Mikkelsenguerrero8459
Celiac disease (CD) is an immune-mediated enteropathy characterized by lifelong gluten intolerance. Interleukin-15 (IL- 15) is a proinflammatory cytokine that is considered a key component in the immune reaction triggered by gluten. Our aim of this study was to evaluate the influence of IL-15 gene polymorphisms on CD development and clinical presentation.
The study was enrolled-with 90 CD patients (49 female/41 male, median years of age 11), their 38 siblings (20 female/18 male, median years of age 8), and 99 healthy controls (66 female/33 male, median years of age 13). Their demographic findings, symptoms, and signs histopathological grade, Human Leukocyte Antigen (HLA) types were recorded. IL-15 gene polymorphisms rs2857261, rs10519613, and rs1057972 were analyzed through PCR.
There was a significantly higher frequency of GG genotype in rs2857972 polymorphisms and TT genotype in rs1057972 polymorphisms in celiac families compared to controls [41% vs. 23% (P = .0008), 36% vs. 11% (P = .001), respectively]. Without considering their HLA status, there was not any difference between celiacs and healthy siblings. However, when stratified according to their HLADQ2 status, rs2857972 GG polymorphism was 1.5 times prominent in celiacs than siblings at homozygous state, whereas rs1057972 TT genotype was found to be 2.5 times prominent in celiac siblings at heterozygous state. There was no association between these polymorphisms and clinical presentation.
rs2857972 GG and rs1057972 TT variants of IL 15 are more prominent in celiac families than controls. However, the impact of IL-15 gene polymorphism on CD development is dependent on HLADQ2 status.
rs2857972 GG and rs1057972 TT variants of IL 15 are more prominent in celiac families than controls. However, the impact of IL-15 gene polymorphism on CD development is dependent on HLADQ2 status.
Data on specific gastrointestinal (GI) motility disorders, such as gastroparesis (GP), chronic intestinal pseudo-obstruction (CIPO), and colonic inertia (CI), as well as awareness among doctors about these disorders are scanty in Asia.
Prospectively maintained records of 60 patients were retrospectively analyzed, and knowledge, attitude, and practice (KAP) of 66 Indian physicians were surveyed electronically.
A total of 60 (age 37.7 ± 18.4 years, 25 female) patients were included in the study (13 [21.7%] GP, 25 [41.7%] CIPO, 14 [23.3%] CI, and 8 [13.3%] overlap of GP and either CIPO [5] or CI [3]), of whom 40 had primary disorders and 20 had secondary disorders due to diabetes mellitus (n = 6), systemic sclerosis (n = 4), paraneoplastic (n = 2), infection (n = 3), Parkinson's disease (n = 1), hypothyroidism (n = 1), hyperparathyroidism (n = 1), celiac disease (n = 1), and amyloidosis (n = 1). Primary disorders were more often misdiagnosed as functional GI disorders, causing diagnostic delays and complications, than secondary disorders. More patients in the primary disorder group underwent surgery compared with those in the secondary group (25/40, 62.5% vs 1/20, 5%). A few rare infectious causes of GI motility disorders due to Strongyloides stercoralis, herpesvirus, and unidentified viruses were found. Of four patients treated with pyridostigmine with (n = 3) or without prucalopride (n = 1), three responded. Awareness about GI motility disorders, particularly the primary disorders, among 66 doctors participating in the KAP survey was inadequate.
Awareness regarding specific GI motility disorders among physicians is lacking, which leads to delay in diagnosis and results in more complications in patients, such as surgery, particularly in those with primary disorders.
Awareness regarding specific GI motility disorders among physicians is lacking, which leads to delay in diagnosis and results in more complications in patients, such as surgery, particularly in those with primary disorders.
The exocrine function of the pancreas is controlled by the autonomic nervous system (ANS), and autonomic neuropathy is a common and serious complication of diabetes. There are many factors contributing to the development of autonomic neuropathy in diabetic patients. Cardiovascular tests have been developed to evaluate the function of the ANS. This study investigated the relationship between cardiovascular autonomic neuropathy (CAN) and pancreas exocrine insufficiency (PEI) in diabetic patients.
This study evaluated 110 individuals with type 2 diabetes mellitus (T2DM) and 40 healthy volunteers. Autonomous neuropathy tests were utilized to diagnose patients, and Ewing and Clarke's criteria were employed to assess the severity of autonomous dysfunction. Stool samples were also collected from patients to measure fecal elastase-1 (FE-1).
A 65.5% incidence of PEI was observed in DM patients. There was no significant correlation among the duration of disease, C-peptide, HbA1c, and PEI, respectively (P = .782, P = .521, P = .580). However, a significant difference between DM patients and controls in terms of cardiac dysautonomia (P = .001) was seen. Moreover, a statistically significant correlation between the degree of cardiac dysautonomia and FE-1 level was observed within the patient group (P =.001).
It is possible that the disruption of exocrine hormone secretion in the pancreas due to the impairment of enteropancreatic reflexes is secondary to diabetic autonomic neuropathy and resulting in PEI. This study also showed that autonomic neuropathy might develop and cause PEI in diabetic patients without known added confounding factors.
It is possible that the disruption of exocrine hormone secretion in the pancreas due to the impairment of enteropancreatic reflexes is secondary to diabetic autonomic neuropathy and resulting in PEI. This study also showed that autonomic neuropathy might develop and cause PEI in diabetic patients without known added confounding factors.
Our study aimed to investigate the effects of glucocorticoid (GC) treatment on liver function, hospitalization length, and expenses, as well as 28-day mortality in patients suffered from hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF).
This is a retrospective study of 349 patients who were hospitalized with HBV-associated ACLF. Biochemical assay results of alanine aminotransferase (ALT) level, aspartate aminotransferase (AST) level, total bilirubin (TBil) level, and creatinine (Cr) level both at admission and before discharge were recorded. GC and antivirus treatment condition, hospitalization length and expenses, as well as 28-day status were also recorded.
Among 349 patients with HBV-associated ACLF, GC treatment did not benefit in liver function outcomes, and even ended in higher ALT and TBil levels comparing to patients treated without GC. However, patients treated with GC might have lower 28-day mortality. Similar results were shown in patients with or without antivirus treatment. In addition, GC treatment could not shorten hospitalization length and could increase the expenses.
Using GC in HBV-associated ACLF patients could not improve their liver function, but might reduce the risk of death, no matter the patient had had antivirus treatment or not. In addition, GC treatment could not shorten hospitalization length and could increase the expenses in HBV-associated ACLF patients.
Using GC in HBV-associated ACLF patients could not improve their liver function, but might reduce the risk of death, no matter the patient had had antivirus treatment or not. In addition, GC treatment could not shorten hospitalization length and could increase the expenses in HBV-associated ACLF patients.
In metabolic associated fatty liver disease (MAFLD) vibration controlled transient elastography (VCTE) by Fibroscan has emerged as a non-invasive diagnostic tool for the measurement of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), which are surrogate markers for hepatic steatosis and fibrosis, respectively. However, obesity constitutes a limitation in terms of creating unreliable examinations due to increased skin to liver capsule distance. NX-2127 Here, we aimed to investigate the feasibility of VCTE in the evaluation of hepatic steatosis and fibrosis in obese individuals.
A total of 126 consecutive obese patients (body mass index ≥30 kg/m2) without a known history of MAFLD enrolled in the study. We performed CAP and LSM measurements and calculated Fibrosis-4 Index for each patient and included data of those patients to the analysis, from whom valid measurements were able to be taken.
Reliable VCTE measurements were able to be obtained in 122 patients (97%), from those in 34 patients with M and 88 patients in XL probe (median age 50 [18-75], 45 males and 77 females). In 1 patient VCTE failed to take any measurements and in 3 the measurements were classified as unreliable. The mean CAP value was 323 ± 48 dB/m and the median LSM value 5.3 [1.8-34.3] kPa.
CAP and LSM assessments by Fibroscan are reliable diagnostic tools for the early diagnosis of hepatic steatosis and fibrosis in obese individuals.
CAP and LSM assessments by Fibroscan are reliable diagnostic tools for the early diagnosis of hepatic steatosis and fibrosis in obese individuals.
Background/Aims Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. Systolic blood pressure (SBP) and body mass index (BMI) are associated with NAFLD. We aimed to evaluate the mediating effect of SBP in the association between BMI and NAFLD.
A total of 21 072 participants were enrolled. Multivariate logistic regression and linear regression models were used to describe the association between BMI, SBP, and NAFLD. The impact of SBP on the association between BMI and NAFLD was determined through mediation analysis.
BMI was positively associated with incident NAFLD overall (odds ratio (OR) = 1.171, 95% CI (1.153-1.189)) and in the female (OR = 1.189, 95% CI (1.157-1.222)) and male groups (OR = 1.162, 95% CI (1.141-1.184)) (P < .001). SBP also showed positive effects in the general, female, and male groups (P < .001). The effect of BMI on SBP also indicated similar positive results in the general (β = 0.913, 95% CI (0.799-1.026)), female (β = 0.956, 95% CI (0.760-1.151)), and male (β = 0.867, 95% CI (0.727-1.006)) groups (P < .001). Mediation analysis showed that SBP contributed to 14.23% of the relationship between BMI and NAFLD in the general group and 31.07 and 22.67% of the relationship in the female and male groups of individuals younger than 50 years old, respectively. The mediation effect appeared higher among females than among males, especially in participants younger than 50 years.
SBP and BMI contribute to the development of NAFLD. SBP mediates a positive association between BMI and NAFLD among individuals younger than 50 years, especially among females.
SBP and BMI contribute to the development of NAFLD. SBP mediates a positive association between BMI and NAFLD among individuals younger than 50 years, especially among females.
The aim of the study is to evaluate the effect of virtual reality application during a colonoscopy on the pain and anxiety experienced by patients.
The study was conducted as experimental, randomized, controlled research. The study was carried out between October 15, 2017 and May 20, 2018 in the Endoscopy Unit of a Public Hospital in northern Turkey. The study sample consisted of 60 patients who underwent colonoscopy. The patients were divided into 2 groups by using simple randomization. The patients in the experimental group watched virtual reality applications during colonoscopy, whereas the patients in the control group underwent standard colonoscopy protocol. Colonoscopy was performed on patients in both groups by the same gastroenterologist without the use of anesthesia. The demographic data of both groups, pain levels during and after the procedure, before and after the procedure anxiety levels were evaluated.
The mean age of the patients in the experimental group was 56.33 ± 11.81, the mean age of the patients in the control group was 56.