Serum resolvin D1 levels as a marker of inflammation in constipation dominant irritable bowel syndrome

WOS: 000518828400005PubMed: 32141819Background/Aims: The objective of this study is to determine the role of circulating resolvin D1 (RvD1) in patients with constipation subtype of irritable bowel syndrome (IBS-C) and evaluate the relationship between abdominal pain severity and RvD1 levels. Materials and Methods: This research included 55 patients with IBS-C and 36 healthy controls. Controls were selected from patients who applied to our department with similar complaints as IBS but were not diagnosed with any type of pathology after further investigations. All participants underwent complete blood count, C-reactive protein (CRP), and RvD1 levels measurements. We also recorded abdominal pain severity and the number of bowel movements. Patients with IBS-C were compared with respect to the demographic features and laboratory measurements. Results: The median CRP concentration in patients with IBS-C was significantly higher than that of controls (p=0.003). However, the median RvD1 concentration was significantly lower in the IBS group than that of the control group (p<0.001). The receiver operating characteristic curve analyses revealed that RvD1 concentration lower than 0.47 ng/mL and CRP concentration higher than 3.40 mg/L may identify patients with IBS-C with a high specificity. In the IBS group, there was a strong negative correlation between abdominal pain severity and RvD1 concentration (r=-0.766, p=0.001). Conclusion: This research demonstrates that patients with IBS-C have higher CRP and lower RvD1 concentrations than healthy controls. Both RvD1 and CRP concentrations predict the presence of IBS-C. Additionally, RvD1 concentrations decreased with the increase in abdominal pain severity. Further research works are needed for investigating the role of the RvD1 analogs in the treatment of IBS

Immediate unprepared polyethylene glycol-flush colonoscopy in elderly patients with severe lower gastrointestinal bleeding

Gul Utku, Ozlem/0000-0003-1043-2627WOS:000539973200006PubMed: 32207216Aims Colon preparation is vital yet more difficult in elderly patients with severe lower gastrointestinal bleeding (LGIB). The aim of this study is to show the efficacy, safety and outcomes of unprepared polyethylene glycol (PEG)-flush retrograde colon cleansing in the diagnosis and treatment of elderly home care patients with LGIB. Methods A single-center study was performed between January 2014 and June 2018. Elderly home healthcare patients presenting with hematochezia were enrolled, and an unprepared retrograde bowel cleansing colonoscopy was performed within the first 8 h after admission to the emergency department. PEG solution (2 L) was added to the water jet tank, and jet pump injection was started from the left side of the colon to the right segment of the colon and ended up at the cecum. Results In total, 33 elderly patients presenting with hematochezia were evaluated. Mean inward and outward procedure times were 17.06 +/- 4.92 (8-33 min) and 28.66 +/- 6.88 (10-30 min), respectively. Most of the bleeding was localized in the right colon at 22 patients (66.3%). Endoscopic treatment was performed in 87.9% of patients. The average length of stay in hospital was 44.70 +/- 42.81 (range 18.00-240.00 h). Conclusions Immediate unprepared PEG-flush colonoscopy in elderly home care patients with acute LGIB is a safe and effective method, which detects bleeding sources and provides endoscopic therapy. With this procedure, the time of hospital stay is reduced. This approach may be used for the initial intervention in patients admitted to emergency departments or intensive care unit with severe acute LGIB.Geriatr Gerontol Int 2020; center dot center dot: center dot center dot-center dot center dot

The Performance of Nesfatin-1 in Distinguishing Irritable Bowel Syndrome Presenting Predominantly with Diarrhea from Celiac Disease

WOS:000545455100028PubMed: 32162872Background: We hypothesized that nesfatin-1, an anti-inflammatory peptide, could be used as a non-invasive diagnostic tool in the identification of celiac disease (CD) and irritable bowel syndrome presenting predominantly with diarrhea (IBS-D). Methods: Thirty-five patients with IBS-D who met the Rome III criteria, 28 patients with celiac disease who met the diagnostic criteria of the Marsh-Oberhuber classification, and 30 age- and gender-matched healthy controls were included in this cross-sectional study. All subjects responded to the IBS Severity Scoring System (IBS-SSS) questionnaire that was used to determine pain severity, pain frequency, bloating, dissatisfaction with bowel habits, and life interference. Results: Nesfatin-1 levels were significantly higher in the CD group compared to the IBS-D group and healthy controls. Nesfatin-1 was also higher in the IBS-D group compared to controls. Nesfatin-1 levels were correlated with IBS-SSS (r = 0.884, p 98.1 pg/mL for nesfatin-1 could discriminate subjects with CD from those with IBS-D and also healthy controls with a sensitivity of 82% and a specificity of 80%. Conclusions: The results of this study show that subjects with CD have higher nesfatin-1 levels compared to those with IBS-D or to the healthy controls. Moreover, nesfatin-1 can discriminate subjects with CD from those with IBS-D and also healthy controls, with high sensitivity and specificity. Further studies with histopathological evaluation are required to clearly address the role of nesfatin-1 in the diagnosis of CD

Rectal pyogenic granulomas: an uncommon cause of gastrointestinal bleeding

WOS: 000427075700022PubMed: 29391319

A RARE CASE OF ISCHEMIC COLITIS: CEFUROXIME-RELATED ANAPHYLACTIC SHOCK

WOS: 000501816300008PubMed: 31574074

HBeAg negative chronic hepatitis B patients with HBV-DNA levels between 2,000-20,000IU/ml and normal aminotransferases are really inactive?

International Liver Congress (ILC) -- APR 11-15, 2018 -- Paris, FRANCEWOS: 000461068602223…European Assoc Study Live

Is the Probiotic Mixture Effective in the Treatment of TNBS-induced Experimental Colitis?

WOS: 000530895000009Objective: Inflammatory bowel disease (IBD) is an idiopathic disease associated with changes in the immune system and in the intestinal microbiota. The most accepted hypothesis of IBD pathogenesis is thought to be the abnormal immunological response and chronic intestinal inflammation, which is caused by the complex interactions between genetic, environmental factors and the host immune system. Microbial flora is important in the maturation of the immune system. Dysbiosis is defined as changes in intestinal microbiota composition and function. Clinical and experimental studies support that dysbiosis plays a significant role in the etiopathogenesis of IBD. Probiotics are useful live microorganisms that provide the intestinal balance in the host. In this study, we aimed to evaluate the anti-inflammatory and anti-oxidant activities of Enterococcus faecium, Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum and Bifidobacterium longum bacteria in the experimental colitis model. Methods: Twenty-four female Wistar-Albino rats and 30 mg 0.5 mL trinitrobenzenesulfonic acid (TNBS) dissolved in 50% ethanol which induced colitis by intrarectal installation. Rats were divided into four groups; healthy control (sham: group A), TNBS colitis (group B), (TNBS + methylprednisolone: group C) and probiotic (TNBS + P: group D). The rats were sacrificed on the 8th day. Macroscopic and microscopic scores, tissue myeloperoxidase (MPO), malondialdehyde (MDA) and superoxide dismutase (SOD) levels were measured. Results: Macroscopic and microscopic scores levels in group A were significantly lower than in group B, C and D. Macroscopic and microscopic scores levels in group C were significantly lower than in group B. Macroscopic scores were statistically similar between group C and D. There was a statistically significant difference between the groups in terms of median MDA levels and median SOD levels (p<0.001). There was no statistically significant difference between the groups in terms of median MPO levels (p=0.114). Median MPO levels were 0.27 (0.15-0.30) in group A, 0.44 (0.22-0.61) in group B, 0.28 (0.25-0.50) in group C, and 0.30 (0.25-0.37) in group D (p=0.114). Median MDA levels were 1.1 (1.0-2.8) in group A, 4.3 (3.1-5.5) in group B, 3.8 (3.2-4.2) in group C, and 3.9 (3.1-4.2) in group D (p<0.001). Median SOD levels were 160.7 (150.1-161.7) in group A, 141.6 (137.9-147.3) in group B, 157.6 (155.2-167.7) in group C, and 164.7 (160.3-168.3) in group D (p<0.001). MDA levels were statistically significantly different between each group. These levels were significantly higher in group B, C and D than in group A; statistically similar in group C and D; and statistically higher in group B than in group C and D (p<0.001 & p=0.047). SOD levels were statistically significantly different between each group. They were significantly lower in group B, C and D than in group B; statistically significantly different in group A, C and D; and statistically higher in group D than in group A and C. Conclusion: Our study showed that probiotics regulate the balance between anti-oxidant and oxidant systems. Therefore, probiotics can be used as a supportive treatment in inflammatory bowel diseases if promoted by clinical trials

The Role of Resolvin D1 in the Differential Diagnosis of the Cholangiocarcinoma and Benign Biliary Diseases

WOS:000545456000025PubMed: 32390401Background: The discrimination of malignant biliary strictures from benign biliary diseases (BBDs) is challenging and complicated. We aimed to investigate whether Resolvin D1 (RvD1) would aid in the discrimination of cholangiocarcinoma (CCA) from BBDs. Methods: Thirty-one patients with CCA, 27 patients with BBD, and 30 healthy controls were enrolled in this crosssectional study. The diagnosis of CCA was based on results obtained from abdominal USG, MRCP, abdominal CT, endosonography, and tumor markers, including CEA and CA 19-9. Histopathological evaluation was performed in the majority of patients, and the final diagnosis was based on surgery or biopsy results. RvD1, CEA, and CA 19-9 were analyzed in all patients with CCA and BBD. Results: RvD1 was significantly lower in those with CCA compared to patients with BBD and healthy controls. In addition, CEA and Ca 19-9 levels were significantly higher in the CCA group than the BBD group (p 94.5 U/mL (AUC: 0.94, 95% CI: 0.898 - 0.998, p < 0.001) could be used to discriminate patients with CCA from those with BBD. Conclusions: Resolvin D1 and CA 19-9 levels might be used to effectively discriminate between BBD and CCA. Moreover, both RvD1 and CA 19-9 levels are associated with the stage of CCA, indicating that they may also be used in assessing disease progression

Antioxidative and Immunomodulatory Effects of A-Lipoic Acid in Rat Colitis Model Induced by Acetic Acid

WOS: 000462182300003Aim: Benefit of alpha-Lipoic acid (ALA) was previously shown in rat-colitis model via suppression of neutrophil accumulation, preservation of endogenous glutathione and inhibition of reactive oxidant generation. Ulcerative colitis is a chronic inflammatory condition of the colon and cytokines (such as TNF-alpha, IL-1 beta and TGF-beta) are crucial components of these inflammatory pathways. Hence, the present study was undertaken to evaluate the antioxidative and immunomodulatory effects of ALA on experimental colitis model induced by acetic acid in Wistar albino rats. Methods: Mice received either a control diet or ALA-supplemented diet for 14 d. Colitis was induced by acetic acid administration at 7th day. Mucosal damage and the activation of immune cells and cytokines were determined by macroscopic score, histological score, tissue cytokine levels (TNF-alpha, IL-1 beta and TGF-beta). Anti-oxidant effect of ALA was determined by Malondialdehyde, and total antioxidative status. Results: Disease activity Index was significantly higher in colitis group compared to control, ALA and ALA-colitis groups (p<0.001). No significant difference was found between DAI of control, ALA and ALA-colitis groups. The inflammatory mediators, TNF-alpha and IL-1 beta, and MDA were elevated in colitis group compared to other groups (p<0.001, p<0.001 respectively). TGF-beta and total antioxidative status were significantly lower in colitis group (p<0.001). Conclusion: ALA may possibly have some therapeutic usefulness in the management of ulcerative colitis

Combination of DKK1 and AFP improves diagnostic accuracy of hepatocellular carcinoma compared with either marker alone

Background/Aims: The Wnt/beta-catenin pathway plays a prominent role in hepatocellular carcinoma (HCC). The Dickkopf (DKK) proteins (DKK1-4) are known Wnt antagonists; the overexpression of DKK1 has been demonstrated in HCC, and increased DKK3 methylation in the HCC tissue is associated with worse prognosis. Thus, the aim of our study was to demonstrate the diagnostic accuracy of serum DKK1 and DKK3 in HCC in comparison with that of serum alpha-fetoprotein (AFP). Materials and Methods: We included consecutive 40 HCC patients, 54 cirrhosis patients, and 39 healthy controls. Serum DKK1 and DKK3 levels were measured by an enzyme-linked immunosorbent assay, and serum AFP levels were measured by a chemiluminescence assay. Results: The AFP levels differed in each group and could help differentiate between groups (p<0.001). The DKK1 levels could help differentiate the HCC group from cirrhosis and control groups (p<0.001), and the DKK3 levels could help differentiate HCC and cirrhosis groups from the control group (p<0.001). Combined usage of DKK1 and AFP increased the diagnostic yield, with a sensitivity, specificity, positive predictive value, and negative predictive value of 87.5\%, 92.3\%, 92.1\%, and 87.8\%, respectively. Conclusion: Although AFP is superior to DKK1 and DKK3 in the diagnosis of HCC, the combination of DKK1 and AFP showed a better diagnostic yield than AFP alone