scholarly journals Results of the non-interventional observational program: Influence of Novel COroNavirus on the condition of patients with liver and gastrointestinal Tract diseases and the effect of Ursodeoxycholic acid drugs and Rebamipide on the course of COVID-19 infection (CONTUR)

2022 ◽  
pp. 106-119
Author(s):  
I. N. Tikhonov ◽  
V. T. Ivashkin ◽  
M. S. Zharkova ◽  
M. V. Maevskaya ◽  
S. N. Koloteeva ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Liver Injury ◽  
Systemic Inflammation ◽  
Gastrointestinal Diseases ◽  
Albumin Level ◽  
Russian Society ◽  
Inflammation Markers ◽  
Obesity And Diabetes ◽  
Observational Program

Intriduction. The course and outcome of COVID-19 infection in patients with liver and gastrointestinal tract diseases remain poorly understood. The article presents a multicenter non-interventional observational program conducted by the Russian Society for the Study of the Liver.Aim. To study the relationship between COVID-19 and injuries of gastrointestinal tract and liver, to assess the effect of therapy with UDCA and Rebamipide on the course and outcome of COVID-19 infection. Materials and methods. 460 patients were enrolled in the study, of which 46% were patients with gastrointestinal and liver diseases. Some patients received Rebamipide and UDCA at a dose of 15 mg/kg body weight, followed by assessment of the clinical and laboratory parameters.Results. In the study group, more severe lung injury and the course of infection were observed. The investigators detected three phenotypes of gastrointestinal tract injury: dyspeptic, diarrheal and painful. The latter was more common in patients with gastrointestinal diseases. Liver injury occurred in 87% of patients with COVID-19 (of which 44% had a history of liver disease). Increased ALT and AST were more often recorded in patients with obesity and diabetes mellitus and correlated with the severity of the infection. An inverse relationship was found between the albumin level and death and transfer to mechanical ventilation. At least 5-day Rebamipide therapy leads to reduction of diarrhea and abdominal pain (p < 0.00001 and p = 0.002), decrease in the levels of systemic inflammatory markers (CRP and ferritin, p<0.00001). The use of UDCA leads to a decrease of the systemic inflammation markers: ferritin and is associated with a significant decrease/normalization of ALT levels (p < 0.00001).Conclusions. In patients with diseases of the gastrointestinal tract and liver, COVID-19 develops in a more severe form and symptoms of gastrointestinal tract injury may prevail in the clinical picture. The severity of liver injury correlates with the severity of COVID-19 and a poor prognosis. Rebamipide reduces diarrhea and abdominal pain. UDCA prevents or reduces liver injury in COVID-19 infection. Both drugs reduce the level of systemic inflammation markers.

scholarly journals Loss of ARID1A Expression is Associated with Systemic Inflammation Markers and has Important Prognostic Significance in Gastric Cancer.

2021 ◽  
Author(s):  
Xuan Wang ◽  
Keying Che ◽  
Tao Shi ◽  
Qin Liu ◽  
Xinyun Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Protein Expression ◽  
Systemic Inflammation ◽  
Prognostic Significance ◽  
Suppressor Gene ◽  
Albumin Level ◽  
Inflammation Markers ◽  
Ffpe Tumor ◽  
Cox Analysis ◽  
Low Expression

Abstract Background: The tumor suppressor gene AT-rich interactive domain 1A (ARID1A) and systemic inflammatory response (SIR) have been reported to be related to the sensitivity of immunotherapy. This study intended to explore the relationship between ARID1A expression and SIR, and to further elucidate the prognostic value of ARID1A expression in gastric cancer (GC).Methods: The mRNA and protein expression of ARID1A were detected in 272 formalin-fixed paraffin-embedded (FFPE) tumor tissues. The data of nine systemic inflammation markers were collected one week before gastrectomy. Univariate and multivariate COX analysis were used to screen out independent predictors of GC.Results: Negative expression of ARID1A protein was related to GC with microsatellite instability-high (MSI-H) (p=0.033), positive programmed cell death-ligand 1 (PD-L1) (p=0.005) and lower albumin level (p=0.0064). Low expression of ARID1A mRNA was common in GC with abnormal E-cadherin (p=0.020) and higher platelet/lymphocyte ratio (PLR) (p=0.0391). Multivariate COX analysis showed that the expression of ARID1A protein (p=0.023), age (p=0.004), T stage (p=0.009) and N stage (p=0.009) were independent predictors of GC. The nomogram established by independent predictors can accurately evaluate the survival risk of patients with GC.Conclusions: The loss of ARID1A protein expression was associated with MSI-H subtype and high expression of PD-L1 in GC. Negative ARID1A protein and low expression of mRNA were associated with aberrant systemic inflammatory markers. Expression of ARID1A protein had important prognostic significance in GC.

ANTICYTOKINE ACTIVITY OF THE PROTOZOA BLASTOCYSTIS SPP

2020 ◽  
pp. 44-48
Author(s):  
Bugero N.V. ◽  
Ilyina N.A. ◽  
Aleksandrova S.M.
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Diseases ◽  
Control Group ◽  
Ulcer Disease ◽  
Cytokine Balance ◽  
High Prevalence ◽  
Blastocystis Spp ◽  
High Level ◽  
Eukaryotic Organisms ◽  
High Degree

In addition to the classical pathogens, which are well understood and well identified, new pathogens with the potential to spread epidemiologically are being identified. Some of these little-known organisms are the simplest Blastocystis spp. blastocystostosis. The clinical significance of Blastocystis spp. and its pathogenicity are still under discussion. This parasite belongs to a group of single-celled eukaryotic organisms living in the colon of the human intestine. Blastocystis spp. is known to be found both in people with reduced immune status and in individuals without any clinical manifestation. It has been established that a sufficiently high degree of invasiveness is observed in persons with gastrointestinal tract diseases, dermatosis, allergic reactions, in patients with carriers of the human immunodeficiency virus, etc. Possessing persistence factors, protozoa blastocysts contribute to the inactivation of host defensive mechanisms, providing a stable anthogonistic effect. In recent years, many works have been devoted to the characteristics of the persistent properties of Blastocystis spr., however, individual properties of blastocysts, in particular, anticytokine activity (ACA), have not yet been studied. In this regard, the work studied the anticytokine activity of microorganisms isolated from healthy subjects and patients with gastrointestinal tract diseases. A high prevalence of the studied characteristic in the subjects was shown. The expression of anticytokine activity in the obtained isolates of blastocysts was the highest in the group of persons with gastric ulcer disease, which decreased in the order of duodenal ulcer, chronic cholecystitis, chronic gastritis, etc. The data obtained in this work on the high level of ACA expression in blastocyst isolates obtained from individuals with gastrointestinal diseases as compared with the control group enables to conclude that their exometabolites may influence the local cytokine balance [1], which supports the inflammatory process.

scholarly journals COVID-19 and gastrointestinal symptoms in Mexico, a systematic review: does location matter?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Antonio Pizuorno ◽  
Nora A. Fierro ◽  
Edgar D. Copado-Villagrana ◽  
María E. Herrera-Solís ◽  
Gholamreza Oskrochi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Mortality Rate ◽  
Clinical Symptoms ◽  
Descriptive Analysis ◽  
Gastrointestinal Symptoms ◽  
Northwest Mexico ◽  
Obesity And Diabetes ◽  
West Mexico ◽  
Southeast Mexico

Abstract Background Covid-19 in Mexico is on the rise in different parts of the country. We aimed to study the symptoms and comorbidities that associate with this pandemic in 3 different regions of Mexico. Methods We analyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitals of Mexico (n = 1607) including Northwest Mexico (Sinaloa state), Southeast Mexico (Veracruz state) and West Mexico (Jalisco state) between March 1 and July 30, 2020. Mexico consists of a total population that exceeds 128 million. Demographics, comorbidities and clinical symptoms were collected. Statistical descriptive analysis and correlation analyses of symptoms, comorbidities and mortality were performed. Results A total of 1607 hospitalized patients positive for COVID-19 across all 3 regions of Mexico were included. The average age was 54.6 years and 60.4% were male. A mortality rate of 33.1% was observed. The most common comorbidities were hypertension (43.2%), obesity (30.3%) and diabetes (31.4%). Hypertension was more frequent in West (45%), followed by Northwest (37%) and Southeast Mexico (29%). Obesity was around 30% in Northwest and West whereas an 18% was reported in Southeast. Diabetes was most common in West (34%) followed by Northwest (22%) and Southeast (13%). This might be related to the highest mortality rate in Northwest (31%) and West (37%) when compared to Southeast. Most common symptoms in our overall cohort were fever (80.8%), cough (79.8%), headache (66%), dyspnea (71.1%), myalgia (53.8%), joints pain (50.8%) and odynophagia (34.8%). Diarrhea was the main gastrointestinal (GI) symptom (21.3%), followed by abdominal pain (18%), and nausea/ vomiting (4.5%). Diarrhea and abdominal pain were more common in West (23.1 and 21%), followed by Southeast (17.8, and 9.8%) and Northwest (11.4 and 3.1%). Conclusion Our study showed a high mortality rate likely related to high frequencies of comorbidities (hypertension, obesity and diabetes). Mortality was different across regions. These discrepancies might be related to the differences in the frequencies of comorbidities, and partially attributed to differences in socio-economic conditions and quality of care. Thus, our findings stress the need for improved strategies to get better outcomes in our population.

scholarly journals An unusual case of chronic abdominal pain: an association between Celiac disease and Crohn’s disease

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Leen Jamel Doya ◽  
Maria Naamah ◽  
Noura Karkamaz ◽  
Narmin Hajo ◽  
Fareeda Wasfy Bijow ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Celiac Disease ◽  
Crohn's Disease ◽  
Histological Study ◽  
Gastrointestinal Diseases ◽  
Bowel Diseases ◽  
Oral Corticosteroids ◽  
History Of ◽  
High Caloric Diet

ABSTRACT Inflammatory bowel diseases (IBD) and Celiac disease (CeD) are immune-mediated gastrointestinal diseases with incompletely understood etiology. Both diseases show a multifactorial origin with a complex interplay between genetic, environmental factors, and some components of the commensal microbiota. The coexistence of celiac disease with Crohn’s disease is rarely reported in the literature. Here, we report a case of a 13-year-old Syrian male who presented with a history of abdominal pain, anorexia and pallor. CeD and Crohn’s disease was documented on gastrointestinal endoscopy and histological study. The patient was treated with a gluten-free, low fiber, high caloric diet, and a course of oral corticosteroids with an improvement in growth rate and abdominal pain.

scholarly journals Eosinophilic Gastrointestinal Diseases: Review and Update

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Mahreema Jawairia ◽  
Ghulamullah Shahzad ◽  
Paul Mustacchia
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Features ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Diseases ◽  
Gastrointestinal Disorders ◽  
Diverse Group ◽  
Intestinal Diseases ◽  
Gastrointestinal Inflammation ◽  
Eosinophilic Gastrointestinal Disorders

Eosinophilic gastrointestinal disorders (EGIDs) are a progressively more frequent diverse group of intestinal diseases. The intention of this paper is to present the newest developments in the care of patients with EGIDs and to sum up a rising literature defining the clinical features and mechanistic elements of eosinophils and their intricate associations with the gastrointestinal tract. Clinicians ought to stay sensitive to EGIDs as a diagnostic likelihood for patients with general gastrointestinal symptoms. Further research is warranted to establish various methods leading to dysfunction coupled with eosinophilic gastrointestinal inflammation.

Histopathological study of gastrointestinal endoscopic biopsies in pediatric patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Faten A Ghazal ◽  
Wesam M Osman ◽  
Sarah A Hakim ◽  
Nada N Tamem
Keyword(s):  
Inflammatory Bowel Disease ◽  
Helicobacter Pylori ◽  
Celiac Disease ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Diseases ◽  
University Hospital ◽  
Gastrointestinal Lesions ◽  
Different Types ◽  
Inflammatory Bowel ◽  
Gastrointestinal Inflammation

Abstract Background Non neoplastic GI lesions in pediatrics are variable and differ in types and prevalence among each pediatric age group. Helicobacter pylori is an important pathogen that can cause gastritis and peptic ulcers in adults as well as in children. Celiac disease is a gluten-dependent autoimmune disorder which affects individuals having genetic susceptibility. Eosinophilic gastrointestinal diseases are disorders that primarily affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia. Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, mainly affecting the gastrointestinal tract with extraintestinal manifestations and associated immune disorders. It seems that it is one of the most common gastrointestinal diseases affecting children in the developed countries. Aim of the work To study different types of paediatric non neoplastic gastrointestinal lesions from gastrointestinal endoscopic biopsies received at the Pathology Department in Ain Shams University hospital during a period of 2 years (2017-2018), and to correlate them with the clinicopathological presentations and endoscopic findings. Patients and Methods A cross sectional study was conducted on all pediatric gastrointestinal biopsies received at Pathology Department in Ain Shams University Hospital during the period of two years (2017- 2018). Only cases with information for all the covariates (n = 580) were selected and the results were statistically analyzed. Results Total 580 pediatric cases were enrolled according to inclusion criteria. Nonspecific gastrointestinal inflammation represented (47.1%), Helicobacter pylori associated gastrointestinal inflammation represented (43.5%), Eosinophilic gastrointestinal disease represented (3.8%), Inflammatory bowel disease (IBD) represented (3.7%), Celiac disease represented (1.9%). Conclusion This is the first study conducted in Ain Shams University Hospitals to assess the different types of pediatric non neoplastic gastrointestinal lesions received with clinicopathological and endoscopic correlation. The most common pediatric non neoplastic GI lesion is Helicobacter pylori infection. The diagnosis of pediatric non neoplastic GI disorder necessitates interdepartmental teamwork between GI pediatricians and pathologists.

scholarly journals Selenium and functional constipation in children

2016 ◽  
Vol 56 (2) ◽  
pp. 111
Author(s):  
Marlina Tanjung ◽  
Supriatmo Supriatmo ◽  
Melda Deliana ◽  
Ade Rachmat Yudiyanto ◽  
Atan Baas Sinuhaji
Keyword(s):  
Abdominal Pain ◽  
Placebo Group ◽  
Side Effects ◽  
Functional Constipation ◽  
Causative Factor ◽  
Gastrointestinal Diseases ◽  
Average Frequency ◽  
Stool Consistency ◽  
Significant Difference ◽  
Selenium Treatment

Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved by intervention with antioxidants. Selenium is an essential trace element and acts as a cofactor of gluthathione peroxidase, which protects membranes from oxidative damage.Objective To determine the effect of selenium on functional constipation in children.Methods We conducted a single-blind, randomized clinical trial from November to December 2012 at the Al-Kautsar Al-Akbar Islamic Boarding School in Medan, North Sumatra. Subjects were children aged 12 to 17 years with functional constipation, diagnosed according to the ROME III criteria. Patients were randomly allocated into either the selenium group (n=57) or the placebo group (n=57). Subjects were clinically evaluated for frequency of defecation, stool consistency, severity of abdominal pain, and side effects during the 2 weeks of treatment (days 7 and 14) and 1 week after treatment had stopped (day 21).Results A total of 114 subjects were eligible to participate. The average frequency of defecation observed on day 14 was 1.5 (SD 0.75) days per defecation (P=0.0001) in the selenium group and 2.4 (0.84) days per defecation in the placebo group, a statistically significant difference (P=0.0001). There was no significant difference in frequency of defecation on the 7th day of treatment. But after day 7, there were significant differences between the groups at days 14 and 21. Normal stool consistency was found in 45 subjects (78.9%) on day 7 and in 57 subjects (100%) on day 14 of treatment in the selenium group, significantly more than those in the placebo group (P<0.05). In placebo group, normal stool consistency was found in 27 subject (47.4%) with (P=0.001) on day 7 and in 38 subject (66.7%) on day 14 of treatment (P=0.0001). On day 14, the selenium group had significantly more subjects without pain than the placebo group [47 subjects (82.5%) vs. 10 subjects (17.5%), respectively (P=0.0001)]. Severity of abdominal pain after 14th day of treatment is without pain 47 subject (82.5%) and mild pain 10 subject (17.5%) (P=0.0001). We found no side effects of selenium treatment in our subjects.Conclusion Selenium is effective in improving clinically functional constipation, in terms of increased frequency of defecation, normalization of stool consistency, and less severe abdominal pain.

scholarly journals Prognostic role of lymphocyte-to-monocyte ratio in pancreatic neuroendocrine neoplasms

2020 ◽  
Vol 9 (4) ◽  
pp. 289-298 ◽  
Author(s):  
Wentao Zhou ◽  
Tiantao Kuang ◽  
Xu Han ◽  
Wenqi Chen ◽  
Xuefeng Xu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Systemic Inflammation ◽  
Lymphocyte Count ◽  
Neuroendocrine Neoplasms ◽  
Inflammation Markers ◽  
Clinical Value ◽  
Term Survival ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio

Objectives Systemic inflammation markers have been demonstrated to be associated with prognosis in various tumors. In this study, we aimed to assess the value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index and the counts of lymphocyte, monocyte and neutrophil in predicting prognosis among patients with resected pancreatic neuroendocrine neoplasms (pNENs). Methods A total of 174 patients were included in the study. Univariate and multivariate analyses were performed to evaluate the predictive roles of inflammation markers for relapse-free survival (RFS) and overall survival (OS) in pNEN patients. Results The optimal cut-off values of NLR, LMR and lymphocyte count were 1.9, 5.0 and 1.4 × 109/L, respectively, determined by the X-tile software. RFS was found to be significantly longer in patients with NLR ≤1.9 (P = 0.041), LMR >5.0 (P < 0.001) and lymphocyte count >1.4 × 109/L (P = 0.002) in comparison to those with NLR >1.9, LMR ≤5.0 and lymphocyte count ≤1.4 × 109/L, respectively. Multivariate analysis revealed that LMR (hazard ratio 0.30, 95% CI 0.11–0.85, P = 0.023) was an independent predictor for RFS, but not NLR or lymphocyte count. For long-term survival analysis, patients with NLR ≤1.9 (P = 0.016) were found to be associated with favorable OS, but NLR was not an independent factor validated by multivariate analysis. Conclusions Preoperative LMR is an independent systemic inflammation marker to predict relapses in pNEN patients who underwent curative resections, whose clinical value needs to be verified in further large sample-based prospective studies.

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