Relatives of Crohn's disease patients and breast cancer: An overlooked condition

AbstractRecent data suggest that patients suffering from Crohn’s disease (CD) may be at higher risk of developing extra-intestinal malignancies. This is attributed to inflammation and immunodepression due to medications. However, a genetic predisposition cannot ruled out. In the present study we investigated the prevalence of breast cancer in first-degree female relatives of CD patients compared with relatives of patients without evidence of gastrointestinal diseases. A total of 1302 female first-degree relatives of CD patients and 1294 relatives of controls were included. We found that CD was an independent risk factor for breast cancer development (OR = 2.76, 95% CI = 1.2–6.2; p = 0.017), and this is particularly evident in mothers (3.6% vs 1%, p = 0.009 − OR = 3.7, 95% CI 1.4–10). Among CD group, smoking habit of CD patients was associated with increased risk of cancer compared with relatives of non-smokers (7.7% vs 2.9%, p = 0.01 – OR = 2.8 95% CI 1.2–6.6). Intriguingly, stage at diagnosis was significantly higher in CD relatives (p = 0.04). Our findings suggest that first-degree female relatives of CD patients are at higher risk of developing breast cancer but receive diagnosis at more advanced stages, therefore advocating the need of more active screening protocol in this population

Congruency of genetic predisposition to lactase persistence and lactose breath test

The physiological decline of lactase production in adulthood, in some individuals, is responsible for the so-called “Lactose Intolerance.” This clinical syndrome presents with gastrointestinal and non-gastrointestinal symptoms following the consumption of dairy containing food. Lactose intolerance can be evaluated by means of the Lactose Breath Test (phenotype) and/or genetic evaluation of lactase-gene polymorphism (genotype). A comparison of the two tests was carried out in a large number of symptomatic adult subjects, which are selected and not representative of the general population. Congruency was as high as 88.6%. Among lactase non-persistent (genotype C/C), 14 subjects showed a negative Lactose Breath Test (LBT), possibly due to young age. Among lactase-persistent (genotype C/T), four subjects showed a positive LBT, which helps to diagnose secondary lactose intolerance. Symptoms, both gastrointestinal and extra-gastrointestinal, were reported by 90% of patients during the breath test. Clinical use of both tests in the same patients could be taken into consideration as a sharp diagnostic tool. We suggest considering the use of the genetic test after LBT administration, when secondary hypolactasia is suspected, for completion of diagnostic procedures

Clinical Study Functional Outcomes and Quality of Life after Restorative Proctocolectomy in Paediatric Patients: A Case-Control Study

Background. Restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) has some peculiarities in paediatric ulcerative colitis (UC). Aims. The primary aim was to compare the bowel function of patients undergoing IPAA between those operated on in childhood and adulthood. The secondary aim was to compare the quality of life (QoL) and outcomes for children between medical and surgical therapies. Method. Children undergoing IPAA were compared with adult patients undergoing IPAA between 2007 and 2012. Function was assessed 1 year after ileostomy closure. Function and QoL of medically managed paediatric patients were compared with their surgical counterparts. Results. Twelve paediatric IPAA patients were compared with 24 adult ones. Acute presentation was common in the former, usually after failed biological treatment. Recurrent pouchitis was more frequent in children. Younger patients exhibited a trend toward better discrimination and continence. QoL was excellent in both groups. Twelve medically treated children were enrolled for secondary aim. Functioning was similar in IPAA-and medically managed children, but the former had a better QoL, confirmed by parents' perception. Conclusions. Similar function is achieved by IPAA in childhood or adulthood. IPAA may offer a better QoL compared to prolonged medical management. The beneficial effects of IPAA experienced by children were similarly observed by their parents

Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity

<p>Abstract</p> <p>Background</p> <p>Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten. Gluten-sensitive individuals (GS) cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in CD, but the overall clinical picture is generally less severe and is not accompanied by the concurrence of tissue transglutaminase autoantibodies or autoimmune comorbidities. By studying and comparing mucosal expression of genes associated with intestinal barrier function, as well as innate and adaptive immunity in CD compared with GS, we sought to better understand the similarities and differences between these two gluten-associated disorders.</p> <p>Methods</p> <p>CD, GS and healthy, gluten-tolerant individuals were enrolled in this study. Intestinal permeability was evaluated using a lactulose and mannitol probe, and mucosal biopsy specimens were collected to study the expression of genes involved in barrier function and immunity.</p> <p>Results</p> <p>Unlike CD, GS is not associated with increased intestinal permeability. In fact, this was significantly reduced in GS compared with controls (<it>P </it>= 0.0308), paralleled by significantly increased expression of claudin (CLDN) 4 (<it>P </it>= 0.0286). Relative to controls, adaptive immunity markers interleukin (IL)-6 (<it>P </it>= 0.0124) and IL-21 (<it>P </it>= 0.0572) were expressed at higher levels in CD but not in GS, while expression of the innate immunity marker Toll-like receptor (TLR) 2 was increased in GS but not in CD (<it>P </it>= 0.0295). Finally, expression of the T-regulatory cell marker FOXP3 was significantly reduced in GS relative to controls (<it>P </it>= 0.0325) and CD patients (<it>P </it>= 0.0293).</p> <p>Conclusions</p> <p>This study shows that the two gluten-associated disorders, CD and GS, are different clinical entities, and it contributes to the characterization of GS as a condition associated with prevalent gluten-induced activation of innate, rather than adaptive, immune responses in the absence of detectable changes in mucosal barrier function.</p

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Sportpsychologie : Jugendliche im Leistungssport

Jugendliche im Leistungssport - Chance oder Krise, Sieg oder Niederlage? - Derzeit absolvieren etwa 180 Jugendliche im Schulsportleistungsmodell KÃ$rnten eine duale Ausbildung (Sport und Schule) mit dem Ziel eine erfolgreiche Karriere als Spitzensportler zu verfolgen; weiters werden mehrere hundert Jugendliche, die in unterschiedlichsten Sportarten bereits nationale und internationale Erfolge verzeichnen konnten, in diversen Sportvereinen trainiert. Schwierigkeiten, Belastungen, Visionen dieser jugendlichen Leistungssportler, aber auch die Frage "Gibt es die typische SportlerpersÃnlichkeit" werden mittels Fragebogen, Interviews und PersÃnlichkeitstests erhoben. Das Schulsportleistungsmodell KÃ$rnten wird im Vorfeld der Untersuchung erklÃ$rt, um dem Leser einen Einblick in Organisation, Struktur und Problematik dieser Trainings- bzw. Unterrichtsform deutlich zu machen. Die Ergebnisse der empirischen Untersuchung - sowohl nach quantitativer als auch qualitativer Analyse - bilden die Grundlage fÃr das Institut SPORTMETHICS. Das Institut soll Sportler optimal betreuen, indem es ein interdisziplinÃ$res Angebot fÃr sie darstellt: Sportmedizin, Sportchirurgie, Sportwissenschaften, Sportpsychologie, PÃ$dagogik, ErnÃ$hrungswissenschaften. Der psychologische Bereich dieses Instituts deckt folgende Felder ab: · Diagnostik · Therapie: Entspannungstechniken, spezielle Therapie, GesprÃ$chsfÃhrung, etc. · Wettkampfvorbereitung / Wettkampfbegleitung · Spezielle Diagnostik und Therapie: z.B. Depression, Burnout, Magersucht, etc. Den Abschluss des praktischen Teils bildet eine Darstellung wie Sportmediziner, Sportwissenschafter, Psychologen, Trainer, PÃ$dagogen, ErnÃ$hrungswissenschafter am - fÃr den Sportler - effektivsten zusammenarbeiten kÃnnten und wie sportpsychologische Erkenntnisse und Methoden im Schul-, Freizeit- und Gesundheitssport, im Leistungssport und rehabilitativen Sport umgesetzt werden.<b theoretische Grundlage fÃr die optimale Betreuung von Sportlern dienen PhÃ$nomene im Sport, die von allgemeiner Bedeutung sind: Entwicklung der Sportpsychologie, ihr GrundverstÃ$ndnis sowie ihr Gegenstandsbereich, ihre Fragestellungen und eine EinfÃhrung in handlungstheoretische Grundlagen, weiters kognitive und motivale Aspekte sportlicher Handlungen und PersÃnlichkeit. Der Teil, der sich auf die Arbeit mit Jugendlichen bezieht, wird ergÃ$nzt durch Themen wie: · Grundlagen des Kindes- und Jugendsports - betrachtet aus entwicklungspsychologischer, sozialpsychologischer und sportbiologischer Sicht · Kinder und Jugendliche im Leistungssport -Definitionen; leistungsfÃrdernde und leistungshemmende Faktoren: Dopingthematik, Ébertraining, Burn-out , psychische ErmÃdung · TalentfÃrderung im Kindes- und JugendalterYoung persons in high-performance sport. Chance or crises; winner or loser? At the moment there are taught about 180 teenies in the SSLK (= sports and school model in Carinthia). One day they want to be successful in high-performance sport. Many other young persons are educated in different kinds of sport and in different clubs. Most of them have won national and international prizes. Difficulties, burdens, visions of these young high-performance sportsmen and sportswomen and the question "Is there a typical sports-personality?" are discussed. The results of both the quantitative and the qualitative research are the base for the institute SPORTMETHICS. This institute takes care for the athletes in different areas: sports-medicine, sports-surgery, sports science, psychology, pedagogics, nutrition. The practical part shows an efficient cooperation between sports-physician, sports-scientist, psychologist, coach, educationist and nutrition experts. The theoretical part is a summary of psychological themes which are important for sportive persons e.g.: Development of the sports psychology Elements of the sports psychology Personality Kognitive and motivational aspects in the sports psychology Acting and emotions (fear, fun, aggression) in sports. The part about children and youngsters is enreached by themes like e.g.: Stages of development Social elements in sports Biological elements in sports Doping, overtraining syndrome, burnout Sportively talented children.Riegler Bernhard ; Riegler Gabriele BarbaraZwei TitelblätterIm Inhaltverzeichnis sind die Teile den Autoren zugeordnetKlagenfurt, ,Univ., Diss., 2005KB2005 04OeBB(VLID)241168