Elevated blood pressure is an indicator of cardiovascular stress and increased risk of cardiovascular-related morbidity and mortality. There is emerging evidence suggesting air pollutants, including particulate matter (PM), could promote hypertension, thereby increasing cardiovascular disease risk. Repeated measurement analyses were conducted to examine the associations of three types of PM with systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) in 220 participants, (mean age = 58.5 years) from the Community Assessment of Freeway Exposure and Health study (CAFEH), most of whom live near a major highway. Ambient levels of air pollutants including particle number concentration (PNC; a measure of ultrafine particle (UFP) concentration), fine PM (PM2.5, Particle diameter <2.5 µm), and black carbon (BC) were measured at a central site <7 km from the study areas. Central sites are good at capturing short-term temporal trends in pollution associated with meteorological changes over regional areas. Linear mixed-effect models that accounted for repeated measures within one person were used to examine the associations between blood pressure variables and daily average of ambient PNC, PM2.5, or BC, controlling for demographic characteristics and major confounders including temperature. Our PNC model predicted that a higher PNC of 10,000 particles/cm3 was associated with higher DBP of 2.40 mmHg (p = 0.03), independent of other factors in the model. There were no significant associations for PM2.5 or BC. Post hoc subgroup analyses by obesity status showed that positive associations of DBP with PNC were more pronounced among obese individuals than non-obese individuals. These results suggested that PNC levels are associated with increased blood pressure, which may contribute to cardiovascular disease risk. More research is needed to assess the relationship between PNC and blood pressure and to address possible residual confounding.

Background Alcohol use disorders are associated with single nucleotide polymorphisms in GABRA2, the gene encoding the GABAA receptor α2-subunit in humans. Deficient GABAergic functioning is linked to impulse control disorders, intermittent explosive disorder, and to drug abuse and dependence, yet it remains unclear if α2-containing GABAA receptor sensitivity to endogenous ligands is involved in excessive alcohol drinking. Methods Male wild-type C57BL/6J and point-mutated mice rendered insensitive to GABAergic modulation by benzodiazepines (H101R), allopregnanolone or THDOC (Q241M), or high concentrations of ethanol (S270H/L277A) at α2-containing GABAA receptors were assessed for their binge-like, moderate or escalated chronic drinking using drinking in the dark, continuous access and intermittent access to alcohol protocols, respectively. Social approach by mutant and wild-type mice in forced alcohol abstinence was compared to approach by EtOH-naïve controls. Social deficits in forced abstinence were treated with allopregnanolone (0, 3.0, 10.0 mg/kg, i.p.) or midazolam (0, 0.56, 1.0 mg/kg, i.p.). Results Mice with benzodiazepine-insensitive α2-containing GABAA receptors (H101R) escalated their binge-like drinking. Mutants harboring the Q241M point-substitution in Gabra2 showed blunted chronic intake in the continuous and intermittent access protocols. S270H/L277A mutants consumed excessive amounts of alcohol but, unlike wild-types, they did not show forced abstinence-induced social deficits. Conclusions These findings suggest a role for: 1.) H101 for species-typical binge-like drinking, 2.) Q241 for escalated chronic drinking, and 3.) S270 and/or L277 for the development of forced abstinence-associated social deficits. Clinical findings report reduced BZD-binding sites in the cortex of dependent patients; the present findings suggest a specific role for BZD-sensitive α2-containing receptors. In addition, amino acid residue 241 in Gabra2 is necessary for positive modulation and activation of GABAA receptors by allopregnanolone and THDOC; we postulate that neurosteroid action on α2-containing receptor may be necessary for escalated chronic ethanol intake.

We evaluated serial FMT by retention enema in patients with severe or severe/complicated CDI unresponsive to at least 48 hours of standard antibiotic therapy. Of the 15 patients included, despite initial improvement in most patients, only 5 patients sustained cure at 30 days and serious adverse events occurred in 4 patients.

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e15594 Background: The age of life expectancy in the United States is 78.9 years of age and continues to increase with the help of public health initiatives along with scientific and technological breakthroughs in medicine. However, colorectal cancer screening guidelines for those over age 75 are individualized and not recommended in those over 85. We aimed to investigate the demographic differences of colorectal cancer by sex and race in patients aged 75 vs those aged 50-75, in the community and academic practice. Methods: Data were analyzed from the National Cancer Database between 2010-2014. Results were divided into two categories (50-75 year old, >75 year old) and included number of patients, sex and race. Patient characteristics were compared with Mann-Whitney U, Pearson’s Chi-square, and the Kaplan-Meier method. Data was further analyzed comparing sex and race using chi-square analysis. Results: 167, 059 patients were included in the analysis. 49,551 cases identified in the academic practice and 117, 508 in the community practice. In the academic practice, group A (age 50-75), 57.3% (20,810) were male vs. 42.7% (15,488) female. In community practice, group A, 56.5% (43, 915) were male vs 43.5% (33, 742) female (p-value <0.05). Conversely, in the academic practice-group B (age >75), 46.2% (6127) were male vs 53.8% (7126) female. In the community practice-group B, 55.3% (22,027) were female vs 44.7% (17,824) male; (p-value <0.05).For Black patients, decline in cases is seen by age. In academic practice, 16.5% of cases were aged 50-75 vs. 11.9% over age 75. In community practice; 11.5% were aged 50-75 vs. 6.5%, p<0.05). Comparatively there was an increase in cases in White patients by age diagnosed in academic and community practice; 77.5% vs 84.2 in 50-75 and 84.8 vs. 90.9% in >75, respectively (p<0.05). Conclusions: Women age >75 comprised a statistically significant greater proportion of colorectal cancer cases compared to men age >75 in both the community and academic setting. Contrary to established reports detailing higher incidence rates in males aged 50-75. Furthermore, there is an increase in cases with age in White patients in comparison with a decrease in cases in Black patients. These findings may suggest the need for a more universal and less individualized approach for individuals over age 75.

e15595 Background: Current guidelines recommend cessation of average risk colorectal cancer screening at age 75, after which a more individualized approach is endorsed. There is limited data on characteristics of colorectal cancer in patients over the age of 75. We aimed to determine if colorectal cancer site and metastasis is greater in the community vs academic setting in patients aged 50-75 compared to those age 75 or older. Methods: Data were analyzed from the National Cancer Database (NCDB) between 2010-2014. Results were divided into two categories (50-75 year old, >75 year old) and included number of patients, site of cancer and site of metastasis. Patient characteristics and survival were compared with Mann-Whitney U, Pearson’s Chi-square, and the Kaplan-Meier method. Results: 167, 059 patients were included in the analysis. In the academic setting, group A (age 50-75) contained 36, 298 patients and group B (>75) contained 13,253 patients. In the community setting, group A involved 77, 657 patients and group B, 39,851 patients. In the academic setting, group A identified 57.7% of cases involving the colon vs 42.3% involving the rectum. In group B, 71.4% cases involved the colon vs 28.6% involving the rectum. In the community setting, group A identified 64.4% of cases involving the colon compared to 35.6% involving the rectum. For group B, 76.2% of cases diagnosed were in the colon vs. 23.8% of cases involving the rectum. Overall, indicating a statistically significant increase seen in colon involvement in the older age group (<0.001). In community and academic practice, there is a statistically significant increase in the cases involving metastasis for group A, compared to group B (p<0.001) This is seen for specific sites as well, including bone, liver and lung, (p< 0.001) but not brain involvement in academic practice. Conclusions: In this study, we found a statistically greater number of cases of involving metastasis in patients aged 50-75 compared to patients aged 75 and older in both academic and community practices. In both the academic and community setting, older patients demonstrated statistically greater involvement of the colon compared to patients aged 50-75. Overall, there were more cases of colon and rectal cancer for both age groups seen in the community setting compared to the academic setting.

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