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Elliver M, Salö M, Roth B, Ohlsson B, Hagander L, Gudjonsdottir J. Associations between Th1-related cytokines and complicated pediatric appendicitis. Sci Rep 2024; 14:4613. [PMID: 38409170 PMCID: PMC10897334 DOI: 10.1038/s41598-024-53756-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
The pathogenesis of appendicitis is not understood fully, and the diagnosis can be challenging. Previous research has suggested an association between a T helper (Th) 1-dependent immune response and complicated appendicitis. This prospective cohort study aimed to evaluate the association between serum concentrations of the Th1-associated cytokines interleukin (IL)-1α, IL-1β, IL-2, IL-6, IL-10, IL-17A and tumor necrosis factor beta (TNF-β) and the risk of complicated appendicitis in children. Appendicitis severity was determined through histopathological examination. A total of 137 children < 15 years with appendicitis were included with a median age of 10 years (IQR 8-12); 86 (63%) were boys, and 58 (42%) had complicated appendicitis. Children with complicated appendicitis had significantly higher concentrations of serum IL-6 and IL-10, and lower of TNF-β. After adjustment for age, symptom duration, and presence of appendicolith in a multivariable logistic regression, a higher concentration of IL-6 remained associated with an increased risk of complicated appendicitis (aOR 1.001 [95% CI 1.000-1.002], p = 0.02). Serum concentrations of IL-1α, IL-1β, IL-2, IL-10, IL-17A and TNF-β were not significantly associated with the risk of complicated appendicitis. In conclusion, our results suggests that the systemic inflammatory response in complicated appendicitis is complex and not solely Th1-dependent.
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Affiliation(s)
- Matilda Elliver
- Department of Clinical Sciences in Lund, Lund University, Lund, Sweden.
| | - Martin Salö
- Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
- Department of Pediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Bodil Roth
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Bodil Ohlsson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Lars Hagander
- Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
- Department of Pediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Johanna Gudjonsdottir
- Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
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Roth B, Ohlsson B. Microscopic colitis found together with celiac disease in a female population is associated with one episode of lymphocytic colitis. BMC Gastroenterol 2024; 24:70. [PMID: 38347511 PMCID: PMC10860280 DOI: 10.1186/s12876-024-03158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 02/04/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Microscopic colitis (MC) is considered a chronic disease associated with autoimmune disease, smoking, and drugs. The aim was to examine the association between MC and celiac disease, adjusted for smoking, considering subtypes and clinical course of the disease in a retrospectively collected female cohort. METHODS Women (n = 240), ≤ 73 years, diagnosed as MC in medical records or pathological registers were invited. One hundred and fifty-eight women accepted to be included. Participants completed a study questionnaire about sociodemographic factors, lifestyle habits, and medical history; the Rome III questionnaire; and the visual analog scale for irritable bowel syndrome (VAS-IBS). Participants were categorized into collagenous colitis (CC) (n = 92) and lymphocytic colitis (LC) (n = 66) or MC with one episode of the disease (n = 70) and refractory MC (n = 88). Presence of IBS-like symptoms were noted. Blood samples were collected and analyzed for anti-transglutaminase antibodies. Differences between groups were calculated and logistic regression was adjusted for smoking habits. RESULTS MC and celiac disease debuted simultaneously in half of the cases. Celiac disease was most prevalent in LC (12.1% vs. 3.3%; p = 0.05) and MC with one episode (12.9% vs. 2.3%; p = 0.01). Anti-transglutaminase antibodies were found in one patient with one episode of MC. Corticosteroid use was most often found in CC (37.0% vs. 21.2%; p = 0.037) and refractory MC (38.6% vs. 20.0%; p = 0.015). Past smokers were most prevalent in patients with one episode of MC (54.3 vs. 29.5%; p = 0.007). Current smoking was the smoking habit with highest prevalence of IBS-like symptoms. When adjusted for smoking habits, celiac disease was associated with LC (OR: 4.222; 95% CI: 1.020-17.469; p = 0.047) and tended to be inversely associated with refractory MC (OR: 0.210; 95% CI: 0.042-1.506; p = 0.058). CONCLUSION Celiac disease is most common in patients with one episode of LC. The question remains whether LC in combination with celiac disease should be classified as celiac disease or two different entities.
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Affiliation(s)
- Bodil Roth
- Department of Internal Medicine, Lund University, Skåne University Hospital, Jan Waldenströms Street 15, Floor 5, 205 02, Malmö, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Lund University, Skåne University Hospital, Jan Waldenströms Street 15, Floor 5, 205 02, Malmö, Sweden.
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Roth B, Ohlsson B. A starch- and sucrose-reduced diet may lead to improvement of intestinal and extraintestinal symptoms in more conditions than irritable bowel syndrome and congenital sucrase-isomaltase deficiency. Nutrition 2024; 117:112254. [PMID: 37924624 DOI: 10.1016/j.nut.2023.112254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES A starch- and sucrose-reduced diet has been found to improve gastrointestinal and extraintestinal symptoms in irritable bowel syndrome, as well as reduce weight and improve psychological well-being. Our hypothesis was that a starch- and sucrose-reduced diet would also be beneficial in other conditions with similar symptoms. The aim of the present research letter was to describe the role of a starch- and sucrose-reduced diet in a pilot project in patients with diarrhea having varying causes. METHODS One man, age 36 y, suffering from functional diarrhea and one woman, 56 y, suffering from microscopic colitis, were randomized to a starch- and sucrose-reduced diet for 4 wk. At baseline, dietary information was given, and blood samples collected. Weight and waist circumference were measured. The participants completed the irritable bowel syndrome severity scoring system for evaluating specific gastrointestinal and extraintestinal symptoms and visual analog scale for irritable bowel syndrome for evaluation of specific gastrointestinal symptoms and psychological well-being. The degrees of satiety and sweet craving were measured on visual analog scales. After 4 wk, all procedures were repeated. RESULTS Weight, body mass index, and waist circumference were decreased during the intervention. The total amount of gastrointestinal symptoms was decreased in the participants with functional diarrhea, and diarrhea and bloating were decreased in both participants. Both had reduced extraintestinal symptoms and improved psychological well-being. Blood levels had mainly unchanged or slightly increased values of measurements reflecting nutrient intake. CONCLUSIONS A starch- and sucrose-reduced diet may lead to weight reduction, reduced symptoms, and improved well-being in several patient categories, not only in patients suffering from irritable bowel syndrome. Future randomized trials should be done.
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Affiliation(s)
- Bodil Roth
- Department of Internal Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Lund University, Skåne University Hospital, Malmö, Sweden.
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Manoharan L, Roth B, Bang C, Stenlund H, Ohlsson B. An Okinawan-Based Nordic Diet Leads to Profound Effects on Gut Microbiota and Plasma Metabolites Linked to Glucose and Lipid Metabolism. Nutrients 2023; 15:3273. [PMID: 37513690 PMCID: PMC10384944 DOI: 10.3390/nu15143273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Dietary interventions modify gut microbiota and clinical outcomes. Weight reduction and improved glucose and lipid homeostasis were observed after adopting an Okinawan-based Nordic diet (O-BN) in individuals with type 2 diabetes. The aim of the present study was to explore changes in metabolomics and gut microbiota during O-BN and correlate changes with clinical outcomes. A total of 30 patients (17 women), aged 57.5 ± 8.2 years, diabetes duration 10.4 ± 7.6 years, 90% over-weight, were included. Participants were provided an O-BN for 12 weeks. Before and after intervention, and 16 weeks afterwards, anthropometry and clinical data were estimated and questionnaires were collected, as well as samples of blood and stool. Plasma metabolomics were determined by gas- (GC-MS) or liquid- (LC-MS) chromatography-based mass spectrometry and fecal microbiota determination was based on 16S rRNA amplicons from regions V1-V2. During the intervention, weight (6.8%), waist circumference (6.1%), and levels of glucose, HbA1c, insulin, triglycerides, and cholesterol were decreased. Of 602 metabolites, 323 were changed for any or both periods; 199 (101 lipids) metabolites were decreased while 58 (43 lipids) metabolites were increased during the intervention. Changes in glucose homeostasis were linked to changes in, e.g., 1,5-anhydroglucitol, thyroxine, and chiro-inositol. Changes of microbe beta diversity correlated positively with food components and negatively with IL-18 (p = 0.045). Abundance differences at phylum and genus levels were found. Abundances of Actinobacteria, Bacteroidetes, Firmicutes, and Verrucomicrobia correlated with anthropometry, HbA1c, lipids, inflammation, and food. Changes in metabolites and microbiota were reversed after the intervention. The O-BN-induced changes in metabolomics and gut microbiota correspond to clinical outcomes of reduced weight and inflammation and improved glucose and lipid metabolism.
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Affiliation(s)
- Lokeshwaran Manoharan
- National Bioinformatics Infrastructure Sweden (NBIS), SciLifeLab, Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22100 Lund, Sweden
| | - Bodil Roth
- Department of Clinical Sciences Malmö, Lund University, SE-22100 Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Corinna Bang
- Institute for Clinical Molecular Biology, Christian-Albrecht's University, 24105 Kiel, Germany
| | - Hans Stenlund
- Umeå Plant Science Centre (UPSC), Department of Plant Physiology, Umeå University, 90187 Umeå, Sweden
| | - Bodil Ohlsson
- Department of Clinical Sciences Malmö, Lund University, SE-22100 Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, SE-20502 Malmö, Sweden
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Xu J, Molin G, Davidson S, Roth B, Sjöberg K, Håkansson Å. CRP in Outpatients with Inflammatory Bowel Disease Is Linked to the Blood Microbiota. Int J Mol Sci 2023; 24:10899. [PMID: 37446076 DOI: 10.3390/ijms241310899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The circulation is a closed system that has been assumed to be free from bacteria, but evidence for the existence of a low-density blood microbiota is accumulating. The present study aimed to map the blood microbiota of outpatients with Crohn's disease (CD) or with ulcerative colitis (UC) by 16S metagenomics. A diverse microbiota was observed in the blood samples. Regardless of the type of disease, the alpha diversity of the microbiota was positively associated with C-reactive protein (CRP). The blood microbiota had a surprisingly high proportion of Proteobacteria in comparison with human oral and colonic microbiotas. There was no clear difference in the overall pattern of the microbiota between CD and UC. A non-template control (NTC) was included in the whole process to control for the potential contamination from the environment and reagents. Certain bacterial taxa were concomitantly detected in both blood samples and NTC. However, Acinetobacter, Lactobacillus, Thermicanus and Paracoccus were found in blood from both CD and UC patients but not in NTC, indicating the existence of a specific blood-borne microbiota in the patients. Achromobacter dominated in all blood samples, but a minor amount was also found in NTC. Micrococcaceae was significantly enriched in CD, but it was also detected in high abundance in NTC. Whether the composition of the blood microbiota could be a marker of a particular phenotype in inflammatory bowel disease (IBD) or whether the blood microbiota could be used for diagnostic or therapeutic purposes deserves further attention.
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Affiliation(s)
- Jie Xu
- Department of Food Technology, Engineering and Nutrition, Lund University, 22100 Lund, Sweden
| | - Göran Molin
- Department of Food Technology, Engineering and Nutrition, Lund University, 22100 Lund, Sweden
| | - Sanna Davidson
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, 20502 Malmö, Sweden
| | - Bodil Roth
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, 20502 Malmö, Sweden
| | - Klas Sjöberg
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, 20502 Malmö, Sweden
| | - Åsa Håkansson
- Department of Clinical Sciences, Lund University, 21428 Malmö, Sweden
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Pocevičiūtė D, Roth B, Schultz N, Nuñez-Diaz C, Janelidze S, Olofsson A, Hansson O, Wennström M. Plasma IAPP-Autoantibody Levels in Alzheimer's Disease Patients Are Affected by APOE4 Status. Int J Mol Sci 2023; 24:ijms24043776. [PMID: 36835187 PMCID: PMC9960837 DOI: 10.3390/ijms24043776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Pancreas-derived islet amyloid polypeptide (IAPP) crosses the blood-brain barrier and co-deposits with amyloid beta (Aβ) in brains of type 2 diabetes (T2D) and Alzheimer's disease (AD) patients. Depositions might be related to the circulating IAPP levels, but it warrants further investigation. Autoantibodies recognizing toxic IAPP oligomers (IAPPO) but not monomers (IAPPM) or fibrils have been found in T2D, but studies on AD are lacking. In this study, we have analyzed plasma from two cohorts and found that levels of neither immunoglobulin (Ig) M, nor IgG or IgA against IAPPM or IAPPO were altered in AD patients compared with controls. However, our results show significantly lower IAPPO-IgA levels in apolipoprotein E (APOE) 4 carriers compared with non-carriers in an allele dose-dependent manner, and the decrease is linked to the AD pathology. Furthermore, plasma IAPP-Ig levels, especially IAPP-IgA, correlated with cognitive decline, C-reactive protein, cerebrospinal fluid Aβ and tau, neurofibrillary tangles, and brain IAPP exclusively in APOE4 non-carriers. We speculate that the reduction in IAPPO-IgA levels may be caused by increased plasma IAPPO levels or masked epitopes in APOE4 carriers and propose that IgA and APOE4 status play a specific role in clearance of circulatory IAPPO, which may influence the amount of IAPP deposition in the AD brain.
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Affiliation(s)
- Dovilė Pocevičiūtė
- Cognitive Disorder Research Unit, Department of Clinical Sciences Malmö, Lund University, 214 28 Malmö, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Lund University, Skåne University Hospital, 214 28 Malmö, Sweden
| | - Nina Schultz
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 223 62 Lund, Sweden
| | - Cristina Nuñez-Diaz
- Cognitive Disorder Research Unit, Department of Clinical Sciences Malmö, Lund University, 214 28 Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 223 62 Lund, Sweden
| | | | - Anders Olofsson
- Department of Medical Biochemistry and Biophysics, Umeå University, 901 87 Umeå, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 223 62 Lund, Sweden
- Memory Clinic, Skåne University Hospital, 212 24 Malmö, Sweden
| | - Malin Wennström
- Cognitive Disorder Research Unit, Department of Clinical Sciences Malmö, Lund University, 214 28 Malmö, Sweden
- Correspondence:
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Crettenand F, Assayed Leonardi N, Martinez Carrique S, Roth B. Comparing continuous wound infiltration with thoracic epidural analgesia for postoperative pain management in open nephrectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Schaer S, Rakauskas A, Valerio M, Roth B. A preliminary assessment of microultrasound performance in detecting clinically significant prostate cancer in the anterior prostate: An inter-reader evaluation. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Grilo N, Crettenand F, Dartiguenave F, Dias S, Blanc C, Roth B, Lucca I. Impact of ERAS® protocol compliance on length of stay, bowel recovery and complications after radical cystectomy. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Svensson A, Roth B, Kronvall L, Ohlsson B. TSH receptor antibodies (TRAb) - A potential new biomarker for endometriosis. Eur J Obstet Gynecol Reprod Biol 2022; 278:115-121. [PMID: 36152376 DOI: 10.1016/j.ejogrb.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/28/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The prevalence of several autoimmune diseases, including thyroid dysfunction, has been reported to be increased in patients with endometriosis. Upregulated thyroid stimulation hormone (TSH) receptors in ectopic endometrium and elevated serum titers of TSH receptor antibodies (TRAb) IgG in endometriosis patients indicates an overlap in pathophysiology. However, cross-reactivity with other antibodies must be excluded. The objective of this study was to compare the expression of autoantibodies in women with endometriosis and two control groups to evaluate the potential of TRAb IgG as a diagnostic marker for endometriosis. STUDY DESIGN This cross-sectional study was carried out in 172 women with surgically confirmed endometriosis and two control groups consisting of 50 healthy blood donors and 114 women from Malmö Offspring Study consisting of people from the general population. Serum levels of thyroid hormones, TSH and TRAb autoantibodies, AXIN1, and autoantibodies against follicle stimulating hormone (FSH), human chorionic gonadotropin (hCG), luteinizing hormone (LH), and their receptors, were analyzed. The patients answered a questionnaire and estimated their gastrointestinal symptoms using the Visual Analogue Scale for Irritable Bowel Syndrome. RESULTS Of the endometriosis patients, 29.1 % had TRAb IgG above the present detection limit of ≥ 1.0 IE/L compared to 2.6 % of the controls from MOS (p < 0.001) and 94.5 % had levels of TRAb over the previous detection limit ≥ 0.3 IE/L compared to 7.9 % of the controls (p < 0.001). Titers of both TRAb IgG and IgM were increased in patients compared to controls from MOS and blood donors, respectively (p < 0.001). There was no increase of autoantibodies against FSH, FSH receptor (FSHR), hCG, LH, LH receptor (LHR) or TSH compared to the blood donor controls. TRAb titers did not correlate with age, disease duration, AXIN1, TSH, thyroid hormones or gastrointestinal symptoms. CONCLUSION TRAb IgG and IgM are slightly elevated in patients with endometriosis with no cross-reactivity with other autoantibodies. The results indicate that TRAb is truly elevated and thereby has the potential to be used to support the diagnosing of endometriosis.
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Affiliation(s)
- Agnes Svensson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 205 02 Malmö, Sweden.
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 205 02 Malmö, Sweden.
| | - Linnea Kronvall
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 205 02 Malmö, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 205 02 Malmö, Sweden.
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Pocevičiūtė D, Nuñez-Diaz C, Roth B, Janelidze S, Giannisis A, Hansson O, Wennström M. Increased plasma and brain immunoglobulin A in Alzheimer’s disease is lost in apolipoprotein E ε4 carriers. Alzheimers Res Ther 2022; 14:117. [PMID: 36008818 PMCID: PMC9414424 DOI: 10.1186/s13195-022-01062-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/15/2022] [Indexed: 11/25/2022]
Abstract
Background Alzheimer’s disease (AD) is foremost characterized by β-amyloid (Aβ)-extracellular plaques, tau-intraneuronal fibrillary tangles (NFT), and neuroinflammation, but over the last years it has become evident that peripheral inflammation might also contribute to the disease. AD patients often demonstrate increased levels of circulating proinflammatory mediators and altered antibody levels in the blood. In our study, we investigated the plasma Immunoglobulin A (IgA) levels in association with apolipoprotein E (APOE) ε4 status and Aβ pathology. Methods IgA levels in antemortem-collected (cohort I) and postmortem-collected (cohort II) plasma samples from AD patients (n = 30 in cohort I and n = 16 in cohort II) and non-demented age-matched controls (NC) (n = 42 in cohort I and n = 7 in cohort II) were measured using ELISA. Hippocampal sections from cohort II were immunostained against IgA, and the IgA area fraction as well as the number of IgA positive (IgA+) cells in the cornu ammonis region were analysed using ImageJ. The relationship between plasma IgA levels and cognition, C-reactive protein (CRP), and cerebrospinal fluid (CSF) AD biomarkers in cohort I as well as neuropathology, IgA+ cell number, and IgA area fraction in cohort II was analysed before and after grouping the cohorts into APOEε4 carriers and APOEε4 non-carriers. Results Plasma IgA levels were higher in AD patients compared to NC in both cohorts. Also, AD patients demonstrated higher IgA area fraction and IgA+ cell number compared to NC. When APOEε4 status was considered, higher plasma IgA levels in AD patients were only seen in APOEε4 non-carriers. Finally, plasma IgA levels, exclusively in APOEε4 non-carriers, were associated with cognition, CRP, and CSF Aβ levels in cohort I as well as with IgA area fraction, IgA+ cell number, and Aβ, Lewy body, and NFT neuropathology in cohort II. Conclusions Our study suggests that AD pathology and cognitive decline are associated with increased plasma IgA levels in an APOE allele-dependent manner, where the associations are lost in APOEε4 carriers. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01062-z.
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Göpel W, Kribs A, Roll C, Wieg C, Teig N, Hoehn T, Welzing L, Vochem M, Hoppenz M, Bührer C, Mehler K, Hubert M, Eichhorn J, Schmidtke S, Rausch TK, König IR, Härtel C, Roth B, Herting E. Multicentre randomised trial of invasive and less invasive surfactant delivery methods showed similar spirometry results at 5-9 years of age. Acta Paediatr 2022; 111:2108-2114. [PMID: 35896864 DOI: 10.1111/apa.16499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/28/2022]
Abstract
AIM We explored whether subnormal forced expiratory volume within one second (FEV1 ) at 5-9 years of age was lower in children born preterm who received less invasive surfactant administration (LISA) rather than surfactant via an endotracheal tube. METHODS The multicentre, randomised Nonintubated Surfactant Application trial enrolled 211 preterm infants born at 23-26 weeks of gestation from 13 level III neonatal intensive care units from April 2009 to March 2012. They received surfactant via LISA (n=107) or after conventional endotracheal intubation (n=104). The follow-up assessments were carried out by a single team blinded to the group assignments. The main outcome was FEV1 <80% of predicted values. RESULTS Spirometry was successful in 102/121 children. The other children died or were lost to follow up. Median FEV1 was 93% (interquartile range 80-113%) of predicted values in the LISA group and 86% (interquartile range 77-102%) in the control group (p=0.685). Rates of FEV1 < 80% were 11/57 (19%) and 15/45 (33 %) respectively, which was an absolute risk reduction of 14% (95% confidence interval -3.1% to 31.2%, p=0.235). There were no differences in other outcome measures. CONCLUSION The proportion of children aged 5-9 years with subnormal FEV1 was not significantly different between the groups.
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Affiliation(s)
- W Göpel
- Department of Paediatrics, University Hospital of Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - A Kribs
- Department of Paediatrics, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - C Roll
- Department of Neonatology, Vest Children's Hospital Datteln, University Witten-Herdecke, Datteln, Germany
| | - C Wieg
- Children's Hospital Aschaffenburg-Alzenau, Aschaffenburg, Germany
| | - N Teig
- Department of Neonatology, University Children's Hospital, Ruhr University Bochum, Bochum, Germany
| | - T Hoehn
- Department of General Paediatrics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - L Welzing
- Department of Paediatrics, Hospital Köln-Porz, Germany
| | - M Vochem
- Olgahospital Stuttgart, Stuttgart, Germany
| | - M Hoppenz
- Department of Neonatology and Paediatric Intensive Care Medicine, Children's Hospital, Cologne, Germany
| | - C Bührer
- Department of Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Mehler
- Department of Paediatrics, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - M Hubert
- Department of Neonatology and Paediatric Intensive Care, DRK-Children's Hospital, Siegen, Germany
| | - J Eichhorn
- Children's Hospital Leverkusen, Leverkusen, Germany
| | - S Schmidtke
- Department of Neonatology, Asklepios Klinik Barmbek, Hamburg, Germany
| | - T K Rausch
- Institute of Medical Biometry and Statistics, University of Lübeck, Germany
| | - I R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Germany
| | - C Härtel
- Children's Hospital, University of Würzburg, Würzburg, Germany
| | - B Roth
- Department of Paediatrics, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - E Herting
- Department of Paediatrics, University Hospital of Schleswig-Holstein, University of Lübeck, Lübeck, Germany
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Roth B, Larsson E, Ohlsson B. Poor intake of vitamins and minerals is associated with symptoms among patients with irritable bowel syndrome. J Gastroenterol Hepatol 2022; 37:1253-1262. [PMID: 35304769 PMCID: PMC9544605 DOI: 10.1111/jgh.15830] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/27/2022] [Accepted: 03/06/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Poor food habits with insufficient intake of micronutrients have been described in irritable bowel syndrome (IBS), which could be of importance for development of gastrointestinal and extraintestinal symptoms. The study aims were to examine intake and plasma/serum levels of micronutrients in IBS and whether these factors were associated with symptoms and restrictions and to study the effects of a starch- and sucrose-reduced diet (SSRD). METHODS One hundred five patients with IBS or functional gastrointestinal disorder (FGID) according to Rome IV criteria were included to SSRD/controls for 4 weeks. Patients completed a study questionnaire about lifestyle habits, medical health, IBS-symptom severity score (IBS-SSS), visual analog scale for IBS (VAS-IBS), and diary books before and after study start. Plasma/serum levels of micronutrients were analyzed at baseline. RESULTS Intake of micronutrients at baseline was lower than recommended according to national guidelines. Gastrointestinal symptoms were inversely associated with intake and plasma levels of iron. Extraintestinal symptoms and fatigue inversely associated with intake of vitamin B6, phosphorus, magnesium, and iodine, as was plasma levels of iron, and positively associated with plasma iron-binding capacity. Fatigue was also inversely associated with calcium, iron, and zinc intakes. Plasma ferritin was lower in participants on restrictions. SSRD increased the intake of several vitamins, selenium, and fat, whereas sodium intake was decreased, with markedly reduced symptoms. CONCLUSION Irritable bowel syndrome patients had low intake of micronutrients at baseline, which associated inversely with total IBS-SSS, extraintestinal IBS-SSS, and fatigue. SSRD increased the intake of several micronutrients, which correlated weakly with symptom improvement.
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Affiliation(s)
- Bodil Roth
- Department of Internal MedicineSkåne University HospitalMalmöSweden
- Department of Clinical SciencesLund UniversityLundSweden
| | - Ewa Larsson
- Department of Internal MedicineSkåne University HospitalMalmöSweden
- Department of Clinical SciencesLund UniversityLundSweden
| | - Bodil Ohlsson
- Department of Internal MedicineSkåne University HospitalMalmöSweden
- Department of Clinical SciencesLund UniversityLundSweden
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14
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Svensson A, Garcia-Etxebarria K, Åkesson A, Borgfeldt C, Roth B, Ek M, D'Amato M, Ohlsson B. Applicability of polygenic risk scores in endometriosis clinical presentation. BMC Womens Health 2022; 22:208. [PMID: 35659226 PMCID: PMC9166598 DOI: 10.1186/s12905-022-01788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Risk prediction is an essential part of preventative medicine and in recent years genomic information has become an interesting factor in risk models. Polygenic risk scores (PRS) combine the effect of many genetic variations into a single score which has been shown to have predictive value for many diseases. This study aimed to investigate the association between PRS for endometriosis and the clinical presentation of the disease. Methods Women with endometriosis (N = 172) were identified at the Department of Gynecology. All participants answered questionnaires regarding sociodemographic factors, lifestyle habits and medical history, registered bowel symptoms on the Visual Analog Scale for Irritable Bowel Syndrome and passed blood samples. DNA was extracted and samples were genotyped, and a PRS was calculated based on previous genome-wide association studies of endometriosis. Inflammatory proteins and TSH receptor antibodies (TRAb) in serum were analyzed. Results Inverse associations were identified between PRS and spread of endometriosis, involvement of the gastrointestinal tract and hormone treatment. However, significance was lost when calculated as p for trend and the specificity and sensitivity were low. There were no correlations between PRS and TRAb or inflammatory proteins. Conclusion The findings indicate that specific PRS should be developed to predict clinical presentations in patient with endometriosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01788-w.
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Affiliation(s)
- Agnes Svensson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.
| | - Koldo Garcia-Etxebarria
- Biodonostia, Gastrointestinal Genetics Group, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas Y Digestivas (CIBERehd), 20014, San Sebastian, Spain
| | - Anna Åkesson
- Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Malin Ek
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Mauro D'Amato
- Gastrointestinal Genetics Lab, CIC bioGUNE - BRTA, Derio, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,Department of Medicine and Surgery, LUM University, Casamassima, Italy
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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15
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Martel P, Rakauskas A, Dagher J, La Rosa S, Meuwly JY, Roth B, Valerio M. The benefit of adopting Microultrasound in the prostate cancer imaging pathway: A lesion-by-lesion analysis: Biopsies prostatiques guidée par micro-échographie, quel bénéfice ? Une analyse lésion par lésion. Prog Urol 2022; 32:6S26-6S32. [PMID: 36719643 DOI: 10.1016/s1166-7087(22)00172-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION - Microultrasound (MicroUS) is a novel imaging modality relying on a high-frequency transducer which confers a three-fold improvement in spatial resolution as compared with conventional transrectal ultrasound. We evaluated the diagnostic value of MRI-MicroUS fusion biopsy and determined the additional benefit of employing MicroUS. METHODS - Retrospective analysis of consecutive treatment-naïve men undergoing MRI-MicroUS fusion biopsy between May 2018 and March 2019. Pre-biopsy MRI was systematically reviewed in a dedicated meeting where suspicious lesions PIRADS ≥ 3 were registered and uploaded in the ExactVu MicroUS device. MRI and MicroUS lesions were individually marked in a PIRADS v2 scheme. The biopsy protocol included MRI-MicroUS fusion and MicroUS targeted biopsies; systematic biopsies were performed at clinician's discretion. The diagnostic value was evaluated in terms of detection rate of clinically significant prostate cancer, defined as Gleason pattern ≥ 4 at histology. RESULTS - In all, 148 patients with a median age of 69 years (IQR 63-74) and median PSA density of 0.16 ng/ml/cc (0.10-0.23) were included. Clinically significant cancer was detected in 42.5% (63/148) patients. MRI detected 89 lesions in the peripheral zone; 73% (65/89) were visible on MicroUS. Clinically significant cancer was detected in 46.1% (30/65) MRI and MicroUS visible lesions, and in 4.2% (1/24) lesions only visible on mpMRI. MicroUS additionally identified 35 suspicious lesions non-visible on MRI of which clinically significant cancer was present in 25.7% (9/35). CONCLUSION - Adding MicroUS to the conventional pathway seems to increase the detection rate of clinically significant disease in unselected men undergoing biopsy. © 2022 Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- P Martel
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - A Rakauskas
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - J Dagher
- Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - S La Rosa
- Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland; Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - J Y Meuwly
- Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - B Roth
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - M Valerio
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland.
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16
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Nilholm C, Manoharan L, Roth B, D'Amato M, Ohlsson B. A starch- and sucrose-reduced dietary intervention in irritable bowel syndrome patients produced a shift in gut microbiota composition along with changes in phylum, genus, and amplicon sequence variant abundances, without affecting the micro-RNA levels. United European Gastroenterol J 2022; 10:363-375. [PMID: 35484927 PMCID: PMC9103372 DOI: 10.1002/ueg2.12227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background/Aim A randomized clinical trial with a starch‐ and sucrose‐reduced diet (SSRD) in irritable bowel syndrome (IBS) patients has shown clear improvement of participants' symptoms. The present study aimed to explore the effects of the SSRD on the gut microbiota and circulating micro‐RNA in relation to nutrient intake and gastrointestinal symptoms. Methods IBS patients were randomized to a 4‐week SSRD intervention (n = 80) or control group (n = 25); habitual diet). At baseline and 4 weeks, blood and fecal samples, 4 day‐dietary records, and symptom questionnaires were collected, that is, Rome IV questionnaires, IBS‐symptom severity score (IBS‐SSS) and visual analog scale for IBS (VAS‐IBS). Micro‐RNA was analyzed in blood and microbiota in faeces by 16S rRNA from regions V1–V2. Results The alpha diversity was unaffected, whereas beta diversity was decreased (p < 0.001) along with increased abundance of Proteobacteria (p = 0.0036) and decreased abundance of Bacteroidetes phyla (p < 0.001) in the intervention group at 4 weeks. Few changes were noted in the controls. The shift in beta diversity and phyla abundance correlated with decreased intakes of carbohydrates, disaccharides, and starch and increased fat and protein intakes. Proteobacteria abundance also correlated positively (R2 = 0.07, p = 0.0016), and Bacteroidetes negatively (R2 = 0.07, p = 0.0017), with reduced total IBS‐SSS. Specific genera, for example, Eubacterium eligens, Lachnospiraceae UCG‐001, Victivallis, and Lachnospira increased significantly in the intervention group (p < 0.001 for all), whereas Marvinbryantia, DTU089 (Ruminoccocaceae family), Enterorhabdus, and Olsenella decreased, together with changes in amplicon sequence variant (ASV) levels. Modest changes of genus and ASV abundance were observed in the control group. No changes were observed in micro‐RNA expression in either group. Conclusion The SSRD induced a shift in beta diversity along with several bacteria at different levels, associated with changes in nutrient intakes and reduced gastrointestinal symptoms. No corresponding changes were observed in the control group. Neither the nutrient intake nor the microbiota changes affected micro‐RNA expression. The study was registered at ClinicalTrials.gov data base (NCT03306381).
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Affiliation(s)
- Clara Nilholm
- Department of Internal Medicine, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Lokeshwaran Manoharan
- Department of Laboratory Medicine, National Bioinformatics Infrastructure Sweden (NBIS), SciLifeLab, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Mauro D'Amato
- Gastrointestinal Genetics Lab, CIC bioGUNE - BRTA, Derio, Spain.,Ikerbasque, Basque Foundation for Science, Bilboa, Spain.,Department of Medicine and Surgery, LUM University, Casamissama, Italy
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
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17
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Roth B, Myllyvainio J, D’Amato M, Larsson E, Ohlsson B. A Starch- and Sucrose-Reduced Diet in Irritable Bowel Syndrome Leads to Lower Circulating Levels of PAI-1 and Visfatin: A Randomized Controlled Study. Nutrients 2022; 14:nu14091688. [PMID: 35565656 PMCID: PMC9101041 DOI: 10.3390/nu14091688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/31/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023] Open
Abstract
Irritable bowel syndrome (IBS) is characterized by gastrointestinal symptoms. Overweight and increased risk of metabolic syndromes/diabetes are observed in IBS, conditions associated with plasminogen activator inhibitor-1 (PAI-1) and visfatin. The aim of this study was to measure blood levels of AXIN1, cholecystokinin (CCK), enkephalin, ghrelin, neuropeptide Y (NPY), PAI-1, and visfatin before and after a 4-week intervention with a starch- and sucrose-reduced diet (SSRD). A total of 105 IBS patients were randomized to either SSRD (n = 80) or ordinary diet (n = 25). Questionnaires were completed, and blood was analyzed for AXIN1 and hormones. AXIN1 (p = 0.001) and active ghrelin levels (p = 0.025) were lower in IBS than in healthy volunteers at baseline, whereas CCK and enkephalin levels were higher (p < 0.001). In the intervention group, total IBS-symptom severity score (IBS-SSS), specific gastrointestinal symptoms, psychological well-being, and the influence of intestinal symptoms on daily life were improved during the study, and weight decreased (p < 0.001 for all), whereas only constipation (p = 0.045) and bloating (p = 0.001) were improved in the control group. PAI-1 levels tended to be decreased in the intervention group (p = 0.066), with a difference in the decrease between groups (p = 0.022). Visfatin levels were decreased in the intervention group (p = 0.007). There were few correlations between hormonal levels and symptoms. Thus, this diet not only improves IBS symptoms but also seems to have a general health-promoting effect.
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Affiliation(s)
- Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, SE-20502 Malmö, Sweden;
- Department of Clinical Sciences, Lund University, SE-22100 Lund, Sweden; (J.M.); (E.L.)
| | - Julia Myllyvainio
- Department of Clinical Sciences, Lund University, SE-22100 Lund, Sweden; (J.M.); (E.L.)
| | - Mauro D’Amato
- Gastrointestinal Genetics Lab, CIC bioGUNE—BRTA, 48160 Derio, Spain; or
- Ikerbasque, Basque Foundation for Science, 48080 Bilbao, Spain
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | - Ewa Larsson
- Department of Clinical Sciences, Lund University, SE-22100 Lund, Sweden; (J.M.); (E.L.)
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, SE-20502 Malmö, Sweden;
- Department of Clinical Sciences, Lund University, SE-22100 Lund, Sweden; (J.M.); (E.L.)
- Correspondence:
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18
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Martel P, Rakauskas A, Dagher J, La Rosa S, Meuwly JY, Roth B, Valerio M. WITHDRAWN: The benefit of adopting Microultrasound in the prostate cancer imaging pathway : A lesion-by-lesion analysis. Prog Urol 2022:S1166-7087(22)00066-5. [PMID: 35292179 DOI: 10.1016/j.purol.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Microultrasound (MicroUS) is a novel imaging modality relying on a high-frequency transducer which confers a three-fold improvement in spatial resolution as compared with conventional transrectal ultrasound. We evaluated the diagnostic value of MRI-MicroUS fusion biopsy and determined the additional benefit of employing MicroUS. METHODS Retrospective analysis of consecutive treatment-naïve men undergoing MRI-MicroUS fusion biopsy between May 2018 and March 2019. Pre-biopsy MRI was systematically reviewed in a dedicated meeting where suspicious lesions PIRADS≥3 were registered and uploaded in the ExactVu MicroUS device. MRI and MicroUS lesions were individually marked in a PIRADS v2 scheme. The biopsy protocol included MRI-MicroUS fusion and MicroUS targeted biopsies; systematic biopsies were performed at clinician's discretion. The diagnostic value was evaluated in terms of detection rate of clinically significant prostate cancer, defined as Gleason pattern≥4 at histology. RESULTS In all, 148 patients with a median age of 69 years (IQR 63-74) and median PSA density of 0.16ng/ml/cc (0.10-0.23) were included. Clinically significant cancer was detected in 42.5% (63/148) patients. MRI detected 89 lesions in the peripheral zone; 73% (65/89) were visible on MicroUS. Clinically significant cancer was detected in 46.1% (30/65) MRI and MicroUS visible lesions, and in 4.2% (1/24) lesions only visible on mpMRI. MicroUS additionally identified 35 suspicious lesions non-visible on MRI of which clinically significant cancer was present in 25.7% (9/35). CONCLUSION Adding MicroUS to the conventional pathway seems to increase the detection rate of clinically significant disease in unselected men undergoing biopsy.
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Affiliation(s)
- P Martel
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - A Rakauskas
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - J Dagher
- Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - S La Rosa
- Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland; Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - J Y Meuwly
- Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - B Roth
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - M Valerio
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland.
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19
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Bosshard P, Tsaturyan A, Bokova E, Bonny O, Stritt K, Roth B. The impact of stenting prior to oral chemolysis of upper urinary tract uric acid stones. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Gudjonsdottir J, Roth B, Lovén G, Ohlsson B, Hagander L, Salö M. An Evaluation of Serum IgE and Th2-Associated Interleukins in Children With Uncomplicated and Complicated Appendicitis. Front Pediatr 2022; 10:884138. [PMID: 35586830 PMCID: PMC9108389 DOI: 10.3389/fped.2022.884138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/01/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The pathogenesis of appendicitis is not understood completely and establishing a correct diagnosis can be clinically challenging. Previous investigations have shown an association between a T helper cell (Th)2-mediated inflammatory response, for example immunoglobulin E (IgE)-mediated allergy, and a decreased risk of complicated appendicitis. The present study aimed to evaluate differences in serum concentrations of IgE and Th2-associated interleukins (IL) in children with uncomplicated and complicated appendicitis. METHOD A prospective study including children <15 years with appendicitis. Blood samples were collected preoperatively at the time of clinical assessment at the Pediatric Emergency Department and analyzed for concentrations of serum total IgE and IL-4, IL-9, and IL-13. Associations with complicated appendicitis were evaluated through logistic regression adjusting for age, appendicolith, and symptom duration. RESULTS 138 children with confirmed appendicitis were included. The median age was 10 (IQR 8-12) years, 87 (63%) were boys and 58 (42%) had complicated appendicitis. Children with complicated appendicitis had significantly higher concentrations of IL-9 and IL-13 compared to children with uncomplicated appendicitis. In the univariate logistic regression, high concentrations of IL-13 were associated with an increased risk of complicated appendicitis [OR 1.02 (95% CI 1.01-1.04) p = 0.005], which remained in the multivariate analysis [aOR 1.02 (95% CI 1.01-1.04), p = 0.01]. Serum concentrations of IgE, IL-4, and IL-9 did not significantly affect the risk of complicated appendicitis. CONCLUSION High levels of IL-13 seem to be associated with an increased risk of complicated appendicitis. This is incongruent with the hypothesis of an Th1/Th17-driven inflammation in this type of appendicitis.
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Affiliation(s)
- Johanna Gudjonsdottir
- Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden.,Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Gustav Lovén
- Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Lars Hagander
- Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden.,Department of Pediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Martin Salö
- Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden.,Department of Pediatric Surgery, Skåne University Hospital, Lund, Sweden
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21
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Ek M, Roth B, Bengtsson M, Ohlsson B. Gastrointestinal Symptoms in Women With Endometriosis and Microscopic Colitis in Comparison to Irritable Bowel Syndrome: A Cross-Sectional Study. Turk J Gastroenterol 2021; 32:819-827. [PMID: 34787086 DOI: 10.5152/tjg.2020.19583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Gastrointestinal (GI) symptoms similar to irritable bowel syndrome (IBS) are often present in women with endometriosis and microscopic colitis (MC). The objective of this study was to estimate GI symptoms in IBS, endometriosis, and MC, to compare the clinical expression of the diseases. METHODS Women with IBS, endometriosis, and MC were identified by diagnosis codes at a tertiary center. The patients had to complete the visual analog scale for IBS to estimate specific GI symptoms. Women fulfilling Rome III criteria for IBS were diagnosed as IBS (n = 109) and divided into subgroups depending on predominating symptoms. Women diagnosed with endometriosis (n = 158) and MC (n = 88) were evaluated whether they also fulfilled the Rome III criteria for IBS. RESULTS Women with IBS experienced aggravated abdominal pain, diarrhea, bloating and flatulence, nausea and vomiting, the urgency to defecate, the sensation of incomplete evacuation and intestinal symptom's influence on daily life, and impaired psychological wellbeing, compared to women with endometriosis. When patients with endometriosis also fulfilled the criteria for IBS, all symptoms in the 2 cohorts, except intestinal symptom's influence on daily life, were equal. Women with IBS or diarrhea-predominated IBS experienced aggravated abdominal pain, bloating and flatulence, intestinal symptom's influence on daily life, and impaired psychological well-being compared to MC, but at equal levels as MC with IBS-like symptoms. CONCLUSIONS Women with IBS generally experience aggravated GI symptoms and impaired psychological well-being compared to endometriosis and MC. Patients with endometriosis or MC, in combination with IBS, express similar symptoms as patients with sole IBS.
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Affiliation(s)
- Malin Ek
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Mariette Bengtsson
- Faculty of Health and Society, Institution of Care Science, Malmö University, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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22
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Abstract
PURPOSE Peripheral autonomic neuropathy, including enteric neuropathy, may be subtle and unrecognized for several years. Diagnosis of enteric neuropathy demands complicated examinations such as full-thickness bowel biopsy. We hypothesized that knowledge about simultaneous occurrence of different types of neuropathy would lead to faster recognition and diagnosis of autonomic/enteric neuropathy. The aim of the present systematic review was to increase the awareness of disease groups causing autonomic and enteric neuropathy along with sensorimotor neuropathy. METHODS A systematic search strategy was used in PubMed, Embase and Web of Science. First, 4978 articles were identified. Review of titles/abstracts rendered exclusion of animal studies, articles not written in English or full-length, case reports, conference abstracts and duplicates until 357 articles remained. The full-length evaluation resulted in 35 studies (27 non-systematic reviews) which described objectively verified peripheral autonomic, enteric and sensorimotor neuropathy within the same disease. RESULTS Diabetes is the most common disease in society rendering generalized peripheral neuropathy. Accumulation of tissue deposits in amyloidosis, Lewy body disorders and sarcoidosis lead to widespread peripheral neuropathy. Several autoimmune disorders such as systemic sclerosis and primary Sjögren's syndrome present themselves with neuropathy. Paraneoplastic neuropathy may appear prior to symptoms from the malignancy. Both the infection per se, as well as the autoimmune response to the infection, i.e., Guillain-Barré syndrome, may lead to widespread peripheral neuropathy. Hereditary disorders with disturbed metabolism lead to intermittent attacks of neuropathy. CONCLUSIONS The major causes of generalized peripheral neuropathy are diabetes, diseases with tissue deposits, autoimmunity, infections, malignancy and metabolic diseases.
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Affiliation(s)
- Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
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23
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Deppe AC, Kolibay F, Burst V, Simon S, Rothschild M, Kochanek M, Annecke T, Adler C, Dusse F, Hof M, Langebartels G, Reimers S, Muckel S, Roth B, Wolff J, Onur OA. [Prioritization of intensive medical treatment places - Concept proposal]. Chirurg 2021; 92:822-829. [PMID: 33404665 PMCID: PMC7786159 DOI: 10.1007/s00104-020-01334-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 11/16/2022]
Abstract
In the situation of a shortage of ventilation beds, ethically justifiable, transparent and comprehensible decisions must be made. This concept proposes that all patients are first intubated depending on necessity and then assessed by a triage team afterwards. In this situation newly admitted COVID patients compete with newly admitted Non-COVID patients as well as patients already treated in intensive care units for a ventilator. The combination of short-term and long-term prognoses should enable the interprofessional triage team to make comprehensible decisions. The aim of the prioritization concept is to save as many human lives as possible and to relieve the treatment team of the difficult decision on prioritization.
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Affiliation(s)
- A C Deppe
- Herzchirurgische Intensivstation, Klinik und Poliklinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland.
| | - F Kolibay
- Katastrophenschutzbeauftragter, Stabsabteilung Klinikangelegenheiten und Krisenmanagement des Ärztlichen Direktors, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - V Burst
- Zentrale Notaufnahme, Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - S Simon
- Zentrum für Palliativmedizin, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - M Rothschild
- Institut für Rechtmedizin, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - M Kochanek
- Internistische Intensivstation, Klinik I für Innere Medizin: Hämatologie und Onkologie, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - T Annecke
- Anästhesiologische Intensivstation, Klinik für Anästhesiologie und operative Intensivmedizin, Universität zu Köln, Medizinische Fakultät und Klinikum der Universität zu Witten/Herdecke, Kliniken Köln, Köln, Deutschland
| | - C Adler
- Kardiologische Intensivstation, Klinik III für Innere Medizin: Allgemeine und interventionelle Kardiologie, Elektrophysiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - F Dusse
- Anästhesiologische Intensivstation, Klinik für Anästhesiologie und operative Intensivmedizin, Universität zu Köln, Medizinische Fakultät und Klinikum der Universität zu Witten/Herdecke, Kliniken Köln, Köln, Deutschland
| | - M Hof
- Neurochirurgische Intensivstation, Klinik und Poliklinik für allgemeine Neurochirurgie, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - G Langebartels
- Ärztlicher Koordinator Intensivmedizin, Stabsabteilung Klinikangelegenheiten und Krisenmanagement des Ärztlichen Direktors, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - S Reimers
- Pflegedienstleitung Intensivpflege, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - S Muckel
- Juristische Fakultät, Öffentliches Recht und Religionsrecht, Institute für Religionsrecht, Universität zu Köln, Köln, Deutschland
| | - B Roth
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - J Wolff
- Katholische Seelsorge, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
| | - O A Onur
- Neurologische Intensivstation, Klinik und Poliklinik für Neurologie, Universität zu Köln, Medizinische Fakultät und Uniklinik, Köln, Deutschland
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Cloitre M, Valerio M, Roth B, Berthold D, Tawadros T, Meuwly J, Heym L, Duclos F, Viguet-Carrin S, Vallet V, Bourhis J, Herrera F. PD-0764 Quality of life, toxicity, and PSA control after 50 Gy SBRT to the dominant intraprostatic nodule. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Moschella P, Roth B, LeMatty A, Falconer R, Mousavi E, Nafchi A, Ashley N, DesJardins J. 22 Flow and Pressure Differential Results of a Novel Low-Cost Portable Negative Pressure Patient Enclosure For COVID-19. Ann Emerg Med 2021. [PMCID: PMC8335526 DOI: 10.1016/j.annemergmed.2021.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Stenberg P, Roth B, Ohlsson B. Zinc as a modulator of transglutaminase activity - Laboratory and pathophysiological aspects. J Transl Autoimmun 2021; 4:100110. [PMID: 34195588 PMCID: PMC8233124 DOI: 10.1016/j.jtauto.2021.100110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 01/17/2023] Open
Abstract
For a whole century, citrate has been used as an in vitro anticoagulant via chelation of calcium. Later, also EDTA was introduced as an anticoagulant. An often overlooked fact is that zinc is bound to citrate and EDTA with affinities much greater than that for calcium, imposing problems in biomedical research. In vivo, proteins of the S100 family are released from leukocytes and known to bind calcium. Some of them, e.g., calprotectin, also chelate zinc. Thus, at an inflamed site, the ratio between Ca2+ and Zn2+ is changed. This mechanism is of importance for the modulation of the activation of a fascinating family of post-translationally acting calcium-dependent thiol enzymes, the transglutaminases, which are inhibited by zinc. This presentation illustrates the complexity of in vitro studies with zinc. Moreover, it exemplifies the role of Zn2+ in pathophysiological situations such as celiac disease and neurodegeneration. Citrate, EDTA and DTT bind zinc as well as calcium. At inflammation, calprotectin binds Zn2+, which leads to low concentrations of the ion. Zn2+ inhibits the activation of transglutaminases and peptidylarginine deiminases.
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Affiliation(s)
- Pål Stenberg
- Lund University, Skåne University Hospital Malmö, Clinical Coagulation Research Unit, Malmö, Sweden
| | - Bodil Roth
- Lund University, Skåne University Hospital Malmö, Department of Internal Medicine, Malmö, Sweden
| | - Bodil Ohlsson
- Lund University, Skåne University Hospital Malmö, Department of Internal Medicine, Malmö, Sweden
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Rakauskas A, Peters M, Martel P, La Rosa S, Meuwly JY, Roth B, Valerio M. Tranperineal vs. transrectal micro-ultrasound and mpMRI targeted prostate biopsies: propensity score-matched study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Assadian O, Golling M, Krüger CM, Leaper D, Mutters NT, Roth B, Kramer A. Surgical site infections: guidance for elective surgery during the SARS-CoV-2 pandemic - international recommendations and clinical experience. J Hosp Infect 2021; 111:189-199. [PMID: 33600892 PMCID: PMC7883712 DOI: 10.1016/j.jhin.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic not only had an impact on public life and healthcare facilities in general, but also affected established surgical workflows for elective procedures. The strategy to protect patients and healthcare workers from infection by SARS-CoV-2 in surgical departments has needed step-by-step development. Based on the evaluation of international recommendations and guidelines, as well as personal experiences in a clinical 'hot spot' and in a 450-bed surgical clinic, an adapted surgical site infection (SSI) prevention checklist was needed to develop concise instructions, which described roles and responsibilities of healthcare professionals that could be used for wider guidance in pandemic conditions. METHOD Publications of COVID-19-related recommendations and guidelines, produced by health authorities and organizations, such as WHO, US-CDC, ECDC, the American College of Surgery and the Robert Koch Institute, were retrieved, assessed and referenced up to 31st January 2020. Additionally, clinical personal experiences in Germany were evaluated and considered. RESULTS Part 1 of this guidance summarizes the experience of a tertiary care, surgical centre which utilized redundant hospital buildings for immediate spatial separation in a 'hot spot' COVID-19 area. Part 2 outlines the successful screening and isolation strategy in a surgical clinic in a region of Germany with outbreaks in surrounding medical centres. Part 3 provides the synopsis of personal experiences and international recommendations suggested for implementation during the COVID-19 pandemic. CONCLUSION Understanding of COVID-19, and SARS-CoV-2-related epidemiology, is constantly and rapidly changing, requiring continuous adaptation and re-evaluation of recommendations. Established national and local guidelines for continuation of surgical services and prevention of SSI require ongoing scrutiny and focused implementation. This manuscript presents a core facility checklist to support medical institutions to continue their clinical and surgical work during the COVID-19 pandemic.
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Affiliation(s)
- O Assadian
- Regional Hospital Wiener Neustadt, Austria; Institute for Skin Integrity and Infection Prevention, University of Huddersfield, UK
| | - M Golling
- Surgical Clinic I, Diakonie-Klinikum Schwäbisch Hall gGmbH, Germany
| | - C M Krüger
- Immanuel Klinikum Rüdersdorf, Department of Surgery, Center for Robotics, Rüdersdorf b. Berlin, Germany
| | - D Leaper
- Department of Surgery, University of Newcastle upon Tyne, UK; Department of Clinical Sciences, ISIaIP, University of Huddersfield, Huddersfield, UK
| | - N T Mutters
- Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany; CEOsys Network of the National University Medicine Research Network on Covid-19 (NUM)
| | - B Roth
- Surgical Clinic, District Hospital Belp/Switzerland, FMH for General and Trauma Surgery, Wattenwil, Switzerland
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany; CEOsys Network of the National University Medicine Research Network on Covid-19 (NUM).
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Svensson A, Brunkwall L, Roth B, Orho-Melander M, Ohlsson B. Associations Between Endometriosis and Gut Microbiota. Reprod Sci 2021; 28:2367-2377. [PMID: 33660232 PMCID: PMC8289757 DOI: 10.1007/s43032-021-00506-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/21/2021] [Indexed: 02/06/2023]
Abstract
The gut microbiota has been associated with many diseases, including endometriosis. However, very few studies have been conducted on this topic in human. This study aimed to investigate the association between endometriosis and gut microbiota. Women with endometriosis (N=66) were identified at the Department of Gynaecology and each patient was matched with three controls (N=198) from the general population. All participants answered questionnaires about socioeconomic data, medical history, and gastrointestinal symptoms and passed stool samples. Gut bacteria were analyzed using 16S ribosomal RNA sequencing, and in total, 58 bacteria were observed at genus level in both patients with endometriosis and controls. Comparisons of the microbiota between patients and controls and within the endometriosis cohort were performed. Both alpha and beta diversities were higher in controls than in patients. With the false discovery rate q<0.05, abundance of 12 bacteria belonging to the classes Bacilli, Bacteroidia, Clostridia, Coriobacteriia, and Gammaproteobacter differed significantly between patients and controls. Differences observed between patients with or without isolated ovarian endometriosis, involvement of the gastrointestinal tract, gastrointestinal symptoms, or hormonal treatment disappeared after calculation with false discovery rate. These findings indicate that the gut microbiota may be altered in endometriosis patients.
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Affiliation(s)
- Agnes Svensson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 20502, Malmö, Sweden
| | - Louise Brunkwall
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 20502, Malmö, Sweden
| | | | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Jan Waldenströms street 15, floor 5, 20502, Malmö, Sweden.
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Roth B, Jouve E, Daguzan A, Richardson A, Sambuc R, Bernard O, Lagouanelle-Simeoni MC. Descriptive study of young disabled children aged 2-6, enrolled in mainstream schools, and benefiting from special needs assistants in the Bouches-du-Rhône in 2014. Arch Pediatr 2020; 28:39-46. [PMID: 33309119 DOI: 10.1016/j.arcped.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 06/22/2020] [Accepted: 10/31/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Since the law of February 11, 2005, in France, the number of children with disabilities enrolled in ordinary schools has increased steadily. As a result, the amount of personal support provided by a special needs assistant (personal support) is also increasing. The aim of the study was to describe the diseases and impairments of disabled children aged 2-6, enrolled in mainstream schools and benefiting from personal support for schooling by special needs assistants in the Bouches-du-Rhône (France) in 2014. METHODS A cross-sectional descriptive study was performed. Children included were benefiting from either an individual or shared personal support. Physicians from the territorial organization in charge of disability coded diseases and deficiencies using the International Classification of Diseases, 10th revision, and nomenclature inspired by the International Classification of Functioning, Disability and Health. RESULTS Medical data were coded for 990 children out of 1260 of the total population. These young disabled children were most frequently children with pervasive developmental disorders (23.3%), lack of expected normal physiological development (19.9%), or mixed specific developmental disorders (13.5%), and most often had behavioral, personality, and relational skills disorders (61.8%), psychomotor function impairments (51.9%), or written or oral language learning impairment (43.2%). Finally, the two main types of impairments most represented among these children were psychological impairments (86.7%) and language and speech impairments (79.8%). The children were most often supported by an individual personal support (for one child only) than by a shared personal support (60% vs. 40%). They were mainly boys (almost 75%). CONCLUSION This study provides working guidelines for the management of health policies relating to disability at the territorial or even national level.
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Affiliation(s)
- B Roth
- Service d'évaluation médicale, APHM, Hôpital Conception, 13005 Marseille, France.
| | - E Jouve
- Service d'évaluation médicale, APHM, Hôpital Conception, 13005 Marseille, France
| | - A Daguzan
- Service d'évaluation médicale, APHM, Hôpital Conception, 13005 Marseille, France; Aix Marseille Université, Laboratoire de Psychologie Sociale (LPS), 13100 Aix-en-Provence, France
| | - A Richardson
- MDPH (Maison Départementale des Personnes Handicapées), Conseil Général des Bouches-du-Rhône, 4, quai d'Arenc, 13304 Marseille, France
| | - R Sambuc
- Aix Marseille Université, CEReSS (Centre d'Études et de Recherche sur les Services de Santé et la Qualité de Vie), 13385 Marseille, France
| | - O Bernard
- PMI (Protection Maternelle et Infantile), Conseil Départemental des Bouches-du-Rhône, 4, quai d'Arenc, 13304 Marseille, France
| | - M C Lagouanelle-Simeoni
- Service d'évaluation médicale, APHM, Hôpital Conception, 13005 Marseille, France; Aix Marseille Université, Laboratoire de Psychologie Sociale (LPS), 13100 Aix-en-Provence, France
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Saidi K, Nilholm C, Roth B, Ohlsson B. A carbohydrate-restricted diet for patients with irritable bowel syndrome lowers serum C-peptide, insulin, and leptin without any correlation with symptom reduction. Nutr Res 2020; 86:23-36. [PMID: 33450656 DOI: 10.1016/j.nutres.2020.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022]
Abstract
Alterations in gut endocrine cells and hormone levels have been measured in patients with irritable bowel syndrome (IBS). The hypothesis of the present study was that hormone levels would change after 4 weeks of a starch- and sucrose-reduced diet (SSRD) intervention corresponding to decreased carbohydrate intake and symptoms. Among 105 IBS patients from primary and tertiary healthcare, 80 were randomized to SSRD, while 25 followed their ordinary diet. Food diaries, Rome IV, and IBS-symptom severity score (IBS-SSS) questionnaires were completed, and blood samples were collected at baseline and after the intervention. Serum C-peptide, gastric inhibitory peptide, glucagon, glucagon-like peptide-1, insulin, leptin, luteinizing hormone, polypeptide YY, and glucose were measured, along with the prevalence of autoantibodies against gonadotropin-releasing hormone; its precursor, progonadoliberin-2, and receptor; and tenascin C. Carbohydrate intake was lower in the intervention group than in controls at week 4 (median: 88 [66-128] g vs 182 [89-224] g; P < .001). The change in carbohydrate intake, adjusted for weight, was associated with a decrease in C-peptide (β: 14.43; 95% confidence interval [CI]: 4.12-24.75) and insulin (β: 0.18; 95% CI: 0.04-0.32) levels. Glucose levels remained unchanged. The IBS-SSS scores were lower in the intervention group but not in controls (P < .001), without any association with changes in hormone concentrations. There was no difference in autoantibody prevalence between patients and healthy controls. In conclusion, the hypothesis that reduced carbohydrate intake corresponded to altered hormonal levels in IBS was accepted; however, there was no relationship between hormonal concentrations and symptoms.
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Affiliation(s)
- Khadija Saidi
- Lund University, Skåne University Hospital Malmö, Department of Internal Medicine, Malmö, Sweden.
| | - Clara Nilholm
- Lund University, Skåne University Hospital Malmö, Department of Internal Medicine, Malmö, Sweden.
| | - Bodil Roth
- Lund University, Skåne University Hospital Malmö, Department of Internal Medicine, Malmö, Sweden.
| | - Bodil Ohlsson
- Lund University, Skåne University Hospital Malmö, Department of Internal Medicine, Malmö, Sweden.
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Rentsch C, Thalmann G, Lucca I, Kwiatkowski M, Wirth G, Strebel R, Engeler D, Pedrazzini A, Hüttenbrink C, Schultze-Seemann W, Bubendorf L, Wicki A, Roth B, Bosshard P, Püschel H, Boll D, Hefermehl L, Roghmann F, Gierth M, Schäfer S, Hayoz S. Results of a phase II single arm clinical trial assessing efficacy, safety and tolerability of the recombinant Bacillus Calmette Guérin (BCG) VPM1002BC in patients with BCG failure - SAKK 06/14. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33377-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Dihm K, Ek M, Roth B, Ohlsson B. Plasma AXIN1 expression exhibit negative correlations with inflammatory biomarkers and is associated with gastrointestinal symptoms in endometriosis. Biomed Rep 2020; 12:211-221. [PMID: 32257184 PMCID: PMC7100128 DOI: 10.3892/br.2020.1282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
The cytoplasmic protein AXIN1 is involved in the Wnt signalling pathway and its expression is increased in patients with endometriosis compared with healthy controls. The aim of the present cross-sectional study was to further assess the levels of AXIN1 and other inflammatory biomarkers in patients with endometriosis. Patients with laparoscopy-verified endometriosis were recruited (n=172) and completed a questionnaire regarding socioeconomic factors, lifestyle habits and medical history. Plasma AXIN1 and high-sensitivity C-reactive protein (hs-CRP) levels were analysed by ELISA. The levels of calprotectin were determined in the faeces, and the haemoglobin concentration and number of erythrocytes, leukocytes and platelets were determined in the blood in a subgroup of 64 patients during clinical routine procedures. F-calprotectin expression was detected in 18 women (28.1%), who had more severe constipation and more frequently experienced incomplete evacuation when defecating, and 5 women (7.8%) exhibited elevated levels. P-AXIN1 levels were higher in patients who received hormonal treatment, and correlated inversely with faecal-calprotectin levels (P=0.003), B-haemoglobin levels (P=0.030) and the numbers of B-erythrocytes (P=0.033) and B-platelets (P=0.017), but were not correlated with hs-CRP levels (P=0.818). Higher levels of AXIN1 were associated with the duration of the gastrointestinal symptoms and with diarrhoea, constipation, vomiting and nausea and the intestinal symptoms' effect on quality of life, and tended to be associated with the duration of endometriosis. Hs-CRP expression was not associated with the clinical characteristics or symptoms of endometriosis, but higher levels were associated with obesity (P=0.002) and hormonal treatment (P=0.011). In conclusion, P-AXIN1 expression was negatively correlated with certain inflammatory biomarkers and was positively associated with gastrointestinal symptoms. P-AXIN1 levels were increased in patients who received hormonal treatment, highlighting the importance of obtaining native samples for future studies regarding its role in the development and presentation of endometriosis. However, hs-CRP and other studied biomarkers seemed to be of no value for the assessment and diagnosis of endometriosis.
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Affiliation(s)
- Katharina Dihm
- Department of Internal Medicine, Skane University Hospital, Lund University, 205 02 Malmo, Sweden
| | - Malin Ek
- Department of Internal Medicine, Skane University Hospital, Lund University, 205 02 Malmo, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skane University Hospital, Lund University, 205 02 Malmo, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skane University Hospital, Lund University, 205 02 Malmo, Sweden
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Paz T, Bloom A, Roth B, Kalish Y, Rottenstreich A, Elchalal U. Pharmacomechanical Catheter Thrombolysis for Pregnancy-Related Proximal Deep Venous Thrombosis: Prevention of Post-Thrombotic Syndrome. J Vasc Surg Venous Lymphat Disord 2020. [DOI: 10.1016/j.jvsv.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Heratizadeh A, Fricke D, Meinhardt-Wollweber M, Roth B, Werfel T. Non-contact remote digital dermoscopy - new perspectives on differential diagnosis of inflammatory skin diseases. J Eur Acad Dermatol Venereol 2019; 34:e125-e126. [PMID: 31710132 DOI: 10.1111/jdv.16056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D Fricke
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Hannover, Germany
| | - M Meinhardt-Wollweber
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Hannover, Germany
| | - B Roth
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Hannover, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Ek M, Roth B, Valentin L, Nordengren J, Ohlsson B. Autoantibodies common in patients with gastrointestinal diseases are not found in patients with endometriosis: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2019; 240:370-374. [DOI: 10.1016/j.ejogrb.2019.05.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/23/2019] [Indexed: 02/07/2023]
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Roth B, Zhou MY, Drummer D. Influence of the Mold Temperature and Part Thickness on the Replication Quality and Molecular Orientation in Compression Injection Molding of Polystyrene. INT POLYM PROC 2019. [DOI: 10.3139/217.3802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
It is well known that the process of injection molding with dynamic mold temperature control leads to a good replication quality of high aspect ratio microstructures. However, the inhomogeneous pressure distribution during the holding pressure phase results in an anisotropy of the component properties, low dimensional accuracy and, especially with optical polymers, in undesired stress birefringence. The anisotropy is based on the orientation of the molecular chains in the flow direction, which can be reduced by an injection-compression molding (ICM) process. In order to use the synergy from both processes, an injection-compression molding process with dynamic mold temperature control can be utilized. Within the scope of this investigation, the new process was reproduced by an ICM process at elevated mold temperature (ICM_EMT) and compared with injection molding (IM) with regard to molding accuracy and optical properties in dependence of component thickness and mold temperature. In order to evaluate the molding accuracy, the roughness of a wire-eroded microstructure on the cavity surface was measured. To determine the degree of orientation, the optical properties considered were the transmission and the path difference. It was shown that the adapted ICM process was able to achieve a high degree of replication accuracy with a low degree of orientation, especially for thin-walled components. ICM at elevated mold temperature reduced the path difference in the components with the lowest wall thickness by a factor of two while at the same time optimizing the replication of the microstructure. This could also be confirmed by transmission measurements.
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Affiliation(s)
- B. Roth
- Institute of Polymer Technology , Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen , Germany
| | - M.-Y. Zhou
- Institute of Polymer Technology , Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen , Germany
| | - D. Drummer
- Institute of Polymer Technology , Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen , Germany
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Nilholm C, Roth B, Ohlsson B. A Dietary Intervention with Reduction of Starch and Sucrose Leads to Reduced Gastrointestinal and Extra-Intestinal Symptoms in IBS Patients. Nutrients 2019; 11:nu11071662. [PMID: 31330810 PMCID: PMC6682926 DOI: 10.3390/nu11071662] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/12/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022] Open
Abstract
Patients with irritable bowel syndrome (IBS) exhibit low-grade inflammation and increased gut permeability. Dietary sugar has been shown to contribute to low-grade inflammation and increased gut permeability, and to correlate with gastrointestinal (GI) symptoms. The aim of the present study was to examine the effect of a starch- and sucrose-reduced diet (SSRD) on gastrointestinal (GI) and extra-intestinal symptoms in IBS. One hundred and five IBS patients (82 women, 46.06 ± 13.11 years), with irritable bowel syndrome-symptom severity scale (IBS-SSS) > 175, were randomized to SSRD for 4 weeks or continued ordinary eating habits. The visual analog scale for irritable bowel syndrome (VAS-IBS), IBS-SSS, and 4-day food diaries were collected at baseline and after 2 and 4 weeks. After the intervention, one-third of the patients did not fulfill the criteria for IBS/functional gastrointestinal disorder. Half of the participants changed from moderate/severe disease to no/mild disease according to IBS-SSS. Comparisons between the groups showed decreased weight and sweet cravings, and parallel decreases in total IBS-SSS and extra-intestinal IBS-SSS scores, in the intervention group compared to controls (p < 0.001 for all). When calculating separate extra-intestinal symptoms, belching (p = 0.001), muscle/joint pain (p = 0.029), urinary urgency (p = 0.017), and tiredness (p = 0.011) were decreased after introduction of SSRD compared to controls. In conclusion, SSRD improves both GI and extra-intestinal symptoms in IBS.
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Affiliation(s)
- Clara Nilholm
- Department of Internal Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden.
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Laugier Hervy O, Dubus JC, Stremler-Le Bel N, Baravalle-Einaudi M, Reynaud R, Adiceam P, Roth B, Gross G. WS15-2 Early management of glucose disorders in cystic fibrosis children drastically decreases antibiotics consumption. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30206-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Melchert O, Wollweber M, Roth B. Optoacoustic inversion via convolution kernel reconstruction in the paraxial approximation and beyond. Photoacoustics 2019; 13:1-5. [PMID: 30510898 PMCID: PMC6257913 DOI: 10.1016/j.pacs.2018.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 10/05/2018] [Accepted: 10/23/2018] [Indexed: 06/09/2023]
Abstract
In this article we address the numeric inversion of optoacoustic signals to initial stress profiles. Therefore we study a Volterra integral equation of the second kind that describes the shape transformation of propagating stress waves in the paraxial approximation of the underlying wave-equation. Expanding the optoacoustic convolution kernel in terms of a Fourier-series, a best fit to a pair of observed near-field and far-field signals allows to obtain a sequence of expansion coefficients that describe a given "apparative" setup. The resulting effective kernel is used to solve the optoacoustic source reconstruction problem using a Picard-Lindelöf correction scheme. We verify the validity of the proposed inversion protocol for synthetic input signals and explore the feasibility of our approach to also account for the shape transformation of signals beyond the paraxial approximation including the inversion of experimental data stemming from measurements on melanin doped PVA hydrogel tissue phantoms.
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Abstract
Traditionally, urothelial carcinoma of the upper urinary tract was a clear indication for radical nephroureterectomy with bladder cuff excision. It has been shown that in well-selected patients and depending on tumor stage, a kidney-sparing approach can be pursued with good oncological outcome and equivalent to the radical approach. The prevention of local and bladder recurrences is an important factor. Instillation therapies with bacillus Calmette-Guérin and/or mitomycin C have been successfully used to this end. Due to the low incidence of upper tract urothelial cancer and due to the usually retrospective nature of existing literature, however, data is limited. In this article, we provide a review of the indication, technical execution and results of instillation therapies of the upper urinary tract.
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Affiliation(s)
- P Bosshard
- Urologische Universitätsklinik, Inselspital, Universitätsspital Bern, 3010, Bern, Schweiz
| | - G N Thalmann
- Urologische Universitätsklinik, Inselspital, Universitätsspital Bern, 3010, Bern, Schweiz.
| | - B Roth
- Urologische Universitätsklinik, Inselspital, Universitätsspital Bern, 3010, Bern, Schweiz
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Ek M, Roth B, Engström G, Ohlsson B. AXIN1 in Plasma or Serum Is a Potential New Biomarker for Endometriosis. Int J Mol Sci 2019; 20:ijms20010189. [PMID: 30621017 PMCID: PMC6337238 DOI: 10.3390/ijms20010189] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/26/2018] [Accepted: 12/30/2018] [Indexed: 12/12/2022] Open
Abstract
Although endometriosis is considered an inflammatory disease, no reliable diagnostic biomarkers exist for use in clinical practice. The aim was to investigate the inflammatory profile in endometriosis using an exploratory approach of inflammation-related proteins. Patients with laparoscopy-verified endometriosis (N = 172), women with microscopic colitis (N = 50), healthy controls (N = 31), and age-matched controls from the general population (N = 100) were enrolled and questionnaires regarding socioeconomic factors, lifestyle habits, and medical history were completed. Sera from patients and healthy controls were analyzed for 92 inflammatory biomarkers using Proximity Extension Assay technology (PEA). Plasma AXIN1 levels were analyzed in patients with endometriosis and controls from the general population by ELISA. General linear model adjusted for age, Mann–Whitney U-test, and principal component analysis (PCA) were used for statistical calculations. Serum levels of AXIN1 and ST1A1 were increased in endometriosis compared with MC (p < 0.001) and healthy controls (p = 0.001), whereas CXCL9 levels were decreased. Plasma levels of AXIN1 were elevated in endometriosis compared with age-matched controls from the general population (30.0 (17.0–38.0) pg/mL vs. 19.5 (15.0–28.0) pg/mL, p < 0.001). PCA analysis identified four clusters of proteins, where one cluster differed between endometriosis and controls, with strong correlations for AXIN1 and ST1A1. Plasma/serum AXIN1 is an interesting biomarker to be further evaluated in endometriosis.
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Affiliation(s)
- Malin Ek
- Department of Internal Medicine, Skåne University Hospital, Lund University, 221 00 Lund, Sweden.
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, 221 00 Lund, Sweden.
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Clinical Research Centre, Lund University, Box 50332, 202 13 Malmö, Sweden.
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, 221 00 Lund, Sweden.
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Brenneman R, Fischer-Valuck B, Gay H, Contreras J, Arora V, Christodouleas J, Andriole G, Bullock A, Figenshau R, Kim E, Knoche E, Pachynski R, Picus J, Roth B, Michalski J, Baumann B. A Propensity Analysis Comparing Definitive Chemo-Radiation for Muscle-Invasive Adenocarcinoma of the Bladder Versus Urothelial Carcinoma of the Bladder using the National Cancer Database (NCDB). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fischer-Valuck B, Michalski J, Christodouleas J, Kim E, DeWees T, Andriole G, Arora V, Bullock A, Carmona R, Figenshau R, Grubb R, Guzzo T, Knoche E, Malkowicz S, Mamtani R, Pachynski R, Picus J, Roth B, Gay H, Baumann B. Effectiveness of Adjuvant Radiation Therapy after Radical Cystectomy for Locally Advanced Bladder Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bohlin J, Dahlin E, Dreja J, Roth B, Ekberg O, Ohlsson B. Longer colonic transit time is associated with laxative and drug use, lifestyle factors, and symptoms of constipation. Acta Radiol Open 2018; 7:2058460118807232. [PMID: 30364803 PMCID: PMC6198400 DOI: 10.1177/2058460118807232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 09/23/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Gastrointestinal symptoms and changes in colonic transit time (CTT) are common in the population. PURPOSE To evaluate consecutive patients who had been examined for CTT, along with completion of a diary about laxative and drug use, lifestyle factors, and gastrointestinal symptoms, to identify possible associations with longer or prolonged CTT. MATERIAL AND METHODS A total of 610 consecutive patients had undergone the radiopaque marker method with an abdominal X-ray for clinical purposes. The patients had completed a diary regarding medical treatment, lifestyle factors, stool habits, and their perceived constipation and abdominal pain during the examination period. The associations between CTT and laxative use, lifestyle factors, stool habits, and symptoms were calculated by logistic regression. RESULTS Women had longer CTT (2.5 [1.6-3.9] vs. 1.7 [1.1-3.0] days, P < 0.001), lower weekly stool frequency (6 [3-10] vs. 8 [5-12], P = 0.001), and perceived more constipation (P = 0.025) and abdominal pain (P = 0.001) than men. High coffee consumption (P = 0.045), bulk-forming (P = 0.007) and osmotic (P = 0.001) laxatives, and lower stool frequency, shaped stool, and perceived constipation (P for trend < 0.001) were associated with longer CTT. In total, 382 patients (63%) were treated with drugs affecting motility. In the 228 patients without drug treatment, longer CTT was associated with female sex and smoking, and lower frequency of symptoms and prolonged CTT were observed compared to patients using drugs. Tea, alcohol, and abdominal pain did not associate with CTT. CONCLUSIONS Female sex, coffee, smoking, drug use, infrequent stools, shaped stool, and perception of constipation are associated with longer or prolonged CTT.
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Affiliation(s)
- Johan Bohlin
- Lund University, Skane University Hospital, Department of
Internal Medicine, Malmö, Sweden
| | - Erik Dahlin
- Lund University, Skane University Hospital, Department of
Internal Medicine, Malmö, Sweden
| | - Julia Dreja
- Lund University, Skane University Hospital, Department of
Imaging and Function, Lund University, Skåne University Hospital, Malmö,
Sweden
| | - Bodil Roth
- Lund University, Skane University Hospital, Department of
Internal Medicine, Malmö, Sweden
| | - Olle Ekberg
- Lund University, Skane University Hospital, Department of
Imaging and Function, Lund University, Skåne University Hospital, Malmö,
Sweden
| | - Bodil Ohlsson
- Lund University, Skane University Hospital, Department of
Internal Medicine, Malmö, Sweden
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Nilholm C, Roth B, Höglund P, Blennow K, Englund E, Hansson O, Zetterberg H, Ohlsson B. Dietary intervention with an Okinawan-based Nordic diet in type 2 diabetes renders decreased interleukin-18 concentrations and increased neurofilament light concentrations in plasma. Nutr Res 2018; 60:13-25. [PMID: 30527256 DOI: 10.1016/j.nutres.2018.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/22/2018] [Accepted: 08/17/2018] [Indexed: 12/20/2022]
Abstract
Food may induce inflammation and favor development of metabolic diseases, which have been associated with increased inflammation and potential risk of cognitive impairment. It is customary to know whether food or disease promote inflammation. Our hypothesis was that Okinawan-based Nordic (O-BN) diet leads to decreased circulating concentrations of inflammatory and neural biomarkers. The objectives of this study were to examine the effects of the O-BN diet on inflammatory and neural responses. First, 2 different breakfasts; one standard and another O-BN-based, were given in random order to 19 healthy volunteers. Second, a 12-week O-BN-dietary intervention was performed in type 2 diabetes mellitus (T2DM), where the participants were followed for another 16-weeks, with registration of anthropometry and metabolic parameters. Non-diabetic subjects served as controls at baseline. Plasma was analyzed for cytokines by a 10-plex Luminex assay and neurofilament light (NfL) by an ultrasensitive Single molecule assay. Cytokine levels decreased after a single breakfast intake, independent of diet composition. Cytokine levels were higher in T2DM than in controls. Anthropometric and metabolic parameters were improved by the dietary intervention. In parallel, cytokine levels were lowered, although only significantly for IL-18 (P = .001), with a tendency of significance for IL-12p70 (P = .07). Levels of IL-18 correlated with glucose, HbA1c and lipids, but not with body mass index, insulin or blood pressure. NfL levels increased during the intervention (P = .049). O-BN-based diet does not affect postprandial cytokine levels in health, whereas it renders decreased circulating IL-18 levels along with metabolic biomarkers in T2DM, with no beneficial effect on NfL.
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Affiliation(s)
- Clara Nilholm
- Lund University, Skane University Hospital, Department of Internal Medicine, Malmö, Sweden
| | - Bodil Roth
- Lund University, Skane University Hospital, Department of Internal Medicine, Malmö, Sweden
| | - Peter Höglund
- Lund University, Skane University Hospital, Department of Clinical Chemistry & Pharmacology, Lund, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Elisabet Englund
- Lund University, Department of Oncology and Pathology, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK
| | - Bodil Ohlsson
- Lund University, Skane University Hospital, Department of Internal Medicine, Malmö, Sweden.
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Ohlsson B, Darwiche G, Roth B, Höglund P. Alignments of endocrine, anthropometric, and metabolic parameters in type 2 diabetes after intervention with an Okinawa-based Nordic diet. Food Nutr Res 2018; 62:1328. [PMID: 29599686 PMCID: PMC5854836 DOI: 10.29219/fnr.v62.1328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 02/19/2018] [Accepted: 02/19/2018] [Indexed: 12/26/2022] Open
Abstract
Background An Okinawa-based Nordic diet with moderately low carbohydrate content and high fat and protein content has been shown to improve anthropometry and metabolism in type 2 diabetes. Objective The objectives of this study were to measure plasma or serum levels of hormones regulating energy metabolism and metabolic control, that is, cholecystokinin (CCK), Cortisol, C-peptide, ghrelin, glucagon, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), insulin, leptin, plasminogen activator inhibitor-1 (PAI-1), polypeptide YY (PYY), resistin, and visfatin after this diet intervention, and to determine partial correlations between hormonal levels and anthropometric and metabolic responses. Design A total of 30 patients (17 women) with type 2 diabetes, mean age 57.5 ± 8.2 years, and body mass index (BMI) 29.9 ± 4.1 kg/m2 were served the diet for 12 weeks. Fasting hormones were measured by Luminex and enzyme–linked immunosorbent assay (ELISA) before study start and after 12 and 28 weeks, along with anthropometric and metabolic parameters. Result The levels of CCK (P = 0.005), cortisol (P = 0.015), C-peptide (P = 0.022), glucagon (P = 0.003), GLP-1 (P = 0.013), GIP (P < 0.001), insulin (P = 0.004), leptin (P < 0.001), and PYY (P < 0.001) were lowered after dietary intervention. These reduced levels only remained for PYY at week 28 (P = 0.002), when also ghrelin (P = 0.012) and visfatin (P = 0.021) levels were reduced. Changes of glucose values correlated with changed levels of C-peptide and PYY (P < 0.001), insulin (P = 0.002), and PAI-1 (P = 0.009); changes of triglyceride values with changed levels of C-peptide, insulin, and PYY (P < 0.001) and PAI-1 (P = 0.005); changes of insulin resistance with changes of leptin levels (P = 0.003); and changes of BMI values with changed levels of C-peptide, insulin, and leptin (P < 0.001). Conclusions Okinawa-based Nordic diet in type 2 diabetes has significant impact on the endocrine profile, which correlates with anthropometric and metabolic improvements.
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Affiliation(s)
- Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Gassan Darwiche
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Peter Höglund
- Department of Clinical Chemistry and Pharmacology, Skåne University Hospital, Lund University, Lund, Sweden
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Linninge C, Roth B, Erlanson-Albertsson C, Molin G, Toth E, Ohlsson B. Abundance of Enterobacteriaceae in the colon mucosa in diverticular disease. World J Gastrointest Pathophysiol 2018; 9:18-27. [PMID: 29487763 PMCID: PMC5823699 DOI: 10.4291/wjgp.v9.i1.18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/17/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To compare gut bacterial diversity and amount of Enterobacteriaceae in colonic mucosa between patients with and without diverticular disease (DD).
METHODS Patients in a stable clinical condition with planned elective colonoscopy were included. Blood samples and colon mucosa biopsies were collected at the colonoscopy. Study questionnaires including questions about gastrointestinal symptoms were completed by the patients and physicians. DNA from mucosa samples was isolated and the amount of Enterobacteriaceae was estimated using PCR assay. Terminal restriction fragment length polymorphism was applied to assess microbial diversity. Diversity was estimated by calculations of richness (number of terminal restriction fragments) and Shannon-Wiener and Simpson’s indices.
RESULTS A total of 51 patients were included, 16 patients with DD [68 (62-76) years] and 35 controls [62 (40-74) years] without any diverticula. Patients with DD had significantly higher levels of Enterobacteriaceae than those without DD (P = 0.043), and there was an inverse relationship between the amount of Enterobacteriaceae and the Simpson’s index (rs = -0.361, P = 0.033) and the Shannon-Wiener index (rs = -0.299, P = 0.081). The Simpson’s index (P = 0.383), Shannon-Wiener index (P = 0.401) or number of restrictions fragments (P = 0.776) did not differ between DD and controls. The majority of patients experienced gastrointestinal symptoms, and 22 patients (43.1%) fulfilled the criteria for irritable bowel syndrome, with no difference between the groups (P = 0.212). Demography, socioeconomic status, lifestyle habits, inflammatory biomarkers, or symptoms were not related to the amount of Enterobacteriaceae or bacterial diversity.
CONCLUSION Patients with DD had higher amount of Enterobacteriaceae in the colon mucosa compared to patients without diverticula.
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Affiliation(s)
- Caroline Linninge
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund S-223 63, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö S-205 02, Sweden
| | | | - Göran Molin
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund S-223 63, Sweden
| | - Ervin Toth
- Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö S-205 02, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö S-205 02, Sweden
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Abstract
Summary
Objectives: It is not uncommon that the introduction of a new technology fixes old problems while introducing new ones. The Veterans Administration recently implemented a comprehensive electronic medical record system (CPRS) to support provider order entry. Progress notes are entered directly by clinicians, primarily through keyboard input. Due to concerns that there may be significant, invisible disruptions to information flow, this study was conducted to formally examine the incidence and characteristics of input errors in the electronic patient record.
Methods: Sixty patient charts were randomly selected from all 2,301 inpatient admissions during a 5-month period. A panel of clinicians with informatics backgrounds developed the review criteria. After establishing inter-rater reliability, two raters independently reviewed 1,891 notes for copying, copying errors, inconsistent text, inappropriate object insertion and signature issues.
Results: Overall, 60% of patients reviewed had one or more input-related errors averaging 7.8 errors per patient. About 20% of notes showed evidence of copying, with an average of 1.01 error per copied note. Copying another clinician’s note and making changes had the highest risk of error. Templating resulted in large amounts of blank spaces. Overall, MDs make more errors than other clinicians even after controlling for the number of notes.
Conclusions: Moving towards a more progressive model for the electronic medical record, where actions are recorded only once, history and physical information is encoded for use later, and note generation is organized around problems, would greatly minimize the potential for error.
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Melchert O, Wollweber M, Roth B. An efficient procedure for custom beam-profile convolution in polar coordinates: testing, benchmarking and application to biophotonics. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aaa51a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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