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Role of Protease Activated Receptor in Progression of Liver Disease - A Review
No full textProtease activated receptors are G –protein coupled receptors involved in hepatic fibrogenesis. PAR expressed on a number of cells including platelets, endothelial cells, monocytes, dendritic cells and hepatic stellate cells (HSC). They are activated after proteolytic cleavage by thrombin [1-3]. They augment the production of proinflammatory cytokines and profibrotic pathways. We herein review role of PAR in progression of liver disease
Polycystic Liver Disease in Autosomal Dominant Polycystic Kidney Disease
No full textLiver cysts are a commonly encountered phenomenon and may represent a broad cluster of disorders of diverse etiology. Most cysts are asymptomatic and do not require treatment. Simple cysts are the most prevalent. Polycystic liver disease (PLD) can be diagnosed when more than 20 cysts are detected in the liver. In most cases PLD is associated with autosomal dominant polycystic kidney disease (ADPKD), but it may also occur in the course of other disorders and in an isolated dominantly inherited form. In ADPKD cystogenesis is associated with loss-of-function mutations in PKD1 or PKD2 genes. Isolated autosomal dominant polycystic liver disease (ADPLD) pathogenesis is linked to mutations in PRKCSH and Sec63 genes. PLD results from structural changes in the biliary tree development. Both in ADPKD related PLD and in autosomal dominant polycystic liver disease symptoms usually appear when the cysts are large or numerous enough to significantly increase the liver volume. Most important complications of the disease are: cyst infection, cyst rupture, intracystic hemorrhage and liver failure. Treatment of PLD depends on liver phenotype and symptoms severity. Invasive treatment is needed in patients with advanced PLD and liver failure
Correlation of Fecal Calprotectin with Small Bowel MRI Findings in Crohn’s Disease
No full textObjective: In Crohn’s disease, correlation of fecal neutrophil-derived biomarker calprotectin with small bowel magnet resonance enteroclysis (MRE) is scarcely studied.Methods: 51 consecutive Crohn’s disease patients undergoing MRE and having a measured fecal calprotectin at the time of the MRE were retrospectively studied. MRE findings were scored by an experienced radiologist according to a ranking taking into account 15 MRE variables. Furthermore, radiologist assessed the MRE findings as active, inactive or normal.Results: Median fecal calprotectin in patients with active ileal inflammation was significantly higher (281 μg/g, interquartil range IQR 66-574) than in those without signs of active inflammation in MRE (83 μg/g, IQR 48-245 p =0.0435). Fecal calprotectin correlated significantly with bowel wall thickening and enhancement detected in MRE. Using receiver operator characteristic curve, the highest sum for sensitivity (60%) and specificity (76%) was achieved at calprotectin concentration 213 μg/g to detect active Crohn’s disease.Conclusion: Fecal calprotectin correlates significantly with signs of active Crohn’s disease in MRE and is significantly higher among patients with active inflammatory MRE finding than in those without signs of active inflammation
My Approach to Interpretation of Colon Biopsies
No full textAdequate interpretation of colon biopsies forms a vital pillar in colon diseases. It aids in establishing the diagnosis of colitis, noting the severity and extent of inflammation and follow the course of the diseases. This review aims at classifying major forms of colitis also with approach to cases of colon biopsies
Considerations on the Quality of Clinical Trials on Non-alcoholic Fatty Liver Disease
No full textNon-alcoholic fatty liver disease (NAFLD) become the focus of health concern due to the liver injury it caused and a series of metabolic disorders it brought. Since therapeutic methods are limited, potential agents or compounds that target the diseases are urgently needed, thus high level clinical trials with standardized design are the essential step for the application of new drugs on NAFLD. Although quite a number of clinical reports on NAFLD have released, questions are still there, some of the key issues, such as evaluative criteria, behavior intervention control and efficacy parameters selection, failed to get common consensus worldwide. In addition, some of the important definitions on NAFLD diagnosis were confusing. Aiming at the aforementioned questions, we tried to give comments and suggestions, expecting to contribute to the quality improvement of clinical NAFLD trials
What is the Role of Cutaneous Lymphocyte Antigen in the Pathogenesis of Behçet’s Disease: A Randomized, Prospective Double-Blinded Study
No full textBackground: Behcet’s Disease (BD) is a chronic systemic vasculitis of unknown etiology. Cutaneous lymphocyte antigen (CLA) has an important role in the migration of T cells into the inflamed skin.Objective: Our aim was to investigate the relationship between CLA+T cell and clinical activity of BD.Methods: A total of 80 Behçet patients and 20 healthy controls were involved in this study. BD patients were divided into four groups: ocular group genital ulcer group vessel/skin lesion group, inactive group. 10.000 cells in peripheral blood were used to assess the expression levels of CD3, CD4, CD8, CLA+CD4 and CLA+CD8 in lymphocytes with CLA/FITC clone HECA-452 kit.Results: Erythrocyte sedimentation rate, C-reactive protein and lymphocyte CLA+CD8 levels were found to be higher, whereas CD4/CD8 and CLA+CD4/CLA+CD8 ratios were found lower in patients with BD when compared to controls.Conclusions: CLA may be an important finding in the determination of etiopathogenesis, disease activity and prognosis of BD
Letter to the Editor: Treatment of Gonorrhea in Russia: Recent History
No full textThe recent history of gonorrhea treatment in Russia is discussed here after three case histories. Some outdated methods of topical treatment and provocation, not used in other countries, are described. Being informed of the lengthy and unpleasant treatment, high-risk groups avoided the prevention and treatment centers (so-called dermato-venerological dispensaries) and practiced self-treatment, which contributed to the spread of sexually transmitted infections (STI). Today there are grounds for optimism: diagnostics and treatment of STI are being adjusted to the international standards. In conclusion, the antimicrobial resistance of N. gonorrhoeae is briefly discussed
Functional and Neuropsychological Abilities in Adults with Fetal Alcohol Spectrum Disorders
No full textObjective: This study investigated functional and neuropsychological abilities in adults with mild to moderate fetal alcohol spectrum disorder (FASD).Method: Sixty-eight participants completed various neuropsychological tests such as the California Verbal Learning Test – 2nd edition (CVLT-2), Trail Making Test parts A and B (TMTA/TMTB), Stroop Color and Word Test (Stroop), Grooved Pegboard Test (GPT), Finger Tapping Test (FTT), and Independent Living Scales (ILS). Independent samples t-tests were used to compare performance between brain scores 2 and 3. Hierarchical logistic regression was used to identify predictors for brain scores.Results: Adults with severe impairment (i.e., a brain score of 3) performed significantly worse than those with milder brain dysfunction (i.e., a brain score of 2) on TMTB, Stroop, CVLT-2, and ILS (money management, and managing home and transportation subscales). Test scores from the CVLT-2 (long-delay cued recall) and ILS (money management subscale) predicted brain scores.Conclusions: Psychosocial ability remained low in all participants and should be assessed as a discrete factor for guiding interventions in adults. The results provided an important piece of reference in support of the inclusion of psycho-emotional elements in the new diagnostic guidelines for FASD
Predictive Bias Towards Neutral Stimuli in Non-Clinical Anxious Individuals
No full textThe relationship among predictive bias towards neutral stimuli, trait anxiety and gender in non-clinical individuals is studied. According to the scores on Trait Anxiety Inventory (TAI), 31 individuals are randomly selected from the highest 20% scorers as the high anxiety group, and 31 individuals from the lowest 20% scorers as the low anxiety group. Three types of stimulus situations are designed in the experiment, that is, 100% predictable, 50% predictable and unpredictable stimulus situations. MANOVA, which is performed on the reaction of high/low anxiety groups under three stimulus situations, shows that significant differences exist between high anxiety and low anxiety group under the 50% predictable and unpredictable conditions. Independent sample T test shows significant gender differences on predictive bias exist only in high anxiety group. Results of this study show that predictive bias towards neutral stimulus can be found in non-clinical anxious individuals and is significantly correlated with trait anxiety. In addition, predictive bias is more evident in high anxious female
Definition of Italian Specific DXA References for Diagnosis of Osteoporosis: Preliminary Data from the Osteoporosis Registry of Magenta Rheumatology School (OSTEOREMA)
No full textBackground: Osteoporosis is the most common metabolic bone disease and dual energy X ray absorptiometry (DXA) scans is the gold standard to evaluate individuals at risk of osteoporosis. Up to date, studies focused on population specific DXA values among general population are lacking. Primary aim of this study was to obtain lumbar and femoral DXA values of Italy adult females based on a nationally representative sample aged 20 years and older, attempting to obtain a national specific normative bone mineral density (BMD) levels curve.Methods: demographic and anthropometric data of females aged 20 years and older that performed their first DXA (QDR 9000 Hologic, Waltham, Mass.) in our Hospital between 2006 and 2015 were extracted from our local registry using a random sampling technique. Criteria for patient choice were: absence of known risk factors of Osteoporosis (e.g. smoke, alcohol), metabolic disease that affects bone (e.g. diabetes), a normal BMI between 18.5 to 24.5, previous fractures, any medication for treatment of osteoporosis or corticosteroids, spondylosis radiologically relevant. Our database was compared to Caucasian normal values incorporated into Hologic’s scan analysis software, that we proven were comparable in terms of BMI, gender and age.Results: DXA scan of 15335 women were extracted and analysed. Mean age was 64.2 ± 12.8 years (range 20.8 to 90). Mean BMI was 22.4± 5.1 (range 20.1 to 24.3). Mean menopause age was 41.3±5 (range 31-54). Mean menarche age was 16.3±5 (range 11-17). The lumbar and femoral BMD were substantially constant between 25 and 35 years (test for trend using ANOVA: P =0.31); these data collected in premenopausal women (mean 1.043± 0.12 g/cm2 for lumbar spine and 0.97± 0.136 g/cm2 for femoral neck) were thus defined as the reference peak bone mass values, significantly lower compared to the Hologic reference values (mean 1.079±0.11 g/cm2, p<0.05). The frequency of osteopenia and osteoporosis were so significantly different depending on whether you use the manufacturer criteria rather than those derived from collected data (X square p=0,01).Conclusions: our data suggest that the reference curves for the lumbar spine and femoral neck are significantly different from the current normative data reported by the manufacturer for the Italian population