The Role of Adipocytokines in Colon Cancer and Adenomas

Background: Metabolic changes resulting from obesity, insulin insensitivity, and imbalances in hormones such as adiponectin, leptin, resistin, apelin and visfatin, which are derived from white adipose tissue-derived hormone, are directly linked to both colon cancer (CC) and inflammatory bowel diseases increasing tissue-derived risk. We conducted this study to evaluate the relationship between the circulating concentrations of adiponectin, leptin, resistin, apelin and visfatin and colon adenoma and CC. Methods: Our study included 90 participants aged >18 years who were divided into three groups: colon cancer, adenoma and control. The serum concentrations of the investigated adipohormones were measured with ELISA in 30 patients with colon adenoma, 30 with CC and 30 controls with no colon pathology. Results: Demographic, anthropometric, metabolic and hormonal parameters were also recorded. The group means were compared by using one-way analysis of variance (ANOVA). Dual comparisons between groups were analyzed with the Tukey test. Pearson correlation coefficient was used to determine the relation between continuous variables. Adiponectin and leptin levels in patients with adenomas (p<0.000; p<0.000, respectively) and CC (p<0.000; p<0.000, respectively) were lower than in controls. Apelin level in patients with CC (p<0.000; p<0.000, respectively) was lower than in patients with adenomas and in controls. Resistin and visfatin levels in patients with CC (p<0.000; p<0.000, respectively) were higher than in patients with adenomas and in controls. Conclusions: We have concluded that adiponectin, leptin, resistin, apelin and visfatin levels may play an important role in colon carcinogenesis. We also assume that adiponectin and leptin may be associated with the risk of colon adenoma

Nutrition

In recent years, nutritional support is an indispensible therapy with medication. The appropriate diet should be chosen for the patients. Indications and complications should not be overlooked when making these choices. Different nutrition modules should be applied for different patient groups. Chemotherapy associated cachexia and catabolism is common in oncology patients. In these patients lipid and carbohydrate balanced nutrition should be provided. Protein, carbohydrate and fat distribution at meals is important in diabetic patients. Intensive care patients are exposed to many stress factors and these patients are susceptible to infection. Lipid-weighted diet should be preferred in mechanical ventilation patients, especially those with respiratory insufficiency. In addition, glutamine amino acid supplementation, which strengthens immunity in these patients, has been shown to reduce mortality and morbidity. In patients with chronic renal failure, protein restriction should be made to provide nitrogen balance, minerals and vitamin replacements should not be forgotten. In chronic diseases of liver, salt restriction, diet protein, carbohydrate and fat ratio should be balanced. It is known that with all these treatments, there are many complications decreased that can develop secondary to chronic diseases

Effect of Direct-acting Oral Anticoagulants and Warfarin on Hospital Outcomes in Upper Gastrointestinal Bleeding

Objective: To evaluate the comparison of direct-acting oral anticoagulants (DOACs) and warfarin for their effects on major bleeding and hospital outcomes in patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). Study Design: An observational study. Place and Duration of Study: Tekirdag Namik Kemal University Hospital, Hitit University Erol Olçok Education and Research Hospital, between January and December 2021. Methodology: Adult patients prescribed warfarin and DOACs were followed up for one year. Their length of hospital stay, need for intensive care unit admission, need for red blood cell transfusion, and major bleeding rates were compared. Results: Thirty-two patients (61.5%) were user of DOACs (DOAC group), and 20 patients (38.5%) were users of warfarin (warfarin group). No statistically significant difference was determined between patients in warfarin group and DOAC group for the number of packed red blood cells transfused [median 3 (0-6) units, 3 (0-10) units, p=0.229, respectively], length of hospital stay [median 5 days (3-10), and 4.5 days (2-20), p=0.739, respectively], rate of intensive care unit admission [(n=9, 45%; and n=10 (31%), p=0.623, respectively] and the occurrence of major bleeding events (warfarin-70%; DOACs-78%; p=0.529). Conclusion: Major bleeding episodes and hospital outcomes of acute NVUGIB were similar between patients receiving warfarin and DOACs. © 2022 College of Physicians and Surgeons Pakistan. All rights reserved

The Prevelance of Irritable Bowel Syndrome in Patients with Ankylosing Spondylitis

ÖzAmaç: İrritabl barsak sendromu (İBS), barsak alışkanlıklarında değişim ve kronik karın ağrısı ile karakterize bağırsağın fonksiyonel birhastalığıdır. İBS’ nin Romatoid artrit (RA) gibi inflamatuar patolojilerle artmış birlikteliğine rağmen, patofizyolojisinde inflamasyonun rolünetleştirilebilmiş değildir. Ankilozan Spondilit (AS) başlıca aksiyel iskelet sistemini tutan, kronik inflamatuvar bir hastalıkdır. Çalışmamızınamacı AS’ de İBS sıklığını tespit etmek ve bunun başta hastalık aktivitesi olmak üzere diğer faktörlerle ilişkisini ortaya koymaktır.Materyal ve Metot: Çalışmaya Namık Kemal Üniversitesi romatoloji kliniğindeki 145 AS tanılı hasta dahil edildi. Hastaların demografik,klinik ve laboratuvar verileri ile birlikte hastalık aktivitesi ve biyolojik ilaç kullanımı kaydedildi. ROMA III kriterlerine göre İBS tanısı ve tipiincelendi.Bulgular: AS hastalarındaki İBS sıklığı %31.7 idi. İBS sıklığı hastalık aktivitesi yüksek olan (BASDAI>4) ve biyolojik ajan tedavisialanlarda anlamlı şekilde yüksekti (p4) and in patients treated with biological agents (p values <0.001, 0.010, respectively). IBS was significantly higher in female patients by gender and young patients (<50) by age (p: 0.012 and p: 0.01 respectively). Conclusion: IBS, when compared to the normal population, was found to be higher (%31,7) in patients with AS. The relationship between AS disease activity score and IBS suggests the effect of inflammation in pathogenesis. As a result, in patients with AS, especially with high disease activity, gastroenterological complaints should be questioned; and IBS as frequent comorbidity, shouldn’t be ignored in the follow-u

The influence of vitamin D deficiency on eradication rates of Helicobacter pylori

Background. Helicobacter pylori eradication therapy improves the healing of various gastro-duodenal diseases such as chronic gastritis and peptic ulcer, and also reduces gastric cancer incidence. Several studies have reported on risk factors other than antibiotic resistance related to Helicobacter pylori eradication failure. Objectives. In this study, we aimed to investigate whether or not the serum levels of 25-hydroxy-vitamin D (25(OH)D) influence eradication rates of H. pylori. Material and methods. 220 patients diagnosed with H. pylori gastritis using endoscopic biopsy had their 25-OH vitamin D levels measured via the electrochemiluminescence method before beginning eradication therapy of H. pylori. Gastric biopsies obtained at endoscopy were examined for H. pylori strains and histopathologic findings. All patients were treated with bismuth-containing quadruple therapy for 14 days. H. pylori eradication was determined via the 14C-urea breath test performed 4 weeks after the end of therapy. Based on the 25-OH vitamin D levels, the patients were divided into 2 groups: group 1 (deficient) had a vitamin D level of = 10 ng/mL. Results. Eradication was successful in 170 (77.2%) patients and failed in 50 (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean 25(OH)D levels were significantly lower in the eradication failure group compared to the successful treatment group (9.13 +/- 4.7 vs 19.03 +/- 8.13; p = 0.001). There were significantly more patients with deficient 25(OH)D levels in the failed treatment group compared to the successful treatment group (p = 0.001). Conclusions. Our findings suggest that 25-OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori, which may lead to a need for supplementation of vitamin D before eradication of H. pylori

Maligniteyi Saptamak için Gaitada Gizli Kan Testi Ne Kadar Etkilidir?

Amaç: Kanser, kalp damar hastalıklarından sonra ikinci önde gelen ölüm nedeni ve önemli bir halk sağlığı sorunudur. Aile hekimliği polikliniğine başvuran hastalarda periyodik sağlık muayenesi (PSM) kapsamında istenen gaitada gizli kan test (GGKT) pozitifliklerinde kolorektal kanser (KRK) görülme sıklığını ortaya koymayı amaçladık. Gereç ve Yöntem: Çalışmaya bir üniversite hastanesinin aile hekimliği polikliniğine genel sağlık kontrolü için başvuran 50-70 yaş arasındaki 119 kişi dahil edildi. Katılımcılara sosyo-demografik verilerin ve KRK risk faktörlerinin sorgulandığı bir anket uygulandı. Hastaların hemogram, GGKT, kolonoskopi sonuçları ve patoloji sonuçları değerlendirildi. Bulgular: Araştırmaya katılan 119 kişinin 62’si (%52,1) kadın, 57’si (%47,9) erkekti. Katılımcıların yaş ortalaması 61,0±7,6 yıl idi. Tüm katılımcılardan 65 kişinin (%54,6) GGTK’i pozitif saptandı. Araştırmaya katılan 5 kişiye (%4,2) kolonoskopi işleminde alınan biyopsi sonuç raporlarına göre KRK tanısı konuldu. KRK tanısı konan 5 kişinin GGKT sonucu pozitif olup, GGKT pozitif çıkan tüm hastalardaki malignite saptanma oranı, araştırmamızda %7,7 (n=5) olarak bulundu. Çalışmamızda GGKT pozitifliği ve KRK tanısı arasında istatistiksel olarak anlamlı bir ilişki saptandı. Sonuç: Birinci basamak PSM kılavuzlarının uygun önerileri doğrultusunda ve risk düzeyi yüksek olan bireylerde KRK taramalarında, GGKT erken tanı koyması ve en kısa sürede tedaviye yönlendirmesine katkı sağlamaktadır

Relationship among MIF, MCP-1, viral loads, and HBs Ag levels in chronic hepatitis B patients

Background/aim: To determine whether macrophage migration inhibitory factor (MIF) and monocyte chemoattractant protein-1 (MCP-1) levels in patients with hepatitis B (HB) are different than in normal individuals and whether the HB surface antigen (HBs Ag) level and viral load are correlated with each other and with the two aforementioned parameters. Materials and methods: Sera were obtained from 52 chronic active HB (CAHB) patients and 33 healthy controls, and their MIF and MCP-1 levels were measured. Statistical analyses were performed. A value of P < 0.05 was considered statistically significant. Results: The MIF and MCP-1 values of the control group were increased compared to those of the CAHB group. The MIF and MCP-1 levels were negatively correlated with HBs Ag levels and viral loads. The MIF and MCP-1 levels were positively correlated. The HBs Ag levels and the log10 of the viral loads were positively correlated. Conclusion: We conclude that the negative correlation of MIF and MCP-1 with viral load and HBs Ag levels may be due to T-cell deficiency, antinuclear antibody seropositivity, and/or inhibition of chemokine ligand 2 receptors by viral antigens. More studies with a greater number of subjects are needed to evaluate the potential role of MIF and MCP in CAHB

Iron Deficiency Anaemia is Associated with Decreased Levels of Macrophage Migration Inhibitory Factor and Monocyte Chemoattractant Protein-1

Many bodily systems are affected by iron deficiency anaemia (IDA), including the immune system. However, the pathophysiological mechanisms whereby this anaemia promotes deterioration in immunity remain largely unexplained. In order to enlighten this pathophysiological link, serum levels of macrophage migration inhibitory factor (MIF) and monocyte chemoattractant protein-1 (MCP-1), which play an important roles in a healthy functioning immune system, were examined in patients with IDA and healthy volunteers. A total of 30 patients with IDA (mean age 33.6+/-7.8 years, 30% male) and 30 healthy individuals (mean age 30.1 +/- 8.8 years, 27 % male) were included. Serum MIF and MCP-1 levels were measured in a sandwich-assay format, using commercial enzyme-linked immunosorbent assay kits. There was no statistically significant difference in age and gender distribution between participants with IDA and controls (p> 0.05). Serum MIF and MCP-1 concentrations were lower in the IDA group than in the control group (p < 0.005, and p < 0.01, respectively). When considering the role of MIF and MCP-1 in maintaining the normal immune response of the organism, a decrease in production in patients with IDA may contribute to immune dysfunction in these individuals

Peripheral blood levels of cellular and humoral immunity parameters in esophageal and gastric cancer patients

Aim: To evaluate parameters of cellular and humoral immunity in gastric and esophageal cancer patients. Material and methods: In this study, we recruited 40 patients with newly diagnosed esophageal cancer (20 of them) or stomach cancer (20 of them) and 20 healthy individuals of similar age as a control group. In the study and control groups we measured CD3, CD4, CD8, CD19, CD4/CD8 ratio and the ratio of natural killer cells using the flow cytometer device. Results were evaluated with factorial analysis of variance and Duncan test. Results: The CD3 and CD8 ratios were significantly higher in patients with esophageal cancer (p = 0.012, p = 0.003, respectively) and the ratio of NK cells was significantly higher in patients with stomach cancer (p = 0.001) when compared to the control group. The ratio of CD19 was significantly lower in the two cancer groups (p = 0.031). There were no significant differences in the ratio of CD4 and CD4/CD8 between the groups. No correlation between the stage of cancer and the ratio of CD cells was detected. Discussion: In conclusion, understanding of the cancer immunology of esophageal and stomach cancer will provide insight into the pathogenesis of the cancer Therefore, further and extensive cancer immunology studies should be conducted to understand the nature of the upper gastrointestinal tract cancers

Investigation of serum macrophage migration inhibitor factor and monocyte chemotactic protein-1 levels in irritable bowel syndrome

Aim: Irritable bowel syndrome (IBS), a functional disorder of the bowel, has been thought to result from immune activation. The aim of this study was to evaluate macrophage migration inhibitory factor (MMIF) and monocyte chemotactic protein-1 (MCP-1) levels in IBS patients. Materials and methods: We enrolled 30 IBS patients and 30 healthy controls. The MMIF and MCP-1 levels of all patients and controls were detected using commercial enzyme-linked immunosorbent assay kits. Results: Serum MMIF and MCP-1 levels were markedly higher in IBS patients than in controls. White blood cell, neutrophil, lymphocyte, monocyte, eosinophil, and basophil counts did not differ significantly between groups. Conclusion: These results show that alterations in MMIF and MCP-1 affect the proinflammatory process. They also suggest that MMIF and MCP-1 may play a substantial role in IBS