Plasma carnitine is associated with fatigue in chronic hepatitis C but not in irritable bowel syndrome : Carnitine and fatigue in hepatitis C

International audienceObjectives Fatigue is an important determinant of altered quality of life in patients affected by chronic hepatitis C (CHC) or the irritable bowel syndrome (IBS). In this study, we aimed at determining the contributory role of plasma levels of leptin and carnitine on fatigue in CHC and IBS. Methods We enrolled 70 patients with CHC, 42 with IBS and 44 healthy subjects. Fatigue was evaluated using the Fatigue Impact Scale questionnaire. Body composition was assessed through impedance analysis. Plasma carnitine and leptin were measured. Results Fatigue scores were significantly more elevated in patients with CHC and IBS than in healthy subjects. Patients with CHC, but not with IBS, had significant lower plasma levels of total and free carnitine adjusted for fat mass compared to healthy subjects. In patients with CHC, and not with IBS, fatigue scores were negatively correlated with plasma levels of carnitine. Levels of free carnitine were significantly and independently associated with the severity of fatigue in patients with CHC (OR=2.019, p=0.02, CI 95% [1.01-1.23]).Conclusions In patients with CHC, the severity of fatigue is associated with low level of carnitine, suggesting that an oral supplementation may be effective to relieve fatigue in CHC. The underlying mechanism of fatigue in IBS does not seem to involve carnitine

EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe

Background: The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. Methods: EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. Results: EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. Conclusion: This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe

Laparoscopic sleeve gastrectomy for morbid obesity

The incidence of obesity is steadily rising, and it has been estimated that 40% of the US population will be obese by the year 2025 if the current trend continues. In recent years there has been renewed interest in the surgical treatment of morbid obesity in concomitance with the epidemic of obesity. Bariatric surgery proved effective in providing weight loss of large magnitude, correction of comorbidities and excellent short-term and long-term outcomes, decreasing overall mortality and providing a marked survival advantage. The Laparoscopic Sleeve Gastrectomy (LSG) has increased in popularity and is currently very “trendy” among laparoscopic surgeons involved in bariatric surgery. As LSG proved to be effective in achieving considerable weight loss in the short-term, it has been proposed by some as a sole bariatric procedure. This editorial focuses on the particular advantages of LSG in the treatment of morbid obesity

Low risk of irritable bowel syndrome after Clostridium difficile infection

OBJECTIVE: The incidence of postinfectious irritable bowel syndrome (IBS) ranges between 4% and 32% of individuals after bacterial or parasitic infection. This study analyzed IBS symptoms in hospitalized patients three months after a symptomatic Clostridium difficile infection

Amplified spontaneous emission from opal photonic crystals engineered with structural defects

In this work, we report on the optical properties and amplified spontaneous emissions (ASE) of polystyrene opals engineered with planar structural defects containing a conjugated polymer emitter. Defects in opals give rise to allowed states inside the photonic stop band, which are probed by transmittance and reflectance spectroscopy. The emission spectrum of the polymer embedded in the defect layer is strongly modified and fingerprints of defect states located inside the stop band are recognized. Amplified spontaneous emission for these engineered photonic crystals is clearly observed

Photopolymerization of hybrid organic/inorganic materials based on nanostructured units for photonic applications

In this work we report on the study of the photopolymerization process in hybrid organic-inorganic films containing photopolymerizable acrylic and methacrylic groups and. The films are doped with a proper photo-initiator for radical polymerization of (meth)acrylic units and are prepared using the sol-gel technique. The photo-initiator is activated by using continuum (single-photon polymerization) or pulsed (two-photon polymerization) laser sources at different wavelengths. After the development of the unexposed regions with a suitable solvent, the photopolymerized structures are observed with microscopy techniques. The effects of the composition of the photopolymerizable mixture, the irradiation parameters (laser power and exposure time) and the external atmosphere in which the photopolymerization is performed are investigated. The fabrication of 3D microstructures using multiphoton absorption processes is a promising technique that involves low amount of incident exposure dose with potentially high spatial resolutio

Photonic devices based on patterning by two photon induced polymerization technique

Two and three dimensional structures with micron and submicron resolution have been achieved in commercial resists, polymeric materials and sol-gel materials by several lithographic techniques. In this context, silicon-based sol-gel materials are particularly interesting because of their versatility, chemical and thermal stability, amount of embeddable active compounds. Compared with other micro- and nano-fabrication schemes, the Two Photon Induced Polymerization is unique in its 3D processing capability. The photopolymerization is performed with laser beam in the near-IR region, where samples show less absorption and less scattering, giving rise to a deeper penetration of the light. The use of ultrashort laser pulses allows the starting of nonlinear processes like multiphoton absorption at relatively low average power without thermally damaging the samples. In this work we report results on the photopolymerization process in hybrid organic-inorganic films based photopolymerizable methacrylate-containing Si-nanobuilding blocks. Films, obtained through sol-gel synthesis, are doped with a photo-initiator allowing a radical polymerization of methacrylic groups. The photo-initiator is activated by femtosecond laser source, at different input energies. The development of the unexposed regions is performed with a suitable solvent and the photopolymerized structures are characterized by microscopy techniques