Current Issue : April - June Volume : 2018 Issue Number : 2 Articles : 6 Articles
Acute pancreatitis (AP) is a complex disease that results in significant morbidity and mortality. For many decades, it has compelled\nresearchers to explore the exact pathogenesis and the understanding of the pathogenesis of AP has progressed dramatically.\nCurrently, premature trypsinogen activation and NF-�ºB activation for inflammation are two remarkable hypotheses for the\nmechanism of AP. Meanwhile, understanding of the influence of genetic polymorphisms has resulted in tremendous\ndevelopment in the understanding of the advancement of complex diseases. Now, genetic polymorphisms of AP have been\nnoted gradually and many researchers devote themselves to this emerging area. In this review, we comprehensively describe\ngenetic polymorphisms combined with the latest hypothesis of pathogenesis associated with AP....
Obesity now affects millions of people and places them at risk of developing metabolic syndrome, nonalcoholic fatty liver disease\n(NAFLD), and even hepatocellular carcinoma. This rapidly emerging epidemic has led to a search for cost-effective methods to\nprevent the metabolic syndrome and NAFLD as well as the progression of NAFLD to cirrhosis and hepatocellular carcinoma. In\nmurine models, time-restricted feeding resets the hepatic circadian clock and enhances transcription of key metabolic regulators\nof glucose and lipid homeostasis. Studies of the effect of dawn-to-sunset Ramadan fasting, which is akin to time-restricted\nfeeding model, have also identified significant improvement in body mass index, serum lipid profiles, and oxidative stress\nparameters. Based on the findings of studies conducted on human subjects, dawn-to-sunset fasting has the potential to be a\ncost-effective intervention for obesity, metabolic syndrome, and NAFLD....
Serum �±-fetoprotein- (AFP-) elevated gastric cancer is a rare tumor that has a poor prognosis due to high incidence of liver\nmetastasis. This study sought to investigate the optimal treatment modality. A total of 319 gastric cancer patients with liver\nmetastasis (GCLM) whose serum AFP levels were tested before treatment were enrolled in this study. They were classified as the\nserum AFP â�¥ 20 ng/ml group (n = 74) and the AFP < 20 ng/ml group (n = 245). Median OS of the AFP < 20 ng/ml group was\nsignificantly longer than that of the AFP â�¥ 20 ng/ml group (15.7m versus 10.9 m, P = 0 004). ORR of first-line chemotherapy\nwas 43.3% and 56.1% of the two groups, respectively (P = 0 024). Of patients who received doublet regimen, ORR of the\nAFP â�¥ 20 ng/ml group was significantly lower (38.2 versus 56.9%, P = 0 013), while in those received triplet regimens, ORR\nbetween two groups was similar (66.7% versus 66.7%, P = 0 676). Moreover, for patients of the AFP â�¥ 20 ng/ml group, those who\nreached PR had a longer survival period (15.4m versus 9.4 m, P = 0 017), and combined with local treatment for liver metastasis\nalso seemed to improve prognosis (19.2m versus 8.4 m, P = 0 003). In conclusion, serum AFP-elevated GCLM had a poorer\nprognosis. Multimodality treatment including aggressive first-line chemotherapy with triplet regimen may be needed when\ntreating them....
Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome.\nSystemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a singlecentre\nretrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the\ntype of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida\ninfections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related\nwith a statistically significant difference (p < 0 05) with a complication after OA closure, total complications, time elapsed after\nOA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration\nof the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too.\nConclusions. Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida\ninfection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be\nconsidered on an individual basis....
Background. The pro- and anti-inflammatory cytokines play an important role in the immune response against H. pylori infection.\nThe proinflammatory cytokines of Th17 cells have been suggested to play a major role in H. pylori infection and resulting gastric\ninflammation. Objective. The objective of this study was to compare the expression of selected inflammatory cytokines (IL-10,\nIL-17, IL-21, IL-23, and TNF-�±) in H. pylori-infected patients and healthy controls and to understand their association with\nH. pylori infection and disease severity. Results. The expression levels of IL-17 and IL-23 were significantly higher in H. pyloriinfected\npatients. The expression of IL-21 was also higher in H. pylori-positive patients but there was no significant\nassociation with infection. IL-17 expression showed a significant increase with the severity of chronic gastritis. Conclusion.\nThe proinflammatory cytokine, IL-17, shows a significant association with H. pylori infection and disease severity in a Sri\nLankan dyspeptic patient population....
Background and Aims. Nonceliac gluten sensitivity (NCGS) is a gluten-related emerging condition. Since few data about NCGS\nhistopathology is available, we assessed the markers of lymphocyte and innate immunity activation. Materials and Methods. We\nretrieved duodenal biopsy samples of patients with NCGS diagnosis according to the Salerno criteria. We selected specimens of\npositive (seropositive celiac disease/Marsh 1-2 stage) and negative (normal microscopic picture) controls. Immunohistochemistry\nfor CD3 (intraepithelial lymphocytes-IELs), CD4 (T helper lymphocytes), CD8 (T cytotoxic lymphocytes), and CD1a/CD117\n(Langerhans/mast cells) was performed. ANOVA plus Bonferroniâ��s tests were used for statistical analysis. Results. Twenty\nNCGS, 16 celiac disease, and 16 negative controls were selected. CD3 in NCGS were higher than negative controls and lower\nthan celiac disease (18.5 �± 6.4, 11.9 �± 2.8, and 40.8 �± 8.1 IELs/100 enterocytes; p < 0 001). CD4 were lower in NCGS than controls\nand celiac disease (31.0 �± 22.1, 72.5 �± 29.5, and 103.7 �± 15.7 cells/mm2; p < 0 001). CD8 in NCGS were similar to negative\ncontrols, but lower than celiac disease (14.0 �± 7.4 and 34.0 �± 7.1 IELs/100 enterocytes, p < 0 001). CD117 were higher in NCGS\nthan celiac disease and negative controls (145.8 �± 49.9, 121.3 �± 13.1, and 113.5 �± 23.4 cells/mm2; p = 0 009). Conclusions. The\ncombination of CD4 and CD117, as well as IEL characterization, may be useful to support a clinical diagnosis of NCGS....
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