adenoma did not differ (10/182 (10%) in the aspirin group vs 7/83 (7%) in the placebo group; NS). CONCLUSION: Daily low-dose aspirin decreased adenoma recurrence significantly at 1 year but not at year 4. This discrepancy might be explained by a differential effect of aspirin according to the natural history of the polyp. TRIAL REGISTRATION NUMBER: NCT 00224679. [ABSTRACT FROM AUTHOR]

In a view to better understand the determinants of postprandial nitrogen (N) metabolism, we assessed the postprandial retention and oxidation of dietary N after ingestion of intact or hydrolyzed casein in humans. For this purpose, 10 healthy adult volunteers equipped with a naso-intestinal tube ingested 15N-labeled casein (30g) either intact (CA) or hydrolyzed (CH) in a mixed meal (700 kcal). Digesta, plasma and urine were sampled for 8 h after meal ingestion. Dietary N recovered at the terminal ileum was higher during the first 3h in CH than in CA. The real ileal digestibility was 93.94±1.5% (SD) for CA and 90.84±4.0% for CH. The appearance of 15N-amino acids (AA) in the plasma of CH peaked at 3h, whereas for CA a plateau was reached only 5h postprandially. The incorporation of dietary N at 8h into serum protein was similar for CA and CH (8.94±2.6%). The deamination of casein-derived AA, determined in the body and urinary urea pools, was faster but lower for CH than for CA. Endogenous urea production was 90% higher in CH than in CA. Finally, the net postprandial protein utilization ((N absorbed-N deaminated)/N ingested) was similar for CA and CH (73.94±7.4%). In contrast to previous observations, the faster systemic appearance of dietary amino acids did not lead to a decrease in dietary N retention, however CA and CH were associated with different urea production rates and presumably urea recycling fluxes in the postprandial phase. [ABSTRACT FROM AUTHOR]