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1Microbiota modification by probiotic supplementation reduces colitis associated colon cancer in mice显示文摘AIM To investigate the effect of probiotic supplementation during the development of an experimental model of colitis associated colon cancer(CAC). METHODS C57 BL/6 mice received an intraperitoneal injection of azoxymethane(10 mg/kg), followed by three cycles of sodium dextran sulphate diluted in water(5% w/v). Probiotic group received daily a mixture of Lactobacillus acidophilus, Lactobacil us rhamnosus and Bifidobacterium bifidum. Microbiota composition was assessed by 16 Sr RNA Illumina Hi Seq sequencing. Colon samples were collected for histological analysis. Tumor cytokines was assessed by Real Time-PCR(Polymerase Chain Reaction); and serum cytokines by Multiplex assay. All tests were two-sided. The level of significance was set at P < 0.05. Graphs were generated and statistical analysis performed using the software Graph Pad Prism 5.0. The project was approved by the institutional review board committee. RESULTS At day 60 after azoxymethane injection, the mean number of tumours in the probiotic group was 40% lower than that in the control group, and the probiotic group exhibited tumours of smaller size(< 2 mm)(P < 0.05). There was no difference in richness and diversity between groups. However, there was a significant difference in beta diversity in the multidimensional scaling analysis. The abundance of the genera Lactobacillus, Bifidobacterium, Allobaculum, Clostridium XI and Clostridium XVⅢ increased in the probiotic group(P < 0.05). The microbial change was accompanied by reduced colitis, demonstrated by a 46% reduction in the colon inflammatory index; reduced expression of the serum chemokines RANTES and Eotaxin; decreased p-IKK and TNF-α and increased IL-10 expression in the colon. CONCLUSION Our results suggest a potential chemopreventive effect of probiotic on CAC. Probiotic supplementation changes microbiota structure and regulates the inflammatory response, reducing colitis and preventing CAC.Maria Carolina S Mendes Daiane SM Paulino Sandra R Brambilla Juliana A Camargo Gabriela F Persinoti José Barreto C Carvalheira 2018World Journal of Gastroenterology2018,24,18:17
2Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study显示文摘Patrick Marcellin Edward Gane Maria Buti Nezam Afdhal William Sievert Ira M Jacobson Mary Kay Washington George Germanidis John F Flaherty Raul Aguilar Schall Jeffrey D Bornstein Kathryn M Kitrinos G Mani Subramanian John G McHutchison E Jenny Heathcote 2012The Lancet2012,,:14
3Hepatocellular carcinoma: Review of disease and tumor biomarkers显示文摘Hepatocellular carcinoma(HCC) is a common malignancy and now the second commonest global cause of cancer death. HCC tumorigenesis is relatively silent and patients experience late symptomatic presentation. As the option for curative treatments is limited to early stage cancers, diagnosis in non-symptomatic individuals is crucial. International guidelines advise regular surveillance of high-risk populations but the current tools lack sufficient sensitivity for early stage tumors on the background of a cirrhotic nodular liver. A number of novel biomarkers have now been suggested in the literature, which may reinforce the current surveillance methods. In addition, recent metabonomic and proteomic discoveries have established specific metabolite expressions in HCC, according to Warburg's phenomenon of altered energy metabolism. With clinical validation, a simple and non-invasive test from the serum or urine may be performed to diagnose HCC, particularly benefiting low resource regions where the burden of HCC is highest.Jin Un Kim Mohamed I F Shariff Mary M E Crossey Maria Gomez-Romero Elaine Holmes I Jane Cox Haddy K S Fye Ramou Njie Simon D Taylor-Robinson 2016World Journal of Hepatology2016,8,10:13
4New strategies for colorectal cancer screening显示文摘Colorectal cancer (CRC) is still one of the leading causes of cancer-related death in Western countries, despite major improvements in its treatment. The dramatically high social and economic impact of CRC on human health makes the identification of a reliable screening tool of paramount importance. Current screening methods, such as the fecal occult blood test and colonoscopy do not adequately meet the ideal requisites of a screening test because, even if they are effective, they are limited first by too low specificity and sensitivity, or second by high invasiveness, costs and risk. Nowadays extended efforts are made by researchers to look for more reliable and effective screening tests based on a systems biology approach, using biological samples easily available, such as urine, breath, serum and feces. The effectiveness and reliability of several new attempts to screen these patients by non-invasive analysis of their biological samples using genomic (genetic and epigenetic alteration), transcriptomic (miRNA), proteomic (cancer-related antigens, new antibodies against tumor-associated antigens, mutated proteins) and metabolomic (volatile organic metabolites) methods are discussed in this review. Among the most interesting new screening tools, fecal fluorescent long-DNA, fecal miRNA and metabolomic evaluation in breath and/ or serum seem to be most promising.Maria Di Lena Elisabetta Travaglio Donato F Altomare 2013World Journal of Gastroenterology2013,19,12:12
5Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis显示文摘AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.Giliane Belarmino Maria Cristina Gonzalez Raquel S Torrinhas Priscila Sala Wellington Andraus Luiz Augusto Carneiro D'Albuquerque Rosa Maria R Pereira Valéria F Caparbo Graziela R Ravacci Lucas Damiani Steven B Heymsfield Dan L Waitzberg 2017World Journal of Hepatology2017,9,7:11
6Research advances on the multiple uses of Moringa oleifera: a sustainable alternative for socially neglected population显示文摘Moringa oleifera Lam(Moringaceae) is a plant with high nutritional and medicinal value. Native to India, it is now widely distributed throughout tropical and subtropical regions of the world. Its different parts are sources of proteins, vitamins and minerals and present different pharmacological and biotechnological potential. Moreover, M. oleifera seeds are widely used in water and effluent treatment, for their coagulation, flocculation and sedimentation properties, their ability of improving water quality, by reducing organic matter and microbial load, with special applicability in intensive animal production systems, such as aquaculture. In addition, due to its high nutritional value and several medicinal properties, this tree may act as a nutritional and medical alternative for socially neglected populations. In this context, this review gathers information on M. oleifera, emphasizing its chemical constituents, nutritional, pharmacological and antimicrobial properties, applications in the treatment of water effluents, and ecological and social aspects.Raimunda Samia Nogueira Brilhante Jamille Alencar Sales Vandbergue Santos Pereira Débora de Souza Collares Maia Castelo-Branco Rossana de Aguiar Cordeiro Célia Maria de Souza Sampaio Manoel de Araújo Neto Paiva Joao Bosco Feitosa dos Santos JoséJúlio CostaSidrim Marcos Fábio Gadelha Rocha 2017Asian Pacific Journal of Tropical Medicine2017,10,7:10
7Plasma betatrophin levels in patients with liver cirrhosis显示文摘AIM: To investigate the plasma levels of betatrophin in patients with cirrhosis.METHODS: Forty patients diagnosed at the clinic with liver cirrhosis according to biological, ultrasonographic,or histological criteria were included.The severity of cirrhosis was classified according to Pugh's modification of Child's classification and MELD score. Insulin resistance(IR) was assessed by the Homeostasis Model Assessment. A total of 20 patients showed a MELD score higher than 14. The control group consisted in 15 sex-and aged-matched subjects.Fasting blood samples were obtained for subsequent analysis. Serum insulin was determined by Liaison automated immune chemiluminiscence assay(DiaSorin S.p.A.) using a sandwich assay. The sensitivity of the assay was 0.2 μU/mL. The intra and interassay variation coefficients were < 4% and < 10%,respectively. The normal values were between 2 and17 μU/mL. Human active betatrophin was analyzed by specific quantitative sandwich ELISA(Aviscera Bioscience). The sensitivity of the assay was 0.4 ng/mL, and the intra and interassay reproducibility were< 6% and < 10%, respectively.RESULTS: Plasma betatrophin levels were significantly increased in patients with cirrhosis compared with those in healthy subjects(P = 0.0001). Betatrophin levels were also associated with disease severity, being higher in Child-Pugh C patients compared to Child-Pugh B(P< 0.0005) and in patients who displayed a MELD score higher than 14 points compared to patients with lower punctuation(P = 0.01). In addition, we found a positive correlation between plasma betatrophin levels and the severity of cirrhosis according to Child-Pugh classification(r = 0.53; P < 0.01) or MELD score(r = 0.45; P <0.01). In the overall cohort, a moderate correlation between serum betatrophin and plasmatic bilirrubin(r= 0.39; P < 0.01) has been observed, as well as an inverse correlation between betatrophin and albumin(r =-0.41; P < 0.01) or prothrombin time(r =-0.44;P <0.01). Moreover, insulin resistance was observed in82.5% of the cirrhotic patients. In this group of patients,betatrophin levels were significantly higher than those in the group of patients without IR(P < 0.05).CONCLUSION: Plasma betatrophin is increased in patients with cirrhosis. This increase is related to the severity of cirrhosis, as well as with the emergence of insulin resistance.Maria Teresa Arias-Loste Maria Teresa García-Unzueta Susana Llerena Paula Iruzubieta Angela Puente Joaquín Cabezas Carmen Alonso Antonio Cuadrado José Antonio Amado Javier Crespo Emilio Fábrega 2015World Journal of Gastroenterology2015,21,37:9
8Autoimmune hepatitis and anti-tumor necrosis factor alpha therapy:A single center report of 8 cases显示文摘This article describes cases of anti-tumor necrosis factor(TNF)-α-induced autoimmune hepatitis and evaluates the outcome of these patients in relation to their immunosuppressive strategy. A retrospective analysis of medical records was performed in our center, in order to detect cases of autoimmune hepatitis(AIH) associated with anti-TNF biologic agents. We describe and analyze eight cases of AIH following anti-TNF therapy, 7 with infliximab and 1 with adalimumab. A distinction should be made between induction of autoimmunity and clinically evident autoimmune disease. Liver biopsy is useful in detecting the role of the TNF-α antagonist in the development of AIH. The lack of relapse after discontinuing immunosuppressive therapy favors, as in this case series, an immune-mediated drug reaction as most patients with AIH have a relapse after treatment is suspended. Although AIH related to anti-TNF therapy is rare, a baseline immunological panel along with liver function tests should be performed in all patients with autoimmune disease before starting biologics.Susana Rodrigues Susana Lopes Fernando Magro Hélder Cardoso Ana Maria Horta e Vale Margarida Marques Eva Mariz Miguel Bernardes Joanne Lopes Fátima Carneiro Guilherme Macedo 2015World Journal of Gastroenterology2015,21,24:9
9ROS-induced DNA damage and PARP-1 are required for optimal induction of starvation-induced autophagy显示文摘响应滋养的应力,房间开始能导致改编或死亡的一个 autophagy 节目。位于从饥饿发信号到 autophagy 的开始下面的机制充分没被理解。在当前的学习,我们证明 PARP-1 的缺席或 inactivation 强烈推迟导致饥饿的 autophagy。我们发现了那 DNA 损坏是由 γ 测量了的导致饥饿的 autophagy 的一个早事件; -H2AX 累积和彗星试金,与在两个参数显示减小的 PARP-1 猛烈房间。在饥饿期间,导致 ROS 的 DNA 损坏激活 PARP-1,导致 ATP 弄空(在滋养的剥夺以后的一个早事件) 。PARP-1 的缺席弄钝 AMPK 激活并且阻止了 mTOR 活动的完全的损失,导致在 autophagy 的延期。PARP-1 弄空在饥饿的房间赞成 apoptosis,建议在滋养的剥夺以后的 autophagy 和 PARP-1 激活的一个支持幸存的角色。在 PARP-1 变异的老鼠的出生不满一月的婴儿使遭到了到尖锐饥饿的 vivo 结果表演,也显示缺乏的肝 autophagy,暗示为在导致饥饿的 autophagy 的 PARP-1 的一个生理的角色。因此,表明小径的 PARP 是 autophagy 承诺追随者饥饿的起始的步骤的一个关键管理者。Jose Manuel Rodriguez-Vargas Maria Jose Ruiz-Magana Carmen Ruiz-Ruiz Jara Majuelos-Melguizo Andreina Peralta-Lea Maria Isabel Rodriguez Jose Antonio Munoz-Gaimez Mariano Ruiz de Almodovar Eva Siles Abelardo Lopez Rivas Marja Jaattela F Javier Oliver 2012Cell Research2012,22,7:8
10Potential of soluble CD26 as a serum marker for colorectal cancer detection显示文摘Colorectal cancer is characterized by a low survival rate even though the basis for colon cancer development,which involves the evolution of adenomas to carcinoma,is known.Moreover,the mortality rates continue to rise in economically transitioning countries although there is the opportunity to intervene in the natural history of the adenoma–cancer sequence through risk factors,screening,and treatment.Screening in particular accounted for most of the decline in colorectal cancer mortality achieved in the USA during the period 1975-2000.Patients show a better prognosis when the neoplasm is diagnosed early.Among the variety of screening strategies,the methods range from invasive and costly procedures such as colonoscopy to more low-cost and non-invasive tests such as the fecal occult blood test(guaiac and immunochemical).As a non-invasive biological serum marker would be of great benefit because of the performance of the test,several biomarkers,including cytologic assays,DNA and mRNA,and soluble proteins,have been studied.We found that the soluble CD26(sCD26)concentration is diminished in serum of colorectal cancer patients compared to healthy donors,suggesting the potential utility of a sCD26 immunochemical detection test for early diagnosis.sCD26 originates from plasma membrane CD26 lacking its transmembrane and cytoplasmic domains.Some 90%–95%of sCD26 has been associated with serum dipeptidyl peptidase IV(DPPIV)activity.DPP-IV,assigned to the CD26 cluster,is a pleiotropic enzyme expressed mainly on epithelial cells and lymphocytes.Our studies intended to validate this test for population screening to detect colorectal cancer and advanced adenomas are reviewed here.Oscar J Cordero Monica Imbernon Loretta De Chiara Vicenta S Martinez-Zorzano Daniel Ayude Maria Paez de la Cadena F Javier Rodriguez-Berrocal 2011World Journal of Clinical Oncology2011,2,6:5
11Hepatitis B and D Viruses Exploit Sodium Taurocholate Co-transporting Polypeptide for Species-specific Entry into Hepatocytes显示文摘Yi Ni Florian A. Lempp Stefan Mehrle Shirin Nkongolo Christina Kaufman Maria F?lth Jan Stindt Christian K?niger Michael Nassal Ralf Kubitz Holger Sültmann Stephan Urban 2013Gastroenterology2013,,:5
12Modification of tubular chitosan-based peripheral nerve implants: applications for simple or more complex approaches显示文摘Surgical treatment of peripheral nerve injuries is still a major challenge in human clinic.Up to now,none of the well-developed microsurgical treatment options is able to guarantee a complete restoration of nerve function.This restriction is also effective for novel clinically approved artificial nerve guides.In this review,we compare surgical repair techniques primarily for digital nerve injuries reported with relatively high prevalence to be valuable attempts in clinical digital nerve repair and point out their advantages and shortcomings.We furthermore discuss the use of artificial nerve grafts with a focus on chitosan-based nerve guides,for which our own studies contributed to their approval for clinical use.In the second part of this review,very recent future perspectives for the enhancement of tubular(commonly hollow)nerve guides are discussed in terms of their clinical translatability and ability to form three-dimensional constructs that biomimick the natural nerve structure.This includes materials that have already shown their beneficial potential in in vivo studies like fibrous intraluminal guidance structures,hydrogels,growth factors,and approaches of cell transplantation.Additionally,we highlight upcoming future perspectives comprising co-application of stem cell secretome.From our overview,we conclude that already simple attempts are highly effective to increase the regeneration supporting properties of nerve guides in experimental studies.But for bringing nerve repair with bioartificial nerve grafts to the next level,e.g.repair of defects>3 cm in human patients,more complex intraluminal guidance structures such as innovatively manufactured hydrogels and likely supplementation of stem cells or their secretome for therapeutic purposes may represent promising future perspectives.Nina Dietzmeyer Maria F?rthmann Claudia Grothe Kirsten Haastert-Talini 2020Neural Regeneration Research2020,15,8:4
13High prevalence of vitamin A deficiency in Crohn's disease patients according to serum retinol levels and the relative dose-response test显示文摘AIM:To assess the vitamin A status of patients with Crohn's disease(CD) by evaluating serum retinol levels and the relative dose response(RDR) test(liver retinol stores).METHODS:Vitamin A nutritional status was measured by serum retinol obtained by high performance liquid chromatography and the RDR test for evaluation of the hepatic stores.Body composition was performed by densitometry by dual-energy X-ray absorptiometry.Vitamin A dietary intake was assessed from a semiquantitative food frequency questionnaire.RESULTS:This study included 38 CD patients and 33 controls.Low serum retinol concentrations were detected in 29% of CD patients vs 15% in controls(P < 0.005).The RDR test was positive in 37% of CD patients vs 12% in controls,which indicated inadequate hepatic vitamin A stores(P < 0.005).Individuals with hypovitaminosis A had lower BMI and body fat compared with those without this deficiency.There was no association between vitamin A deficiency and its dietary intake,ileal location,presence of disease activity and prior bowel resections.CONCLUSION:Patients with CD have higher prevalence of vitamin A deficiency,as assessed by two independent methods.Márcia Soares-Mota Tianny A Silva Luanda M Gomes Marco AS Pinto Laura MC Mendon?a Maria Lúcia F Farias Tiago Nunes Andrea Ramalho Cyrla Zaltman 2015World Journal of Gastroenterology2015,21,5:4
14Cardiovascular risk after orthotopic liver transplantation, a review of the literature and preliminary results of a prospective study显示文摘Improved surgical techniques and greater efficacy of new anti-rejection drugs have significantly improved the survival of patients undergoing orthotopic liver transplantation(OLT). This has led to an increased incidence of metabolic disorders as well as cardiovascular and cerebrovascular diseases as causes of morbidity and mortality in OLT patients. In the last decade, several studies have examined which predisposing factors lead to increased cardiovascular risk(i.e., age, ethnicity, diabetes, NASH, atrial fibrillation, and some echocardiographic parameters) as well as which factors after OLT(i.e., weight gain, metabolic syndrome, immunosuppressive therapy, and renal failure) are linked to increased cardiovascular mortality. However, currently, there are no available data that evaluate the development of atherosclerotic damage after OLT. The awareness of high cardiovascular risk after OLT has not only lead to the definition of new but generally not accepted screening of high risk patients before transplantation, but also to the need for careful patient follow up and treatment to control metabolic and cardiovascular pathologies after transplant. Prospective studies are needed to better define the predisposing factors for recurrence and de novo occurrence of metabolic alterations responsible for cardiovascular damage after OLT. Moreover, such studies will help to identify the timing of disease progression and damage,which in turn may help to prevent morbidity and mortality for cardiovascular diseases. Our preliminary results show early occurrence of atherosclerotic damage, which is already present a few weeks following OLT, suggesting that specific, patient-tailored therapies should be started immediately post OLT.Giuseppina Pisano Anna L Fracanzani Lucio Caccamo Maria F Donato Silvia Fargion 2016World Journal of Gastroenterology2016,22,40:4
15Exercise manual for liver disease patients显示文摘AIM: To increase inspiratory muscle strength and improve the quality of life of candidates for liver transplantation.METHODS: Twenty-three candidates for liver transplantation participated in the control group and 14 made up the intervention group. The control group consisted of 18 men and 5 women, body mass index(BMI) 27.3 ± 4.5 kg/m2 and Model for End-Stage Liver Disease(MELD) 18.2 ± 6.1. The intervention group consisted of 11 men and 3 women, BMI 28.6 ± 5.4 kg/m2 and MELD 18 ± 4.5. The presence or absence of ascites was identified in the first patient evaluation and after three months. We evaluated maximal inspiratory pressure(MIP) and maximal expiratory pressure, spirometry, root mean square(RMS) of diaphragm and rectus abdominis, and the quality of life. The exercises were performed daily by patients at home for three months and were supervised at distance monthly. The manual consisted of diaphragmatic breathing exercises, diaphragmatic isometric exercise, Threshold IMT®, lifting upper limbs with a bat and strengthening the abdomen. RESULTS: There was significant difference(P = 0.01) between the first(initial) and the third month(final) MIP in the control group and in the intervention group, but there was no difference(P = 0.45) between the groups.The RMS of the diaphragm was lower(P = 0.001) and the functional capacity was higher(P = 0.006) in the intervention group compared to the control. The general health and mental health domains received higher scores after three months in the control group(P = 0.01) and the intervention group(P = 0.004), but there was no significant difference between them. The comparison between the presence of initial ascites with the presence of ascites was performed after three months in the control group(P = 0.083) and intervention group(P = 0.31). There was no significant difference, in relation to the presence of ascites after three months between groups(P = 0.21). In the intervention group, patients with ascites at the end of the time period had decreased scores on the social aspects SF-36 domain(P = 0.023) compared to those who had no ascites. CONCLUSION: The proposed exercises provide an increase in the inspiratory muscle strength and improve functional capacity, consequently bettering the quality of life of liver disease patients.Vivian Limongi Daniele Costa Dos Santos Aurea Maria de Oliveira da Silva Ilka de Fátima Santana Ferreira Boin Raquel Silveira Bello Stucchi 2016World Journal of Transplantation2016,6,2:3
16Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari 2019World Journal of Gastroenterology2019,25,38:2
17Liver fat deposition and mitochondrial dysfunction in morbid obesity:An approach combining metabolomics with liver imaging and histology显示文摘AIM: To explore the usefulness of magnetic resonance imaging(MRI) and spectroscopy(MRS) for assessment of non-alcoholic fat liver disease(NAFLD) as compared with liver histological and metabolomics findings. METHODS: Patients undergoing bariatric surgery following procedures involved in laparoscopic sleeve gastrectomy were recruited as a model of obesityinduced NAFLD in an observational, prospective, singlesite, cross-sectional study with a pre-set duration of 1 year. Relevant data were obtained prospectively and surrogates for inflammation, oxidative stress and lipid and glucose metabolism were obtained through standard laboratory measurements. To provide reliable data from MRI and MRS, novel procedures were designed to limit sampling variability and other sources of error using a 1.5T Signa HDx scanner and protocols acquired from the 3D or 2D Fat SAT FIESTA prescription manager. We used our previously described 1H NMRbased metabolomics assays. Data were obtained immediately before surgery and after a 12-mo period including histology of the liver and measurement of metabolites. Values from 1H NMR spectra obtained after surgery were omitted due to technical limitations.RESULTS: MRI data showed excellent correlation with the concentration of liver triglycerides, other hepatic lipid components and the histological assessment, w h i c h e xc l u d e d t h e p r e s e n c e o f n o n-a l c o h o l i c steatohepatitis(NASH). MRI was sufficient to follow up NAFLD in obese patients undergoing bariatric surgery and data suggest usefulness in other clinical situations. The information provided by MRS replicated that obtained by MRI using the-CH3 peak(0.9 ppm), the-CH2- peak(1.3 ppm, mostly triglyceride) and the-CH=CH- peak(2.2 ppm). No patient depicted NASH. After surgery all patients significantly decreased their body weight and steatosis was virtually absent even in patients with previous severe disease. Improvement was also observed in the serum concentrations of selected variables. The most relevant findings using metabolomics indicate increased levels of triglyceride and monounsaturated fatty acids in severe steatosis but those results were accompanied by a significant depletion of diglycerides, polyunsaturated fatty acids, glucose-6-phosphate and the ATP/AMP ratio. Combined data indicated the coordinated action on mitochondrial fat oxidation and glucose transport activity and may support the consideration of NAFLD as a likely mitochondrial disease. This concept may helpto explain the dissociation between excess lipid storage in adipose tissue and NAFLD and may direct the search for plasma biomarkers and novel therapeutic strategies. A limitation of our study is that data were obtained in a relatively low number of patients.CONCLUSION: MRI is sufficient to stage NAFLD in obese patients and to assess the improvement after bariatric surgery. Other data were superfluous for this purpose.Nahum Calvo Raúl Beltrán-Debón Esther Rodríguez-Gallego Anna Hernández-Aguilera Maria Guirro Roger Mariné-Casadó Lidón Millá Josep M Alegret Fàtima Sabench Daniel del Castillo María Vinaixa Miguelàngel Rodríguez Xavier Correig Roberto García-álvarez Javier A Menendez Jordi Camps Jorge Joven 2015World Journal of Gastroenterology2015,21,24:2
18Adenocarcinoma of the third and fourth portions of the duodenum: The capsule endoscopy value显示文摘Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However,its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this work is to report an adenocarcinoma of the third and fourth duodenal portions,emphasizing its diagnostic difficulty and the value of video capsule endoscopy. A man,40 years old,with no medical history,with abdominal discomfort and progressive fatigue,presented four months ago with one episode o f m o d e ra t e m e l e n a. T h e p hy s i c a l e x a m i n a t i o n was normal,except for mucosal pallor. Blood tests were consistent with microcytic,hypochromic iron deficiency anemia with 7.8 g/d L hemoglobin. The upper and lower endoscopy were normal. Additional work-up with video capsule endoscopy showed a polypoid lesion involving the third and fourth portions o f t h e d u o d e n u m. B i o p s y s h o w e d a m o d e ra t e l y differentiated adenocarcinoma. Abdominal computed tomography showed a wall thickening from the third duodenal portion to the proximal jejunum,without distant metastasis. The patient underwent segmental resection(distal duodenum and proximal jejunum) with duodenojejunostomy. The surgical specimen histology confirmed the biopsy diagnosis,with transmural infiltration,without nodal involvement. Conclusion: Adenocarcinoma of the third and fourth portions of the duodenum is difficult to diagnose and capsule endoscopy is of great value.Feliciano Chanana Paquissi Ana Henriqueta Filipe Bunga Pimentel Lima Maria de Fátima do Nascimento Vieira Lopes Francisco Viamontes Diaz 2015World Journal of Gastroenterology2015,21,31:2
19Oral refeeding in mild acute pancreatitis:An old challenge显示文摘Although the idea that pancreas rest has long been considered as a very relevant topic in acute pancreatitis (AP)therapy,the right time and type of diet to be offered to patients recovering from an acute attack are a great challenge to clinicians who treat this condition.Fortunately,the last decade was noted for several trials looking for the best answer to the question:'when and how to start oral refeeding in AP?'It is well known that 80%of patients present with mild disease characterized by usually uncomplicated clinical course are managed with pancreatic rest through nil per oral;while the use of specific nutritional intervention is an exception.Therefore,mild AP has been the most investigated form of AP and researchers have tried different kind of meals to offer calories and reduce costs by shortening hospitalization time.Usually in mild AP,the oral refeeding is introduced between the first 3 d and 7 d after hospitalization but,the type of diet and patients’tolerance have been scrutinized in detail with mixed results.Although 20%to 25%have pain recurrence requiring nutritional support and greater time of hospitalization,most patients seem to tolerate oral refeeding well.We propose analyzing the most recent investigations of this matter and their conclusions to develop a better understanding of the management of AP.Júlio Maria F Chebli Pedro D Gaburri Liliana A Chebli 2011World Journal of Gastrointestinal Pathophysiology2011,2,6:2
20Knowledge, perception and practices about malaria, climate change, livelihoods and food security among rural communities of central Tanzania显示文摘Background:Understanding the interactions between malaria and agriculture in Tanzania is of particular significance when considering that they are the major sources of illness and livelihoods.The objective of this study was to determine knowledge,perceptions and practices as regards to malaria,climate change,livelihoods and food insecurity in a rural farming community in central Tanzania.Methods:Using a cross-sectional design,heads of households were interviewed on their knowledge and perceptions on malaria transmission,symptoms and prevention and knowledge and practices as regards to climate change and food security.Results:A total of 399 individuals(mean age=39.8±15.5 years)were interviewed.Most(62.41%)of them had attained primary school education and majority(91.23%)were involved in crop farming activities.Nearly all(94.7%)knew that malaria is acquired through a mosquito bite.Three quarters(73%)reported that most people get sick from malaria during the rainy season.About 50%of the respondents felt that malaria had decreased during the last 10 years.The household coverage of insecticide treated mosquito nets(ITN)was high(95.5%).Ninety-six percent reported to have slept under a mosquito net the previous night.Only one in four understood the official Kiswahili term(Mabadiliko ya Tabia Nchi)for climate change.However,there was a general understanding that the rain patterns have changed in the past 10 years.Sixty-two percent believed that the temperature has increased during the same period.Three quarters of the respondents reported that they had no sufficient production from their own farms to guarantee food security in their household for the year.Three quarters(73.0%)reported to having food shortages in the past five years.About half said they most often experienced severe food shortage during the rainy season.Conclusion:Farming communities in Kilosa District have little knowledge on climate change and its impact on malaria burden.Food insecurity is common and community-based strategies to mitigate this need to be established.The findings call for an integrated control of malaria and food insecurity interventions.Benjamin K Mayala Carolyn A Fahey Dorothy Wei Maria M Zinga Venera M Bwana Tabitha Mlacha Susan F Rumisha Grades Stanley Elizabeth H Shayo Leonard EG Mboera 2015Infectious Diseases of Poverty2015,4,1:2
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