Eosinophilic Gastroenteritis as a Rare Cause of Recurrent Epigastric Pain

Eosinophilic gastroenteritis (EGE) is a rare inflammatory disorder of gastrointestinal tract characterized by eosinophilic infiltration of the bowel wall. It can mimic many gastrointestinal disorders due to its wide spectrum of presentations. Diagnose is mostly based on excluding other disorders and a high suspicion. Here we report a case of 26 year old man with a history of sever epigastric pain followed by nausea, vomiting since a few days before admission with final diagnosis of EGE

Allele and haplotype frequencies for HLA-DQ in Iranian celiac disease patients

AIM: To assess the distribution of human leukocyte antigen (HLA)-DQ2 and -DQ8 in Iranian celiac disease (CD) patients and compare them to healthy Iranian controls. METHODS: To predict the HLA-DQA1 and -DQB1 genes, we used six previously reported HLA-tagging single nucleotide polymorphism to determine HLA genotypes in 59 Iranian patients with 'biopsy-confirmed' CD and in 151 healthy Iranian individuals. To test the transferability of the method, 50 cases and controls were also typed using a commercial kit that identifies individual carriers of DQ2, DQ7 and DQ8 alleles. RESULTS: In this pilot study 97% of CD cases (n = 57) and 58% of controls (n = 87) were carriers of HLA-DQ2 and/or HLA-DQ8 heterodimers, either in the homozygous or heterozygous state. The HLA-DQ pattern of these 57 CD patients: heterozygous DQ2.2 (n = 14) and homozygous DQ2.2 (n = 1), heterozygous DQ2.5 (n = 33) and homozygous DQ2.5 (n = 8), heterozygous DQ8 (n = 13) and homozygous DQ8 (n = 2). Two CD patients were negative for both DQ2 and DQ8 (3%). CONCLUSION: The prevalence of DQ8 in our CD population was higher than that reported in other populations (25.4%). As reported in other populations, our results underline the primary importance of HLA-DQ alleles in the Iranian population's susceptibility to CD. (C) 2014 Baishideng Publishing Group Inc. All rights reserved

Adverse events in people taking macrolide antibiotics versus placebo for any indication

BACKGROUND: Macrolide antibiotics (macrolides) are among the most commonly prescribed antibiotics worldwide and are used for a wide range of infections. However, macrolides also expose people to the risk of adverse events. The current understanding of adverse events is mostly derived from observational studies, which are subject to bias because it is hard to distinguish events caused by antibiotics from events caused by the diseases being treated. Because adverse events are treatment-specific, rather than disease-specific, it is possible to increase the number of adverse events available for analysis by combining randomised controlled trials (RCTs) of the same treatment across different diseases. OBJECTIVES:To quantify the incidences of reported adverse events in people taking macrolide antibiotics compared to placebo for any indication. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which includes the Cochrane Acute Respiratory Infections Group Specialised Register (2018, Issue 4); MEDLINE (Ovid, from 1946 to 8 May 2018); Embase (from 2010 to 8 May 2018); CINAHL (from 1981 to 8 May 2018); LILACS (from 1982 to 8 May 2018); and Web of Science (from 1955 to 8 May 2018). We searched clinical trial registries for current and completed trials (9 May 2018) and checked the reference lists of included studies and of previous Cochrane Reviews on macrolides. SELECTION CRITERIA: We included RCTs that compared a macrolide antibiotic to placebo for any indication. We included trials using any of the four most commonly used macrolide antibiotics: azithromycin, clarithromycin, erythromycin, or roxithromycin. Macrolides could be administered by any route. Concomitant medications were permitted provided they were equally available to both treatment and comparison groups. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted and collected data. We assessed the risk of bias of all included studies and the quality of evidence for each outcome of interest. We analysed specific adverse events, deaths, and subsequent carriage of macrolide-resistant bacteria separately. The study participant was the unit of analysis for each adverse event. Any specific adverse events that occurred in 5% or more of any group were reported. We undertook a meta-analysis when three or more included studies reported a specific adverse event. MAIN RESULTS: We included 183 studies with a total of 252,886 participants (range 40 to 190,238). The indications for macrolide antibiotics varied greatly, with most studies using macrolides for the treatment or prevention of either acute respiratory tract infections, cardiovascular diseases, chronic respiratory diseases, gastrointestinal conditions, or urogynaecological problems. Most trials were conducted in secondary care settings. Azithromycin and erythromycin were more commonly studied than clarithromycin and roxithromycin.Most studies (89%) reported some adverse events or at least stated that no adverse events were observed.Gastrointestinal adverse events were the most commonly reported type of adverse event. Compared to placebo, macrolides caused more diarrhoea (odds ratio (OR) 1.70, 95% confidence interval (CI) 1.34 to 2.16; low-quality evidence); more abdominal pain (OR 1.66, 95% CI 1.22 to 2.26; low-quality evidence); and more nausea (OR 1.61, 95% CI 1.37 to 1.90; moderate-quality evidence). Vomiting (OR 1.27, 95% CI 1.04 to 1.56; moderate-quality evidence) and gastrointestinal disorders not otherwise specified (NOS) (OR 2.16, 95% CI 1.56 to 3.00; moderate-quality evidence) were also reported more often in participants taking macrolides compared to placebo.The number of additional people (absolute difference in risk) who experienced adverse events from macrolides was: gastrointestinal disorders NOS 85/1000; diarrhoea 72/1000; abdominal pain 62/1000; nausea 47/1000; and vomiting 23/1000.The number needed to treat for an additional harmful outcome (NNTH) ranged from 12 (95% CI 8 to 23) for gastrointestinal disorders NOS to 17 (9 to 47) for abdominal pain; 19 (12 to 33) for diarrhoea; 19 (13 to 30) for nausea; and 45 (22 to 295) for vomiting.There was no clear consistent difference in gastrointestinal adverse events between different types of macrolides or route of administration.Taste disturbances were reported more often by participants taking macrolide antibiotics, although there were wide confidence intervals and moderate heterogeneity (OR 4.95, 95% CI 1.64 to 14.93; Iand#178; = 46%; low-quality evidence).Compared with participants taking placebo, those taking macrolides experienced hearing loss more often, however only four studies reported this outcome (OR 1.30, 95% CI 1.00 to 1.70; Iand#178; = 0%; low-quality evidence).We did not find any evidence that macrolides caused more cardiac disorders (OR 0.87, 95% CI 0.54 to 1.40; very low-quality evidence); hepatobiliary disorders (OR 1.04, 95% CI 0.27 to 4.09; very low-quality evidence); or changes in liver enzymes (OR 1.56, 95% CI 0.73 to 3.37; very low-quality evidence) compared to placebo.We did not find any evidence that appetite loss, dizziness, headache, respiratory symptoms, blood infections, skin and soft tissue infections, itching, or rashes were reported more often by participants treated with macrolides compared to placebo.Macrolides caused less cough (OR 0.57, 95% CI 0.40 to 0.80; moderate-quality evidence) and fewer respiratory tract infections (OR 0.70, 95% CI 0.62 to 0.80; moderate-quality evidence) compared to placebo, probably because these are not adverse events, but rather characteristics of the indications for the antibiotics. Less fever (OR 0.73, 95% 0.54 to 1.00; moderate-quality evidence) was also reported by participants taking macrolides compared to placebo, although these findings were non-significant.There was no increase in mortality in participants taking macrolides compared with placebo (OR 0.96, 95% 0.87 to 1.06; Iand#178; = 11%; low-quality evidence).Only 24 studies (13%) provided useful data on macrolide-resistant bacteria. Macrolide-resistant bacteria were more commonly identified among participants immediately after exposure to the antibiotic. However, differences in resistance thereafter were inconsistent.Pharmaceutical companies supplied the trial medication or funding, or both, for 91 trials. AUTHORS' CONCLUSIONS: The macrolides as a group clearly increased rates of gastrointestinal adverse events. Most trials made at least some statement about adverse events, such as "none were observed". However, few trials clearly listed adverse events as outcomes, reported on the methods used for eliciting adverse events, or even detailed the numbers of people who experienced adverse events in both the intervention and placebo group. This was especially true for the adverse event of bacterial resistance.</p

Ets1 gene (Ets Proto-Oncogene1) expression changes in patients with celiac disease under a gluten-free diet

Background. One of the effective genes in the pathogenesis of the celiac disease is the Ets1 gene, which encodes the transcription factor Ets1 and is highly conserved during evolution. The Ets1 gene inhibits the differentiation of T helper 17 (Th17) cells and the production of interleukin-17A (IL-17A) by these cells and decreased expression of the Ets1 gene can lead to autoimmune disorders. The aim of this study is to evaluate the changes in Ets1 gene expression in the blood samples of patients with celiac disease compared with the control group. Methods. Blood samples were collected from twenty patients with celiac disease under a gluten-free diet and also from twenty healthy people. After RNA extraction and cDNA synthesis, a specific primer pair of the Ets1 gene was designed and its expression changes were examined by real-time PCR. Results. The expression of the Ets1 gene in patients with celiac disease on a gluten-free diet did not show a significant difference compared with healthy individuals (P-value= 0.54).. Conclusion. Failure to observe a significant difference between the patient and the control group can be due to the effect of the duration of the gluten-free diet and also the inadvertent entry of gluten from hidden sources into the diet of patients under treatment. Practical Implications. According to the results observed in this study, it is possible that if the gluten-free diet is followed more strictly and over a longer period of time by patients with celiac disease, the expression of the Ets1 gene will proceed as we expected. This issue needs to be evaluated in future studies with a larger community

Is liver fibrosis in association with opium addiction and intravenous drug abuse among hepatitis C virus-infected patients?

Introduction: Hepatitis C virus (HCV) infection is a prevalent etiology that leads to cirrhosis. Various factors affect liver fibrosis progression. In the current study, we aimed to assess the probable role of opium consumption and intravenous drug abuse(IVDU) on liver inflammation and fibrosis. Methods: This is a case-control study conducted on 58 patients with hepatitis C virus infection in 2012. Anti-HCV antibody and quantitative HCV-RNA burden were performed for all patients. Then, they underwent a liver biopsy for the determination of inflammation grading and liver fibrosis based on the Hepatic Activity Index(HAI). Regarding inflammation grade, patients were divided into two groups of 0-4 grade as controls and 5-18 as cases. Considering the fibrosis score, patients were divided into two groups of 0-2 score as controls and 3-6 score as cases. Results: This study was conducted on HCV positive patients; among them, 74.1% were smokers, and 53.4% were opium addicts. Regarding liver inflammation grading, 52.2% of cases and 25.7% of controls were IVDU and 65.2% versus 45.7% were opium addict (P-value=0.04 and 0.145, respectively). On the other hand, regarding fibrosis score, 60% of cases versus 50% of controls were opium addicts, while 30% of cases versus 39% of controls were IVDUs (P-value&gt;0.05). Conclusion: Contrary to the previous studies, we found no association between opium addiction with either liver inflammation or fibrosis. Based on this study, IVDU was only associated with liver inflammation, but liver fibrosis

Evaluation of involved proteins in colon adenocarcinoma: an interactome analysis

Aim: Assessment of related genes to colon cancer to introduce crucial ones, was the aim of this research. Background: Colon cancer is one of the invasive colorectal diseases. This disease is preventable and manageable if it be diagnosed in early stage. The aggressive tools for its detection imply more investigation for new molecular diagnostic methods. Methods: Numbers of 300 genes from String database (SD) are analyzed via constructed Protein-protein interaction (PPI) network by Cytoscape software 3.4.0. Based on centrality parameters the main connected component of network was analyzed and the crucial genes were introduced. Cluster analysis of the network and gene ontology for the nodes of the main cluster revealed more details about the role of the key proteins related to colon cancer disease. Results: The constructed network was consisted of 300 genes which among them 68 genes were isolated and the 232 other genes formed the main connected component. Ten crucial genes related to colon adenocarcinoma were introduced that presented in cluster 1. Gene ontology analysis showed that cluster 1 is involved in 226 biological processes which are classified in 25 groups. Conclusion: In conclusion, results indicate that the identified key proteins play significant roles in colon adenocarcinoma. It may be possible to introduce a few diagnostic biomarker candidates for colon cancer disease

Effect of Vitamin E on Oxidative Stress Markers of Proteins and Lipids in Children with Idiopathic Epilepsy

Introduction: Epilepsy is regarded as one of the prevalent neurological disorders in children. The role of anti-oxidants in protection of epilepsy has been discussed in several studies. Vitamin E can be mentioned as a natural antioxidant to neutralize free radicals. Therefore, the present study aimed to evaluate the effects of vitamin E on oxidative stress markers such as malone dialdehyde(MDA) and protein carbonyl(PC) in children suffering from idiopathic epilepsy and vitamin D deficiency. Methods: In the current study, children suffering from idiopathic epilepsy and vitamin D deficiency were randomly divided into two groups. One group was treated with 50000 units of vitamin D oral capsules (per week) for 8 weeks and the other &nbsp;group was treated with 100 units of vitamin E (per day) for one month as well as 50000 unit of vitamin D for 8 weeks. The amount of MDA and PC were measured by the spectrophotometer method. The obtained data were analyzed via the &nbsp;SPSS software (ver, 19) using t-test. Results: The results indicated that the amount of&nbsp; MAD and PC revealed a significant decrease after the treatment. In fact, in the group treated with vitamin E, the amount of PC decreased significantly compared with the other group, though MDA reduction was not proved to be significant. Discussion: The findings of the present study revealed that treatment with vitamin E could reduce the PC amount in regard with epileptic patients