Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up

Objective. Atrophic gastritis (AG) is a risk condition for gastric cancer and type I gastric carcinoids. Recent studies assessing the overall risk of gastric cancer and carcinoids in AG at long-term follow up are lacking. This study aimed to investigate in a prospective cohort of AG patients the occurrence of gastric cancer and carcinoids at long-term follow up. Methods. A total of 200 AG patients from a prospective cohort (67% female, median age 55 years) with a follow up of 7.5 (range: 4-23.4) years were included. Inclusion criteria were presence of AG and at least one follow-up gastroscopy with biopsies at ≥4 years after AG diagnosis. Follow-up gastroscopies at 4-year intervals were performed. Results. Overall, 22 gastric neoplastic lesions were detected (crude incidence 11%). Gastric cancer was diagnosed in four patients at a median follow up of 7.2 years (crude incidence 2%). Eleven type I gastric carcinoids were detected at a median follow up of 5.1 years (crude incidence of 5.5%). In seven patients, six low-grade and one high-grade dysplasia were found. The annual incidence rate person-year were 0.25% (95% confidence interval [CI]: 0.067-0.63%), 0.43% (95% CI: 0.17-0.89%), and 0.68% (95% CI: 0.34-1.21%) for gastric cancer, dysplasia, and type I-gastric carcinoids, respectively. The incidence rates of gastric cancer and carcinoids were not different (p = 0.07). Conclusion. This study shows an annual incidence rate of 1.36% person-year for gastric neoplastic lesions in AG patients at long-term follow up. AG patients are similarly exposed to gastric cancer and type I gastric carcinoids

Role of Fibre in Nutritional Management of Pancreatic Diseases

The role of fibre intake in the management of patients with pancreatic disease is still controversial. In acute pancreatitis, a prebiotic enriched diet is associated with low rates of pancreatic necrosis infection, hospital stay, systemic inflammatory response syndrome and multiorgan failure. This protective effect seems to be connected with the ability of fibre to stabilise the disturbed intestinal barrier homeostasis and to reduce the infection rate. On the other hand, in patients with exocrine pancreatic insufficiency, a high content fibre diet is associated with an increased wet fecal weight and fecal fat excretion because of the fibre inhibition of pancreatic enzymes. The mechanism by which dietary fibre reduces the pancreatic enzyme activity is still not clear. It seems likely that pancreatic enzymes are absorbed on the fibre surface or entrapped in pectin, a gel-like substance, and are likely inactivated by anti-nutrient compounds present in some foods. The aim of the present review is to highlight the current knowledge on the role of fibre in the nutritional management of patients with pancreatic disorders

Influence of dietary vitamin E supplementation on cholesterol oxidation and fresh colour in beef aged for 3 and 14 days

The effects of dietary vitamin E supplementation on the susceptibility to lipid oxidation and colour of the Longissimus thoracis (LT) muscle aged in vacuum packaged conditions for 3 or 14 days were studied. For this purpose, Charolais cattle were fed on a diet providing daily 60 mg (control) or 5500 mg of vitamin E per animal (supplemented) for 30 and 60 days before slaughter. Dietary vitamin E supplementation increased the liver vitamin E content, but not in the LT muscle of treated animals. The vitamin supplementation for 30 and 60 days has shown non-consistent effects in reducing cholesterol oxidation products of vacuum-packed aged meat. However, the vitamin E supplementation for 60 days was effective on Lightness stability in LT muscle during vacuum-packed ageing. Overall, from the practical standpoint, this study suggests that supranutritional supplementation up to 60 days may not increase the vitamin E content of Charolais LT muscle giving little, if any, benefits on meat colour and cholesterol oxidation. However, the present study suggests that it would be interesting to determine in which extent specific oxysterols are related to the meat colour and whether colour parameters can be useful for predicting the formation of cholesterol oxidation products along the industrial meat production chain.The effects of dietary vitamin E supplementation on the susceptibility to lipid oxidation and colour of the Longissimus thoracis (LT) muscle aged in vacuum packaged conditions for 3 or 14 days were studied. For this purpose, Charolais cattle were fed on a diet providing daily 60mg (control) or 5500mg of vitamin E per animal (supplemented) for 30 and 60 days before slaughter. Dietary vitamin E supplementation increased the liver vitamin E content, but not in the LT muscle of treated animals. The vitamin supplementation for 30 and 60 days has shown non-consistent effects in reducing cholesterol oxidation products of vacuum-packed aged meat. However, the vitamin E supplementation for 60 days was effective on Lightness stability in LT muscle during vacuum-packed ageing. Overall, from the practical standpoint, this study suggests that supranutritional supplementation up to 60 days may not increase the vitamin E content of Charolais LT muscle giving little, if any, benefits on meat colour and cholesterol oxidation. However, the present study suggests that it would be interesting to determine in which extent specific oxysterols are related to the meat colour and whether colour parameters can be useful for predicting the formation of cholesterol oxidation products along the industrial meat production chain

BDNF/TrkB axis activation promotes epithelial-mesenchymal transition in idiopathic pulmonary fibrosis

Background: Neurotrophins (NT) belongs to a family of growth factors which promotes neurons survival and differentiation. Increasing evidence show that NT and their receptor are expressed in lung tissues suggesting a possible role in lung health and disease. Here we investigated the expression and functional role of the TrkB/BDNF axis in idiopathic pulmonary fibrotic lung (myo)fibroblasts. Methods: Lung fibroblast were isolated from IPF patients and characterized for the expression of mesenchymal markers in comparison to normal lung fibroblasts isolated from non-IPF controls. Results: BDNF treatment promoted mesenchymal differentiation and this effect was counteracted by the TrkB inhibitor K252a. In this regard, we showed that K252a treatment was able to control the expression of transcription factors involved in epithelial to mesenchymal transition (EMT). Accordingly, K252a treatment reduced matrix metalloproteinase-9 enzyme activity and E-cadherin expression while increased cytoplasmic β-catenin expression. Conclusions: Our results suggest that BDNF/TrkB axis plays a role in EMT promoting the acquisition of (myo)fibroblast cell phenotype in IPF. Targeting BDNF/TrkB seems to represent a viable approach in order to prevent EMT dependent lung fibrosis

A new method for evaluating the distribution of aggregate claims

In the present paper, we propose a method of practical utility for calculating the aggregate claims distribution in a discrete framework. It is an approximated method but unlike the other approximated methods proposed in the literature: the approximation concerns both the counting distribution and the convolution of the severity distributions; the approximation does not consist in truncating the original distribution up to a given number of terms nor in replacing it with another distribution or a more general function (but simply in considering only the significant numerical realizations and in neglecting the others); the resulting approximation of the aggregate claims distribution is lower than a prefixed maximum error (10(-6) in our applications). In particular, the probability distribution and also the first three moments are exact with the prefixed maximum error. The proposed method does not require special assumptions on the counting distribution nor the identical distribution of the severity random variables and it does not incur in underflow and overflow computational problems. It proves to be more flexible, easier and cheaper than the (exact and approximated) methods using recursion and Fast Fourier Transform. We show some applications using both a Poisson distribution and a Generalized Pareto mixture of Poisson distributions as counting distribution. In addition to the specific application proposed in this paper, the method can be applied in many other (life and nonlife) actuarial fields where the sum of discrete random variables and the calculation of compound distributions are involved. Besides, it can be extended in multivariate cases. (c) 2005 Elsevier Inc. All rights reserved

Novel Insights into the Vasoprotective Role of Heme Oxygenase-1

Cardiovascular risk factors contribute to enhanced oxidative stress which leads to endothelial dysfunction. These events trigger platelet activation and their interaction with leukocytes and endothelial cells, thus contributing to the induction of chronic inflammatory processes at the vascular wall and to the development of atherosclerotic lesions and atherothrombosis. In this scenario, endogenous antioxidant pathways are induced to restrain the development of vascular disease. In the present paper, we will discuss the role of heme oxygenase (HO)-1 which is an enzyme of the heme catabolism and cleaves heme to form biliverdin and carbon monoxide (CO). Biliverdin is reduced enzymatically to the potent antioxidant bilirubin. Recent evidence supports the involvement of HO-1 in the antioxidant and antiinflammatory effect of cyclooxygenase(COX)-2-dependent prostacyclin in the vasculature. Moreover, the role of HO-1 in estrogen vasoprotection is emerging. Finally, possible strategies to develop novel therapeutics against cardiovascular disease by targeting the induction of HO-1 will be discussed

What’s hidden under the gastric intestinal metaplasia? Diffuse-type adenocarcinoma dscovered by targeted biopsies: a case-report

Gastric corpus atrophy and intestinal metaplasia are two well established gastric precancerous conditions and scientific evidence shows a confidential relationship between this precancerous condition and intestinal type gastric cancer, according to Lauren classification. Differently, the background histological gastric mucosa characteristics from whom diffuse type gastric cancer may arise, need to be clarified. In this case, report we present a case of an 81-year-old female with corpus atrophic gastritis in whom we arrived at the diagnosis of diffuse type gastric cancer by following specific guidelines related to the characterization and the endoscopic-histological surveillance of gastric precancerous conditions

Cortisol Secretion in Patients With Type 2 Diabetes: Relationship With Chronic Complications

n/

Nucleophosmin and its AML-associated mutant regulate c-Myc turnover through Fbw7γ

Mutations leading to aberrant cytoplasmic localization of nucleophosmin (NPM) are the most frequent genetic alteration in acute myelogenous leukemia (AML). NPM binds the Arf tumor suppressor and protects it from degradation. The AML-associated NPM mutant (NPMmut) also binds p19Arf but is unable to protect it from degradation, which suggests that inactivation of p19Arf contributes to leukemogenesis in AMLs. We report here that NPM regulates turnover of the c-Myc oncoprotein by acting on the F-box protein Fbw7γ, a component of the E3 ligase complex involved in the ubiquitination and proteasome degradation of c-Myc. NPM was required for nucleolar localization and stabilization of Fbw7γ. As a consequence, c-Myc was stabilized in cells lacking NPM. Expression of NPMmut also led to c-Myc stabilization because of its ability to interact with Fbw7γ and delocalize it to the cytoplasm, where it is degraded. Because Fbw7 induces degradation of other growth-promoting proteins, the NPM–Fbw7 interaction emerges as a central tumor suppressor mechanism in human cancer

TCD4pos lymphocytosis in rheumatoid and psoriatic arthritis patients following TNFα blocking agents

BACKGROUND: Lymphocyte expansion and true lymphocytosis are commonly observed in the everyday clinical practice. The meaning of such phenomenon is often poorly understood so that discrimination between benign and malignant lymphocytosis remains difficult to establish. This is mainly true when lymphocytosis rises in patients affected by immune-mediated chronic inflammatory diseases under immunosuppressive treatment, conditions potentially associated with lymphomagenesis. In this brief report the development of mild T CD4pos lymphocytosis in a group of patients with chronic arthritis under anti-TNF-α treatment is described. METHODS: Two hundred eight rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients have been evaluated longitudinally for at least 1-year before and 2-years after anti-TNF-α therapy introduction for the possible appearance of a lymphocyte expansion. In patients who developed lymphocyte expansion, T, B and NK cells were analysed. RESULTS: Twenty-five out of 208 (12%) subjects developed a mild T CD4pos lymphocytosis, during anti-TNF-α therapy, which reverted after its interruption. Higher lymphocyte count, more frequent use of steroids and shorter disease duration, before biological therapy start, have emerged as risk factors for lymphocytosis development. CONCLUSIONS: This is the first longitudinal cohort study evaluating the onset of lymphocytosis in RA and PsA patients under anti-TNF-α treatment and its possible clinical relevance. A mild T CD4pos lymphocytosis has been observed in 12% of RA and PsA patients probably related to anti-TNF-α treatment as previously reported by anecdotal cases. Patients with higher baseline lymphocyte count, use of steroids and shorter disease duration before the introduction of biologic therapy, seem to be prone to develop this laboratory reversible abnormality