Communicable Diseases Among Refugees with a Focus on the Middle East

During the past few years, millions of refugees from the Middle East and North Africa fled their countries to almost everywhere in the globe. Civil wars and acts of violence are the main reasons behind the exodus of populations seeking a better life and more secure living conditions. In fact, the current conflict in Syria and Iraq led to massive influx of refugees worldwide and in particular to neighboring countries of the Middle East. This refugee situation is unparalleled since the end of World War II. Besides the individual tragedies of refugees, a public health disaster is being witnessed in the countries of origin which, in many instances, affect the hosting countries as well. Many of these hosting countries witnessed a re-emergence of numerous communicable diseases as a result of the influx of refugees; they were unprepared, and their health sectors did not deliver the adequate response. In this chapter, we review major sexually transmitted diseases in refugees, with a focus on the Middle East. We also discuss the major actions taken in response to the ongoing displacement of refugees by the Government of Lebanon and suggest solutions and recommendations to the Lebanese public health system which is facing new urgent challenges

Inflammatory bowel disease, colorectal cancer and type 2 diabetes mellitus: The links.

The co-occurrence of the three disease entities, inflammatory bowel disease (IBD), colorectal cancer (CRC), type 2diabetes mellitus (T2DM) along with inflammation and dismicrobism has been frequently reported. Some authors have even suggested that dysbiosis could be the link through a molecular crosstalk of multiple inflammatory loops including TGFβ, NFKB, TNFα and ROS among others. This review focuses on the inflammatory process along with the role of microbiota in the pathophysiology of the three diseases. The etiology of IBD is multifactorial, and like CRC and T2DM, it is associated with a widespread and sustained GI inflammation and dismicrobism, whereby an array of pro-inflammatory mediators and other related biomolecules are up-regulated, both locally and systematically. Such a persistent or an inadequately resolved chronic inflammation may be a causative agent, in the presence other factors, leading to several pathologies such as IBD, CRC and T2DM. TGFβ plays a crucial role in pancreatic β cell malfunctioning as glucotoxicity stimulates its signaling cascade through smad 3, IL-6 and epithelial to mesenchymal transition. Such a cascade could lead to macrophages and other cells recruitment, inflammation, then IBD and CRC. NFkB is also another key regulator in the crosstalk among the pathways leading to the three disease entities. It plays a major role in linking inflammation to cancer development through its ability to up regulate several inflammatory and tumor promoting cytokines like: IL-6, IL-1 α and TNF α, as well as genes like BCL2 and BCLXL. It activates JAK/STAT signaling network via STAT3 transcription factors and promotes epithelial to mesenchymal transition. It also increases the risk for T2DM in obese people. In brief, NFKB is a matchmaker between inflammation, IBD, cancer and diabetes. In addition, TNFα plays a pivotal role in systemic inflammation. It is increased in the mucosa of IBD patients and has a central role in its pathogenesis. It also activates other signaling pathways like NFKB and MAPK leading to CRC. It is also overexpressed in the adipose tissues of obese patients thus linking it to T2DM, chronic inflammation and consequently CRC. On the other hand, increasing evidence suggests that dysbiosis plays a role in initiating, maintaining and determining the severity of IBD. Actually, among its functions, it modulates genotoxic metabolites which are able to induce CRC, a fact proven to be sustained by stool transfer from patients with CRC. Probiotics, however, may actively prevent CRC as well as IBD and results in a significant decrease in fasting glycemia in T2DM patients. In conclusion, IBD, CRC and T2DM are commonly occurring interrelated clinical problems. They share a common basis influenced by an inflammatory process, an imbalance in intestinal microbiota, and a crosstalk between various signaling pathways. Would probiotics interrupt the crosstalk or orient it in the physiological direction

The Use of Stem Cells in Burn Wound Healing: A Review

Burn wound healing involves a series of complex processes which are subject to intensive investigations to improve the outcomes, in particular, the healing time and the quality of the scar. Burn injuries, especially severe ones, are proving to have devastating effects on the affected patients. Stem cells have been recently applied in the field to promote superior healing of the wounds. Not only have stem cells been shown to promote better and faster healing of the burn wounds, but also they have decreased the inflammation levels with less scar progression and fibrosis. This review aims to highlight the beneficial therapeutic effect of stem cells in burn wound healing and to discuss the involved pathways and signaling molecules. The review covers various types of burn wound healing like skin and corneal burns, along with the alternative recent therapies being studied in the field of burn wound healing. The current reflection of the attitudes of people regarding the use of stem cells in burn wound healing is also stated

IBD, malignancy and oral microbiota: Analysis of the literature

The human microbiota, in adults, varies in number and species based on the location in the gastrointestinal tract. The highest concentration is at the intestinal level, where mainly Bacteroidetes, Actinobacteria, Firmicutes and proteobacteria are found. Instead, in the oral cavity, five major phyla exists. Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes and Fusobacteria. Variations in the microbiota cause bysbiosis, which is responsible to a great extent for the onset of many diseases including inflammatory bowel disease (IBD) and colorectal cancer (CRC). In some cases (8-10%) IBD has shown oral manifestations that may reflect a change in the composition of the oral microbiota. This work relates, through a meta-analysis of the literature, how variations of the oral microbiota, or the combination of micro-organism that inhabit the oral cavity, can influence the onset of IBD and CRC

Association Between Helycobacter Pylori Infection and Pathological Oral Manifestations

Data from the literature are controversial regarding the presence of Helicobacter pylori (H. pylori) in dental plaque and its association with gastric infection. One of the possible mechanisms suggested for re-infection is the recolonization with H. pylori from dental plaque. The purpose of this review was to determine whether dental plaque, poor oral hygiene, and periodontal disease were risk factors for H. pylori infection