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Lee SM, Lee JA, Chung SH, Lee JH, Shim JW, Lim JW, Kim CR, Chang YS. Nationwide Long-Term Growth and Developmental Outcomes of Infants for Congenital Anomalies in the Digestive System and Abdominal Wall Defects With Surgery in Korea. J Korean Med Sci 2023; 38:e372. [PMID: 38111278 PMCID: PMC10727918 DOI: 10.3346/jkms.2023.38.e372] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/22/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Infants with congenital anomalies of the digestive system and abdominal wall defects requiring surgery are at risk of growth and developmental delays. The aim of this study was to analyze long-term growth and developmental outcomes for infants with congenital anomalies of the digestive system and abdominal wall defects who underwent surgery in Korea. METHODS We extracted data from the Korean National Health Insurance Service database for the years 2013-2019. Major congenital anomalies were defined according to the International Classification of Diseases-10 and surgery insurance claim codes. The χ² test and the Cochran-Armitage trend test were performed for data analysis. RESULTS A total of 4,574 infants with major congenital anomalies in the digestive system and abodminal wall defects, who had undergone surgey, were reviewed. Anorectal obstruction/stenosis was the most prevalent anomaly (4.9 per 10,000 live births). The prevalence of congenital anomalies of the digestive system was 15.5 per 10,000 live births, and that of abdominal wall defects was 1.5 per 10,000 live births. Seven percent of infants with congenital anomalies in the digestive system died, of which those with diaphragmatic hernia had the highest mortality rate (18.8%). Among 12,336 examinations at 6, 12, 24, 36, 48, 60, and 72 months of age, 16.7% showed a weight below the 10th percentile, 15.8% had a height below the 10th percentile, and 13.2% had a head circumference below the 10th percentile. Abnormal developmental screening results were observed in 23.0% of infants. Infants with esophageal atresia with/without tracheoesophageal fistula most often had poor growth and development. Delayed development and cerebral palsy were observed in 490 (10.7%) and 130 (2.8%) infants respectively. Comparing the results of infants born in 2013 between their 24- and 72-month health examinations, the proportions of infants with poor height and head circumference growth increased by 6.5% and 5.3%, respectively, whereas those with poor weight growth and abnormal developmental results did not markedly change between the two examinations. CONCLUSION Infants with congenital anomalies of the digestive system and abdominal wall defects exhibit poor growth and developmental outcomes until 72 months of age. Close monitoring and careful consideration of their growth and development after discharge are required.
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Affiliation(s)
- Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jin A Lee
- Department of Pediatrics, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Jang Hoon Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jae Won Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Woo Lim
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Yun Sil Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea.
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Zhang MQ, Wu GZ, Zhang JP, Hu CQ. The comparative analysis of gastrointestinal toxicity of azithromycin and 3'-decladinosyl azithromycin on zebrafish larvae. Toxicol Appl Pharmacol 2023; 469:116529. [PMID: 37100089 DOI: 10.1016/j.taap.2023.116529] [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: 12/14/2022] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023]
Abstract
The most commonly reported side effect of azithromycin is gastrointestinal (GI) disorders, and the main acid degradation product is 3'-Decladinosyl azithromycin (impurity J). We aimed to compare the GI toxicity of azithromycin and impurity J on zebrafish larvae and investigate the mechanism causing the differential GI toxicity. Results of our study showed that the GI toxicity induced by impurity J was higher than that of azithromycin in zebrafish larvae, and the effects of impurity J on transcription in the digestive system of zebrafish larvae were significantly stronger than those of azithromycin. Additionally, impurity J exerts stronger cytotoxic effects on GES-1 cells than azithromycin. Simultaneously, impurity J significantly increased ghsrb levels in the zebrafish intestinal tract and ghsr levels in human GES-1 cells compared to azithromycin, and ghsr overexpression significantly reduced cell viability, indicating that GI toxicity induced by azithromycin and impurity J may be correlated with ghsr overexpression induced by the two compounds. Meanwhile, molecular docking analysis showed that the highest -CDOCKER interaction energy scores with the zebrafish GHSRb or human GHSR protein might reflect the effect of azithromycin and impurity J on the expression of zebrafish ghsrb or human ghsr. Thus, our results suggest that impurity J has higher GI toxicity than azithromycin due to its greater ability to elevate ghsrb expression in zebrafish intestinal tract.
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Affiliation(s)
- Miao-Qing Zhang
- Key Laboratory of Biotechnology of Antibiotics, The National Health Commission (NHC), Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Gui-Zhi Wu
- National Center for ADR Monitoring, Beijing 100022, China
| | - Jing-Pu Zhang
- Key Laboratory of Biotechnology of Antibiotics, The National Health Commission (NHC), Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
| | - Chang-Qin Hu
- National Institutes for Food and Drug Control, Beijing 102629, China.
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Rahimian Z, Feili A, Ghaderpanah R, Sadrian S, Hosseini SA, Ranjbar M, Feili M, Lankarani KB. COVID-19-associated acute pancreatitis: a systematic review of case reports. Przegl Epidemiol 2023; 77:66-73. [PMID: 37283284 DOI: 10.32394/pe.77.07] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) mainly involves the respiratory system but can also affect the digestive system and cause several gastrointestinal manifestations. Acute pancreatitis has been reported as one of the rare presentations of COVID-19. This study aimed to systematically review case reports on COVID-19-associated acute pancreatitis. METHODS Publications were retrieved through a comprehensive search in four databases on October 1, 2021. Eligible ones that demonstrated the potential association of acute pancreatitis and COVID-19 were included for data extraction. RESULTS After screening 855 citations, 82 articles containing 95 cases were included, and their data were extracted. The most common presentation was abdominal pain (88/95, 92.6%), followed by nausea/vomiting (61/95, 64.2%). Mortality was reported in 10.5% of cases. The initial presentation was acute pancreatitis, COVID-19, and concomitant in 32.6% (31/95), 48.4% (46/95), and 18.9% (18/95) of cases, respectively. Among the included cases, acute pancreatitis severity was associated with ICU admission, COVID-19 severity, and the outcome. Also, the initial presentation was associated with COVID-19 severity (P values ˂0.05). CONCLUSIONS Current evidence indicates that acute pancreatitis can present before, after, or concomitant with COVID-19. Appropriate investigations should be performed in cases with suspicious clinical presentations. Longitudinal studies should address whether or not, there is a causative relationship between COVID-19 and acute pancreatitis.
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Affiliation(s)
- Zahra Rahimian
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afrooz Feili
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | | | - Maryam Ranjbar
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Feili
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Sadeghi Amiri L, Nikbakhsh N, Javanian M, Mouodi S, Mousavi T, Alijanpour S, Vala F, Mirzad M, Shokri Shirvani J, Shirafkan H. Ten-year data analysis of digestive system malignancies in Babol, North of Iran: 2008-2017. Caspian J Intern Med 2022; 13:76-83. [PMID: 35178211 PMCID: PMC8797825 DOI: 10.22088/cjim.13.1.76] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/13/2020] [Accepted: 01/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Unlike some regions of the world where digestive system cancers are not considered as important health problems, these neoplasms are among the most common malignancies in the northern region of Iran. METHODS This observational analytical study was carried out based on data collected by the Cancer Registration Center affiliated to the Vice Chancellery for Health of Babol University of Medical Sciences, North of Iran, during 2008-2017. Crude incidence rate (CR), and age-standardized incidence rate (ASR) have been calculated for different GI cancers, based on the primary involved site; and have been compared in different years, patients' age, gender and place of residence. RESULTS Totally, 4332 records were related to digestive system cancers. Mean age of patients was 63.48±14.73 years; men (2743; 63.3%) were more affected than women (1589; 36.7%) (p<0.001). The most incident malignancies of digestive system were from stomach, colorectal and esophagus in men; and colorectal, stomach and esophagus in women, respectively. These three cancers accounted for 3725 (85.98%) of total GI malignancies. The mean age of patients in various types of GI cancers was statistically different (p<0.001). Age- standardized incidence rate showed different values in different years; from 521.40 (95% CI: 462.79-580.00) in year 2016 to 1834.33 (95% CI: 1637.36-2031.29) in year 2008. CONCLUSION Gastric, esophageal and colorectal cancers were the most prevalent digestive system malignancies in Babol, North of Iran, and accounted for about 86% of all GI tract cancers. A considerable variation has been found in incident gastrointestinal cancers in different years.
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Affiliation(s)
- Leili Sadeghi Amiri
- Basic Science Department, Agricultural Science and Natural Resources University, Sari, Iran
| | - Novin Nikbakhsh
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Simin Mouodi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran,Correspondence: Simin Moudi, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. E-mail: , Tel: 0098 1132190624, Fax: 0098 1132190624
| | - Tahere Mousavi
- Cancer Registry Department, Babol University of Medical Sciences, Babol, Iran
| | - Sedigheh Alijanpour
- Cancer Registry Department, Babol University of Medical Sciences, Babol, Iran
| | - Fattaneh Vala
- Cancer Registry Department, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Mirzad
- Cancer Registry Department, Babol University of Medical Sciences, Babol, Iran
| | - Javad Shokri Shirvani
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hoda Shirafkan
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Gough NR, Xiang X, Mishra L. TGF-β Signaling in Liver, Pancreas, and Gastrointestinal Diseases and Cancer. Gastroenterology 2021; 161:434-452.e15. [PMID: 33940008 PMCID: PMC8841117 DOI: 10.1053/j.gastro.2021.04.064] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [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: 02/02/2021] [Revised: 04/05/2021] [Accepted: 04/25/2021] [Indexed: 02/06/2023]
Abstract
Genetic alterations affecting transforming growth factor-β (TGF-β) signaling are exceptionally common in diseases and cancers of the gastrointestinal system. As a regulator of tissue renewal, TGF-β signaling and the downstream SMAD-dependent transcriptional events play complex roles in the transition from a noncancerous disease state to cancer in the gastrointestinal tract, liver, and pancreas. Furthermore, this pathway also regulates the stromal cells and the immune system, which may contribute to evasion of the tumors from immune-mediated elimination. Here, we review the involvement of the TGF-β pathway mediated by the transcriptional regulators SMADs in disease progression to cancer in the digestive system. The review integrates human genomic studies with animal models that provide clues toward understanding and managing the complexity of the pathway in disease and cancer.
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Affiliation(s)
- Nancy R. Gough
- The Institute for Bioelectronic Medicine, Feinstein Institutes for Medical Research & Cold Spring Harbor Laboratory, Department of Medicine, Division of Gastroenterology and Hepatology, Northwell Health, Manhasset, New York
| | - Xiyan Xiang
- The Institute for Bioelectronic Medicine, Feinstein Institutes for Medical Research & Cold Spring Harbor Laboratory, Department of Medicine, Division of Gastroenterology and Hepatology, Northwell Health, Manhasset, New York
| | - Lopa Mishra
- The Institute for Bioelectronic Medicine, Feinstein Institutes for Medical Research & Cold Spring Harbor Laboratory, Department of Medicine, Division of Gastroenterology and Hepatology, Northwell Health, Manhasset, New York; Center for Translational Medicine, Department of Surgery, The George Washington University, Washington, District of Columbia.
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Viana EDF, Carvalho Mello HHD, Carvalho FB, Café MB, Leandro NSM, Arnhold E, Stringhini JH. Blood biochemical parameters and organs development of brown layers fed reduced dietary protein levels in two rearing systems. Anim Biosci 2021; 35:444-452. [PMID: 34293840 PMCID: PMC8902232 DOI: 10.5713/ab.21.0145] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/19/2021] [Indexed: 11/27/2022] Open
Abstract
Objective An experiment was conducted to evaluate the effect of different levels of crude protein (CP) and two rearing systems (cage and floor), on blood parameters and digestive and reproductive organ development of brown laying hens. Methods A total of 400 Hisex Brown laying hens between 30 and 45 weeks of age were distributed in a completely randomized design and a 2×4 factorial arrangement, with main effects including two rearing systems (cage and floor) and levels of CP (140, 150, 160, and 180 g/kg), in a total of eight treatments and five replicates of 10 birds each with initial body weight of 1,877 g (laying hen in cage) and 1,866 g (laying hens in floor). The parameters evaluated were plasma total protein, albumin, uric acid, total cholesterol, relative weights of oviduct, abdominal fat, liver, gizzard, crest and dewlap, length of small intestine and oviduct. Results The blood parameters were similar in birds reared in cage and floor systems. The birds reared on the floor showed greater small intestine and oviduct weight (%) and lower liver and pancreas weight (%). A significant interaction was observed between factors for the relative gizzard, crest and dewlap weight, serum protein, uric acid, and total cholesterol (P<0.05). The diets with 140 g/kg CP resulted in lower serum protein and lower cholesterol in birds reared in floor system, while birds reared in cage system showed no effect of CP on both parameters. Birds reared in cage and fed with 140 and 150 g/kg CP presented lower uric acid. The group of birds reared in floor system fed 180 g/kg had greater uric acid. Conclusion The dietary protein level can be reduced up to 140 g/kg for Hisex Brown hens (30 to 45 weeks of age) without an important effect on metabolic profile and organ development in both rearing systems.
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Affiliation(s)
| | | | | | | | | | - Emmanuel Arnhold
- Department of Animal Science, Federal University of Goiás, GO, 74690-900, Brazil
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Sagami S, Kobayashi T, Miyatani Y, Okabayashi S, Yamazaki H, Takada T, Kinoshita K, Allocca M, Kunisaki R, Ramaswamy PK, Shiraki M, Hibi T, Kataoka Y. Accuracy of Ultrasound for Evaluation of Colorectal Segments in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2021; 19:908-921.e6. [PMID: 32777549 DOI: 10.1016/j.cgh.2020.07.067] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 05/08/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS The accuracy of ultrasound for evaluation of individual colorectal segments in patients with inflammatory bowel diseases (IBD) has not been evaluated in a systematic review. We evaluated the diagnostic accuracy of ultrasound in different colorectal segments of patients with IBD. METHODS We searched publication databases from inception through March 2019 for studies that assessed the accuracy of ultrasound in detection of inflammation in right, transverse, and left colon and in rectum in patients with IBD, using findings from colonoscopy as the reference standard. Subgroup analyses were performed including IBD type, patient age, body mass index, and study design. The risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. RESULTS Nineteen studies (1101 patients) were included in the qualitative synthesis. After we assessed the risk of bias, 7 studies (comprising 84 patients with Crohn's disease and 420 patients with ulcerative colitis) were included in the meta-analysis. Bowel wall thickness ≥ 3 mm identified colorectal segments with inflammation with 86.4% pooled sensitivity (95% CI, 76.1%-92.7%) and 88.3% pooled specificity (95% CI, 58.1%-97.6%). In rectum only, bowel wall thickness ≥ 3 mm identified inflammation with 74.5% sensitivity (95% CI, 53.0%-88.3%) and 69.5% specificity (95% CI, 33.6%-91.1%). Diagnostic accuracy was comparable among subgroups. Increased bowel wall flow and loss of stratification had higher true-positive odds ratios. CONCLUSIONS Based on meta-analysis of patient-level data, ultrasound has higher diagnostic accuracy for detecting inflammation in colon than rectum in patients with IBD. Studies are needed to increase the accuracy of ultrasound detection of inflammation in rectum.
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Affiliation(s)
- Shintaro Sagami
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
| | - Yusuke Miyatani
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Shinji Okabayashi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshihiko Takada
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Kinoshita
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Mariangela Allocca
- Humanitas Clinical and Research Center - IRCCS, Milan, Rozzano, and Department of Biomedical Sciences, Humanitas University, Milan, Rozzano, Italy
| | - Reiko Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | | | - Manabu Shiraki
- Inflammatory Bowel Disease Center, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yuki Kataoka
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan; Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Tan ND, Qiu Y, Xing XB, Ghosh S, Chen MH, Mao R. Associations Between Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blocker Use, Gastrointestinal Symptoms, and Mortality Among Patients With COVID-19. Gastroenterology 2020; 159:1170-1172.e1. [PMID: 32422208 PMCID: PMC7228878 DOI: 10.1053/j.gastro.2020.05.034] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Nian-Di Tan
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,COVID-19 Medical Team, West Campus of Wuhan Union Hospital, Wuhan, China
| | - Yun Qiu
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiang-Bin Xing
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,COVID-19 Medical Team, West Campus of Wuhan Union Hospital, Wuhan, China
| | - Subrata Ghosh
- National Institute for Health Research Biomedical Research Institute, Institute of Translational Medicine, University of Birmingham, Birmingham, United Kingdom,University Hospitals Birmingham National Health Service Foundation Trust, United Kingdom
| | - Min-Hu Chen
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Ren Mao
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Kop-Bozbay C, Akdag A, Atan H, Ocak N. Response of broilers to supplementation of branched-chain amino acids blends with different valine contents in the starter period under summer conditions. Anim Biosci 2020; 34:295-305. [PMID: 32106646 PMCID: PMC7876711 DOI: 10.5713/ajas.19.0828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/21/2019] [Accepted: 02/19/2020] [Indexed: 11/27/2022] Open
Abstract
Objective The objectives of this study were to compare the effects of normal and low protein content (PC) of starter diet supplemented or not with blends of branched-chain amino acids (BCAAs) on growth performance of broilers under summer conditions and to investigate whether these effects altered some quality traits and the characteristics of gastrointestinal tract. Methods A total of 768 mixed-sex broiler chicks (Ross 308, one-d-old) with an average initial body weight (BW) of 47.6±1.03 g were allocated into six treatments with four replications in 2×3 factorial arrangement. Factors were: PC, normal (N, 22% to d 15); and low (L, 20% to d 15); and added BCAA blends, L-leucine, L-isoleucine, and L-valine at zero (0L:0I:0V); 1.0, 0.25, and 0.25 (4L:1I:1V); or 1.0, 0.25, 0.75 (4L:1I:3V) g/kg of diet. Hence, six dietary treatments were named as N0L:0I:0V, N4L:1I:1V, N4L:1I:3V, L0L:0I:0V, L4L:1I:1V, and L4L:1I:3V. Average indoor temperature and humidity were 32.8°C±1.7°C and 61.1% ±4.12%, respectively. Results BW, feed conversion ratio (FCR) and carcass weight were not affected by PC, BCCA and their interaction (p>0.05). The L diets decreased the water holding capacity of the breast (p = 0.002) and thigh (p = 0.050) meats and dressing percentage (p = 0.005) compared to the N diets. The 4L:1I:1V diet decreased breast yield compared to the 0L:0I:0V diets (p = 0.041). The effect of PC on feed intake, mortality and gastrointestinal trait weight were depended on the L:I:V ratios under summer conditions due to interactions between factors (p<0.05). The FI and mortality of L4L:1I:1V broilers were lower than those of N4L:1I:1V birds (p<0.05). Conclusion It was concluded that the blends of BCAAs used failed to improve performance and to promote breast yields, because diets with normal or with reduced protein supplemented or not with BCAAs up to d 15 produced a similar BW and FCR in broilers raised in hot-climate conditions.
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Affiliation(s)
- Canan Kop-Bozbay
- Department of Animal Science, Faculty of Agriculture, Eskisehir Osmangazi University, 26480, Eskisehir, Turkey
| | - Ahmet Akdag
- Department of Animal Science, Faculty of Agriculture, Ondokuz Mayis University, 55139, Samsun, Turkey
| | - Helin Atan
- Department of Animal Science, Faculty of Agriculture, Eskisehir Osmangazi University, 26480, Eskisehir, Turkey
| | - Nuh Ocak
- Department of Animal Science, Faculty of Agriculture, Ondokuz Mayis University, 55139, Samsun, Turkey
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Le Berre C, Sandborn WJ, Aridhi S, Devignes MD, Fournier L, Smaïl-Tabbone M, Danese S, Peyrin-Biroulet L. Application of Artificial Intelligence to Gastroenterology and Hepatology. Gastroenterology 2020; 158:76-94.e2. [PMID: 31593701 DOI: 10.1053/j.gastro.2019.08.058] [Citation(s) in RCA: 259] [Impact Index Per Article: 64.8] [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: 12/20/2018] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 02/07/2023]
Abstract
Since 2010, substantial progress has been made in artificial intelligence (AI) and its application to medicine. AI is explored in gastroenterology for endoscopic analysis of lesions, in detection of cancer, and to facilitate the analysis of inflammatory lesions or gastrointestinal bleeding during wireless capsule endoscopy. AI is also tested to assess liver fibrosis and to differentiate patients with pancreatic cancer from those with pancreatitis. AI might also be used to establish prognoses of patients or predict their response to treatments, based on multiple factors. We review the ways in which AI may help physicians make a diagnosis or establish a prognosis and discuss its limitations, knowing that further randomized controlled studies will be required before the approval of AI techniques by the health authorities.
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Affiliation(s)
- Catherine Le Berre
- Institut des Maladies de l'Appareil Digestif, Nantes University Hospital, France; Institut National de la Santé et de la Recherche Médicale U954 and Department of Gastroenterology, Nancy University Hospital, University of Lorraine, France
| | | | - Sabeur Aridhi
- University of Lorraine, Le Centre National de la Recherche Scientifique, Inria, Laboratoire Lorrain de Recherche en Informatique et ses Applications, Nancy, France
| | - Marie-Dominique Devignes
- University of Lorraine, Le Centre National de la Recherche Scientifique, Inria, Laboratoire Lorrain de Recherche en Informatique et ses Applications, Nancy, France
| | - Laure Fournier
- Université Paris-Descartes, Institut National de la Santé et de la Recherche Médicale, Unité Mixte De Recherché S970, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Malika Smaïl-Tabbone
- University of Lorraine, Le Centre National de la Recherche Scientifique, Inria, Laboratoire Lorrain de Recherche en Informatique et ses Applications, Nancy, France
| | - Silvio Danese
- Inflammatory Bowel Disease Center and Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Institut National de la Santé et de la Recherche Médicale U954 and Department of Gastroenterology, Nancy University Hospital, University of Lorraine, France.
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Shah SC, Tepler A, Peek RM, Colombel JF, Hirano I, Narula N. Association Between Helicobacter pylori Exposure and Decreased Odds of Eosinophilic Esophagitis-A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2019; 17:2185-2198.e3. [PMID: 30659992 PMCID: PMC7354099 DOI: 10.1016/j.cgh.2019.01.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 11/20/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Previous or current infection with Helicobacter pylori (exposure) has been reported to protect against eosinophilic esophagitis (EoE), perhaps owing to H pylori-induced immunomodulation. However, findings vary. We performed a systematic review and meta-analysis of comparative studies to define the association between H pylori exposure and EoE more clearly. METHODS We searched 4 large databases to identify comparative clinical studies that included sufficient detail to determine the odds or risk of EoE (primary outcome) or esophageal eosinophilia (secondary outcome) among individuals exposed to H pylori (exposed) vs individuals who were tested and found to be unexposed. Estimates were pooled using a random-effects model. Meta-regression and sensitivity analyses were planned a priori. Studies were evaluated for quality, risk of bias, publication bias, and heterogeneity. RESULTS We analyzed 11 observational studies comprising data on 377,795 individuals worldwide. H pylori exposure vs nonexposure was associated with a 37% reduction in odds of EoE (odds ratio, 0.63; 95% CI, 0.51-0.78) and a 38% reduction in odds of esophageal eosinophilia (odds ratio, 0.62; 95% CI, 0.52-0.76). Fewer prospective studies found a significant association between H pylori exposure and EoE (P = .06) than retrospective studies. Effect estimates were not affected by study location, whether the studies were performed in pediatric or adult populations, time period (before vs after 2007), or prevalence of H pylori in the study population. CONCLUSIONS In a comprehensive meta-analysis, we found evidence for a significant association between H pylori exposure and reduced odds of EoE. Studies are needed to determine the mechanisms of this association.
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Affiliation(s)
- Shailja C. Shah
- Division of Gastroenterology, Hepatology, and Nutrition,
Vanderbilt University Medical Center, Nashville TN USA
| | - Adam Tepler
- Department of Medicine, Montefiore Medical Center, New
York NY USA
| | - Richard M. Peek
- Division of Gastroenterology, Hepatology, and Nutrition,
Vanderbilt University Medical Center, Nashville TN USA
| | | | - Ikuo Hirano
- Division of Gastroenterology, Northwestern University
Feinberg School of Medicine, Chicago IL USA
| | - Neeraj Narula
- Division of Gastroenterology, Department of Medicine and
Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton
Ontario Canada
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Kim CK, He P, Bialkowska AB, Yang VW. SP and KLF Transcription Factors in Digestive Physiology and Diseases. Gastroenterology 2017; 152:1845-1875. [PMID: 28366734 PMCID: PMC5815166 DOI: 10.1053/j.gastro.2017.03.035] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [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: 12/15/2016] [Revised: 03/21/2017] [Accepted: 03/24/2017] [Indexed: 12/14/2022]
Abstract
Specificity proteins (SPs) and Krüppel-like factors (KLFs) belong to the family of transcription factors that contain conserved zinc finger domains involved in binding to target DNA sequences. Many of these proteins are expressed in different tissues and have distinct tissue-specific activities and functions. Studies have shown that SPs and KLFs regulate not only physiological processes such as growth, development, differentiation, proliferation, and embryogenesis, but pathogenesis of many diseases, including cancer and inflammatory disorders. Consistently, these proteins have been shown to regulate normal functions and pathobiology in the digestive system. We review recent findings on the tissue- and organ-specific functions of SPs and KLFs in the digestive system including the oral cavity, esophagus, stomach, small and large intestines, pancreas, and liver. We provide a list of agents under development to target these proteins.
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Affiliation(s)
- Chang-Kyung Kim
- Department of Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Ping He
- Department of Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Agnieszka B. Bialkowska
- Department of Medicine, Stony Brook University School of Medicine, Stony Brook, NY,Corresponding Authors: Vincent W. Yang & Agnieszka B. Bialkowska, Department of Medicine, Stony Brook University School of Medicine, HSC T-16, Rm. 020; Stony Brook, NY, USA. Tel: (631) 444-2066; Fax: (631) 444-3144; ;
| | - Vincent W. Yang
- Department of Medicine, Stony Brook University School of Medicine, Stony Brook, NY,Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY,Corresponding Authors: Vincent W. Yang & Agnieszka B. Bialkowska, Department of Medicine, Stony Brook University School of Medicine, HSC T-16, Rm. 020; Stony Brook, NY, USA. Tel: (631) 444-2066; Fax: (631) 444-3144; ;
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Grigg-Gutierrez N, Laboy C, Ramos L, Amaral K, Toro DH. Diagnostic Yield of Video Capsule Endoscopy for Small Bowel Bleeding: Eight Consecutive Years of Experience at the VA Caribbean Healthcare System. P R Health Sci J 2016; 35:93-96. [PMID: 27232871] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the diagnostic yield of video capsule endoscopy (VCE) in patients with small bowel gastrointestinal bleeding and examine the impact of this diagnostic technology on the clinical management of this complaint. METHODS This was a retrospective study in which all patients who underwent VCE (May 7, 2003 - December 31, 2011) were included. Records were reviewed for the type of bleeding (overt vs. occult; when present), demographic data, lab results, and capsule endoscopy findings. Information regarding medical treatment (i.e., endoscopic intervention, surgical therapy, or both) was also recorded. RESULTS A total of 229 subjects were included in the study. Most were men; the mean age of all the subjects was 69.8 years. Of the 229 VCEs, 154 (67.3%) were done because of occult bleeding and 75 (32%) because of overt bleeding. VCEs were normal in 34 (14.9%) cases and non-diagnostic in 15 (6.6%). Angiodysplasia, erosions, and ulcers were the most common findings (48.5%, 24.5%, and 10.92% respectively). Active bleeding was reported in 7 cases (3%). Nearly 20% of the 229 cases required either endoscopic or surgical intervention. CONCLUSION In our study, VCE achieved a diagnostic yield of 78.6%. In 1 of every 5 subjects, video capsule endoscopy led to the identification of small bowel lesions that required either endoscopic or surgical resection, rather than conservative treatment with iron replacement. VCE proved to be a very useful investigative tool, not only for establishing the source of bleeding but also, most importantly, for directing the appropriate therapy for lesions that would otherwise have been missed by conventional studies.
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Affiliation(s)
| | - Carlos Laboy
- Gastroenterology Department, VA Caribbean Healthcare System, San Juan, PR
| | - Liliana Ramos
- Gastroenterology Department, VA Caribbean Healthcare System, San Juan, PR
| | - Karla Amaral
- Gastroenterology Department, VA Caribbean Healthcare System, San Juan, PR
| | - Doris H Toro
- Gastroenterology Department, VA Caribbean Healthcare System, San Juan, PR
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14
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Shirbeigi L, Oveidzadeh L, Jafari Z, Fard MSM. Acne Etiology and Treatments in Traditional Persian Medicine. Iran J Med Sci 2016; 41:S19. [PMID: 27840485 PMCID: PMC5103524] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Traditional Persian medicine (TPM) is based on humors theory. Temperament or mizaj is the result of a combination of four fundamental humors called blood, phlegm, yellow bile, and black bile. Like any other diseases, acne is the result of humoral imbalance. Acne is a highly prevalent dermatological problem, which has both physical and psychological effects on patients. The aim of this study was to determine the etiology of acne formation and natural remedies from the perspective of Persian scientists. METHODS The etiology and treatment of acne were collected and analyzed from selected TPM medical textbooks. Some selected plants in these books were assessed in tabular format and their anti-acne activities were compared with modern medicine's databases. RESULTS In the acne treatment, considering six essential schemes for health, diet and herbal remedies as well as manipulation are recommended. Although the mentioned herbs in acne treatment have antibacterial, anti-inflammatory, and antioxidant effects; however, some have special proven effects on the acne formation process. There is also a strong relationship between the digestive system and skin. This paper was rendered to show ancient Persian scholar's viewpoints on acne and its treatment. CONCLUSION Some reported remedies might be beneficial towards further studies on acne treatment.
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Affiliation(s)
- Leila Shirbeigi
- Department of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran, University of Medical Sciences, Tehran, Iran
| | - Laleh Oveidzadeh
- Department of Iranian Traditional Medicine, Faculty of Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran
| | - Zahra Jafari
- Department of Iranian Traditional Medicine, Faculty of Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran
| | - Monireh Sadat Motahari Fard
- Department of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran, University of Medical Sciences, Tehran, Iran
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Dinesh HN, Kumar CJ, Sanjay HM, Sachin V, Basavaraju. Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study. J Clin Diagn Res 2015; 9:PC12-4. [PMID: 26417553 DOI: 10.7860/jcdr/2015/13833.6242] [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: 03/07/2015] [Accepted: 06/23/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. AIM To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. MATERIALS AND METHODS Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. RESULTS A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. CONCLUSION We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital.
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Affiliation(s)
- H N Dinesh
- Associate Professor, Department of General Surgery, MMCRI and KR Hospital , Mysore, Karnataka, India
| | - Cd Jagadish Kumar
- Post Graduate Student, Department of General Surgery, MMCRI and KR Hospital , Mysore, Karnataka, India
| | - H M Sanjay
- Post Graduate Student, Department of General Surgery, MMCRI and KR Hospital , Mysore, Karnataka, India
| | - V Sachin
- Post Graduate Student, Department of General Surgery, MMCRI and KR Hospital , Mysore, Karnataka, India
| | - Basavaraju
- Post Graduate Student, Department of General Surgery, MMCRI and KR Hospital , Mysore, Karnataka, India
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16
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Khalaf N, White D, Kanwal F, Ramsey D, Mittal S, Tavakoli-Tabasi S, Kuzniarek J, El-Serag HB. Coffee and Caffeine Are Associated With Decreased Risk of Advanced Hepatic Fibrosis Among Patients With Hepatitis C. Clin Gastroenterol Hepatol 2015; 13:1521-31.e3. [PMID: 25777972 DOI: 10.1016/j.cgh.2015.01.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 10/14/2014] [Revised: 01/12/2015] [Accepted: 01/28/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND & AIMS Coffee or caffeine has been proposed to protect against hepatic fibrosis, but few data are available on their effects in patients with chronic hepatitis C virus (HCV) infection. METHODS We conducted a cross-sectional study of veterans with chronic HCV infection to evaluate the association between daily intake of caffeinated and decaffeinated coffee, tea, and soda, and level of hepatic fibrosis, based on the FibroSURE test (BioPredictive, Paris, France) (F0-F3, mild [controls] vs. F3/F4-F4, advanced). Models were adjusted for multiple potential confounders including age, alcohol abuse, and obesity. RESULTS Among 910 patients with chronic HCV infection, 98% were male and 38% had advanced hepatic fibrosis. Daily intake of caffeinated coffee was higher among controls than patients with advanced fibrosis (1.37 vs. 1.05 cups/d; P = .038). In contrast, daily intake of caffeinated tea (0.61 vs. 0.56 cups/d; P = .651) or soda (1.14 vs. 0.95 cans/d; P = .106) did not differ between the groups. A higher percentage of controls (66.0%) than patients with advanced fibrosis (57.9%) consumed 100 mg or more of caffeine daily from all sources (P = .014); controls also received a larger proportion of their caffeine from coffee (50.2% vs. 43.0%; P = .035). Hepatoprotective effects of an average daily intake of 100 mg or more of caffeine (adjusted odds ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .020) and 1 cup or more of caffeinated tea by non-coffee drinkers (adjusted odds ratio, 0.56; 95% confidence interval, 0.34-0.94; P = .028) persisted after adjustment for confounders, including insulin resistance. CONCLUSIONS A modest daily caffeine intake (as little as 100 mg) may protect against advanced hepatic fibrosis in men with chronic HCV infection. Additional research is needed to confirm these findings in women and in people with other chronic liver diseases.
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Affiliation(s)
- Natalia Khalaf
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Donna White
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Fasiha Kanwal
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - David Ramsey
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Sahil Mittal
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Shahriar Tavakoli-Tabasi
- Section of Infectious Diseases, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Jill Kuzniarek
- Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Hashem B El-Serag
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas.
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Karaman U, Daldal N, Ozer A, Enginyurt O, Erturk O. Epidemiology of Cyclospora Species in Humans in Malatya Province in Turkey. Jundishapur J Microbiol 2015; 8:e18661. [PMID: 26421126 PMCID: PMC4584132 DOI: 10.5812/jjm.18661v2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 03/02/2014] [Revised: 05/10/2014] [Accepted: 05/31/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cyclospora species are rare among other Coccidia parasites and can cause recurrent gastroenteritis. Cyclospora spp. can infect reptiles, insects, rodents, and mammals. OBJECTIVES The present study aimed to determine the epidemiology of Cyclospora spp. in Malatya province and its neighboring provinces. PATIENTS AND METHODS Totally, 2281 stool samples taken from patients with digestive system complaints who referred to the polyclinics affiliated with Inonu University, Faculty of Medicine in Malatya Province and its neighboring provinces, in 2006, and whose stool specimens were submitted to the parasitology department were examined. A questionnaire was developed to determine the epidemiology of Cyclospora spp. in the patients as the dependent variable of the study. All the participants signed an informed written consent. The samples were coated with Entellan™ after staining via acid-fast staining and were examined on an immersion microscope objective. The data are presented as mean, standard deviation, or number/percentage. The chi-square test was used for the statistical analyses. Statistically, a P value < 0.05 was accepted as meaningful. RESULTS The stool samples were examined via direct microscopic examination and acid-fast staining. Positivity was determined in 129 (5.7%) cases. In the overall assessment of the patients with respect to general body itching, rectal itching, allergy, immunosuppression plus cancer, shortness of breath, ulcerative colitis, diarrhea, abdominal pain, salivation, constipation, nausea, vomiting, growth retardation, and anemia, there was no significant relationship. However, in the statistical evaluations among the positive cases, the difference was found to be significant. CONCLUSIONS The study was conducted in Malatya Province, but patients from the neighboring provinces were also included in the evaluation during the study. Of all the positive cases, 5.6% were those from Malatya Province and its surrounding areas. Additionally, Cyclospora spp. were observed among the patients referring to the polyclinics with digestive system complaints in 8.1% of those from the Adiyaman province and in 6.9% of those from the Kahramanmaraş region. The incidence of Cyclospora cayetanensis may be higher in these regions if an epidemiological study is performed. Consequently, we suggest that Cyclospora spp. be investigated in digestive system disorders, especially in immunosuppressed patients.
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Affiliation(s)
- Ulku Karaman
- Department of Medical Parasitology, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Nilgun Daldal
- Department of Medical Parasitology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ali Ozer
- Public Health Department, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ozgur Enginyurt
- Department of Family Medicine, Faculty of Medicine, Ordu University, Ordu, Turkey
- Corresponding author: Ozgur Enginyurt,Department of Family Medicine, Faculty of Medicine, Ordu University, Ordu, Turkey, E-mail:
| | - Omer Erturk
- Literature Department, Faculty of Science, Ordu University, Ordu, Turkey
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Halligan S, Wooldrage K, Dadswell E, Shah U, Kralj-Hans I, von Wagner C, Faiz O, Teare J, Edwards R, Kay C, Yao G, Lilford RJ, Morton D, Wardle J, Atkin W. Identification of Extracolonic Pathologies by Computed Tomographic Colonography in Colorectal Cancer Symptomatic Patients. Gastroenterology 2015; 149:89-101.e5. [PMID: 25796362 DOI: 10.1053/j.gastro.2015.03.011] [Citation(s) in RCA: 18] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 02/12/2015] [Accepted: 03/06/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Symptoms suggestive of colorectal cancer may originate outside the colorectum. Computed tomographic colonography (CTC) is used to examine the colorectum and abdominopelvic organs simultaneously. We performed a prospective randomized controlled trial to quantify the frequency, nature, and consequences of extracolonic findings. METHODS We studied 5384 patients from 21 UK National Health Service hospitals referred by their family doctor for the investigation of colorectal cancer symptoms from March 2004 through December 2007. The patients were assigned randomly to groups that received the requested test (barium enema or colonoscopy, n = 3574) or CTC (n = 1810). We determined the frequency and nature of extracolonic findings, subsequent investigations, ultimate diagnosis, and extracolonic cancer diagnoses 1 and 3 years after testing patients without colorectal cancer. RESULTS Extracolonic pathologies were detected in 959 patients by CTC (58.7%), in 42 patients by barium enema analysis (1.9%), and in no patients by colonoscopy. Extracolonic findings were investigated in 142 patients (14.2%) and a diagnosis was made for 126 patients (88.1%). Symptoms were explained by extracolonic findings in 4 patients analyzed by barium enema (0.2%) and in 33 patients analyzed by CTC (2.8%). CTC identified 72 extracolonic neoplasms, however, barium enema analysis found only 3 (colonoscopy found none). Overall, CTC diagnosed extracolonic neoplasms in 72 of 1634 patients (4.4%); 26 of these were malignant (1.6%). There were significantly more extracolonic malignancies detected than expected 1 year after examination, but these did not differ between patients evaluated by CTC (22.2/1000 person-years), barium enema (26.5/1000 person-years; P = .43), or colonoscopy (32.0/1000 person-years; P = .88). CONCLUSIONS More than half of the patients with symptoms of colorectal cancer are found to have extracolonic pathologies by CTC analysis. However, the proportion of patients found to have extracolonic malignancies after 1 year of CTC examination is not significantly greater than after barium enema or colonoscopy examinations. International Standard Randomised Controlled Trials no: 95152621.isrctn.com.
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Affiliation(s)
| | | | | | - Urvi Shah
- Imperial College London, London, United Kingdom
| | | | | | - Omar Faiz
- Imperial College London, London, United Kingdom
| | | | - Rob Edwards
- Queen Mary University of London, London, United Kingdom
| | - Clive Kay
- Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, United Kingdom
| | - Guiqing Yao
- University of Southampton, Southampton, United Kingdom
| | | | - Dion Morton
- University of Birmingham, Birmingham, United Kingdom
| | - Jane Wardle
- University College London, London, United Kingdom
| | - Wendy Atkin
- Imperial College London, London, United Kingdom
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Qhalib HA, Zain GH. Hepatobiliary Complications of Sickle Cell Disease among Children Admitted to Al Wahda Teaching Hospital, Aden, Yemen. Sultan Qaboos Univ Med J 2014; 14:e556-e560. [PMID: 25364561 PMCID: PMC4205070] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/18/2013] [Accepted: 06/19/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES This study aimed to describe the pattern of hepatobiliary complications among patients with sickle cell disease (SCD) and to assess their correlation with age, gender and other risk factors. METHODS This cross-sectional study assessed 106 patients with SCD who were admitted to Al Wahda Teaching Hospital in Aden, Yemen, between January and June 2009. A full history, thorough examination, essential laboratory investigations (including a complete blood count, liver function test and viral markers test) and an abdominal ultrasound were performed on all patients. The clinicopathological characteristics of the hepatobiliary complications were analysed for their correlation to different risk factors such as age and gender. RESULTS It was found that 46.2% of the patients with SCD had hepatobiliary complications. Of these, 36.7% had viral hepatitis, 26.0% had cholecystitis and 20% had gallstones. A total of 60.4% of the affected patients were male. The mean levels of alanine aminotransferase (59.4 and 56.0 U/L) and aspartate transaminase (40.1 and 38.3 U/L) were significantly elevated in patients with viral hepatitis and cholecystitis, respectively. Hepatitis B virus surface antigen showed higher positivity (10.4%) than anti-hepatitis A and anti-hepatitis C antibodies. Hepatobiliary complications increased significantly with age and were notably higher among those who were often admitted to hospital and/or underwent frequent blood transfusions. CONCLUSION This study suggests that hepatobiliary complications are common among SCD patients and the likelihood of developing such complications increases as patients age. Thus, regular clinical follow-ups, abdominal ultrasound studies and periodic liver function tests, as well as serological tests for viral hepatitis, are strongly recommended. These can help in the early detection of these complications and allow opportunities for their management and prevention.
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Affiliation(s)
- Hana A. Qhalib
- Department of Paediatrics, Faculty of Medicine, Aden University, Aden, Yemen
| | - Gamal H. Zain
- Department of Paediatrics, Faculty of Medicine, Aden University, Aden, Yemen
- Paediatric Haematology & Oncology Unit, Al Wahda Teaching Hospital, Aden, Yemen
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20
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Leighton JA, Gralnek IM, Cohen SA, Toth E, Cave DR, Wolf DC, Mullin GE, Ketover SR, Legnani PE, Seidman EG, Crowell MD, Bergwerk AJ, Peled R, Eliakim R. Capsule endoscopy is superior to small-bowel follow-through and equivalent to ileocolonoscopy in suspected Crohn's disease. Clin Gastroenterol Hepatol 2014; 12:609-15. [PMID: 24075891 DOI: 10.1016/j.cgh.2013.09.028] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 03/20/2013] [Revised: 07/29/2013] [Accepted: 09/04/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Evaluation of the small intestine for inflammation has traditionally relied on small-bowel follow-through (SBFT), but multiple studies have demonstrated its low diagnostic accuracy. Capsule endoscopy (CE) transmits high-quality images of the small intestinal mucosa; it can be used to visualize the entire length of the small bowel and much of the mucosa. We compared the diagnostic yields of CE vs SBFT in a prospective study of patients with suspected small-bowel Crohn's disease. METHODS Eighty patients with signs and/or symptoms of small-bowel Crohn's disease (age, 10-65 years) underwent CE, followed by SBFT and ileocolonoscopy. Readers were blinded to other test results. The primary outcome was the diagnostic yield for inflammatory lesions found with CE before ileocolonoscopy compared with SBFT and ileocolonoscopy. A secondary outcome was the incremental diagnostic yield of CE compared with ileocolonoscopy and CE compared with SBFT. RESULTS The combination of CE and ileocolonoscopy detected 107 of 110 inflammatory lesions (97.3%), whereas the combination of SBFT and ileocolonoscopy detected only 63 lesions (57.3%) (P < .001). The diagnostic yield of CE compared with ileocolonoscopy was not different (P = .09). The diagnostic yield was higher for CE than for SBFT (P < .001). Of the 80 patients with suspected Crohn's disease, 25 (31.3%) had the diagnosis confirmed. Eleven were diagnosed by CE findings alone and 5 by ileocolonoscopy findings alone. In the remaining 9 patients, diagnostic findings were identified by at least 2 of the 3 modalities. No diagnoses were made on the basis of SBFT findings alone. CONCLUSIONS CE was better than SBFT and equivalent to ileocolonoscopy in detecting small-bowel inflammation. Although ileocolonoscopy remains the initial diagnostic test of choice, CE is safe and can establish the diagnosis of Crohn's disease in patients when ileocolonoscopy results are negative or the terminal ileum cannot be evaluated. ClinicalTrials.gov Number: NCT00487396.
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Affiliation(s)
| | - Ian M Gralnek
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
| | - Stanley A Cohen
- Children Center for Digestive Health Care, Children Healthcare of Atlanta, Atlanta, Georgia
| | - Ervin Toth
- Department of Gastroenterology, Skane University Hospital, Malmö, Sweden
| | - David R Cave
- University of Massachusetts Medical School, Worcester, Massachusetts
| | | | | | | | | | - Ernest G Seidman
- Research Institute of McGill University Health Center, Montreal General Hospital, Montreal, Quebec, Canada
| | | | | | | | - Rami Eliakim
- Department of Gastroenterology, Sheba Medical Center, Tel-Aviv, Israel
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