Background Previous studies have reported additional cancers associated with BRCA mutations; however, type, magnitude of risk, and gender differences remain to be clarified. The purpose of this study was to evaluate the incidence of cancers other than breast and ovarian cancer in known mutation carriers. Methods An institutional review board approved study identified 1072 patients who had genetic counseling at our institution and tested positive for a deleterious BRCA mutation. The expected number of cancer cases was calculated from the number of individuals in the study sample multiplied by the general population cancer incidence rates. The expected and observed number of cases were calculated in 5 year intervals to accommodate different age-related incidence rates. Standardized incidence ratios (SIRs) for each cancer type were calculated. Results We identified 1177 cancers in the 1072 mutation carriers comprising 30 different cancer types. Individuals with a BRCA1 mutation did not have a significant increase in cancers other than breast and ovarian; however, a trend in melanoma was observed. Individuals with a BRCA2 mutation had a significantly higher number of observed cases compared to expected cases for pancreatic cancer (SIR = 21.7, 95%CI = 13.1–34.0, p value <0.001) in both men and women and prostate cancer in men (SIR = 4.9, 95%CI = 2.0–10.1, p value =0.002). Conclusions The results of this study uphold the current recommendations for HBOC screening of cancers other than breast and ovarian by the National Comprehensive Cancer Network. Larger cohorts and collaborations are needed to further verify these findings.

Background: About 35% of humans have methane producing gut flora. Methane-producing IBS subjects were generally constipated. In animal models, methane infusion slows intestinal transit. Whether methanogenic flora alters colonic transit or stool characteristics and its relationship to constipation is unclear. Aim: To examine the prevalence and association of methanogenic flora in patients with slow transit constipation (ST) and normal transit constipation (NT) and non-constipated controls. Methods: Ninety six consecutive subjects with chronic constipation (Rome III) were evaluated with radio-opaque marker (ROM) transit studies and were classified as slow transit (>20% ROM retention) or normal transit. All constipated subjects and 106 non constipated controls underwent breath tests to assess methane production. Baseline CH4 of ≥ 3 ppm was used to define presence of methanogenic flora. Stool frequency and consistency were assessed using a prospective stool diary. Correlation analyses were performed. Results: Forty eight subjects had ST and 48 had NT. Prevalence of methanogenic flora was higher (p < 0.05) in ST (75%) compared to NT (44%) or controls (28%). ST patients had higher methane production compared to NT and controls (p<0.05). NT patients also produced more methane compared to controls (p < 0.05). There was moderate(p<0.05) correlation between baseline, peak and AUC of methane response with colonic transit but not with stool characteristics. Conclusions: Presence of methanogenic flora is associated with chronic constipation. Methane production following carbohydrate challenge and its prevalence were higher in ST than NT, although stool characteristics were similar in both groups. Methane production correlated with colonic transit, suggesting an association with stool transport but not with stool characteristics.

About one-third of patients with suspected IBS had fructose intolerance. When compliant, symptoms improved on fructose-restricted diet despite moderate impact on lifestyle; noncompliance was associated with persistent symptoms. Fructose intolerance is another jigsaw piece of the IBS puzzle that may respond to dietary modification.

Purpose-Age-related changes in tongue function may contribute to dysphagia in elderly people. Our purpose was to investigate whether aged rats that have undergone tongue exercise would manifest increased protrusive tongue forces and increased genioglossus (GG) muscle fiber cross sectional areas.Method-Forty-eight young adult, middle-aged and old Fischer 344/Brown Norway rats received 8 weeks of tongue exercise. Protrusive tongue forces were measured before and after exercise. GG muscle fiber cross sectional area was measured in exercised rats and compared with cross sectional areas in a no-exercise control group.Results-A significant increase in maximum tongue force was found following exercise in all age groups. In addition, a trend for increased GG muscle fiber cross sectional area, and a significant increase in variability of GG muscle fiber cross sectional area were identified post-exercise. Conclusion-The findings of this study have implications for treatment of elderly persons with dysphagia using tongue exercise programs. Specifically, increases in tongue force that occur following 8 weeks of progressive resistance tongue exercise may be accompanied by alterations in tongue muscle fiber morphology. These changes may provide greater strength and endurance for goal-oriented actions associated with the oropharyngeal swallow and should be investigated in future research.

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