Histologic findings at diagnosis as predictive markers of clinical outcome in pediatric ulcerative colitis

Background: The role of histological inflammation at diagnosis as a possible prognostic factor for disease course has not been investigated. Aims: To assess whether histologic findings at diagnosis could predict clinical outcomes and evaluate the association between clinical, biochemical, endoscopic, and histological findings. Methods: Prospective single-center study including pediatric UC patients with a minimum follow-up of 12 months. The association between histological activity (Nancy Index, Robarts Histopathology Index, and Geboes Score) and 12-month clinical outcomes was evaluated. Secondarily, we assessed the correlation between histological scores and endoscopic and inflammatory markers at the diagnosis. Inter-observer agreement for histologic and endoscopic scores was also evaluated. Results: Forty-nine UC patients were included. No association was found between 1-year clinical relapse and the three histological indices at diagnosis (p > 0.05). Good concordance was found among the three histological scores (p < 0.001), and between all histological and endoscopic indices (p < 0.05). No correlation was found between histologic scores and serum inflammatory markers. Inter-observer agreement was good for eMayo, Nancy and Robarts score (k = 0.71, k = 0.74 and k = 0.68, respectively) and moderate for Geboes (k = 0.46). Conclusions: Histological findings at diagnosis cannot be used as a predictor of the disease course. The three histological scores used in routine clinical practice show an overall good correlation and reliability

Glycerol accelerates recovery of barrier function in vivo.

Two studies were performed to evaluate the influence of glycerolon the recovery of damaged stratum corneum barrier function.Measurements of transepidermal water loss and capacitancewere conducted in a 3-day follow-up after tape stripping (study1) and a 7-day follow-up after a barrier damage due to arepeated washing with sodium lauryl sulphate. In study 1 afaster barrier repair (transepidermal water loss) was monitoredin glycerol-treated sites. Significant differences between glycerolopen vs. untreated and glycerol occluded vs. untreated wereobserved at day 3. Stratum corneum hydration showedsignificantly higher values in the sites treated with glycer-olzocclusion, compared with all other sites. In study 2 a fasterbarrier repair was seen in glycerol-treated sites, with significantdifferences against untreated and base-treated sites 7 days afterthe end of the treatment. Stratum corneum hydration showedhighest values in the glycerol treated sites after 3 days oftreatment. Glycerol creates a stimulus for barrier repair andimproves the stratum corneum hydration; stratum corneumhydration is not strictly related to barrier homeostasis and canbe optimized by different mechanisms and pathways. Theobserved effects were based on the modulation of barrier repairand were not biased by the humectant effect of glycerol. As theglycerol-induced recovery of barrier function and stratumcorneum hydration were observed even 7 days after the endof treatment, glycerol can be regarded as a barrier stabilizingand moisturizing compound. Key words: tape stripping; SLSwashing; transepidermal water loss (TEWL); capacitance;occlusion; barrier repair.(Accepted May 19, 1999.)Acta Derm Venereol 1999; 79: 418–421.Joachim Fluhr, Department of Dermatology, KarlsruheHospital, Sta¨dt. Klinikum, Moltkestrasse 120, D-76133Karlsruhe, Germany.The mechanisms promoting barrier repair in vivo afterstripping of the stratum corneum (SC) and repeated irritationwith sodium lauryl sulphate (SLS) are not completely clear:the modulation of water flux is probably a key factor involvedin barrier repair (1–7). It is known, that glycerol represents ahygroscopic compound capable of absorbing water from theenvironment and deeper parts of the SC.The purpose of the present study was to evaluate in vivothe effects of glycerol and occlusion in the promotion ofbarrier repair. Two studies were performed to evaluate theeffect of a repeated application of glycerol on damaged SCbarrier. The barrier disruption was performed by tapestripping (study 1) and by repeated washing with SLS over4 days (study 2).MATERIALS AND METHOD

Preliminary experience with the smooth muscle troponin-like protein, calponin, as a novel biomarker for diagnosing acute aortic dissection

Aims The early diagnosis of acute aortic dissection (AD) remains challenging. We sought to determine the utility of the troponin-like protein of smooth muscle, calponin, as a diagnostic biomarker of acute AD. Methods and results Immunoassays against calponin (acidic, basic, and neutral isoforms) were developed and the levels were compared in a convenience sample of 59 patients with radiographically proven AD [34 males, age 59+15 (SD) years] vs. 158 patients suspected of having AD at presentation (116 males, age 63+15 years) but whose final diagnosis was not AD. Basic calponin, which is the most specific and abundant in smooth muscle, and acidic calponin, respectively, showed greater than two-fold and three-fold elevations in patients with acute AD. Diagnostic performance as determined by receiver-operating characteristics curve analysis showed that both acidic and basic calponin have the potential to detect AD in the first 24 h [respective areas under the curve (AUCs) 0.63 and 0.58], with superior performance of basic calponin (when compared with acidic) in the initial 6 h (respective AUCs 0.63 and 0.67). Conclusion Circulating calponin levels were elevated in acute AD compared with controls. These biomarkers have the potential for use as an early diagnostic biomarker for acute AD. Keywords Aortic dissection ? Biomarke

Diabetes and obesity as independent risk factors for osteoporosis: Updated results from the ROIS/EMEROS registry in a population of five thousand post-menopausalwomen living in a region characterized by heavy environmental pressure

Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis

Incidence of breast cancer in Italy: mastectomies and quadrantectomies performed between 2000 and 2005.

Objectives. We aimed to determine the incidence of women's breast cancer in Italy without using statistical approximations. Methods. We analyzed the national hospitalizations database at the Ministry of Health to calculate the number of major surgeries in Italian women (mastectomies and quadrantectomies) due to breast cancer between 2000 and 2005, overall and by age groups (<44, 4564, 6574 and 75 years old). Results. Over the six years examined, an overall number of 100,745 mastectomies and 168,147 quadrantectomies were performed. A total of 41,608 major surgeries due to breast cancer were performed in the year 2000 and this number rose to 47,200 in 2005, with a 13.4% increase over six years. Conclusion. by analyzing the hospitalizations database concerning major breast surgery, incidence of breast cancer in Italy was found to be 26.5% higher than the official estimations which have been computed using statistical models (namely 47,200 vs. 37,300 cases in year 2005)

Effects of C282Y, H63D, and S65C HFE gene mutations, diet, and life-style factors on iron status in a general Mediterranean population from Tarragona, Spain

Mutations in the HFE gene result in iron overload and can produce hereditary hemochromatosis (HH), a disorder of iron metabolism characterized by increased intestinal iron absorption. Dietary quality, alcoholism and other life-style factors can increase the risk of iron overload, especially among genetically at risk populations. Polymorphisms of the HFE gene (C282Y, H63D and S65C) were measured together with serum ferritin (SF), transferrin saturation (TS) and hemoglobin, to measure iron status, in randomly-selected healthy subjects living in the Spanish Mediterranean coast (n = 815; 425 females, 390 males), 18 to 75 years of age. The intake of dietary components that affect iron absorption was calculated from 3-day dietary records. The presence of C282Y/H63D compound heterozygote that had a prevalence of 2.8% in males and 1.2% in females was associated with an elevated TS and SF. No subject was homozygous for C282Y or S65C. The C282Y heterozygote, H63D heterozygote and homozygote and H63D/S65C compound heterozygote genotypes were associated with increased TS relative to the wild type in the general population. These genotypes together with the alcohol and iron intake increase the indicators of iron status, while calcium intake decreases them. We did not observe any affect of the S65C heterozygote genotype on these levels. All the HFE genotypes except for the S65C heterozygote together with the alcohol, iron and calcium intake affect the indicators of iron status. The C282Y/H63D compound heterozygote genotype has the higher phenotypic expression in our Spanish Mediterranean population