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The consumption of capsaicinoids, the active components in chili peppers, has been associated with both positive and negative health effects, and the level of capsaicinoid exposure may be an important determinant. Dietary capsaicinoid exposure was estimated using a previously developed database for capsaicinoid content and a 24-h dietary recall dataset obtained from the Korea National Health and Nutrition Examination Survey. The estimated consumption level was evaluated to determine its potential effects on weight reduction and gastrointestinal distress. The estimated daily mean capsaicinoid intake was 3.25 mg (2.17 mg capsaicin), and most Koreans consumed 1–30 mg of capsaicinoids (0.67–20 mg capsaicin) in a day. No adverse effect of capsaicin consumption was reported other than abdominal pain. For long-term repeated consumption, 30 mg may be the maximum tolerable dose. However, the effects on body weight or energy balance were inconsistent in 4–12 week clinical studies conducted with various capsaicin doses (2–135 mg), which was likely due to the complex interplay between capsaicin dose, study length, and participant characteristics. Therefore, the capsaicin consumption of most Koreans was below the levels that may cause adverse effects. However, more long-term studies for the dose range of 2–20 mg are required to further characterize capsaicin’s health benefits in Koreans.

To elucidate whether serum levels of pepsinogens are associated with the occurrence of gastrointestinal adverse events induced by amino-bisphosphonates (amino-BP), the serum levels of pepsinogen were measured in amino-BP users. Our results indicate that measurement of pepsinogen I is useful in predicting gastric distress induced by amino-BP in osteoporosis.To elucidate whether serum levels of pepsinogens are associated with the occurrence of gastrointestinal adverse events induced by amino-BP, the serum levels of pepsinogen I and II were measured in amino-BP users.When the patients complained of gastric distress symptoms during the first 6 months after amino-BP use resulting in discontinuation of the drug, endoscopical examinations were performed to assess whether gastric lesions were present. A total of 223 amino-BP users were enrolled in the study, of which 47 patients refused to take the drug due to gastric distress symptoms. The remaining 176 patients did not complain of any gastric distress.Among 47 patients, eight patients showed obvious gastric lesions such as gastric or duodenal ulcers and acute gastric mucosal lesions in the endoscopical examination. The remaining 39 patients did not show any gastric lesions. The possible confounding factors, such as a Helicobactor pylori infection or concurrent use of ulcerogenic agents, did cause not affect gastric distress in amino-BP users. The serum pepsinogen I level was significantly associated with severity of the gastric lesion 46.8 ± 27.7, 60.8 ± 32.4, and 103.4 ± 49.2 ng/ml for patients without any gastric distress, with gastric distress accompanied no gastric lesions, and with gastric distress accompanied gastric lesions, respectively.ROC analysis revealed that the cutoff value of pepsinogen I for expectation of gastric regions was 76.8 ng/ml. The results clearly indicate that measurement of pepsinogen I may be useful in predicting gastric distress induced by amino-BP in osteoporosis.

In premodern medicine eating and digestion were often linked to psychic disturbance, yet modern "mental medicine" is generally thought to have abandoned this ancient assumption. The work of Philippe Pinel, founder of French psychiatry and advocate of the "moral treatment," has been regarded as indicative of this process, but in fact eating and digestion remained important to Pinel's understanding of the néuroses, the variety of disease within which he classified both mild and severe forms of mental illness. Pinel's theoretical and clinical innovations in regard to maladies that blended mental and gastric distress left an important legacy both to asylum-based psychiatry and to medical generalists working in private settings in the nineteenth century. Today his work remains valuable for its insistence on the inextricability of the "physical and the moral" in psycho-gastric illness.

We tried to deter free-ranging, mammalian predators from opening untreated eggs by first teaching them during a training period that such behavior will cause discomfort. The discomfort was inflicted by injecting eggs with pulegone, a volatile chemical which irritates the trigeminal nerve upon inhalation and produces gastric distress upon digestion. Pulegone-injected eggs were distributed in eight study sites and were followed by an experiment where untreated eggs were placed in either untreated nests or ones sprayed with pulegone. Our objective was to deceive predators into thinking that the eggs in the latter nests contained pulegone. Some nests were clumped together to simulate the nests of a colonial nesting species, and others were dispersed and hidden to simulate the nests of solitary nesters. Among colonial nests, eggs in nests treated with pulegone survived an average of 4 days compared to 3 days for those in untreated nests. Among solitary nests, there were no differences in the survival of treated and control nests. These findings suggest that egg predation in nesting colonies can be reduced or delayed by training local predators to avoid pulegone-injected eggs and then making the nests in the colony smell of pulegone.

To evaluate the safety and efficacy of high-dose intravenous steroid therapy (HDIST) for the acute treatment of vision-threatening serpiginous choroiditis.Retrospective review of the records of five patients with serpiginous choroiditis who were treated with HDIST (1 g methylprednisolone for three days) in addition to their standard immunosuppressive treatment. The visual acuities and improvement of ocular signs after HDIST were evaluated.Twelve episodes of macula-threatening choroiditis in five patients with serpiginous choroiditis were treated during a seven-year period. All patients responded to HDIST with evidence of a decrease in intraocular inflammation immediately after and complete restoration of visual acuity within 10 days of commencing treatment. In one patient, medical intervention was required because of gastric distress. During the follow-up, three out of five patients experienced new attacks and two patients developed subretinal neovascularization.HDIST is effective in controlling severe vision-threatening serpiginous choroiditis and in improving visual function in a short period of time. However, the effect of this treatment in long-term disease control is uncertain.

Dental prophylaxis with APF gels (1.23%) may cause gastric distress as a side-effect. This gastric irritation is probably due to a direct toxic effect of fluoride (F), swallowed in conjunction with the treatment, on the gastric mucosa. The aim of the present study was to investigate whether-and to what extent-a dental treatment with 3 g of a 0.42%-F gel could affect the gastric mucosa due to inadvertent swallowing of the gel. Ten subjects underwent a control gastroscopy, and two weeks later, a second gastroscopy was performed two h after a F gel treatment. During the gastroscopy, the mucosa was examined and the injuries graded according to an arbitrary scale. Four biopsies of the antral and corpus regions of the stomach were taken and evaluated histologically. The mean (± SD) amount of F retained after the application was 5.1 ± 2.1 mg, i.e., 40% of the applied amount of F. Petechiae and erosions were found in the mucosa in seven of the ten patients. The histopathological evaluation revealed changes in nine of ten patients, with the surface epithelium as the most affected component of the mucosa. The present study clearly shows that a treatment with a F gel of rather low F concentration may result in injuries to the gastric mucosa. The importance of current recommended guidelines so that the amount of F swallowed during a gel application can be minimized is emphasized. From a toxicological standpoint, the use of a low-F gel instead of a 1.23%-F gel in small children is recommended for avoidance of adverse gastric effects.

BIOMEDICINE In a developed world suffering an obesity epidemic, new reports of molecules that regulate appetite and body weight inevitably attract broad interest, and the secreted peptide obestatin (Zhang et al. , Research Articles, p. [996][1], 11 November 2005) was no exception. Derived from the

A self-report questionnaire tapping 98 frequently reported physical stress reactions was subjected to factor analysis. The instrument was given to 1,210 subjects (593 males, 520 females, and 97 who failed to indicate their gender). The final factor solution identified 18 interpretable factors for the combined sample. Some of the more notable findings are: (a) Gastric Distress (Factor 1) is by far the most prominent factor and accounts for .491 of the total variance; (b) the factor solutions for males and females are highly similar, although Cardiorespiratory Activity (Factor 2) is defined by a greater diversity of noncardiac reactions for females than for males; and (c) six independent striated muscle tension factors can be identified for the entire sample. Results are discussed in terms of a behavioral conceptualization of psychosomatic symptoms. Clinical implications are noted.

A group of 129 hospital patients were categorized according to whether they possessed masticating efficiency, which was represented by the presence or absence of posterior teeth. It was determined by examining the records of their hospital stays that masticating efficiency, as defined, did not significantly affect the occurrence of gastric distress.

BY the word “obscure ” we do not mean to infer that the conditions to be discussed are in themselves particularly unusual, but that the causes underlying the atypical symptoms with which certain patients presented themselves, were not at first evident. Newgrowths of the kidney, renal calculi, nephroses, and ptotic conditions are of not infrequent occurrence, and are often easily recognized as being the basic factors concerned in the production of the patient's symptoms. However, the occurrence of these conditions with quite atypical symptoms is not uncommon, and in this paper we wish to discuss briefly some unusual findings in relation to the described symptomatology. Ptotic, or movable, kidney is a condition commonly found in the under-nourished, and accompanied by more or less vague subjective symptoms. Among these are pain, usually dull and aching in character, gastric distress, and more or less polyuria. Often the ptotic kidney may be palpated. With such a group of symptoms and findings, the attention...

D. McD., a locomotive fireman, aged 25, entered Mercy Hospital Dec. 4, 1899. His family history was excellent, and habits were good. He had la grippe seven years ago. During the past year he had suffered from frequent headaches. These occurred almost daily during the preceding month. The pain was severe, and lasted several hours; at times it came twice daily. During the same time he suffered from gastric distress, coming on a few minutes after eating and lasting one or two hours. Gaseous and acid eructations were frequent. For four or five months vomiting occurred soon after several meals, especially if work was undertaken then. His bowels were constipated. Hurried movements caused slight breathlessness. He had noticed at irregular intervals palpitation of the heart. For a year he had not had the endurance which he formerly possessed. His general nutrition was good, his tongue slightly coated, and breath heavy.

The following case will furnish the text for some observations which seem appropriate in the light of this experience: History. —E. L. C., 62 years old, had had attacks of "indigestion" for many years. He sought no medical advice for these attacks of stomach trouble except on one occasion in the fall of last year, when he was put on a liquid diet for about ten days; then, the symptoms subsiding, all restrictions were removed and he felt comfortable until about May 16, 1908. He was visiting in Chicago at this time, and attributed the return of his gastric distress to indulgence in Chinese res taurant meals. He described the trouble as a heartburn, accompanied by belching and some distress in the epigastrium during the height of digestion. He never vomited in any of the attacks, nor did he ever have any pain shortly after eating. There was no history

Summary A case of human intestinal myiasis due to Leptocera venalicia is reported. This species apparently has not been previously reported in connection with human myiasis. Larvae and pupae appeared in various stool specimens over a period of five months. Except for occasional episodes of gastric distress and abdominal cramps, the patient was essentially asymptomatic. The patient probably ingested eggs or larvae with contaminated meat or cheese. The heavy fly population at the patient's home was conducive to myiasis.

SINCE THE first report of a jejunal diverticulum associated with hemorrhage in 18442there have been 24 cases reported up to 1960.6Six additional cases have been found in the literature since then.1,3-7This case is reported because of its dramatic onset, rapid hospital course, and because the actual bleeding point in a jejunal diverticulum was demonstrated in an operation which has been previously reported in three cases.6The importance of recognizing this entity as one of the many obscure causes of upper gastrointestinal hemorrhage is emphasized. Report of Case A 67-year-old white woman was admitted to the Presbyterian-St. Luke's Hospital as an emergency case because she had passed bloody stools during the preceding 24 hours with no previous history of melena. She had been treated intermittently for chronic anemia, and she had a known hiatus hernia with recent episodes of gastric distress which were attributed

Persimmon phytobezoar is not a rare finding in the Southern States. An excellent paper on this subject was presented by Dr. Richard White,2 in which he reviewed the literature and presented three of his own cases. The association of a gastric ulcer in the presence of a phytobezoar is unusual, as is the association of a phytobezoar in a carcinomatous stomach. When the phytobezoar produces such changes in the stomach that it simulates roentgenologically advanced cancer of the stomach and is diagnosed as such, the case is worth adding to the literature on phytobezoars. Case Report.—This 38-year-old trusty prisoner entered the McAlester Oklahoma State Penitentiary Hospital in July, 1939, with a history of profuse hemoptysis and sharp gastric pain of ten days' duration. He gave a history of irregular gastric distress for several months prior to the onset of gastric bleeding. The rest of his history obtained on admission was negative. On admission to the hospital, the patient was extremely weak, showed evidence...

Much attention has been given to the diet of the tuberculous. Quality and daily quantity have received consideration. Digestive disturbances, as expressed by anorexia, vomiting, dyspepsia (gastric distress), intestinal indigestion and diarrhea have long been recognized as forming parts of the general picture in tuberculosis. In the absence of gross signs of digestive derangement, it is not unusual to see a patient eat well but fail to gain in weight. It is common to see a tuberculous patient refuse all food, especially when the system is under the influence of toxins; this may be in the early febrile period as well as in the terminal stage. Again, we see patients with good appetites and high temperatures — far advanced patients, with no appetites and low temperatures. Observing over 200 cases, we found that, as is well known, our patients preferred vegetables and starches; that they consumed foods of these types

Abdominal pain is not generally associated with disease of the brain; when gastric distress does occur in tumors or other cerebral conditions it is either ignored or casually explained on the basis of the associated nausea and vomiting. Occasionally, if the pain is sufficiently severe, gastro-intestinal or gallbladder disease is thought of, as is also the possibility that the cerebral condition is secondary or metastatic in nature. The very rare occurrence of abdominal pain as a symptom of tumors of the fourth ventricle is not generally referred to (Ernest Sachs some time ago reported one case) or regarded as clinically important, and when fleeting thought is given to the fact the opinion ventured is that it may have something to do with the vagus. Many years ago I saw a boy (case 1) with a frontal epidural abscess who presented a clinical picture of acute appendicitis. He was operated on

Since the advent of sulfapyridine we have treated three patients with pneumonia with this drug together with other measures and hope that what we have to offer will be of some benefit to others in the treatment of that most dreaded disease. One patient, a child of 2 years, responded satisfactorily to sulfapyridine without other drastic therapy. The two other patients, both women, became extremely nauseated and vomited after the first dose. The temperature of each was falling but something had to be done to relieve the gastric distress. As continuous operation of the oxygen tent is expensive for the patient, we put them under the tent a half hour before sulfapyridine was administered and kept them there for a half hour after medication, and there was no more nausea or vomiting. The oxygen therapy was continued until the temperature became normal, at which time the dose of sulfapyridine was

A recent query inThe Journalas to the toxicity of barium carbonate1prompts the report of a case of poisoning by barium chloride in an amount well beyond the commonly fatal dose. A woman, aged 25, a stenographer in a chemical laboratory, asked one of the chemists for a teaspoonful of salt to relieve slight gastric distress. The chemist took a bottle out of the chemical cabinet under the impression that it contained sodium chloride and, glancing only at the "-ium chloride" of the label, gave her about a teaspoonful of barium chloride, which she immediately washed down with a glass of water. The peculiar taste caused the error to be discovered at once, but as the young woman felt no immediate ill effects, nothing was done at the time. After a few minutes she began to have some gastric pain, which increased to such a degree that

While conducting experiments on the mechanism of pain in peptic ulcer it occurred to one of us to try the effect of essential oils. Oil of peppermint was selected because it is known as a household remedy for relieving gastric distress. This paper is a report of the action of oil of peppermint on the motility and secretion of the stomach of patients with peptic ulcer. The "Pentsao Kang Mu" (Li Shih Chen, 1597 A. D.), 1 in which is summarized the oldest knowledge of Chinese medicine, records the use of oil of peppermint as an antispasmodic. According to Heupke, 2 peppermint as a remedy was mentioned at the time of Charlemagne. Wallace and Jackson 3 found that oil of peppermint in the intestine influences gastric secretion by reflex action. Meyer and Gottlieb in their textbook 4 stated that carminatives increase the muscular activity of the alimentary canal. Muirhead and

A gastric antacid is a chemical substance introduced into the stomach for the purpose of lowering the hydrogen ion concentration, or acidity, of the gastric contents. Such antacids are in common use in medical practice, mostly in the treatment of peptic ulcer, and in addition they are employed extensively in self medication by those who have recognized the efficacy of sodium bicarbonate in the relief of several types of gastric distress. Of the host of substances which are capable of neutralizing acid, only a few are adaptable to use as gastric antacids, and not more than a dozen have received general attention in therapeutic practice. Unexpected difficulties are often encountered in the use of antacids to lower gastric acidity, because no antacid has yet been found which will simply neutralize acid without exhibiting additional pharmacologic action. These side actions usually have been objectionable rather than desirable. Under these circumstances it

A type of paralysis involving thousands of cases throughout the continent, caused by a product new to medicine and evidently arising from a single source, is so unusual that its effects should be a matter of record. Such was the polyneuritis caused by tricresyl phosphate adulterating extract of jamaica ginger, which arose in epidemic form in many sections of the country, early in 1930. The use of jamaica ginger extract, at least in New England, had for many years been the first thought in many families in cases of gastric distress. Only comparatively recently has it come into more general use among alcoholic addicts as a substitute for, or in combination with, other substances containing alcohol. Had the adulteration with poison occurred in earlier generations before there were more modern remedies for gastric disturbances, it is probable that the type of patients becoming victims of this paralysis would have been