scholarly journals Antibiotic heteroresistance in Mycobacterium tuberculosis isolates: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mao Ye ◽  
Wen Yuan ◽  
Leila Molaeipour ◽  
Khalil Azizian ◽  
Alireza Ahmadi ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Subgroup Analysis ◽  
Detection Method ◽  
Meta Analysis ◽  
Resistance Development ◽  
Pooled Prevalence ◽  
Important Trend ◽  
Reliable Methods ◽  
Selection Of

Abstract Background Mycobacterium tuberculosis (MTB) is responsible for tuberculosis; that continues to be a public health threat across the globe. Furthermore, increasing heteroresistance (HR)-the presence of resistant and susceptible isolates among MTB strains- has been reported from around the world. This phenomenon can lead to full resistance development and treatment failure. Methods We systematically searched the relevant studies in PubMed, Scopus, and Embase (Until October 21, 2020). The study outcomes revealed the weighted pooled prevalence of antibiotic HR in MTB isolates with subgroup analysis by year, quality of study, and heteroresistance detection method. Results A total of 38 studies which had investigated MTB isolates were included in the meta-analysis. Geographically, the highest number of studies were reported from Asia (n  =  24), followed by Africa (n  =  5). Nineteen studies reported HR to isoniazid, with a weighted pooled prevalence of 5% (95% CI 0–12) among 11,761 MTB isolates. Also, there is no important trend for the subgroup analysis by the study period (2001–2014 vs 2015–2017 vs 2018–2020). HR to rifampin was reported in 17 studies, with a weighted pooled prevalence of 7% (95% CI 2–14) among 3782 MTB isolates. HR to fluoroquinolone and ethambutol were reported in 12 and 4 studies, respectively, with weighted pooled prevalence of 10% and 1% among 2153 and 1509 MTB isolates, correspondingly. Conclusion Based on our analysis, HR in MTB isolates with different frequency rate is present worldwide. Thus, the selection of appropriate and reliable methods for HR detection is crucial for TB eradication.

Prevalence of idiopathic REM behavior disorder: a systematic review and meta-analysis

SLEEP ◽  
2021 ◽  
Author(s):  
Calogero Edoardo Cicero ◽  
Loretta Giuliano ◽  
Jaime Luna ◽  
Mario Zappia ◽  
Pierre-Marie Preux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Behavior Disorder ◽  
Significant Heterogeneity ◽  
Pooled Prevalence ◽  
Screening Questionnaires ◽  
Meta Regression

Abstract Study Objectives To provide an overall estimate of the prevalence of idiopathic REM Sleep Behavior Disorder (iRBD). Methods Two investigators have independently searched the PubMed and Scopus databases for population-based studies assessing the prevalence of iRBD. Data about type of diagnosis (polysomnographic diagnosis, defined iRBD [dRBD]; clinical diagnosis, probable RBD [pRBD]), continent, age range of the screened population, quality of the studies, sample size, screening questionnaires and strategies have been gathered. A random effect model was used to estimate the pooled prevalence. Heterogeneity was investigated with subgroup analysis and meta-regression. Results From 857 articles found in the databases, 19 articles were selected for the systematic review and meta-analysis. According to the type of diagnosis, five studies identified dRBD cases given a pooled prevalence of 0.68% (95%CI 0.38-1.05) without significant heterogeneity (Cochran’s Q p=0.11; I 2 = 46.43%). Fourteen studies assessed the prevalence of pRBD with a pooled estimate of 5.65% (95%CI 4.29-7.18) and a significant heterogeneity among the studies (Cochran’s Q p<0.001; I 2 = 98.21%). At the subgroup analysis, significant differences in terms of prevalence were present according to the quality of the studies and, after removing two outlaying studies, according to the continents and the screening questionnaire used. Meta-regression did not identify any significant effect of the covariates on the pooled estimates. Conclusion Prevalence estimates of iRBD are significantly impacted by diagnostic level of certainty. Variations in pRBD prevalence are due to methodological differences in study design and screening questionnaires employed.

scholarly journals The high risk of malarial recurrence in patients with Plasmodium-mixed infection after treatment with antimalarial drugs: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aongart Mahittikorn ◽  
Frederick Ramirez Masangkay ◽  
Kwuntida Uthaisar Kotepui ◽  
Giovanni De Jesus Milanez ◽  
Manas Kotepui
Keyword(s):  
Systematic Review ◽  
Mixed Infection ◽  
Subgroup Analysis ◽  
Initial Treatment ◽  
Meta Analysis ◽  
Antimalarial Drugs ◽  
Secondary Outcome ◽  
Significant Heterogeneity ◽  
Pooled Prevalence ◽  
Significant Difference

Abstract Background Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat Plasmodium-mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of Plasmodium-mixed infection. The results of the study may provide benefits in the management of Plasmodium-mixed infection in co-endemic regions. Methods This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with Plasmodium-mixed infection. The primary outcome was the pooled prevalence of Plasmodium parasitemia after initiating antimalarial treatment for Plasmodium-mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in Plasmodium-mixed infection compared with those in Plasmodium falciparum and Plasmodium vivax mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of Plasmodium parasitemia was compared in subgroup analysis. Results Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of Plasmodium-mixed parasitemia was 30% (95% confidence interval (CI) 16–43; I2: 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of Plasmodium-mixed parasitemia compared with the treatment of P. falciparum was 1.22 (p: 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93; I2: 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of P. falciparum (p: 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05; I2: 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity (p: 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834; I2: 0%). Conclusions The present findings showed a high prevalence of malarial recurrence after the initial treatment of Plasmodium-mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs. Graphic Abstract

scholarly journals The Prevalence of TET2 Gene Mutations in Patients with BCR-ABL-Negative Myeloproliferative Neoplasms (MPN): A Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3078
Author(s):  
Yuh Cai Chia ◽  
Md Asiful Islam ◽  
Phil Hider ◽  
Peng Yeong Woon ◽  
Muhammad Farid Johan ◽  
...  
Keyword(s):  
Regional Differences ◽  
Myeloproliferative Neoplasms ◽  
Meta Analysis ◽  
Gene Mutations ◽  
Screening Methods ◽  
Eligibility Criteria ◽  
Pooled Prevalence ◽  
Critical Appraisal Tool ◽  
Appraisal Tool

Multiple recurrent somatic mutations have recently been identified in association with myeloproliferative neoplasms (MPN). This meta-analysis aims to assess the pooled prevalence of TET2 gene mutations among patients with MPN. Six databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science and Embase) were searched for relevant studies from inception till September 2020, without language restrictions. The eligibility criteria included BCR-ABL-negative MPN adults with TET2 gene mutations. A random-effects model was used to estimate the pooled prevalence with 95% confidence intervals (CIs). Subgroup analyses explored results among different continents and countries, WHO diagnostic criteria, screening methods and types of MF. Quality assessment was undertaken using the Joanna Briggs Institute critical appraisal tool. The study was registered with PROSPERO (CRD42020212223). Thirty-five studies were included (n = 5121, 47.1% female). Overall, the pooled prevalence of TET2 gene mutations in MPN patients was 15.5% (95% CI: 12.1–19.0%, I2 = 94%). Regional differences explained a substantial amount of heterogeneity. The prevalence of TET2 gene mutations among the three subtypes PV, ET and MF were 16.8%, 9.8% and 15.7%, respectively. The quality of the included studies was determined to be moderate–high among 83% of the included studies. Among patients with BCR-ABL-negative MPN, the overall prevalence of TET2 gene mutations was 15.5%.

scholarly journals Seroprevalence of hepatitis C virus infection in Cameroon: a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015748 ◽  
Author(s):  
Jean Joel Bigna ◽  
Marie A Amougou ◽  
Serra Lem Asangbeh ◽  
Angeladine Malaha Kenne ◽  
Jobert Richie Nansseu
Keyword(s):  
Systematic Review ◽  
Hepatitis C ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Hcv Infection ◽  
Representative Study ◽  
East Region ◽  
Pooled Prevalence ◽  
Rural Settings

ObjectiveBetter knowledge of hepatitis C virus (HCV) seroprevalence at the national level can help to implement pertinent strategies to address the HCV-related burden. The aim of this paper was to estimate the seroprevalence of HCV infection in Cameroon.DesignSystematic review and meta-analysis.ParticipantsPeople residing in Cameroon.Data sourcesElectronic databases including PubMed/MEDLINE, AJOL, WHO-Afro Library, Africa Index Medicus, National Institute of Statistics and National AIDS Control Committee, Cameroon from 1 January 2000 to 15 December 2016 were searched. English and French languages papers were considered. Two independent investigators selected studies. The methodological quality of the studies was assessed using the Newcastle–Ottawa scale.Results31 studies including 36 407 individuals were finally considered. There was no national representative study. The overall pooled prevalence was 6.5% (95% CI 4.5% to 8.8%; I²=98.3%). A sensitivity analysis of individuals at low risk of HCV infection showed a pooled prevalence of 3.6% (95% CI 2.3% to 5.2%, I²=97.7%, 18 studies) among 22 860 individuals (general population, blood donors and pregnant women), which was higher than for a high-risk population (healthcare workers and people with other identified comorbidities), 12.2% (95% CI 4.9% to 22.2%; I²=98.3%, 13 studies); p=0.018. The prevalence was higher in the East region, in rural settings, and when using an enzyme immunoassay technique for detecting HCV antibodies. Sex, sites, study period, sample size, timing of data collection and methodological quality of studies were not sources of heterogeneity.LimitationOne-third of studies (29.0%) had a low risk bias in their methodology and most were facility-based (87.1%).ConclusionThe seroprevalence of HCV infection in Cameroon indicates the need for comprehensive and effective strategies to interrupt HCV transmission in the Cameroonian population. Specific attention is needed for the East region of the country, rural settings and high-risk populations. A national representative study is needed to provide better estimates.

scholarly journals Risk factors associated with echinococcosis in Chinese general population: a meta-analysis and systematic review

2021 ◽  
Author(s):  
tiantian zhang ◽  
Bin Li ◽  
Yuying Liu ◽  
Shou Liu
Keyword(s):  
Risk Factors ◽  
Subgroup Analysis ◽  
Human Life ◽  
Meta Analysis ◽  
Test Results ◽  
Knowledge Infrastructure ◽  
Pooled Prevalence ◽  
Specific Subgroup ◽  
And Control ◽  
Chinese National Knowledge Infrastructure

Abstract Background Echinococcosis is a severe zoonotic disease that imposes a substantial burden on human life. Numerous studies on echinococcosis have involved a variety of risk factors, and it is difficult to evaluate the key risk factors. The objectives of this meta-analysis are to summarize available data on the prevalence of human echinococcosis and identify the key risk factors for echinococcosis. Methods Relevant studies were comprehensively searched in the PubMed, EMBASE, Web of Science, Cochrane, Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP Information (VIP), Wanfang and SinoMed databases from database inception until August 22, 2020. A random-effects model was used to estimate the pooled odds ratio (OR) and 95% confidence interval (CI) by integrating the OR values of each risk factor. The I2 and Q statistics were calculated to evaluate the heterogeneity, and potential sources of heterogeneity were identified using sensitivity analysis and subgroup analysis. Publication bias was estimated by funnel plots and Egger’s test. Results A total of 1026 studies were identified through the database search, of which 26 were eligible for this meta-analysis. In total, 23 and 9 of the 26 studies were cystic echinococcosis (CE) and alveolar echinococcosis (AE) studies, respectively (6 papers included both AE and CE). The pooled prevalence of echinococcosis was 5.52% (95% CI: 5.47%-5.58%). Ethnicity (OR = 2.93, 95% CI: 1.81–4.75; I2 = 0), being a herder (OR = 2.66, 95%CI95% CI: 2.25–3.14; I2 = 8%), not washing hands before meals (OR = 2.40, 95% CI: 1.34–4.28; I2 = 82.8%) and being female (OR = 1.45, 95% CI: 1.26–1.66; I2 = 33.9%) were risk factors for AE. The top five risk factors for CE were ethnicity (OR = 3.18, 95% CI: 1.55–6.52; I2 = 79.2%), nomadism (OR = 2.71, 95% CI: 1.65–4.47; I2 = 55.8%), drinking nonboiled water (OR = 2.47, 95% CI: 1.36–4.47; I2 = 85.7), feeding viscera to dogs (OR = 2.35, 95% CI: 1.89–2.91; I2 = 21.5%), and being a herder (OR = 2.19, 95% CI: 1.67–2.86; I2 = 85.1%). The study design-specific subgroup analysis showed that the heterogeneity of CE risk factors decreased to varying degrees. Conclusions Specific characteristics (i.e., ethnicity and herder status) and behaviors (i.e., not washing hands before meals and feeding viscera to dogs ) are possible risk factors for echinococcosis. This study provided remarkable insight for future prevention and control of echinococcosis.

scholarly journals Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kwuntida Uthaisar Kotepui ◽  
Manas Kotepui
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Hepatitis B Virus ◽  
Meta Analysis ◽  
Infection Group ◽  
Pooled Prevalence ◽  
B Virus ◽  
The Difference ◽  
Meta Analyses

Abstract Background Plasmodium spp. and hepatitis B virus (HBV) are among the most common infectious diseases in underdeveloped countries. This study aimed to determine the prevalence of Plasmodium spp. and HBV co-infection in people living in endemic areas of both diseases and to assess the risk factors related to this co-infection. Methods The PubMed, Web of Science, and Scopus databases were searched. Observational cross-sectional studies and retrospective studies assessing the prevalence of Plasmodium species and HBV co-infection were examined. The methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale (NOS), a tool for assessing the quality of nonrandomized studies in meta-analyses, and heterogeneity among the included studies was assessed with Cochran's Q test and the I2 (inconsistency) statistic. The pooled prevalence of the co-infection and its 95% confidence interval (CI) were estimated using the random-effects model, depending on the amount of heterogeneity there was among the included studies. The pooled odds ratio (OR) represented the difference in qualitative variables, whereas the pooled mean difference (MD) represented the difference in quantitative variables. Meta-analyses of the potential risk factors for Plasmodium spp. and HBV co-infection, including patient age and gender, were identified and represented as pooled odds ratios (OR) and 95% CIs. Publication bias among the included studies was assessed by visual inspection of a funnel plot to search for asymmetry. Results Twenty-two studies were included in the present systematic review and meta-analysis. Overall, the pooled prevalence estimate of Plasmodium spp. and HBV co-infection was 6% (95% CI 4–7%, Cochran's Q statistic < 0.001, I2: 95.8%), with prevalences of 10% in Gambia (95% CI: 8–12%, weight: 4.95%), 8% in Italy (95% CI 5–12%, weight: 3.8%), 7% in Nigeria (95% CI 4–10%, weight: 53.5%), and 4% in Brazil (95% CI 2–5%, weight: 19.9%). The pooled prevalence estimate of Plasmodium spp. and HBV co-infection was higher in studies published before 2015 (7%, 95% CI 4–9%, Cochran's Q statistic < 0.001, I2: 96%) than in those published since 2015 (3%, 95% CI 1–5%, Cochran's Q statistic < 0.001, I2: 81.3%). No difference in age and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and the Plasmodium monoinfection group (p: 0.48, OR: 1.33, 95% CI 0.60–2.96). No difference in gender and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and HBV co-infection group and the Plasmodium monoinfection group (p: 0.09, OR: 2.79, 95% CI 0.86–9.10). No differences in mean aspartate aminotransferase (AST), mean alanine aminotransferase (ALT), or mean total bilirubin levels were found (p > 0.05) between the Plasmodium spp. and HBV co-infection group and the Plasmodium monoinfection group. Conclusions The present study revealed the prevalence of Plasmodium spp. and HBV co-infection, which will help in understanding co-infection and designing treatment strategies. Future studies assessing the interaction between Plasmodium spp. and HBV are recommended.

scholarly journals Terminomics Methodologies and the Completeness of Reductive Dimethylation: A Meta-Analysis of Publicly Available Datasets

Proteomes ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 11 ◽  
Author(s):  
Mariella Hurtado Silva ◽  
Iain Berry ◽  
Natalie Strange ◽  
Steven Djordjevic ◽  
Matthew Padula
Keyword(s):  
Meta Analysis ◽  
Unexpected Finding ◽  
Common Occurrence ◽  
Available N ◽  
Historical Literature ◽  
Previous Decade ◽  
Amine Groups ◽  
Selection Of

Methods for analyzing the terminal sequences of proteins have been refined over the previous decade; however, few studies have evaluated the quality of the data that have been produced from those methodologies. While performing global N-terminal labelling on bacteria, we observed that the labelling was not complete and investigated whether this was a common occurrence. We assessed the completeness of labelling in a selection of existing, publicly available N-terminomics datasets and empirically determined that amine-based labelling chemistry does not achieve complete labelling and potentially has issues with labelling amine groups at sequence-specific residues. This finding led us to conduct a thorough review of the historical literature that showed that this is not an unexpected finding, with numerous publications reporting incomplete labelling. These findings have implications for the quantitation of N-terminal peptides and the biological interpretations of these data.

scholarly journals Effect of Exercise on Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kui Chen ◽  
Yan Tan ◽  
You Lu ◽  
Jiayan Wu ◽  
Xueyuan Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Aerobic Exercise ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions

Background. Exercise has an integral impact on the physical and mental wellbeing of patients with Parkinson’s disease (PD), yet no comprehensive and quantitative analysis has been conducted on the effect of exercise on quality of life (QoL) in these patients. This study aimed to evaluate the effect of exercise on overall QoL and different domains of QoL in people with PD, as well as investigating the influence of factors such as the exercise type and intervention period. Methods. Databases, such as PubMed, Embase, and Cochrane Central Register of Controlled Trials, were searched since inception to August 14, 2018 to identify randomized controlled trials that compare the effect of exercise versus no intervention on QoL in PD patients. Following the subgroup analysis, heterogeneity was further explored. The quality of eligible studies was assessed according to PRISMA guidelines. Results. 20 studies were included with 1,143 participants in total. A meta-analysis showed a significant improvement in QoL after exercise intervention in PD patients (SMD = −0.24, 95% CI = −0.36 to −0.12, P<0.001). A subgroup analysis of exercise types revealed significant QoL improvement with aerobic exercise, martial arts, and dance, but not anaerobic exercise and combined exercise. Interventions lasting 12 weeks or longer improved QoL significantly. Conclusions. Exercise interventions, especially aerobic exercise, dance, and Tai Chi, significantly improve QoL in PD patients. At least 12 weeks of exercise is needed to bring about significant benefits.

Meta-analysis of Comparative Therapy Outcome Studies: a Reply to Wilson

1982 ◽  
Vol 10 (4) ◽  
pp. 307-310 ◽  
Author(s):  
David A. Shapiro ◽  
Diana Shapiro
Keyword(s):  
Meta Analysis ◽  
Outcome Studies ◽  
Therapy Outcome ◽  
Meta Analyses ◽  
Selection Of

Wilson's recent critique of the authors' appraisal of meta-analysis appears to misunderstand them as claiming more for meta-analysis than they intended. The present paper seeks to clarify consequent confusions concerning selection of studies, the quality of the literature reviewed, the classification of therapies, and the non-identical results of different meta-analyses. It is acknowledged that no single meta-analysis is definitive.

P059 SIGNIFICANTLY INCREASED MUCOSAL EOSINOPHILS IN PATIENTS WITH POST-IBD IBS-D SYNDROME MAY HAVE A NEW AVENUE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
Mukaddes Tozlu ◽  
Ilimbek Beketaev ◽  
Mamoun Younes ◽  
Wasim Dar ◽  
Changqing Ju ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Genetic Components ◽  
Pooled Prevalence ◽  
Single Center Study ◽  
New Finding ◽  
History Of ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Near Future

Abstract Introduction Inflammatory bowel disease (IBD) patients in remission who present with irritable bowel syndrome with diarrhea (IBS-D) like symptoms pose a diagnostic and therapeutic dilemma that is called post-IBD IBS-D. This syndrome was first reported by Isgar et al. who documented IBS-type symptoms in 33% of their patients with chronic ulcerative colitis (CUC) in remission in 1983. In their meta-analysis of 13 studies incorporating 1,703 patients, Halpin and Ford in 2012 calculated a pooled prevalence of 35% for IBS symptoms among IBD subjects in remission. The post-IBD IBS-D syndrome represents a source of considerable stress, incurs morbidity and impairs quality of life of these patients. The etiology of this syndrome is unknown and may be multifactorial such as environmental, psychological, GI motility disarray, genetic components and possibly by gut microbiome. Methods We conducted a retrospective, single-center study of patients with history of IBD and IBS-D like symptoms. The demographic characteristics, type of IBD, colonoscopy, biopsy findings and empirical medical management outcome were analyzed. Results We have found significantly increased mucosal eosinophils (&gt;50 HPF in both side of the colon examined) in our patients with post-IBD IBS-D syndrome. In this study, 15 CUC patients and 20 Crohn’s disease patients with this syndrome were investigated and showed no clinical, serological, mucosal or microscopic IBD activity. These patients had non-bloody diarrhea (5–20 x daily), lower abdominal cramps (%90), mild weight loss (4–6 lbs) and fecal incontinence (%25) who were placed on the GI-hypoallergenic diet and budesonide therapy. Sixty seven percent of these 35 patients with post-IBD IBS-D responded well clinically to this management. Increased mucosal eosinophils in these patients with post-IBD IBS-D may have eosinophilic colopathy that may be related to intestinal permeability disarray. The epithelium in these IBD patients who are in remission may have the production of pro-inflammatory cytokines by the eosinophils, especially IL-23 and IL-33. This interesting area investigation is in progress by our research faculty. Conclusion In summary, this is an exciting new finding that significantly increased mucosal eosinophils in our patients with post-IBD IBS-D syndrome may have a new avenue, eosinophilic colopathy. Interestingly, these patients have responded to the GI-hypoallergenic diet and budesonide therapy. Obviously, we need more patients in the near future with longer follow-up and we hope that the other investigators may confirm our findings.

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