Dysplasia severity is associated with poor quality of life in patients with Barrett's esophagus referred for endoscopic eradication therapy.

Limited data exist regarding patient-reported outcomes and quality of life (QOL) experienced by patients with Barrett's esophagus (BE) referred for endoscopic eradication therapy (EET). Specifically, the impact of grade of dysplasia has not been explored. The purpose of this study is to measure patient-reported symptoms and QOL and identify factors associated with poor QOL in BE patients referred for EET. This was a prospective multicenter study conducted from January 2015 to October 2017, which included patients with BE referred for EET. Participants completed a set of validated questionnaires to measure QOL, symptom severity, and psychosocial factors. The primary outcome was poor QOL defined by a PROMIS score >12. Multivariable logistic regression analysis was performed to identify factors associated with poor QOL. In total, 193 patients participated (mean age 64.6 years, BE length 5.5 cm, 82% males, 92% Caucasians) with poor QOL reported in 104 (53.9%) participants. On univariate analysis, patients with poor QOL had lower use of twice daily proton pump inhibitor use (61.5% vs. 86.5%, P = 0.03), shorter disease duration (4.9 vs. 5.9 years, P = 0.04) and progressive increase in grade of dysplasia (high-grade dysplasia: 68.8% vs. 31.3%, esophageal adenocarcinoma: 75.5% vs. 24.5%, P < 0.001). Multivariate analysis demonstrated that high-grade dysplasia was independently associated with poor QOL (OR: 5.57, 95% CI: 1.05, 29.5, P = 0.04). In summary, poor QOL is experienced by the majority of patients with BE referred for EET and the degree of dysplasia was independently associated with poor QOL, which emphasizes the need to incorporate patient-centered outcomes when studying treatment of BE-related dysplasia.

Effects of maternal streptozotocin-diabetes on fetal growth, energy reserves and body composition of newborn pigs.

Two doses of Streptozotocin (50 and 100 mg/kg body weight) were administered to two groups of pregnant gilts at d 80 of gestation to determine the influence of two levels of maternal diabetes on the gilts, their developing progenies and the body composition of the pigs. All the experimental animals received 1.82 kg of gestation diet/day throughout gestation. Serum glucose concentration increased to hyperglycemic levels in low-dose and high-dose groups; insulin concentrations decreased (P less than .01) in the high-dose, but not in the low-dose group (P greater than .05). Maternal free fatty acids (FFA) increased (P less than .05) in both treatment groups when compared with the control. However, birth weight of the litter and litter size were not affected. The liver weight increased (P less than .01) in the progeny of high-dose but not the low-dose group. Total liver DNA and RNA were not altered by the treatments, however; total liver protein and protein:DNA ratio increased (P less than .01) in the progeny of high-dose gilts. Pigs from high-dose and low-dose groups showed increases (P less than .01) in liver glycogen concentrations and percentage liver lipid. Body chemical composition data showed increases in percentage dry matter and percentage lipid (P less than .05 and P less than .01, respectively) in the progeny of high-dose but not in the low-dose group. It was concluded that streptozotocin administered to gestating gilts increased the maternal nutrient supply to the developing pigs, which resulted in higher energy status of the pigs at birth.