Original Article: MicroRNA Dysregulation in the Gastric Carcinogenesis Cascade: Can We Anticipate Its Role in Individualized Care?

Pathobiology ◽  
2021 ◽  
pp. 1-13
Author(s):  
Inês Pita ◽  
Diogo Libânio ◽  
Francisca Dias ◽  
Ana Luísa Teixeira ◽  
Inês Nogueira ◽  
...  
Keyword(s):  
Tissue Expression ◽  
Normal Mucosa ◽  
Cross Sectional Study ◽  
Gastric Carcinogenesis ◽  
Endoscopic Biopsy ◽  
Cross Sectional ◽  
Oncogenic Potential ◽  
Individualized Care ◽  
Gastric Neoplasia ◽  
Microrna Dysregulation

<b><i>Background:</i></b> Gastric carcinogenesis progresses from normal mucosa, atrophic/metaplastic gastritis, and dysplasia to adenocarcinoma. MicroRNAs (miRNAs) regulate DNA expression and have been implicated; however, their role is not fully established. <b><i>Aims:</i></b> The aim of this study was to characterize plasma and tissue expression of several miRNAs in gastric carcinogenesis stages. <b><i>Methods:</i></b> Single-center cross-sectional study in 64 patients: 19 controls (normal mucosa); 15 with extensive atrophic/metaplastic gastritis; and 30 with early gastric neoplasia (EGN). Seven miRNAs (miR-21, miR-146a, miR-181b, miR-370, miR-375, miR 181b, and miR-490) were quantified by real time-qPCR in peripheral blood and endoscopic biopsy samples. <b><i>Results:</i></b> We found a significant upregulation of miR-181b, miR-490, and miR-21 in the EGN mucosa (overexpression 2–14-times higher than controls). We observed a significant underexpression of miR-146a and miR-370 in atrophic/metaplastic gastritis (86 and 66% decrease, <i>p</i> = 0.008 and <i>p</i> = 0.001) and in EGN (89 and 62% reduction, <i>p</i> = 0.034 and <i>p</i> = 0.032) compared with controls. There were no differences between lesions and nonneoplastic mucosa and no dysregulation of plasma miRNAs. <b><i>Conclusion:</i></b> We found significant dysregulation of 5 miRNAs in gastric carcinogenesis, suggesting a tumor suppressor role for miR-146a and miR-370 and oncogenic potential for miR-21, miR-181, and miR-490. These changes happen diffusely in the gastric mucosa, suggesting a high-risk field defect, which may influence these patients’ surveillance.

scholarly journals Patients Perception of Risks and Benefits of Biologic Therapy

2019 ◽  
Author(s):  
Kara Mari De Felice
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Personality Trait ◽  
Biologic Therapy ◽  
Cross Sectional Study ◽  
Therapeutic Benefit ◽  
Future Research ◽  
Shared Decision ◽  
Cross Sectional ◽  
Individualized Care

Abstract Biologic therapy continues to be underutilized despite its efficacy and overall favorable side effect profile when compared with corticosteroids. Siegel et al found in a well-done, cross-sectional study that patients perceived that corticosteroids were more beneficial, more familiar, and less dreadful than biologics despite perceiving that corticosteroids are more risky. They also found that perception of risk may be influenced by a patient’s personality trait. Patients who believe that their health is influenced by their own choices or behaviors perceived biologic therapy less scary compared with patients who believed their health is influenced by chance. Physicians and patients disagree about how much medication-related risk is tolerable for improvements on efficacy. However, they are both willing to accept risks for therapies that offer significant therapeutic benefit. Physicians are tasked to translate complex evidenced-based data accurately and should take into account a patient’s personality trait in order to provide individualized care and help guide shared decision-making. Future research should assess physician’s personality traits, treatment experiences, and perception of risks, benefits, and dread of IBD medications and how it influences shared-decision making.

scholarly journals Importance of biopsies and histological evaluation in patients with chronic diarrhea and normal colonoscopies

2014 ◽  
Vol 27 (3) ◽  
pp. 184-187 ◽  
Author(s):  
Franciane Mayra Nicoli KAGUEYAMA ◽  
Fernanda Michely NICOLI ◽  
Mauro Willemann BONATTO ◽  
Ivan Roberto Bonotto ORSO
Keyword(s):  
Differential Diagnosis ◽  
Terminal Ileum ◽  
Chronic Diarrhea ◽  
Collagenous Colitis ◽  
Normal Mucosa ◽  
Cross Sectional Study ◽  
Lymphoid Hyperplasia ◽  
Histological Evaluation ◽  
Cross Sectional ◽  
Eosinophilic Colitis

BACKGROUND: In patients with chronic diarrhea, colonoscopy may identify inflammatory causes or some occult disease, and also can show a normal mucosa. Serial biopsies of intestinal mucosa can be useful for a differential diagnosis, and to modify the treatment. AIM: To evaluate whether the biopsies performed in patients with chronic diarrhea and a normal colonoscopy contribute to the differential diagnosis and alter the therapeutic approach. METHODS: A descriptive, retrospective and cross-sectional study using a computerized database was done. Patients with chronic diarrhea and a normal colonoscopy underwent serial biopsies of the terminal ileum, ascending colon and rectum. RESULTS: From 398 records, 214 were excluded. Of the 184 patients enrolled, 91 showed histological changes: 40% nonspecific inflammation; 5.18% lymphocytic inflammation, 10.37% eosinophilic inflammation; 39.26% lymphoid hyperplasia; 2.22% collagenous colitis; 2.22% melanosis; and 0.74% pseudomelanose. The sites with the largest number of changes were the terminal ileum and right colon. CONCLUSIONS: Serial biopsies in patients with chronic diarrhea and normal colonoscopy identified changes in almost 50% of cases and 22% of these cases may had modified the treatment after identification of collagenous, lymphocytic and eosinophilic colitis.

scholarly journals Gender Differences in the Association between Frailty, Cognitive Impairment, and Self-Care Behaviors Among Older Adults with Atrial Fibrillation

2019 ◽  
Vol 16 (13) ◽  
pp. 2387 ◽  
Author(s):  
Youn-Jung Son ◽  
Kyounghoon Lee ◽  
Bo-Hwan Kim
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Older Patients ◽  
Linear Regression Analysis ◽  
Self Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Plans ◽  
Individualized Care

Atrial fibrillation (AF), common in older adults, increases the risk of heart failure, stroke, and all-cause mortality. Self-care behaviors help avoid adverse events in older patients with AF. However, while frailty and cognitive impairment can contribute to poor self-care behaviors, few studies have explored these relationships in older adults with AF. This cross-sectional study aims to determine associations between frailty, cognitive impairment, and self-care behaviors among older adults with AF by gender. A total of 298 patients with AF aged 60 and over were assessed with a self-reported questionnaire consisting of the Korean version of the FRAIL scale, modified mini-mental state examination, and self-care scale for AF. Prevalence of frailty and prefrailty in men and women was around 11% and 48.4% and 28% and 47.4%, respectively. According to the hierarchical linear regression analysis, in men, prefrailty (β = −2.874, p = 0.013) and frailty (β = −7.698, p < 0.001) were associated with self-care behaviors; in women, frailty (β = −5.476, p = 0.003), and cognitive impairment (β = −3.350, p = 0.044) were associated with self-care behaviors. Developing individualized care plans will require periodic screening of older patients with AF to determine their frailty status and cognitive function.

scholarly journals Perfil sociodemográfico e de saúde de idosos institucionalizados

2019 ◽  
Vol 13 (3) ◽  
pp. 674
Author(s):  
Renata Kelly Lopes de Alcântara ◽  
Maria Lígia Silva Nunes Cavalcante ◽  
Bruna Karen Cavalcante Fernandes ◽  
Valderina Moura Lopes ◽  
Saul Filipe Pedrosa Leite ◽  
...  
Keyword(s):  
Elderly People ◽  
Elderly Women ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Health Profile ◽  
Cross Sectional ◽  
Multiprofessional Team ◽  
Institutionalized Elderly ◽  
Individualized Care ◽  
Quantitative Descriptive

RESUMO Objetivo: buscou-se descrever o perfil sociodemográfico e de saúde de idosos institucionalizados. Método: trata-se de um estudo quantitativo, descritivo, transversal, realizado a partir da avaliação de 219 prontuários de idosos, mediante a aplicação de um instrumento semiestruturado. Analisaram-se os dados com o auxílio do SPSS, versão 20.0, e os apresentaram em tabelas. Resultados: obteve-se predomínio de idosos do sexo feminino, média de idade de 77 anos, escolaridade de 4 a 15 anos de estudo, solteiros, católicos, provenientes de domicílio próprio com tempo de institucionalização menor que 5 anos, aposentados e que recebiam visitas. Viu-se acerca das características clínicas que 44,7% tinham de 3 a 4 comorbidades e 49,3% faziam uso de 0 a 4 medicações. Observou-se sobre o grau de dependência que 35,6% dos idosos apresentavam grau III. Conclusão: ressalta-se que os dados descritos estimulam a reflexão sobre questões que influenciam diretamente o processo de adaptação do idoso à institucionalização, bem como a necessidade de a equipe multiprofissional prestar uma assistência individualizada a partir do conhecimento do perfil dos idosos institucionalizados. Descritores: Idoso; Instituição de Longa Permanência para Idosos; Institucionalização; Saúde do Idoso Institucionalizado; Perfil de Saúde; Envelhecimento.ABSTRACT Objective: to describe the sociodemographic and health profile of institutionalized elderly people. Method: This is a quantitative, descriptive, cross-sectional study based on the evaluation of 219 medical records of the elderly, using a semi-structured instrument. Data were analyzed with the help of the SPSS, version 20.0, and presented in tables. Results: there was a predominance of elderly women, mean age of 77 years, schooling from 4 to 15 years, single marital status, Catholics, coming from their own domicile, with institutionalization time of less than 5 years, retired, and elderly people who received visits. Regarding clinical characteristics, 44.7% had 3 to 4 comorbidities and 49.3% used 0 to 4 medicines. As for the degree of dependence, it was observed that 35.6% of the elderly presented grade III. Conclusion: it is noteworthy that the data described stimulate a reflection on issues that directly influence the process of adaptation of the elderly to institutionalization, as well as the need for the multiprofessional team to provide individualized care based on knowledge of the profile of the institutionalized elderly. Keywords: Elderly; Long Stay Institutions for the Elderly; Institutionalization; Health of Institutionalized Elderly; Health Profile; Aging.RESUMOObjetivo: se buscó describir el perfil sociodemográfico y de salud de adultos mayores institucionalizados. Método: se trata de un estudio cuantitativo, descriptivo, transversal, realizado a partir de la evaluación de 219 prontuarios de adultos mayores, mediante la aplicación de un instrumento semi-estructurado. Se analizaron los datos con el auxilio del SPSS, versión 20.0, y los presentaron en tablas. Resultados: se obtuvo un predominio de adultos mayores del sexo femenino, media de edad de 77 años, escolaridad de 4 a 15 años de estudio, solteros, católicos, provenientes de domicilio propio con tiempo de institucionalización menor que 5 años, jubilados y que recibían visitas. Se observó en las características clínicas que 44,7% tenían de 3 a 4 comorbilidades y 49,3% usaban de 0 a 4 medicamentos. Se observó el grado de dependencia en que 35,6% de los adultos mayores presentaban grado III. Conclusión: se resalta que los datos descriptos estimulan la reflexión sobre cuestiones que influyen directamente el proceso de adaptación del adulto mayor a la institucionalización, así como la necesidad del equipo multi-profesional prestar una asistencia individualizada a partir del conocimiento del perfil de los adultos mayores institucionalizados. Descriptores: Adulto mayor; Institución de Larga Permanencia para Adultos Mayores; Institucionalización; Salud del Adulto Mayor Institucionalizado; Perfil de Salud; Envejecimiento.

Knowledge and Awareness on Personalized Medicine amongst Health Care Specialists and University Students in Health Colleges in Saudi Arabia

2020 ◽  
pp. 177-183
Author(s):  
Nehad J. Ahmed ◽  
Abdulrahman S. Alrawili ◽  
Faisal Z. Alkhawaja
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Personalized Medicine ◽  
University Students ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Poor Knowledge ◽  
Individualized Care ◽  
Awareness Programs

Aim: There are a few studies about the populations' knowledge and perceptions on personalized medicine in Saudi Arabia until now. Therefore, the aim of this study was to assess the knowledge and awareness on personalized medicine amongst health care specialists and university students in health colleges in Saudi Arabia. Methodology: This is a cross-sectional study that include a survey targeting health care specialists. The survey translated to Arabic and after validation, it was converted to an online survey using google forms. Results: About 52.34% of the participants have heard about different terms regarding personalized medicine (personalized medicine, healthcare reform, individualized care and pharmacogenomics). Most of the health care specialists in the present study said that they have poor knowledge about personalized medicine (68.75%). Most of the participants in the present study were interested to learn about personalized medicine and showed a positive attitude about it. Conclusion: The present study found that health care specialists had a poor knowledge about personalized medicine but they are interested to learn more about this field.  Therefore, more training and awareness programs about personalized medicine are needed to facilitate its introduction in Saudi Arabia. Moreover, more focus on this field should be introduced into the health colleges’ curricula.

scholarly journals Detection of human papillomavirus in epithelial lesions of the conjunctiva

2000 ◽  
Vol 118 (5) ◽  
pp. 125-130 ◽  
Author(s):  
Maristela Amaral Palazzi ◽  
Clélia Maria Erwenne ◽  
Luísa Lina Villa
Keyword(s):  
Blot Hybridization ◽  
Low Frequency ◽  
Normal Mucosa ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Climatic Conditions ◽  
Control Group ◽  
Dot Blot ◽  
Cross Sectional ◽  
Hpv Dna

CONTEXT: Many factors like exposure to UV radiation, climatic conditions, genetic predisposition, immunological state and, more recently, the presence of HPV have been implicated in the genesis of some lesions of the conjunctiva, especially the carcinoma. OBJECTIVE: To evaluate the presence of HPV DNA in acquired lesions of the conjunctiva and in normal mucosa. TYPE OF STUDY: Cross-sectional study. SETTING: A public university referral center (the Ophthalmology Service of the A.C. Camargo Hospital - A. Prudente Foundation, São Paulo). PARTICIPANTS: Thirty patients with acquired lesions of the conjunctiva and 60 matched controls (by age and sex) were evaluated in this study, from June 1993 to March 1995. PROCEDURES: The detection of HPV DNA in the normal conjunctiva and in acquired lesions was done by the PCR technique and dot blot hybridization. The material was collected by scraping the normal mucosa and the surface of the lesions. A fragment of fresh frozen tissue and paraffin embedded specimens of each lesion were also included. MAIN MEASUREMENTS: The association between the HPV infection and the presence or absence of conjunctival lesions. RESULTS: Sequences of HPV DNA were detected in 4 of the 31 lesions evaluated (12.9%) and in the healthy mucosa of one individual of the control group (1.6%). HPV type 16 was detected in 2 carcinomas and in the normal mucosa of one individual of the control group. HPV type 11 was demonstrated in 2 papillomas of one patient with lesions in both eyes. CONCLUSIONS: The low frequency of HPV DNA found in the lesions of this sample and the detection of the viral genome in the normal mucosa indicate that there is a weak possibility of association between HPV infection and the carcinoma of the conjunctiva.

scholarly journals Expression Levels of Inflammatory and Oxidative Stress-Related Genes in Skin Biopsies and Their Association with Pityriasis Alba

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 359
Author(s):  
Margarita L. Martinez-Fierro ◽  
Griselda A. Cabral-Pacheco ◽  
Idalia Garza-Veloz ◽  
Andrés E. Campuzano-García ◽  
Alma P. Díaz-Alonso ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Tissue Expression ◽  
Cross Sectional Study ◽  
Healthy Skin ◽  
Cross Sectional ◽  
Expression Levels ◽  
Over Expression ◽  
Common Skin ◽  
Skin Biopsies ◽  
Stress Related Genes

Background and objectives: Pytiriasis alba (PA) is a common skin disorder which affects 80% of children between six and 16 years. The etiology of PA is unclear, but hypo-pigmented patches in photo-exposed zones characterize the disease. Because the high ultraviolet exposition of the skin promotes an acute inflammatory response and an increase of oxidative stress (OS), this study aimed to evaluate the expression levels of inflammatory and OS-related genes in skin biopsies, and their association with PA. Materials and Methods: A cross-sectional study was carried out. Skin biopsies of the lesion sites and healthy skin (controls) from 16 children with PA were evaluated. The tissue expression of IL-4, IL-6, IL-17A, TNFα, INFγ, IL-1β, SOD1, and HMOX1 was analyzed by qRT-PCR, using SYBR Green and glyceraldehyde-3-phosphate dehydrogenase gene as the endogenous control. Results: There were differences in the ΔCq values of HMOX1, SOD1, IL-6, and IFNγ between tissue with lesions and healthy skin (p < 0.05). Compared with healthy skin, IL-6, IFNγ, HMOX1, and SOD1 were predominantly under-expressed in the lesion sites. However, 25% of skin biopsies with lesions showed over-expression of these four genes. Positive correlations between the expression of IL-6 and HMOX1, SOD1, and IFNγ (p < 0.05) were also observed. Conclusions: Our results suggest the presence of molecular stages of PA, defined according to the over-expression (first stage) or under-expression (second stage) of the HMOX1, SOD1, IL-6, and IFNγ genes in abnormal skin tissue. These findings may have implications for the selection of treatment for PA-related lesions.

scholarly journals What happens to adiponectin, resistin and apelin-12 in colorectal adenomas? A cross sectional study.

2020 ◽  
Author(s):  
oguz dikbas ◽  
Ülkü Dagli ◽  
Handan Ankarali ◽  
Buket Kin Tekce ◽  
Fahri Yılmaz ◽  
...  
Keyword(s):  
Colorectal Neoplasia ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Colorectal Adenomas ◽  
Screening Colonoscopy ◽  
Cross Sectional ◽  
Oncogenic Potential ◽  
Control Approach ◽  
Arterial Blood ◽  
Study Results

Abstract BackgroundColorectal adenomas are precancerous neoplastic lesions which may potentially differentiate to the colorectal carcinoma. We investigated whether adiponectin, resistin and apelin 12 serum levels might change in case of colorectal neoplasia. Aims In this study we intended to determine relationship between serum levels of adiponectin, resistin, apelin-12 and presence of colorectal adenoma using case-control approach. Methods Patients undergoing screening colonoscopy in the Abant Izzet Baysal University Medical Faculty Gastroenterology Polyclinics between years 2010 and 2013 were selected for study. Results In this study there were not any difference between groups according to age, body mass index, waist circumference and mean arterial blood pressure (all p>0.05). Adiponectin, resistin and apelin-12 serum levels were not statistically different between groups (p=0.642, p=0.890, p=0.618; respectively). On the other side: Serum apelin-12 levels were found to be statistically higher in patients with severe dysplastic adenoma group compared to both non-dysplastic and without adenoma groups (p=0.014). There was a negative correlation between the number of colorectal adenomas and serum adiponectin levels (p=0.035, r=-0.41). Conclusion Apelin-12 does increase in severe dysplastic adenomas. Apelin-12 is an angiogenic adipocytokine with oncogenic potential. The relation between cancer development and apelin has been shown in different types of tumors. Apelin-12 might be a candidate marker for detecting dysplastic colorectal adenomas.

scholarly journals Evaluation of Celiac Disease Prevalence Among Patients with Refractory Hypothyroidism: A Cross-Sectional Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Pezhman Alavinejad ◽  
Hajieh Bibi Shahbazian ◽  
Alireza Jahanshahi ◽  
Mohamad Faramarzi ◽  
Zahra Shokati Ashkiki
Keyword(s):  
Celiac Disease ◽  
Sensitivity And Specificity ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Diagnostic Procedures ◽  
Normal Mucosa ◽  
Cross Sectional Study ◽  
Pathology Report ◽  
Upper Endoscopy ◽  
Cross Sectional

Background: The association of celiac disease (CD) with refractory hypothyroidism is a known but less common condition. Objectives: This study aimed to evaluate the prevalence of CD among patients with refractory hypothyroidism and compare the accuracy of different diagnostic procedures of CD in these patients. Methods: During a six-month period, 25 patients with refractory hypothyroidism were included from the endocrinology outpatient clinics of Ahvaz Jundishapur University of Medical Sciences, Khuzestan, Iran. For all the participants, the serological profile of CD, including anti-tissue transglutaminase (anti-tTG), anti-endomysial antibody (anti-EMA), and total immunoglobulin A, was determined, and then they were referred to undergo upper endoscopy and random biopsies from the first and second parts of the duodenum. Results: The average duration of hypothyroidism among the participants was 7 months. In addition, 75% of the patients (n = 19) were female. The mean age values of male and female subjects were 31.3 ± 17 and 34.3 ± 8.5 years, respectively (age range: 17 - 53 years). The average daily dosage of levothyroxine was 285.1 ± 89.9 mg. The most common comorbidities were anemia (72%) and diarrhea (24%). The most frequent serologic findings in these patients were positive anti-tTG (28%) and anti-EMA (16%). The most common results of upper endoscopy were normal mucosa (48%), gastritis (28%), duodenal fissuring (8%), duodenal atrophy (8%), and duodenal erythema (8%). Based on the results of the pathology report, 20% of the patients (n = 5) were diagnosed with CD (mostly marsh 1 and 0 stages). The sensitivity and specificity of tTG were 33 and 87.5%, respectively. The sensitivity and specificity of EMA were 11.1 and 87.5%, respectively. Conclusions: Based on the results of this pilot study, the prevalence of CD among cases with refractory hypothyroidism is higher than that of global reports. Furthermore, routine screening of CD in these patients is highly recommended even with negative serology. The endoscopic view is not adequate for the diagnosis of CD among patients with refractory hypothyroidism. In addition, it is necessary to focus on pathology reports and antibody titer.

scholarly journals The Epidemiological and Clinical Characteristics of Celiac Disease among Patientswith Irritable Bowel Syndrome in Zanjan Province, Iran

2021 ◽  
Author(s):  
Hassan Neishaboori ◽  
Somaye Abdollahi Sabet ◽  
Pegah Moharrami Yeganeh ◽  
Seyede Vanoushe Azimi Pirsaraei
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Clinical Characteristics ◽  
Delayed Diagnosis ◽  
Cross Sectional Study ◽  
Endoscopic Biopsy ◽  
Cross Sectional ◽  
Diagnostic Approaches ◽  
Spss Software ◽  
Irritable Bowel

Background: There are some overlaps between celiac disease and irritable bowel syndrome symptoms (IBS). It can lead to misdiagnosis or delayed diagnosis of celiac disease. In some guidelines, it is recommended to screen for celiac in IBS cases. For assessment of the necessity for such diagnostic approaches in patients, this study was done to evaluate the epidemiological and clinical characteristics of celiac disease among IBS cases in Zanjan, Iran. Methods: In this descriptive cross-sectional study, 121 cases with IBS attending to gastroenterology clinics since 2015 to 2018 were enrolled. The laboratory tests and upper digestive endoscopy were performed for all patients. Endoscopic biopsy specimens were taken from the duodenum, and the samples were examined to confirm diagnosis of celiac disease. Data analysis was done by SPSS software. Results: Of 121 studied patients, 51.2% were male. The mean age of the patients was 36.65 ± 10.09 years old. The most common IBS subtype was mixed (80.2%). According to the serology results and Marsh grading, 4.1% and 1.6% had celiac disease and potential celiac disease, respectively. There were statistically significant differences among celiac disease in gastroesophageal reflux disease and abdominal discomfort/cramping. Conclusion: The incidence of celiac disease was evaluated 4.1 cases per each 100 patients with IBS, which was higher than recent similar studies, and screening for celiac disease in these patients is advisable. However, further studies with larger sample size are required to attain more definite results.

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