scholarly journals Contemporary Perspective of Comorbidity in Celiac Syndrome: Connection Between Morphological Changes in Duodenum Mucosa and Biliary Dysfunction

Doctor Ru ◽  
2020 ◽  
Vol 19 (7) ◽  
pp. 52-58
Author(s):  
L.S. Oreshko ◽  
◽  
Z.M. Tshovrebova ◽  
I.G. Bakulin ◽  
M.I. Safoev ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Clinical Symptoms ◽  
Morphological Changes ◽  
Duodenal Papilla ◽  
Study Objective ◽  
Clinical Criteria ◽  
Major Duodenal Papilla ◽  
Study Results ◽  
Biliary Pathology ◽  
Bladder Abnormalities

Study Objective: to identify the key clinical and diagnostic markers of comorbidity presenting the risk of biliary pathology in celiac syndrome patients. Study Design: screening observation. Materials and Methods. The study included 133 patients with confirmed celiac syndrome and biliary dysfunction. Subjective clinical symptoms were analysed on the basis of reviews and questionnaires, while objective clinical symptoms were assessed following physical examination. When clinical symptoms were characterised, presence of subjective clinical criteria of functional disorders of gall bladder (GB) and Oddi’s sphincter were assessed. Study Results. Specific markers of biliary dysfunction in patients with celiac syndrome were identified. Following IV Rome criteria (2016), it was determined that subjective symptoms in some patients were signs of biliary indigestion syndrome: aches in right hypochondrium (45.1%), bitter taste in mouth (36.1%), nausea (36.1%). Subject had ultrasound signs on GB pathologies: bends in GB body (31.6%), GB neck (35.3%) and both (33.1%). Celiac syndrome patients had significant correlation between duodenitis severity and morphological characteristic of the major duodenal papilla. Major duodenal papilla inflammation is associated with lymphocytoplasmocytic (44.4%) and leucocytal infiltration (22.6%), dystrophic charges in glandular epithelium, gland hyperplasia (62.9%) (χ2(3) = 48.53; р < 0.001; С = 0.75), demonstrating impact on bile passage. A higher risk of biliary sludge in gall bladder in patients with celiac syndrome is due to GB abnormalities and signs of inflammation and atrophy in major duodenal papilla mucosa and its relation to major duodenal papilla. Conclusion. Our analysis demonstrated that comorbidity in patients with celiac syndrome is associated with biliary dysfunction syndrome. Biliary dysfunction markers are congenital abnormalities in GB structure, that are a result of GB deformation and dyscholia; marked chronic inflammation of major duodenal papilla and duodenum mucosa; stage 3 atrophic changes in duodenum mucosa, according M.N. Marsh. Keywords: celiac syndrome, biliary dysfunction, gall bladder abnormalities, comorbid pathology.

WAYS TO IMPROVE DIAGNOSIS OF PATIENTS WITH POSTCHOLECYSTECTOMY SYNDROME

2021 ◽  
pp. 31-35
Author(s):  
O. V. Gorbulitch ◽  
S. H. Yefimenko ◽  
S. A. Pavlychenko ◽  
O. A. Lazutkina ◽  
K. A. Aleksanian
Keyword(s):  
Morphological Changes ◽  
Gallstone Disease ◽  
Diagnostic Algorithm ◽  
Sphincter Of Oddi ◽  
Duodenal Papilla ◽  
Biliary Surgery ◽  
Postcholecystectomy Syndrome ◽  
Functional Changes ◽  
Post Surgery ◽  
Major Duodenal Papilla

Postcholecystectomy syndrome is a symptom complex that occurs or worsens after cholecystectomy and is a functional and / or organic disorder. It often complicates the post−surgery course of gallstone disease. The presence of symptoms of the disease indicates a deterioration in the quality of life of patients, but the diagnostic examination is not always possible to detect morphological or functional changes. Thus, at present the syndrome is an urgent problem of gastroenterology and biliary surgery. Diagnostic issues with a differentiated approach to the functional or organic nature of postcholecystectomy syndrome are important for the choice of further treatment tactics. In order to improve the diagnostic algorithm taking into account the changes in the area of the major duodenal papilla, a study was conducted in 137 patients. To determine the functional disorders of the sphincter of Oddi there was used the method of ultrasound investigation of hepatobiliary area and Vater's papilla with choleretic loading on Boyden as well as the Grigoriev's methods in the absence of organic obstruction of the terminal choledochus at previous stages of examination. Morphological changes in the major duodenal papilla area were evaluated using the technique of parietal ph−impedancemetry, which was performed on the background of benign mechanical jaundice in the patients after cholecystectomy during endoscopic retrograde cholangiopancreatography prior to endoscopic papillosphincterotomy. The obtained results help to perform a differentiated approach to the patients who underwent cholecystectomy, taking into account morphofunctional changes in the area of the major duodenal papilla and allow the implementation of the selected methods to the research algorithm of patients with postcholecystectomy syndrome. Key words: postcholecystectomy syndrome, functional and organic changes of major duodenal papilla, patency of the terminal choledochus, treatment tactics.

Efficacy of intrauterine administration of autologous peripheral blood mononuclear cells prior to embryo transfer in patients with recurrent implantation failures in assisted reproductive technology programmes

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 28-33
Author(s):  
T S Amyan ◽  
S G Perminova ◽  
L V Krechetova ◽  
V V Vtorushina
Keyword(s):  
Embryo Transfer ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Peripheral Blood Mononuclear ◽  
Study Objective ◽  
Study Results ◽  
Blood Mononuclear Cells ◽  
History Of ◽  
Group 2

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.

scholarly journals Growth, Tolerance, and Compliance of Infants Fed an Extensively Hydrolyzed Infant Formula with Added 2′-FL Fucosyllactose (2′-FL) Human Milk Oligosaccharide

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 186
Author(s):  
Carlett Ramirez-Farias ◽  
Geraldine E. Baggs ◽  
Barbara J. Marriage
Keyword(s):  
Primary Outcome ◽  
Clinical Symptoms ◽  
Food Protein ◽  
Feeding Intolerance ◽  
Feeding Trial ◽  
Study Results ◽  
Z Scores ◽  
Hydrolyzed Formula ◽  
Intended Use ◽  
Weight For Age

Background: The purpose of this study was to evaluate the growth, tolerance and compliance effects of an extensively hydrolyzed formula with added 2′-FL in an intended use population of infants. Methods: A non-randomized, single-group, multicenter study was conducted. Infants (0–60 days of age) with suspected food protein allergy, persistent feeding intolerance, or presenting conditions where an extensively hydrolyzed formula (eHF) was deemed appropriate were enrolled in a 2-month feeding trial. The primary outcome was maintenance of weight for age z-score during the study. Weight, length, head circumference, formula intake, tolerance measures, clinical symptoms and questionnaires were collected. Forty-eight infants were enrolled and 36 completed the study. Results: Weight for age z-scores of infants showed a statistically significant improvement from study day 1 to study day 60 (0.32 ± 0.11, p = 0.0078). Conclusions: Overall, the results of the study demonstrate that the study formula was well tolerated, safe and supported growth in the intended population.

Effects of a physical self-care support program for patients with fibromyalgia: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Suélem B. de Lorena ◽  
Angela L.B.P. Duarte ◽  
Markus Bredemeier ◽  
Vanessa M. Fernandes ◽  
Eduardo A.S. Pimentel ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Fibromyalgia Impact Questionnaire ◽  
Self Care ◽  
Support Program ◽  
Control Group ◽  
Study Objective ◽  
Study Results ◽  
Significant Difference ◽  
Stretching Exercises ◽  
Care Support

BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P= 0.001) than the CONTROL group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.

scholarly journals Immunotherapy in Allergic Rhinitis: It’s Effect on the Immune System and Clinical Symptoms

2018 ◽  
Vol 6 (7) ◽  
pp. 1248-1252 ◽  
Author(s):  
Samaneh Kouzegaran ◽  
Mohammad Ali Zamani ◽  
Reza Faridhosseini ◽  
Houshang Rafatpanah ◽  
Abdolrahim Rezaee ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Subcutaneous Immunotherapy ◽  
Positive Skin Prick Test ◽  
Tgf Beta ◽  
Positive Skin ◽  
Ifn Gamma ◽  
Clinical Criteria ◽  
Prick Test

BACKGROUND: Allergic rhinitis is one of the most common allergic diseases and characterised by sneezing, rhinorrhea, nasal congestion and nasopharyngeal itching. Subcutaneous immunotherapy (SCIT) for specific allergens is an effective treatment and induces the inhibitory effect of T regulatory lymphocytes and decreases clinical symptoms in allergic rhinitis.AIM: In this study effect of subcutaneous immunotherapy with specific allergens on clinical symptoms and T regulatory and T Helper cells cytokines, in patients with allergic rhinitis are evaluated.METHODS: In this study, 30 patients with moderate to severe allergic rhinitis according to clinical criteria and positive skin prick test for aeroallergens were selected and treated by SCIT. Clinical symptoms and T cells cytokines IL4, IL17, IFN gamma, TGF beta, GITR, FOXP3 and IL-10 (by RT-PCR) were evaluated before and one year after initiation of treatment.RESULTS: Thirty (30) patients with allergic rhinitis at age range 15-45 years old were treated by SCIT, and 23 (14 female, 9 male) patients continued the study, and 7 patients did not continue treatment. After immunotherapy, clinical symptoms decreased significantly. The specific cytokines TGF beta and IL10 levels increased and changes were statistically significant. (Respectively P = 0.013 and P = 0.05) The IL17 level was also increased, but not statistically significant. (P = 0.8) IFN gamma, IL4, GITR, FOXP3, all decreased, but the changes were not statistically significant (P > 0.05).CONCLUSION: Subcutaneous Immunotherapy for specific allergens decreases clinical symptoms in patients with allergic rhinitis and induces tolerance in T lymphocytes, especially by increasing T regulatory cells cytokines, TGF beta and IL10.

scholarly journals Abstract No. 228 EE: Duodenal stenting over the major duodenal papilla using a transhepatic approach

2010 ◽  
Vol 21 (2) ◽  
pp. S87-S88
Author(s):  
L.N. Boucher ◽  
C. Dey ◽  
R. Gadahadh ◽  
T. Cabrera ◽  
N. Khattar ◽  
...  
Keyword(s):  
Duodenal Papilla ◽  
Major Duodenal Papilla

scholarly journals Apple Pomace Consumption Favorably Alters Hepatic Lipid Metabolism in Young Female Sprague-Dawley Rats Fed a Western Diet

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1882 ◽  
Author(s):  
Roy Skinner ◽  
Derek Warren ◽  
Soofia Lateef ◽  
Vagner Benedito ◽  
Janet Tou
Keyword(s):  
Lipid Metabolism ◽  
Apple Pomace ◽  
Western Diet ◽  
Sprague Dawley ◽  
Hepatic Lipid Metabolism ◽  
Study Objective ◽  
Hepatic Lipid ◽  
Sprague Dawley Rats ◽  
Study Results ◽  
Isocaloric Diets

Apple pomace, which is a waste byproduct of processing, is rich in several nutrients, particularly dietary fiber, indicating potential benefits for diseases that are attributed to poor diets, such as non-alcoholic fatty liver disease (NAFLD). NAFLD affects over 25% of United States population and is increasing in children. Increasing fruit consumption can influence NAFLD. The study objective was to replace calories in standard or Western diets with apple pomace to determine the effects on genes regulating hepatic lipid metabolism and on risk of NAFLD. Female Sprague-Dawley rats were randomly assigned (n = 8 rats/group) to isocaloric diets of AIN-93G and AIN-93G/10% w/w apple pomace (AIN/AP) or isocaloric diets of Western (45% fat, 33% sucrose) and Western/10% w/w apple pomace (Western/AP) diets for eight weeks. There were no significant effects on hepatic lipid metabolism in rats fed AIN/AP. Western/AP diet containing fiber-rich apple pomace attenuated fat vacuole infiltration, elevated monounsaturated fatty acid content, and triglyceride storage in the liver due to higher circulating bile and upregulated hepatic DGAT2 gene expression induced by feeding a Western diet. The study results showed the replacement of calories in Western diet with apple pomace attenuated NAFLD risk. Therefore, apple pomace has the potential to be developed into a sustainable functional food for human consumption.

scholarly journals Histomorphometry of penile smooth muscle fiber in severe erectile dysfunction

2005 ◽  
Vol 123 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Joaquim de Almeida Claro ◽  
José Aboim ◽  
Enrico Andrade ◽  
Gustavo Alarcon ◽  
Valdemar Ortiz ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Erectile Dysfunction ◽  
Muscle Fiber ◽  
Arterial Flow ◽  
Control Group ◽  
Study Objective ◽  
Severe Erectile Dysfunction ◽  
Smooth Muscle Fiber ◽  
Study Results ◽  
Age Range

CONTEXT AND OBJECTIVE: Smooth muscle fiber has fundamental importance in erection. Alterations in its function or quantity may be associated with erectile dysfunction. The study objective was to assess the proportion of penile smooth muscle fiber in patients with severe erectile dysfunction. DESIGN AND SETTING: Clinical study, in the Sexual Dysfunction Group, Universidade Federal de São Paulo (Unifesp), and in the Anatomy Laboratory, Universidade Estadual do Rio de Janeiro (UERJ). METHODS: Twenty patients with severe erectile dysfunction were selected to form two groups of ten patients: one with normal arterial flow (age range: 44 to 78 years) and the other with altered arterial flow (age range: 38 to 67 years). These groups were compared with a group formed by ten cadavers aged 18 to 25 years that were presumed to have been potent. Quantification of the smooth muscle fibers was done by means of an immunohistochemical study. RESULTS: The proportion of smooth muscle fiber found was 41.15% for the control group. The patients with erectile dysfunction and normal arterial flow presented 27.24% and those with altered arterial flow presented 25.74%; 19 patients presented at least one chronic disease or risk factor for erectile dysfunction, with prominence for diabetes mellitus, systemic arterial hypertension and smoking. CONCLUSION: Among patients with severe erectile dysfunction, the arterial flow on its own does not present interference in the proportion of smooth muscle fiber. The diminution of the proportion of smooth muscle fiber may result from chronic diseases and vascular risk factors.

scholarly journals Hepatitis C Infections with Cryoglobulinemia: Features and Symptoms

Doctor Ru ◽  
2021 ◽  
Vol 20 (4) ◽  
pp. 26-32
Author(s):  
S.P. Lukashik ◽  
◽  
I.A. Karpov ◽  
O.V. Krasko ◽  
◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Hepatic Cirrhosis ◽  
Hepatitis C Infection ◽  
Genotype 3 ◽  
Virus Genotype ◽  
Study Objective ◽  
Blood Assay ◽  
Study Results

Study Objective: To study the incidence of cryoglobulinemia (CGE) in chronic hepatitis C infection (hepatitis C infection) and to analyse the characteristics of chronic hepatitis C infection with CGE in Belarusian patients. Study Design: Open non-randomised observational study. Materials and Methods. The study included 773 patients with chronic hepatitis C infection (in Minsk). The patients had their anti-hepatitis C antibodies, chronic hepatitis C RNA and virus genotype measured; blood cryoglobulins identified; demographic and epidemiological data collected; and complete blood assay and biochemical blood assay performed. Study Results. 282 (36.5%) subjects had positive blood cryoglobulins test, while 491 (63.5%) patients had negative result. CGE and non-CGE groups had comparable sex, BMI and infection duration parameters. CGE patients had statistically more surgeries (р < 0.001), clinical syndromes (including asthenovegetative, arthralgic and dyspeptic syndromes, р < 0.001 in all cases), hepatic fibrosis F3 (р < 0.05), hepatic cirrhosis (р < 0.001), and extrahepatic diseases (EHDs); more often they had genotype 3 of hepatitis C infection (р < 0.05) and low replicative activity of the virus (р < 0.05). Conclusion. The incidence of CGE in the study population made 36.5%. CGE patients had more pronounced hepatic process chronization, frequenter EHDs, more genotype 3 cases, and lower replicative activity of the virus. Keywords: hepatitis С, hepatic cirrhosis, cryoglobulinemia, extrahepatic diseases.

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