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3. Tenapanor in the Treatment of Irritable Bowel Syndrome with Constipation: Discovery, Efficacy, and Role in Management

Author

Herekar,Anam, Shimoga,Dhanush, Jehangir,Asad, Shahsavari,Dariush, Yan,Yun, Karunaratne,Tennekoon Buddhika, and Sharma,Amol

Subjects
Clinical and Experimental Gastroenterology
Abstract

Anam Herekar, Dhanush Shimoga, Asad Jehangir, Dariush Shahsavari, Yun Yan, Tennekoon Buddhika Karunaratne, Amol Sharma Department of Medicine, Augusta University, Augusta, GA, USACorrespondence: Amol Sharma, Medical College of Georgia, Augusta University, 1120 15th Street, AD 2226, Augusta, GA, 30912, USA, Email amosharma@augusta.eduAbstract: Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction (DGBI). IBS significantly impacts the quality of life of patients. Since its pathogenesis is unclear and can be multifactorial, it highlights the need for new and improved pharmaceutical drugs that not only improve bowel symptoms, but also address global IBS symptoms, such as abdominal pain. Tenapanor, a recently Food & Drug Administration (FDA)-approved medication for IBS with constipation (IBS-C), is a small molecule inhibitor of the sodium/hydrogen exchanger isoform 3 (NHE3) that inhibits the absorption of sodium and phosphate in the gastrointestinal tract, resulting in fluid retention and softer stool. Furthermore, tenapanor reduces intestinal permeability to improve visceral hypersensitivity and abdominal pain. Due to its recent approval, tenapanor was not included in the recent IBS guidelines, however, it may be considered for IBS-C patients failing first-line treatment of soluble fiber. In this review article, we aim to provide in-depth information to the reader regarding the design of tenapanor, its development through Phase I, II and III randomized clinical trials, and its role in the treatment of IBS-C.Keywords: irritable bowel syndrome, irritable bowel syndrome with constipation, IBS, IBS-C, constipation, tenapanor

Published
2023

14. A Complicated Case of Serratia marcescens Infective Endocarditis in the Era of the Current Opioid Epidemic

Author

Yeung, Ho-Man, Chavarria, Brijaé, and Shahsavari, Dariush

Subjects
Article Subject
Abstract

While bacteremia due to Serratia marcescens is not uncommon, it rarely causes infective endocarditis. We report an isolated case of a 53-year-old male with history of intravenous drug abuse who presented with multiple acute pain symptoms and was found to have S. marcescens bacteremia with septic emboli in his spleen, brain, and testes, secondary to a large aortic vegetation, as well as aortic infective endocarditis with severe aortic regurgitation requiring aortic valve replacement. His course of disease was further complicated by epidural and psoas abscesses and a necrotic testicle requiring orchiectomy due to his ongoing intravenous drug abuse. This case is an atypical presentation of S. marcescens infection, as he had no overt signs of infection such as fever or significant leukocytosis that are typical of bacteremia, and it also highlights the severity and complicated nature of S. marcescens-infective endocarditis.

Published
2018
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21. Comparison of hypertension and diabetes mellitus prevalence in areas with and without water arsenic contamination.

Author

Mahram, Manoochehr, Shahsavari, Dariush, Oveisi, Sonia, and Jalilolghadr, Shabnam

Subjects
*HYPERTENSION epidemiology, *ARSENIC, *DIABETES, *METROPOLITAN areas, *RESEARCH funding, *WATER pollution, *LOGISTIC regression analysis, *DISEASE prevalence, *DATA analysis software, *DESCRIPTIVE statistics
Abstract

Background: Arsenic (As), one of the most significant hazards in the environment affecting millions of people around the world is associated with several diseases including cancers, Diabetes Mellitus (DM) and Hypertension (Htn). Drinking water contaminated with inorganic arsenic (iAs) is the primary route of exposure. This study was conducted to determine the difference in the prevalence of DM and Htn in areas with different levels of water contamination of As. Materials and Methods: In this analytic ecologic study, after measurement of As level in drinking water in all urban regions of Qazvin Province (Islamic Republic of Iran), two cities with As level of 20-30 µ/L and two with the As level <5 µg/L were selected as exposed and unexposed groups, respectively. Measuring the prevalence of above-mentioned diseases in the 30-60 year-old population of the said regions as total sampling, the results were statistically analyzed and compared. Results: The mean prevalence of Htn in exposed and unexposed areas were 7.09% and 3.73%, respectively and for DM were 4.53% and 1.99% in the said groups, respectively. There was a positive correlation between As level and Htn (P < 0.001) and between As level and DM (P < 0.001). Conclusion: High level of As in drinking water, even in the range of 20-30 µg/L has a relationship with increased prevalence of DM and Htn. [ABSTRACT FROM AUTHOR]

Published
2013

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