Oral manifestations of inflammatory bowel disease

Inflammatory bowel diseases (IBD), including Crohn\u2019s disease and ulcerative colitis, have important extraintestinal manifestations, notably in the oral cavity. These oral manifestations can constitute important clinical clues in the diagnosis and management of IBD, and include changes at the immune and bacterial levels. Aphthous ulcers, pyostomatitis vegetans, cobblestoning and gingivitis are important oral findings frequently observed in IBD patients. Their presentations vary considerably and might be well diagnosed and distinguished from other oral lesions. Infections, drug side effects, deficiencies in some nutrients and many other diseases involved with oral manifestations should also be taken into account. This article discusses the most recent findings on the oral manifestations of IBD with a focus on bacterial modulations and immune changes. It also includes an overview on options for management of the oral lesions of IBD

INFLAMMATORY BOWEL DISEASE AND COLORECTAL CANCER, NUTRACEUTICAL ASPECTS

Nutraceuticals constitute a group of functional foods that provide added health benefits for various disorders including inflammatory bowel disease (IBD) and colorectal cancer (CCR). The main groups of nutraceuticals include probiotics, prebiotics omega 3 and antioxidants. Studies on nutraceutical showed that this type of food possessed similar properties to drugs but with the benefit of not having side effects. This mini review shows that probiotics and prebiotics, when administered simultaneously with traditional therapies, reduce IBD symptoms and reduce synthesis of enzymes probably involved in colorectal carcinogenesis. Moreover, Omega 3 reduces the synthesis of inflammation mediators and prevenents carcinogenesis through interaction interaction with the signaling pathway NOTCH1/MMP9. Moreover, antioxidant reduce the inflammatory process by inhibiting the synthesis of inflammatory mediators, and inhibit the mechanisms of cell proliferation by inducing apoptosis. In brief, nutraceuticals have gained a huge clinical interest since they could be used along with traditional therapy. Bioavailability studies of nutracetical supplements guarantee a correct intake of the substance by oral administration, a matter which would not have been posible to have entirely with the consumprtion of regular food only

COLORECTAL CARCINOGENESIS; ROLE OF OXIDATIVE STRESS AND ANTIOXIDANTS

One of the contributory causes of colon cancer is the negative effect of reactive oxygen species on DNA repair mechanism. Currently, there is a growing support for the concept that oxidative stress may be an important etiological factor for carcinogenesis. The purpose of this review is to elucidate the role of oxidative stress in promoting colorectal carcinogenesis and to highlight the potential protective role of antioxidants. Several studies have documentes the importance of antioxidants in countering oxidative stress and preventing colorectal carcinogenesis. However, there are conflicting data in the literature concerning its proper use in humans, since these studies did not yeld definitive results and were performed mostly in vitro on cell population, or in vivo in experimental animal models

IMMUNOLOGICAL ASPECTS OF CROHN'S DISEASE: A REGULATORY FUNCTION OF TIM-3/GALECTIN-9 IN LYTH1.

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) and its etiology is multifactorial and involves a combination of genetic environmental factors. The interaction of these factors causes an imbalance of the microbiota, leading to the activation of several immunological and inflammatory mechanism. From an immunological point of view, there seems to be an involvement of the TIM-3/GALECTIN-9 pathway and of the autoregulation of lyTh1. These studies show that in patients with CD the autoregulation of lyth1 is lost due to a reduced concentration of galectin-9 and a reduced TIM-3 expression in LyTh1. This could be one of the reason for the state of perpetual activation of lyTh1, resulting in the chronic inflammation process

Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: A feasibility and acceptability study protocol

Background: Burns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively afect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are benefcial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of beneft for itch and superior efectiveness in comparison to other non-pharmacological interventions for children’s procedural pain and state anxiety. Thus, children with burns can beneft from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of efectiveness are limited and no studies have been identifed that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns. Methods: An observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children’s hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fdelity in delivery), reach, potential efectiveness, and adoption of evaluation procedures and intervention as secondary outcomes. Discussion: Ethical approval was obtained from the Queensland Children’s Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings. The fndings will guide the design of future trials on the efectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN1262000098895

Academic reading format preferences and behaviors among university students worldwide: A comparative survey analysis

This study reports the descriptive and inferential statistical findings of a survey of academic reading format preferences and behaviors of 10,293 tertiary students worldwide. The study hypothesized that country-based differences in schooling systems, socioeconomic development, culture or other factors might have an influence on preferred formats, print or electronic, for academic reading, as well as the learning engagement behaviors of students. The main findings are that country of origin has little to no relationship with or effect on reading format preferences of university students, and that the broad majority of students worldwide prefer to read academic course materials in print. The majority of participants report better focus and retention of information presented in print formats, and more frequently prefer print for longer texts. Additional demographic and post-hoc analysis suggests that format preference has a small relationship with academic rank. The relationship between task demands, format preferences and reading comprehension are discussed. Additional outcomes and implications for the fields of education, psychology, computer science, information science and human-computer interaction are considered

Transumbilical Totally Laparoscopic Single-Port Nissen Fundoplication: A New Method of Liver Retraction: The Istanbul Technique

Mustafa Kemal Ataturk, founder of the Turkish Republic, had guarded many German scientists of a Jewish descent before the Second World War. Dr. Rudolf Nissen was one of the outstanding surgeons who had served in the Turkish university hospitals. He had created an antireflux procedure which is named after his own name while he was working in our clinic, the CerrahpaAYa Hospital. From a laparoscopic approach, the Nissen fundoplication was the gold standard intervention for the surgical treatment of gastroesophageal reflux disease (GERD). Currently, video laparoscopic surgery is evolving quickly with the guidance of new technology. Single-port (SP) laparoscopic transumbilical surgery is one of the newest branches of advanced laparoscopy

Prevalence and degree of bother of pelvic floor disorder symptoms among women from primary care and specialty clinics in Lebanon: an exploratory study

Introduction and hypothesis: The prevalence of pelvic floor disorders (PFD) and their impact on quality of life of women vary among different populations. The purpose of this study was to assess the prevalence of symptoms of PFD, and their degree of bother in a convenience sample of Lebanese women, and to evaluate health-care seeking (HCS) behavior related to PFD. Methods: Women visiting clinics in a University Medical Center in Beirut, Lebanon, completed the self-filled validated Arabic version of the Global Pelvic Floor Bother Questionnaire (PFBQ). Data covering demographics, comorbidities, and HCS behavior related to PFD were collected. Total individual PFBQ scores, individual PFD symptom scores and HCS behavior were correlated to demographic data and comorbidities. Results: The study participants included 900 women. PFBQ scores were significantly higher in women of older age, women with a lower level of education, women with higher vaginal parity, and women who engaged in heavy lifting/physical activity. BMI >25 kg/m2 was the strongest independent risk factor for the presence of PFD symptoms. The overall prevalence of urinary incontinence was 42 %. Anal incontinence was the most bothersome PFD. Almost two thirds of the women reported HCS due to any aspect of PFD. Among symptomatic women who believed that their PFD warranted HCS, financial concern was the most common obstacle irrespective of age and educational level. Conclusions: In this convenience sample of Lebanese women, PFD symptoms were common and were significantly correlated with demographic characteristics and self-reported comorbidities. The key reason for not seeking health care related to PFD was financial concern. © 2016, The International Urogynecological Association

Nerve growth factor and burn wound healing: Update of molecular interactions with skin cells

Burn wound healing is a very intricate and complex process that conventionally includes three interrelated and overlapping stages of hemostasis/inflammation, proliferation and remodeling. This review aims to explore the molecular interactions of NGF with the most prominent cell types in the skin and their respective secretory products during wound healing, particularly burn wound healing. Different types of cells such as, nerve cells, endothelial cells, mast cells, macrophages, neutrophils, keratinocytes and fibroblasts all come into play through a plethora of cytokines and growth factors including nerve growth factor (NGF). NGF is a pleiotropic molecule that exerts its effects on all the aforementioned cells using two types of receptors (TrkA and p75) and affects wound healing by decreasing healing time and improving the quality of the scar. Both receptors mediate cellular proliferation, survival and apoptosis through complex signaling molecules. During the inflammatory phase, macrophages and mast cells secrete ample cytokines and growth factors, including NGF, which participate in the inflammatory reaction and induction of other cells targeting a homeostatic state. The proliferative phase follows, and NGF promotes angiogenesis through VEGF and FGF expression in endothelial cells. NGF also stimulates keratinocyte proliferation and neurite extension through the TrkA-PI3K/Akt pathway. Other molecules such as TGF-β1, IL-1β and TNF-α increase NGF expression in fibroblasts through dynamic interactions with Smads and MAPK molecules. Stimulated fibroblasts induce new collagen production to form the granulation tissue. In the remodeling phase, NGF regulates fibroblasts and induces their differentiation into myofibroblasts ultimately leading to wound contracture. In addition, NGF stimulates melanocytes and enhances hair growth and pigmentation. Such data depict the mechanisms of action of NGF implicated in the various stages of the healing process and support its applicability as a new targeted therapeutic molecule effective in burn wound healing but with some limitations. © 2022 Elsevier Ltd and International Society of Burns Injurie

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 exist: Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes, and Fusobacteria. Variations in the microbiota cause dysbiosis, 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-organisms that inhabit the oral cavity, can influence the onset of IBD and CRC. © 2016 by Nova Science Publishers, Inc. All rights reserved