Clinical mucositis and intestinal permeability abnormalities in metastatic colorectal cancer patients treated with irinotecan and 5-fluoruracil.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14183-e14183 ◽  
Author(s):  
Markus Gifoni ◽  
Roberto Cesar Lima ◽  
Aldo Angelo Moreira Lima ◽  
Adriana Facanha ◽  
Rodrigo Barbosa Callado ◽  
...  

e14183 Background: The comprehension of the mechanisms involved in the adverse events of the cytotoxic drugs available to treat metastatic colorctal cancer (CRC) is necessary to improve their efficacy and safety. The irinotecan, fluoruracil and folinic acid (IFL) bolus regimen have as its major toxicity issue the complex and multi-mediated gastrointestinal mucositis. Nevertheless, it is difficult to obtain a reliable measurement of the intestinal abnormalities and functional consequences caused by intestinal mucositis, as almost all the clinical data available are reported on a patient symptoms-based scale analysis. Methods: With the lactulose/ mannitol permeability test as the experimental platform, we did a prospective case control study with 25 metastatic CRC patients treated with first line IFL. The primary end point was to compare (Wilcoxon test) the lactulose/ mannitol permeability test before the treatment and the same patients tests at the 15th and 29th day of the first IFL cycle. Blood samples of the same individuals were obtained before the treatment and at 15th day of their first IFL cycle to compare the ELISA serum levels of potentially involved cytokines (TNFα, IL-1β, IL-6, IL-18, IL-18bp e IL-33) (paired t-test). Results: In contrast with the pretreatment controls, the lactulose/ mannitol ratio was significantly (p<0,05) increased at the D15 and D29 in patients taking the first IFL cycle. The mannitol excretion rate was also decreased (p<0,05) at the 29th day. This abnormalities also reserve significant (p<0,05 – Spearman coeficient) correlation with the diarrhea and abdominal pain symptoms (NCI-CTC version 4.0) scale reported by the patients. Otherwise, it has not been possible to demonstrate serum levels differences of the addressed cytokines before and after the treatment. Conclusions: The lactulose/ mannitol permeability test is an objective and reliable tool to measure intestinal permeability abnormalities secondary to gastrointestinal mucositis caused by IFL to metastatic CRC patients.This non-invasive test could bring more objetctive measurement of the functional consequences of this limiting toxicity.

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Siyu Tao ◽  
Xue Wang ◽  
Chenxi Liao ◽  
Yan Xiong ◽  
Jie Tang ◽  
...  

Objective. This study aims to evaluate the efficacy of moxibustion on joint swelling and pain and the levels of C-X-C motif chemokine ligand 1 (CXCL1), β-endorphin (β-EP) in serum of rheumatoid arthritis (RA) patients and to investigate the anti-inflammatory and analgesic mechanism of moxibustion on improving RA. Methods. Sixty-eight patients with RA were randomly and equally classified into the control and treatment groups. The control group was treated with routine drug therapy, while the treatment group received routine drug therapy and moxibustion. Both groups were treated for eight weeks. The symptoms and laboratory indicators of RA patients were compared in the two groups before and after intervention. Results. Sixty-one patients completed the study: four patients dropped out from the treatment group and three from the control group. Trial endpoints were change (∆) in symptoms, measured by Ritchie’s articular index (RAI), swollen joint count (SJC), and laboratory indicators, measured by the level of CXCL1, β-EP, tumor necrosis factor-a (TNF-α), and interleukin-1β (IL-1β). ∆RAI, ∆SJC, ∆CXCL1, ∆β-EP, ∆TNF-α, and ∆IL-1β in the treatment group were superior to the control group (13.50 [14.50] versus 6.00 [13.00] in ∆RAI, 4.00 [3.00] versus 2.00 [4.00] in ∆SJC, 0.04 ± 0.79 ng/mL versus -0.01 ± 0.86 ng/mL in ∆CXCL1, -2.43 [5.52] pg/mg versus -0.04 [4.09] pg/mg in ∆β-EP, 3.45 [5.90] pg/mL versus 1.55 [8.29] pg/mL in ∆TNF-α, and 6.15 ± 8.65 pg/mL versus 1.28 ± 8.51 pg/mL in ∆IL-1β; all P  < 0.05). Conclusion. Moxibustion can improve the joint swelling and pain symptoms in patients with RA, which may be related to the fact that moxibustion can reduce the release of inflammatory factors in patients with RA and downregulate the level of CXCL1 and increase the level of β-EP at the same time. This trial is registered with ChiCTR-IOR-17012282.


2019 ◽  
Vol 7 (19) ◽  
pp. 3249-3252 ◽  
Author(s):  
Tissan Rahmayani ◽  
Imam Budi Putra ◽  
Nelva Karmilla Jusuf

BACKGROUND: Acne vulgaris is a chronic inflammatory skin disorder that commonly found in pilosebaceous units which can have an impact on the patient’s psychological burden. The relationship between dermatology and mental health is increasingly understood by the evidence shows that functional integrity and microbes in the gastrointestinal tract may play a role in mediating skin inflammation and emotional behaviour. The gut-brain-skin theory was first described in 1930 by Stokes and Pillsbury, became the basis of many current studies that look for clinical implications of the relationship between the gastrointestinal tract, brain and skin in acne vulgaris. Probiotics are live microorganisms which can provide a healthy effect to the hosts when consumed in adequate amounts. AIM: To determine the effect of oral probiotic on the interleukin-10 serum levels in acne vulgaris and also to determine the side effect of oral probiotic on acne vulgaris. METHODS: This is a pre-experimental clinical study with a pretest-posttest design involving 33 subjects with acne vulgaris. The subjects in this study were measured for IL-10 serum levels before and after oral probiotic was given for 30 days. This research has been approved by the Health Research Ethics Commission of the Faculty of Medicine, Universitas Sumatera Utara. RESULTS: This study found an increase in serum IL-10 levels after oral probiotic in acne vulgaris. The value of serum IL-10 levels before oral probiotic administration was 5.27 ± 1.49 pg/ml, while the value of serum IL-10 levels after oral probiotic administration was 6.19 ± 1.68 pg/ml) with p values obtained through Wilcoxon test was 0,0001 (p < 0.05). The side effect of oral probiotic found in this study is bloating that was found in 2 subjects within the first week using oral probiotic. CONCLUSION: Oral probiotic trigger elevated IL-10 serum levels of acne vulgaris. This study supports previous studies that suggested oral probiotic can be considered as adjuvant acne vulgaris therapy and its side effect is quite safe and tolerable.


2019 ◽  
Vol 49 (1/2019) ◽  

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance


2019 ◽  
Vol 4 (1) ◽  
pp. 66
Author(s):  
Rahmaini Fitri

Pregnancy causes physiological changes in the body and as well as in the oral cavity. Dental and oral diseases associated with pregnancy that is, gingivitis, periodontitis and pregnancy granuloma. Mouth dental disease during pregnancy is not only influenced by the pregnancy itself but rather the lack of knowledge about dental and oral health maintenance. Efforts to improve the knowledge of pregnant women about oral health is done by providing information, information necessary for health education media. In this case the media is created and used to improve the knowledge of pregnant women is the booklet. This study aimed to analyze the differences in knowledge and attitudes before and after maintenance booklet oral health in pregnant women. This study is a quasi experiment with one group pre  and post test design. The sample is the first trimester pregnant women who come to the health center in Sentosa Baru Medan as many as 34 people. Analysis of the data  forcompare the average difference in scores of knowledge and attitudes before and after the intervention used the Wilcoxon test. The results showed there is an increased knowledge and attitude maintenance of oral health in pregnant women after being given a booklet with a value of p < 0.001, a percentage increase of 30% knowledge and attitudes percentage of 37%. The conclusions of this study is increased knowledge and attitude maintenance of oral health in pregnant women after being given a booklet.


2020 ◽  
pp. 19-29
Author(s):  
Patricia Diaz Ortega ◽  
Manuel García Manero

Introduction: Symptomatic uterine fibroids can cause symptoms that can be disabling. There are many treatments, including ulipristal acetate, whose role in reducing symptoms and decreasing the size of the fibroid is well known. With this preliminary study, we also try to evaluate the correlation between myoma vascularization measured by ultrasound (Power Doppler 2D) and serum VEGF levels, before and after treatment with ulipristal acetate; in patients diagnosed with symptomatic uterine fibroids. Materials and Methods: A preliminary, prospective observational pilot study was designed. Twenty-four premenopausal women, diagnosed with symptomatic uterine fibroids, were included and all of them completed the study. Four cycles of ulipristal acetate were administered according to the dose and indications specified in the data sheet. In order to assess the influence of this treatment on the angiogenesis process of the fibroids, measurements of VEGF serum levels were made and their vascularization was assessed by means of 2D power doppler ultrasound; at the beginning and the end of treatment. In addition, several determinations of the same parameters were made throughout the successive visits. Endpoints were defined as the decrease in VEGF levels from previous levels, the decrease in myoma vascularization on ultrasound, and the reduction in myoma size. Result: 24 patients who met the inclusion criteria were enrolled (n=24). The average size of myomas was reduced from 45,08 ? 24,02mm to 29?16,96mm after treatment. The average VEGF serum level significantly decreased after the first treatment cycle (from 147,17 ? 153,51 pg/ml to 102,04 ? 186,08pg/ml). Vascularization of myomas after treatment with ulipristal acetate was analyzed, and a significantly decrease was achieved in 83,3% of cases. Conclusion: There is a correlation between myoma vascularization and treatment with Ulipristal acetate. SPRMs may provide effective treatment for women with symptomatic fibroids by two ways: supports selective progesterone receptor modulators and reduced angiogenesis. Keywords: Angiogenesis; Ulipristal Acetate; Uterine fibroids; VEGF


2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Yusuf Efendi ◽  
Errix Kristian Julianto

ABSTRAKDiera perkembangan jaman saat ini, beberapa keluarga dihadapkan dengan permasalahna tentang adanya angggota keluarga yeng mengaami gangguan jiwa, tak jarang keluarga tidak mengetahui bagaimana merawat angota keluarga dengan gangguan jiwa. Self help group pada keluarga dengan gangguan jiwa perlu dilakukan untuk membantu keluarga mengatasi permasalahannya yang diselesaikan bersama dalam kelompok. Manfaat yang didapatkan pada terapi ini adalah terdapatnya peningkatan pengetahuan keluarga tentang Skizofrenia. Peningkatan pengetahuan ini akan berdampak terhadap kemampuan keluarga dalam merawat klien Skizofrenia..Desain penelitian ini menggunakan desain pre eksperimental dengan rancangan one group pre-posttest design. Sampel pada penelitian ini adalah keluarga penderita Skizofrenia di PKU Jiwa Kalitidu yang berjumlah 32. . Data dikumpulkan menggunakan kuesioner kemudian dianalisis dengan menggunakan uji Wolcoxon sign dengan tingkat kemaknaan 0,05. Hasil penelitian menunjukkan bahwa kondisi responden sebelum dan sesudah dilakukan intervensi dengan self help group pada kemampuan merawat dengan  nilai uji wilcoxon sebesar 0,001 yang berarti ada pengaruh dari intervensi self help group dengan merawat keluarga dengan gangguan jiwa. Kata Kunci       : Self Help Group, Kemampuan Merawat, Skizofrenia   ABSTRACT. In the current era of development, some families are faced with problems about family members who suffer from mental disorders, often families do not know how to care for family members with mental disorders. Self help groups for families with mental disorders need to be done to help families overcome the problems that are solved together in a group. The benefit of this therapy is that there is an increase in family knowledge about Schizophrenia. This increase in knowledge will have an impact on the ability of families to care for Schizophrenia clients.The design of this study used a pre-experimental design with one group pre-posttest design. The sample in this study was the families of Schizophrenics in  Kalitidu public helath centre, amounting to 32.. Data were collected using a questionnaire and then analyzed using the Wolcoxon sign test with a significance level of 0.05.The results showed that the condition of the respondents before and after the intervention with self help group on the ability to care for Wilcoxon test value of 0.001, which means there is an influence of self help group intervention by caring for families with mental disorders. Keywords: Self Help Group, Caring Ability, Schizophrenia


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giulia Brigante ◽  
Giorgia Spaggiari ◽  
Barbara Rossi ◽  
Antonio Granata ◽  
Manuela Simoni ◽  
...  

AbstractTrying to manage the dramatic coronavirus disease 2019 (COVID-19) infection spread, many countries imposed national lockdown, radically changing the routinely life of humans worldwide. We hypothesized that both the pandemic per se and the consequent socio-psychological sequelae could constitute stressors for Italian population, potentially affecting the endocrine system. This study was designed to describe the effect of lockdown-related stress on the hypothalamic-pituitary-thyroid (HPT) axis in a cohort of young men. A prospective, observational clinical trial was carried out, including patients attending the male infertility outpatient clinic before and after the national lockdown for COVID-19 pandemic. The study provided a baseline visit performed before and a follow-up visit after the lockdown in 2020. During the follow-up visit, hormonal measurements, lifestyle habits and work management were recorded. Thirty-one male subjects were enrolled (mean age: 31.6 ± 6.0 years). TSH significantly decreased after lockdown (p = 0.015), whereas no significant changes were observed in the testosterone, luteinising hormone, follicle-stimulating hormone, estradiol and prolactin serum levels. No patient showed TSH serum levels above or below reference ranges, neither before nor after lockdown. Interestingly, TSH variation after lockdown was dependent on the working habit change during lockdown (p = 0.042). We described for the first time a TSH reduction after a stressful event in a prospective way, evaluating the HPT axis in the same population, before and after the national lockdown. This result reinforces the possible interconnection between psychological consequences of a stressful event and the endocrine regulation.


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 312
Author(s):  
Marijana Sinđić ◽  
Draženka Mačak ◽  
Nikola Todorović ◽  
Bianka Purda ◽  
Maja Batez

Integrated neuromuscular training (INT) showed benefits for improving fundamental movement skills (FMS). However, the INT health-related fitness (HRF) effects are lacking. The current study aimed to determine the effects of INT implemented during physical education (PE) in a primary school in the Republic of Serbia on HRF in female children. The sample consisted of 72 healthy girls who were divided into the intervention (EG: n = 37; mean ± SD: age = 8.17 ± 0.31) and control (CG: n = 35; age = 8.11 ± 0.31) groups. The EG and CG performed the INT program and traditional PE activities two times per week within the first ~15 min of PE class, respectively. The Fitnessgram battery tests assessed the HRF (body composition, cardiorespiratory endurance, muscular fitness, and flexibility) before and after the program. After eight weeks, the EG significantly reduced all fat measures, while the CG decreased only triceps skinfold but to a smaller extent (F = 5.92, p < 0.02, ŋ2 = 0.09). Both groups significantly improved the performance of almost all muscular fitness tests (curl-ups, trunk lift, push-ups); however, the EG increased the push-ups more than the CG (F = 9.01, p < 0.01, ŋ2 = 0.14). The EG additionally improved the modified pull-ups (F = 14.09, p < 0.01, ŋ2 = 0.19) and flexed arm hang (F = 28.82, p < 0.01, ŋ2 = 0.33) tests. The flexibility and cardiorespiratory endurance of both groups did not significantly change after eight weeks. This approach of exercise showed positive acceptance and relatively good results after only eight weeks.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Meysam Yousefi ◽  
Sara Rajaie ◽  
Vahideh Keyvani ◽  
Somayeh Bolandi ◽  
Malihe Hasanzadeh ◽  
...  

AbstractCirculating tumor cells (CTCs) have recently been considered as new prognostic and diagnostic markers for various human cancers; however, their significance in epithelial ovarian cancer (EOC) remains to be elucidated. In this study, using quantitative real-time PCR, we evaluated the expression of EPCAM, MUC1, CEA, HE4 and CA125 mRNAs, as putative markers of CTCs, in the blood of 51 EOC patients before and/or after adjuvant chemotherapy. Our results demonstrated that, before chemotherapy, the expression of EPCAM, MUC1, CEA and HE4 mRNAs were correlated to each other. CEA expression was correlated with tumor stage (r = 0.594, p = 0.000) before chemotherapy, whereas its expression after chemotherapy was correlated with serum levels of CA125 antigen (r = 0.658, p = 0.000). HE4 mRNA showed the highest sensitivity both before and after chemotherapy (82.98% and 85.19%, respectively) and the persistence of this marker after chemotherapy was associated with advanced disease stage. The expression of CA125 mRNA had negative correlation with the other markers and with tumor stage and therapy response (evaluated by the measurement of serum CA125 antigen). Collectively, our results indicated a better clinical significance of tumor-specific markers (CEA and HE4 mRNAs) compared to epithelial-specific markers (EPCAM and MUC1 mRNAs).


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1323.2-1324
Author(s):  
K. Sato ◽  
S. Mamada ◽  
C. Hayashi ◽  
T. Nagashima ◽  
S. Minota

Background:Biologic disease modifying anti-rheumatic drugs (DMARDs) have demonstrated that proinflammatory cytokines such as interleukin (IL-) 6 and tumor necrosis factor (TNF) play important roles in the pathogenesis of rheumatoid arthritis (RA). Other cytokines, such as type I interferons (IFNs), are also implicated in its pathogenesis (ref 1). However, the complete picture of the cytokine network involved in RA remains to be elucidated.Objectives:By quantifying sets of cytokines in the serum of RA patients before and after treatment with various biologic DMARDs, we sought to determine the effects of drugs on (A) type I IFNs, (B) soluble IL-6 receptors, and (C) other cytokines.Methods:52 patients with RA were treated with various biologic DMARDs (tocilizumab (TOC): 16, abatacept (ABT): 15, and TNF inhibitors (TNFi): 21). Serum samples were obtained (1) before, (2) approximately 4 weeks after (3) and approximately 12 weeks after the initiation of treatment. A suspension bead-array system was used for analysis; Bio-Plex Human Cytokine 17-plex Assay kits and Express Custom Panels (Bio-Rad), including IFN-β, IFN-α2, soluble IL-6 receptor α (sIL6Rα) and gp130 were used.Results:(1) As expected, the disease activity score 28-joiny count (DAS28) using the erythrocyte sedimentation rate (ESR) significantly decreased in all three groups (TOC, ABT and TNFi) by 12 weeks.(2) IFN-α2 was barely detected in the serum samples. IFN-β seemed to increase slightly in the ABT group, but the increase was not statistically significant.(3) The levels of sIL6Rα did not change substantially. Those of gp130 decreased slightly but significantly in the TOC group by 12 weeks.(4) The levels of IL-6 decreased significantly in the ABT group by 12 weeks. Those in the TNFi group decreased significantly at 4 weeks but not 12 weeks (Fig. 1A).(5) The levels of IL-7 decreased significantly only in the TOC group (Fig. 1B).Conclusion:(1) The biologic DMARDs tested in this study did not significantly affect the serum levels of type I IFNs in this study.(2) The decrease in gp130 in the TOC group may imply that gp130 is induced by IL-6, although whether this level of decrease has physiological significance is open to question.(3) Serum IL-6 was significantly decreased in the TNFi group at 4 weeks but not 12 weeks. TNF has been reported to induce IL-6 (ref 2), but negative feedback loop(s) may be present. Such a feedback system might make the discontinuation of TNFi difficult, even if patients are in remission.(4) IL-7 may be a target of IL-6. A higher level of IL-7 has been reported to be present in the joints of RA patients compared with osteoarthrosis and it is a cytokine implicated in the differentiation of osteoclasts (ref 3). This may partly explain the effect of TOC on preventing bone erosion in RA.References:[1]Ann Rheum Dis. 2007; 66: 1008–14[2]Rheumatology 2007; 46: 920-6[3]Rheumatology 2008; 47: 753-9Acknowledgments:We thank all the members of the Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University. We are also grateful to the patients involved in this study.Disclosure of Interests:Kojiro Sato Grant/research support from: Abbie, Pfizer, Chugai, Astellas, Mitsubishi-Tanabe, Ono, Takeda, Sachiko Mamada: None declared, Chiyomi Hayashi: None declared, Takao Nagashima: None declared, Seiji Minota: None declared


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