108 research outputs found
Risks of combining immunosuppressive and biological treatments in inflammatory bowel disease - in reply
We thank Roblin and Phelip for their comment on a timely
issue. The recent report of the rare hepatosplenic T-cell lymphoma
(HSTCL) in young patients with CD treated with
both infliximab and azathioprine or steroids has rightly unleashed
a series of doubts regarding the optimal use of biological
agents in this and other conditions. How these observations
may directly relate to the design of our study\u2014as
implied by Roblin and Phelip\u2014is unclear though. While azathioprine
by itself has been linked to lymphoma development
including HSTCL, recent studies have shown that neither
infliximab nor methotrexate, which was used in our
study, alone or in combination in CD or in rheumatoid arthritis,
appear to be associated with an increased risk of
developing lymphomas. In addition, methotrexate alone has
never been associated thus far with HSTCL in CD
Infliximab with low-dose methotrexate for prevention of postsurgical recurrence of ileocolonic Crohn disease
Post-Traumatic Right Lumbar Abscess as First Manifestation of Perforated Right Colon Cancer – A Case Report
Besides most common signs and symptoms suggesting a colic cancer, sometimes the clinical presentation can be difficult. Extra-abdominal abscess as a first sign of perforated colon carcinoma is a very unusual finding. We report a case of an old male patient, in bad general condition, with a post-traumatic finding of right lumbar abscess. After the percutaneous drainage with discharge of fecal material and a postponed explorative laparotomy, we discovered a perforated right colon carcinoma with a covered perforation affecting the duodenum wall and spreading to the hepatic bedand over to the back lumbar muscular wall. Because of the diffusion of the tumor, the patient was treated with palliative surgery with duodenum suture, right colon segment resection and subsequent ileocolic anastomosis with an uneventful postoperative course. The patient died 2 months later because of neoplastic cachexia
Changes in chromatin accessibility and transcriptional landscape induced by HDAC inhibitors in TP53 mutated patient-derived colon cancer organoids
: Here we present the generation and characterization of patient-derived organoids (PDOs) from colorectal cancer patients. PDOs derived from two patients with TP53 mutations were tested with two different HDAC inhibitors (SAHA and NKL54). Cell death induction, transcriptome, and chromatin accessibility changes were analyzed. HDACIs promote the upregulation of low expressed genes and the downregulation of highly expressed genes. A similar differential effect is observed at the level of chromatin accessibility. Only SAHA is a potent inducer of cell death, which is characterized by the upregulation of BH3-only genes BIK and BMF. Up-regulation of BIK is associated with increased accessibility in an intronic region that has enhancer properties. SAHA, but not NKL54, also causes downregulation of BCL2L1 and decreases chromatin accessibility in three distinct regions of the BCL2L1 locus. Both inhibitors upregulate the expression of innate immunity genes and members of the MHC family. In summary, our exploratory study indicates a mechanism of action for SAHA and demonstrate the low efficacy of NKL54 as a single agent for apoptosis induction, using two PDOs. These observations need to be validated in a larger cohort of PDOs
Long-Term Functional Outcome after Internal Delorme's Procedure for Obstructed Defecation Syndrome, and the Role of Postoperative Rehabilitation
PURPOSE: To evaluate long-term functional outcomes of Internal Delorme's Procedure (IDP) in patients refractory to conservative treatment for Obstructed Defecation Syndrome (ODS), and to compare those who received postoperative rehabilitation with those who did not.
MATERIALS AND METHODS: All patients with ODS refractory to nonoperative therapy were identified across three regional pelvic floor referral hospitals, and IDP was performed. Postoperatively selected patients received biofeedback therapy. Functional outcomes were established using the Cleveland Clinic Constipation (CCC) score and obstructed defecation score (OD score) preoperatively at 12 months and at the last available follow-up. Patient satisfaction was assessed with a visual analogue score.
RESULTS: From October 2006 to September 2013, IDP was performed in 170 patients: 77 received postoperative biofeedback and 93 did not. Mean follow-up was 6.3 years (range 1-8 years). CCC and OD scores improved significantly in both groups after 12 months and at the last follow-up (p > 0.05). When comparing two groups while there was no significant difference between CCC and OD scores at 12 months, score was significantly better in the group that received rehabilitation at the last follow-up (p = 0.001). Patient satisfaction was higher in the rehabilitation group (67%) compared with those without rehabilitation (55%). Clinical recurrence was recorded in nine patients who did not have postoperative rehabilitation.
CONCLUSIONS: It has been demonstrated that IDP is associated with good long-term functional outcomes. Patients receiving rehabilitation had a better long-term follow-up, a higher overall satisfaction, and lower recurrence rate when compared with the patients who did not receive postoperative rehabilitation
The Adenoma to Polyp Detection Rate Quotient Varies Among Different Patient Populations: Implications for the Quality Metrics of Colonoscopy
Inhibition of APE1-endonuclease activity affects cell metabolism in colon cancer cells via a p53-dependent pathway
The pathogenesis of colorectal cancer (CRC) involves different mechanisms, such as genomic and microsatellite instabilities. Recently, a contribution of the base excision repair (BER) pathway in CRC pathology has been emerged. In this context, the involvement of APE1 in the BER pathway and in the transcriptional regulation of genes implicated in tumor progression strongly correlates with chemoresistance in CRC and in more aggressive cancers. In addition, the APE1 interactome is emerging as an important player in tumor progression, as demonstrated by its interaction with Nucleophosmin (NPM1). For these reasons, APE1 is becoming a promising target in cancer therapy and a powerful prognostic and predictive factor in several cancer types. Thus, specific APE1 inhibitors have been developed targeting: i) the endonuclease activity; ii) the redox function and iii) the APE1-NPM1 interaction. Furthermore, mutated p53 is a common feature of advanced CRC. The relationship between APE1 inhibition and p53 is still completely unknown. Here, we demonstrated that the inhibition of the endonuclease activity of APE1 triggers p53-mediated effects on cell metabolism in HCT-116 colon cancer cell line. In particular, the inhibition of the endonuclease activity, but not of the redox function or of the interaction with NPM1, promotes p53 activation in parallel to sensitization of p53-expressing HCT-116 cell line to genotoxic treatment. Moreover, the endonuclease inhibitor affects mitochondrial activity in a p53-dependent manner. Finally, we demonstrated that 3D organoids derived from CRC patients are susceptible to APE1-endonuclease inhibition in a p53-status correlated manner, recapitulating data obtained with HCT-116 isogenic cell lines. These findings suggest the importance of further studies aimed at testing the possibility to target the endonuclease activity of APE1 in CRC
The older patient with cardiovascular disease: background and clinical implications of the comprehensive geriatric assessment (CGA)
Presence of Bacillus cereus, Escherichia coli and Enterobacteriaceae in fresh and salted Ricotta cheese: official controls in Sardinia during the period 2009 – 2012.
Results of microbiological official analysis carried out during 2009-2012 for detection of Bacillus cereus, Escherichia coli and Enterobacteriaceae in fresh and salted Ricotta cheese marketed in Sardinia, are re-ported. The aim of this research was to evaluate the presence of contaminants indicators of process hy-giene, and the presence of B. cereus, which while not covered in the EC Regulation 2073/05 for this product, it may represent a risk as a potential producer of toxins harmful to the consumer health. Were analyzed a total of 157 samples according to ISO reference. The results indicate a widespread presence of the three types of microorganisms sought: prevalence of B. cereus 53%, 23% Enterobacteriaceae, E. coli 12%. In conclusion, it is desirable the introduction, in the production process, keeping the cold chain to prevent the risk from B. cereus, and improved hygiene of processing plant, equipment and personnel, to reduce recontamination of the product by the Enterobacteriaceae and E. coli
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