The nitrate and nitrite levels of 75 gastric juice samples from young and healthy fasting volunteers were examined. For both parameters a dependence on the specific pH value of the secretion was detected. The rise of the nitrite level from normal 0.1 ppm in the acid to 1.4 ppm in the neutral range can be explained by the activity of the bacterial flora even in the healthy stomach, which has already been demonstrated earlier. The hitherto existing theory that nitrate originates exclusively from the salivary glands, and if not reduced to nitrite by bacteria in the mouth cavity, is brought into the stomach via swallowed saliva only, does not explain the observation that there is a rise in nitrate concentration in neutral juice, too. Further investigations have to be made to see whether there are other endogenous sources of nitrate except the salivary glands in the gastrointestinal tract. The environmental pollutant nitrate must be paid more attention to in future.

Increased days' supply and higher doses/month of IR hydrocodone in the prior 6 months may help to predict levels of HRU and costs in the following year, providing an opportunity to identify patients in order to implement interventions to improve their quality of care.