The frequency of microscopic and focal active colitis in patients with irritable bowel syndrome

<p>Abstract</p> <p>Background</p> <p>Irritable bowel syndrome (IBS) is a chronic functional bowel disorder. The frequency of microscopic colitis and focal active colitis in the colonic mucosa has been investigated in IBS patients.</p> <p>Methods</p> <p>Between June 2007 and September 2010, 378 patients (between 16 and 84 years) were recruited prospectively. Of these 378 patients, 226 patients were diagnosed with IBS using the Rome III criteria. 152 control patients were also enrolled who were undergoing colonoscopy for colorectal cancer screening or investigation of anemia. Histopathological abnormalities identified during colonoscopy were compared between the IBS and control groups.</p> <p>Results</p> <p>The average age of the IBS group was 46.13 ± 14.16 years and and the average age of the control group was 57.01 ± 13.07 years. The prevalence of microscopic colitis (MC) in the diarrhea predominant and the mixed subgroup of IBS patients was 4.32% (7/162) whereas in all IBS patients, the prevalence was 3.09% (7/226). MC was not found in the 152 control cases, (p = 0.045). Lymphocytic colitis was seen in 7 IBS patients, with 1 case in the mixed group and 6 cases in the diarrhea group and there was a significant difference in the frequency of lymphocytic colitis between the IBS subgroups (p < 0.01). Focal active colitis was found in 6.6% (15/226) of the IBS patients and in none of the controls (p < 0.01), and there was no differences between IBS subtypes.</p> <p>Conclusion</p> <p>Microscopic colitis was more often found in the diarrhea predominant/mixed subgroups of IBS patients and in patients who were older women. In patients who are older woman with non-constipated IBS, it may be reasonable to perform a biopsy to screen for microscopic colitis. Focal active colitis was significantly increased in patients with IBS compared to controls.</p

Bone density in proton pump inhibitors users: a prospective study

Patients with gastroesophageal reflux disease (GERD) receive long-term therapy with proton pump inhibitor (PPI) agents. Several studies have recently been published suggesting that treatment with PPI may cause bone fractures, although the number of prospective studies in this regard is limited. The aim of this study is to prospectively investigate the effect of PPIs on bone density. Between March 2009 and January 2011, 114 GERD patients (18-56 years) and 110 healthy controls were included in the present study. Bone mineral densitometry (BMD) by using dual-energy X-ray absorptiometry was assessed at lumbar spine and femur neck. BMD measurements were performed on all subjects at the beginning of the study. The patients were divided according to three drugs by their treatment with esomeprazole, lansoprazole, or pantoprazole. The study group was followed for at least 6 months on PPI therapy, and then BMD measurements were repeated. The mean duration of treatment with PPIs was 8.5 +/- A 2.3 months. In patients receiving PPIs, the mean reduction in total vertebra T score following treatment compared to pre-treatment values was 00.23 +/- A 0.42 units (95 % CI 0.15-0.30) (p < 0.01), while the mean reduction in the femur T score was 0.10 +/- A 0.40 units (95 % CI 0.03-0.18) (p = 0.03). Reduction following treatment in L4 and total vertebra T scores of lansoprazole group was significantly higher than of pantoprazole group (p = 0.04). Reduction in femur T score of esomeprazole group was higher than of lansoprazole group and pantroprazole group, but it is not statistically significant. Treatment with a PPI results in a significant reduction in bone density. Close monitoring is beneficial for patients who are to receive long-term treatment with PPI

Evaluation of drug adherence in patients with non-valvular atrial fibrillation according to geographic regions of Turkey: an analysis from NOAC-TR study

Drug adherence to novel oral anticoagulants (NOAC) varied by countries and popuplations. As a result of NOAC-TR study, in Turkey, drug adhrence to NOACs is poor comparing to other real world studies. However it is not known whether there is a difference between geographic regions of Turkey in terms of NOAC adherence. In this study we aim to investigate the NOAC adherence in patients with non-valvular atrial fibrillation according to the geographic regions in Turkey Method: This cros-sectional study was designed as a subgroup study of NOAC-TR (Drug Adherence in patients with non valvular atrial fibrillation taking non-vitamin K antagonist oral anticoagulants in Turkey). A total of 2802 patients (59% female) taking NOAC (Dabigatran, apixaban, rivaroxaban) due to NVAF at least 3 months, were included. Morisky-8 item drug adherence scale was used. Patients were divided in 3 groups (high, moderate and low adherent) based on drug adherence Results: Of the patients 24% were adherent, 26% were moderate adhererent and 50% were low adherent to NOAC treatment. Drug adhrence was different between geographic regions (p [Med-Science 2017; 6(4.000): 689-695

Visceral Fat Reflects Disease Activity in Patients with Ankylosing Spondylitis

Purpose: Response to infliximab treatment diminishes as body mass index (BMI) increases in patients with ankylosing spondylitis (AS). The purpose of the study was to determine if diminished response to infliximab treatment in patients with AS could be associated with increased visceral adipose tissue rather than increased BMI. Methods: Twenty six AS patients (21 males and five females) who fulfilled the modified New York criteria and who were currently receiving infliximab treatment were enrolled in the study. Pain was measured by the visual analogue scale (VAS). The disease activity and functional status were assessed by the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). The Bath AS Metrology Index (BASMI) was used to evaluate mobility restrictions. Weight and visceral body composition were measured without shoes in light indoor clothes using a bio-impedance meter. Results: There was a significant correlation between visceral adipose tissue amount and disease activity under infliximab treatment. In correlation analysis, visceral fat showed significant correlations between BASDAI (r=0.545, p=0.004) and VAS (r=0.458, p=0.019). Total body fat also showed a significant correlation with BASDAI (r=0.463, p=0.017). Conclusion: A significant correlation was found between visceral adipose tissue amount and disease activity in patients with AS

Efficacy of tenofovir in adefovir-experienced patients compared with treatment-naive patients with chronic hepatitis B

Background: Tenofovir (TDF) has similar antiviral efficacy in both treatment-naive and lamivudine-resistant chronic hepatitis B (CHB) patients. Data on TDF use in patients with adefovir (ADV) resistance is inconsistent. The aim of our study was to assess antiviral efficacy of TDF against nucleoside analogue-naive (NN) and ADV-resistant (ADV-R) CHB and suboptimal responders to ADV (ADV-S)

Safety of once-or twice-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with nonvalvular atrial fibrillation: A NOAC-TR study

WOS: 000433285000010PubMed ID: 28968197Once-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) may increase patient adherence to treatment but may also be associated with a higher risk of bleeding. In this study, we investigated the adherence to once-or twice-daily dosing of NOACs and the risk of bleeding in nonvalvular atrial fibrillation (NVAF) patients. This multicenter cross-sectional study, conducted between 1 September 2015 and 28 February 2016, included 2214 patients receiving NOACs for at least 3 months, due to NVAF. Patients receiving once-daily or twice-daily NOAC doses were 1: 1 propensity score matched for baseline demographic characteristics and the presence of other diseases. The medication adherence was assessed by the 8-item Morisky Medication Adherence Scale. Risk factors were investigated in relation to minor and major bleeding. The mean age of patients was 71 +/- 10 years, and 53% of the patients were women. The medication adherence was lower in patients receiving twice-daily NOAC doses compared to once-daily-dose group (47% versus 53%, p = 0.001), and there was no difference between the groups in terms of minor (15% versus 16%, p = 0.292) and major bleeding (3% versus 3%, p = 0.796). Independent risk factors for bleeding were non-adherence to medication (OR: 1.62, 95% CI: 1.23-2.14, p = 0.001), presence of 3 or more other diseases (OR: 10.3, 95% CI: 5.3-20.3, p < 0.001), and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol) score (OR: 4.84, 95% CI: 4.04-5.8, p < 0.001). In summary, the once-daily dose of NOACs was associated with increased patient adherence to medication, while it was not associated with bleeding complications