Diseases of the upper gastrointestinal tract have become more prevalent over time. Mechanisms of disease formation are still only partially understood. Recent literature has shown that the surrounding microbiome affects the propensity for disease formation in various parts of the upper gastrointestinal tract. A review was performed of any literature to our best knowledge concerning the effects of pharmacologic agents, environmental changes, and surgical intervention on the microbiome of the upper gastrointestinal tract. Searches of the literature were performed using specific keywords related to drugs, surgical procedures, and environmental factors. Many prescription and nonprescription drugs that are commonly used have varying effects on the upper gastrointestinal tract. Proton pump inhibitors may affect the relative prevalence of some organisms in the lower esophagus and have less effect in the proximal esophagus. Changes in the esophageal microbiome correlate with some esophageal diseases. Drugs that induce weight loss have also been shown to affect the microbiomes of the esophagus and stomach. Common surgical procedures are associated with shifts in the microbial community in the gastrointestinal tract. Environmental factors have been shown to affect the microbiome in the upper gastrointestinal tract, as geographic differences correlate with alterations in the microbiome of the gastrointestinal tract. Understanding the association of environmental and pharmacologic changes on the microbiome of the upper gastrointestinal tract will facilitate treatment plans to reduce morbidity from disease.
INTRODUCTION: Proximal aortic neck dilatation (PND) is associated with increased rate of complication after endovascular aneurysm repair (EVAR). Although many studies investigated PND after the placement of endografts that use self-expanding stents, there are no such reports for patients treated with endografts that use polymerfilled sealing rings. The purpose of this study is to examine PND and graft migration after EVAR with the Ovation stent graft.
Introduction:
Diabetes mobile applications (apps) that help patients monitor disease have led to privacy concerns. We aimed to assess privacy policies for diabetes mobile applications with a focus on data transmission to outside parties.
Methods:
The App Store was used to gather apps pertaining to diabetes by searching “diabetes” and “blood sugar”. Two readers evaluated privacy policies (PP) including data sharing and storing techniques for mention of 27 predetermined criteria. All network traffic generated while loading and using the app was intercepted by a man-in-the-middle attack to listen to data delivered between the sender and receiver of data transmissions. A packet analyzer determined contents of transmission, where data was sent, and if transmission contained user data.
Results:
Of 35 apps evaluated, 29 (83%) had PP. The most frequent transmission destinations were Google (n=130 transmissions), Kamai Technologies (n=53), Facebook (n=38) and Amazon (n=33). 35 of 35 apps (100%) were transmitting data to a third party. 2 of 2 (100%) of those who had a privacy policy without mention of a third party transmitted data to a third party. 8 of 8 (100%) apps who mentioned they would not transmit to a third party were found to do so. 19 of 19 (100%) apps who mentioned they would transmit data to a third party were found to do so. All apps (n=6) without a privacy policy were found to be transmitting data to a third party.
Conclusion:
Most diabetes apps on the App store have accessible PP. All apps evaluated transmitted data to a third party, even when the policy stated this would not occur. As mobile applications are increasingly utilized by patients, it is important to warn of privacy implications.
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