Measurement and clinical implications of choroidal thickness in patients with inflammatory bowel disease

ABSTRACTPurpose:Ocular inflammation is a frequent extraintestinal manifestation of inflammatory bowel disease (IBD) and may parallel disease activity. In this study, we evaluated the utility of a choroidal thickness measurement in assessing IBD activity.Methods:A total of 62 eyes of 31 patients with IBD [Crohn's disease (CD), n=10 and ulcerative colitis (UC), n=21] and 104 eyes of 52 healthy blood donors were included in this study. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography. The Crohn's disease activity index (CDAI) and the modified Truelove Witts score were used to assess disease activity in CD and UC, respectively.Results:No significant differences in mean subfoveal, nasal 3000 μm, or temporal 3000 μm choroidal thickness measurements (P>0.05 for all) were observed between IBD patients and healthy controls. Age, smoking, CD site of involvement (ileal and ileocolonic involvement), CDAI, CD activity, and UC endoscopic activity index were all found to be significantly correlated with choroidal thickness by univariate analysis (P<0.05). Smoking (P<0.05) and the CD site of involvement (P<0.01) were the only independent parameters associated with increased choroidal thickness at all measurement locations.Conclusions:Choroidal thickness is not a useful marker of disease activity in patients with IBD but may be an indicator of ileal involvement in patients with CD

Gastrointestinal Bleeding Caused by Meckels Diverticulum Diagnosed by Double Balloon Enteroscopy: Three Cases and a Brief Literature Review

Meckel's diverticulum is a small bulge in the small intestine present at birth and is the most frequent malformation of the gastrointestinal tract. Although Meckel diverticulum is usually of no medical significance, tendency to gastrointestinal bleeding can require clinical attention. Despite the availability of modern imaging techniques, diagnosis is still challenging. We herein report three cases of undiagnosed gastrointestinal bleeding despite a number of imaging techniques. In all of these cases double balloon enteroscopy was successfully used and the diagnosis of Meckels diverticulum was established. We discuss the use of this successfully technique in obscure gastrointestinal (GI) bleeding caused by Meckel's diverticulum in relation to the pertinent literature. [Med-Science 2015; 4(3.000): 2528-35

Protective effect of Urtica dioica on liver damage induced by biliary obstruction in rats

The aim of this study was to evaluate the possible protective effects of Urtica dioica (UD) against liver damage in the common bile duct-ligated rats. A total of 24 male Sprague Dawley rats were divided into three groups, namely, control, bile duct ligation (BDL) and BDL+received UD groups, containing eight animals in each group. The rats in UD-treated groups were given UD oils (2ml/kg) once a day intraperitoneally for 2weeks starting 3days prior to BDL operation. The change demonstrating the bile duct proliferation and fibrosis in expanded portal tracts includes the extension of proliferated bile ducts into the lobules; inflammatory cell infiltration into the widened portal areas were observed in BDL group. Treatment of BDL with UD attenuated alterations in liver histology. The -smooth muscle actin, cytokeratin-positive ductular proliferation and the activity of terminal deoxynucleotidyl transferase dUTP nick end labeling in the BDL were observed to be reduced with the UD treatment. The data indicate that UD attenuates BDL-induced cholestatic liver injury, bile duct proliferation and fibrosis

Synthetic Cannabis-Induced Mania

Synthetic cannabinoids (SC), cannabinoid 1 and cannabinoid 2 receptors agonists, are the psychoactive substances. SC was originally produced to treat medical conditions. Compared to other narcotics, SC is easier to obtain, cheap, and highly potent and has a long half-life. In addition, routine analysis does not detect SC, which has led to widespread use. A case is presented that manic episode was developed with the use of SC. Hospitalization and admission to psychiatric units depending on SC use have been observed mostly with psychosis. Although SC-induced affective symptoms were mentioned in the literature, mania has not been reported before. We aimed to discuss the psychiatric conditions induced by widespread use of SC via our case

DR-70 as a novel diagnostic biomarker for gastric cancer

Background/Aims: To assess the utility of the DR-70 immunoassay in the diagnosis of gastric cancer. Materials and Methods: A total of 29 patients with histologically proven malignant gastric tumor and 29 healthy blood donors were enrolled in this study. DR-70 immunoassay was performed using an enzyme-linked immunosorbent assay kit to quantify the serum levels of fibrin degradation products. Results: The DR-70 values in patients with gastric cancer significantly differed from the values in controls (p<0.0001). Receiver operating characteristic curve analysis revealed >= 1.45 mu g/mL as the best cut-off value to distinguish between patients with gastric cancer and healthy controls. The area under the receiver operating characteristic curve was 0.871. Using >= 1.45 mu g/mL as the cut-off value, the DR-70 immunoassay showed a good clinical performance with a sensitivity of 82.8\% and a specificity of 79.3\%. The positive predictive value was 80.0\%, and the negative predictive value was 82.1\%. Conclusion: The DR-70 immunoassay reliably differs between gastric cancer and healthy controls, promising to become a useful cancer detection tool in clinical practice

Evaluation of neutrophil-to-lymphocyte ratio prior to prostate biopsy to predict biopsy histology: Results of 1836 patients

Introduction: We evaluate the role of NLR prior to prostate biopsy to predict biopsy histology and Gleason score in patients with prostate cancer. Methods: In this retrospective study, we evaluated data of patients underwent prostate biopsy between May 2005 and March 2015. We collected the following data: age, prostate-specific antigen (PSA), biopsy histology, Gleason score (GS) in prostate cancer patients, neutrophil counts, and lymphocyte counts. Patients were grouped as benign prostatic hyperplasia (BPH), prostate cancer, and prostatitis. The Chi square test was used to compare categorical variables and analysis of variance (ANOVA) was applied for continuous variables. Results: Data of 1836 patients were investigated. The mean age, total PSA and neutrophil-lymphocyte ratio (NLR) of the population were 66.8 +/- 8.17 years, 9.38 +/- 4.7 ng/dL, and 3.11 +/- 1.71, respectively. Patients were divided as follows: 625 in the group with BPH history, 600 in the prostatitis group, and 611 in the prostate cancer histology group. The mean NLR of the prostatitis group was higher compared to the prostate cancer and BPH groups (p = 0.0001). The mean NLR of the prostate cancer group was significantly higher compared to the BPH group (p = 0.002). The GS 8-10 group had a significantly higher mean NLR compared to GS 5-6 (3.64 vs. 2.54, p = 0.0001) and GS 7 (3.64 vs. 2.58, p = 0.0001) patients. Conclusions: NLR was found to differ with regard to histology of prostate biopsy and higher GS was associated with higher NLR in patients with prostate cancer. However prostatitis prevents the use of NLR in predicting prostate cancer before a prostate biopsy. Also, the retrospective nature and lack of multivariate analysis in this study somewhat limits the relevance of these results

The Risk of Venous Thromboembolism With Thyroid Surgery

The aim of the study is to assess preoperative risk of venous thromboembolism in thyroid surgery candidates and evaluate postoperative outcomes. This study was conducted on 116 consecutive patients between 2007 and 2008. The patients were classified by a Caprini venous thromboembolism risk assessment form in the preoperative period. The lower extremities of the patients were evaluated for deep venous thrombosis (DVT), by the same radiologist using color Doppler duplex ultrasonography, on preoperative day 1 and postoperative days 12 to 14. Venous diameter, venous wall response to compression, echogenity, thrombus within the lumen, loss of flow, and spectral wave changes were evaluated. Fifteen of the 116 patients withdrew from the study. The mortality rate was zero throughout the entire study. Eighty-seven (75.2%) patients were female and 29 patients (24.8%) were male. The mean age was 46.5 years (19-73 years). There were 18 patients in the "very high risk" group, 74 patients in the "high risk" group, and 24 patients in the "moderate risk" group in preoperative assessment. None of the patients had asymptomatic DVT preoperatively. All patients underwent thyroidectomy, and the average duration of hospitalization was 2.5 days (2 6 days). One (0.9%) patient with a risk score of 6 was diagnosed with asymptomatic DVT in the postoperative period with increased lumen diameter of the popliteal vein, thrombus, and lack of color flow in ultrasonography examination. Thyroid surgery may be a risk factor for developing DVT. In daily clinical practice, risk assessment should be done precisely to prevent venous thromboembolic events preoperatively in thyroid surgery

Rivaroxaban Induces Mucosal Healing in a Rat Model of Trinitrobenzene Sulfonic Acid-Induced Colitis.

This study was designed to identify the effect of rivaroxaban, a direct factor Xa inhibitor, on trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats