Ocular cicatricial pemphigoid (Review)
- PMID: 32905166
- PMCID: PMC7465597
- DOI: 10.3892/etm.2020.8972
Abstract
Ocular cicatricial pemphigoid is a particular form of mucous membrane pemphigoid and it is characterized by a chronic bilateral conjunctivitis with relapsing-remitting periods. Without therapy 75% of the cases develop visual loss due to major ocular complications (e.g. severe dry-eye syndrome, corneal erosions, corneal keratinization, entropion, symblepharon). Pathogenesis remains uncertain and probably linked to an autoimmune type II hypersensitivity response in patients with a genetic predisposition and exposure to different environmental triggers. With a worldwide distribution, no racial predilection and an estimated incidence that largely varies from 1/10,000-1/60,000, ocular cicatricial pemphigoid predominantly affects women aged ~60 years. Conjunctival biopsy with direct immunofluorescence is the gold standard in diagnosis confirmation, but up to 40% of the patients have a negative biopsy result that does not rule out the diagnosis. The skin and many other mucous membranes (e.g. oral, trachea, esophagus, pharynx, larynx, urethra, vagina and anus) may be involved. The disease grading relies on Foster staging system (based on clinical signs) and Mondino and Brown system (based on the inferior fornix depth loss). The differential diagnosis includes atopy, allergies, trauma, chemical burns, radiation, neoplasia, infectious, inflammatory and autoimmune etiologies. The main goals of the treatment are to stop disease progression, to relieve symptoms and to prevent complications. With long-term systemic therapy 90% of the cases can be efficiently controlled. While Dapsone is the first-line treatment in mild to moderate disease in patients without G6PD deficiency, more severe cases require immunosuppressant therapy with azathioprine, mycophenolate mofetil, methotrexate or cyclosporine. Cyclophosphamide, biologics (etanercept or rituximab) and intravenous immunoglobulin therapy are usually reserved for recalcitrant disease and unsatisfactory results to conventional therapy. Dry eye syndrome requires constant lubricating medication and topical steroids, cyclosporine-A and tacrolimus. Surgery should be planed only in quiescent phase as minor conjunctival trauma can significantly worsen the disease.
Keywords: ankyloblepharon; cicatricial pemphigoid immunofluorescence; mucous membrane pemphigoid; ocular pemphigoid; symblepharon.
Copyright: © Branisteanu et al.
supplementary info
CBT and medication in depression (Review)
- PMID: 32904947
- PMCID: PMC7464866
- DOI: 10.3892/etm.2020.9014
Abstract
Depression is a serious problem, primarily for the patient, but in-extenso, for society. The World Health Organization has long signaled an increase in the number of cases of mental health problems globally and, in particular, an increase in the number of people suffering from depression. In the context in which the most effective solutions are sought for the reduction and even remission of depressive symptoms. In the present review literature is analyzed on two current treatment modalities for depression: Cognitive behavioral therapy (CBT) and antidepressive medication (ADM). Both modalities act by the same internal mechanisms, in the same order, but studies found also differences between the ADM and CBT effects depending on early traumatic experiences of the patients, cognitive and genetic variables, other epigenetic factors and patient's history. A literature review is presented, which systematically collects actual data and synthesizes previous research findings in the field of depression treatment using ADM and CBT.
Keywords: ADM; CBT; brain; depression; efficiency; medication.
Copyright: © Vasile et al.
supplementary info
Gaps or links between hormonal therapy and schizophrenia? (Review)
- PMID: 32905106
- PMCID: PMC7465617
- DOI: 10.3892/etm.2020.9017
Abstract
Schizophrenia is considered the most severe and debilitating psychiatric disorder. During the 80's, first reports on abnormalities of the schizophrenic brain which could be objectively observed on MRI, CT scans and other imagistic techniques were published. This showed that schizophrenia is a disorder that goes beyond the functional aspect of the symptomatology. The ties between psychiatry and endocrinology are easily observed, even empirically, by any mental health practitioner, and mirrored by endocrinology specialists. Disorders related to menstruation phase of the menstrual cycle have a code in DSM-V, people expect women 'to have mental disturbances' during puberty, pregnancy, menopause and other periods of life known to cause a hormonal storm. Leaving aside those simple and common beliefs, any mental health specialist can observe the differences between men and women when it comes to psychopathology, and the differences between male and female patients when it comes to a severe disorder such as schizophrenia. Males present more severe symptoms; their evolution is worse and they tend to have more medico-legal issues. On the contrary, the current available treatments for schizophrenia tend to have some side effects easily observed by endocrinologists: from gynecomastia to breast asymmetry in women, hyperprolactinemia, weight gain and other metabolic disorders, the clinic shows us regularly what the science has already told us; that the impact of hormones on the developing brain, starting in utero and going on through life may hold the key to finding better treatments for debilitating disorders such as schizophrenia. This mini-review is focused on the role of estrogen in the evolution of schizophrenia and on reporting trials that showed how hormonal therapy (used mainly for breast cancer and osteoporosis) can improve the outcome of patients with schizophrenia.
Keywords: brain function and structure; estrogen; hormonal therapy; raloxifene; schizophrenia.
Copyright: © Trifu et al.
supplementary info
Genetics of schizophrenia (Review)
- PMID: 32905096
- PMCID: PMC7465115
- DOI: 10.3892/etm.2020.8973
Abstract
A comprehensive review of the body of genetic studies on schizophrenia seems even more daunting than the battle a psychiatrist wages daily in the office with her archenemy of a thousand faces. The following article reunites some genetic, epigenetic and environmental factors of schizophrenia from revered and vast studies in a chronological and progressive fashion. Twin studies set the basics of heritability and a particular study by Davis and Phelps considers the widely ignored influence of prenatal environment in the development of schizophrenia. Mostly ignited by linkage studies, candidate gene studies explore further by fine-mapping the hypothesized variants [mostly in the forms single nucleotide polymorphisms (SNPs) and less but with greater impact copy number variations (CNVs)] associated with the disease. Genome-wide association studies (GWAS) increase considerably the sample sizes and thus the validity of the results, while the next-generation sequencing (NGS) attain the highest yet unreplicated level of validity results.
Keywords: dopamine; gene expression; glutamatergic synapses; schizophrenia; twin studies.
Copyright: © Trifu et al.
supplementary info
Mitochondrial nanotargeting in malignancies (Review)
- PMID: 32905128
- PMCID: PMC7464930
- DOI: 10.3892/etm.2020.9023
Abstract
Malignancies represent a burden for the health system worldwide. Treating them represents a challenge through the prism of the cancer cell behaviour and the serious systemic side effects that usually occur. Both traditional (chemotherapy, radiotherapy and surgery) and associated therapies (immunotherapy and hormone therapy) have reached a plateau. The new trend for the management of malignancies includes nanoparticles (NPs) which are studied for both their diagnostic and therapeutical use. NPs can be designed in various ways, many of them targeting mitochondria causing cellular apoptosis. This review summarizes the main characteristics of NPs that are studied in different cancers to highlight their mechanism of action. Since mitochondria play a key role in the cellular homeostasis, they represent the main target for the experimental current studies. While there are NPs approved by the FDA for clinical use, most of them are still under extended research and still need to prove their efficacy and biocompatibility, preferable with minimal systemic side effects.
Keywords: cancer; malignancy; mitochondria; nanoparticles; theranostic.
Copyright © 2020, Spandidos Publications.
supplementary info
Affective disorders: A question of continuing treatment during pregnancy (Review)
- PMID: 32905103
- PMCID: PMC7465051
- DOI: 10.3892/etm.2020.8989
Abstract
Fetal development, especially in the first trimester, has proven to be heavily influenced by external factors, such as chemical intake of medication. Chronic psychiatric treatment might interfere with the anatomical and physiological wellbeing of the fetus, because psychotropic medication proceeds past the placenta, into the amniotic fluid, and can enter breast milk. Hence some of the medications prescribed for mood disorders should be reconsidered during pregnancy, without sub-optimally treating when it is needed. A literature review is presented which systematically collects modern data and synthesizes previous interdisciplinary research findings on the safety of psychiatric treatment for affective disorders during pregnancy (term-based) and lactation. Antidepressants and mood stabilizers, fundamental strategies in treating affective disorders, have been classified by the FDA as C respectively D drugs pertaining to their risk, with some exception. Most guidelines recommend pharmacologically treating moderate-severe depression, preferably with SSRIs. Evidence advocates that drugs should be used during pregnancy only if clearly needed and the benefit outweighs the risk to the fetus. However, guidelines the American College of Obstetricians and Gynecologists state that antidepressants are a preferred first course of treatment and does not take into account the severity of the depression. Among mood-stabilizers, lithium is considered to be the safest option for pregnant women. Anticonvulsants have a higher risk of teratogenicity compared with lithium, with lamotrigine being the safest one. All mood stabilizers should be recommended in the lowest effective doses. There is controversy regarding the safety of second-generation antipsychotics during pregnancy and further research is required. Several case reports and meta-reviews have been published in order to emphasize the safety of electroconvulsive therapy (ECT) during pregnancy, but practitioners still stigmatize this procedure. Evaluating the overall risk-benefit ratio should be assessed by the medical care provider, taking into consideration current findings.
Keywords: antidepressants; electroconvulsive therapy; mood stabilizers; neonatal toxicity; neurodevelopment; perinatal psychiatry; teratogenesis.
Copyright: © Trifu et al.
supplementary info
Artificial intelligence and deep learning in ophthalmology - present and future (Review)
- PMID: 32905155
- PMCID: PMC7465350
- DOI: 10.3892/etm.2020.9118
Abstract
Since its introduction in 1959, artificial intelligence technology has evolved rapidly and helped benefit research, industries and medicine. Deep learning, as a process of artificial intelligence (AI) is used in ophthalmology for data analysis, segmentation, automated diagnosis and possible outcome predictions. The association of deep learning and optical coherence tomography (OCT) technologies has proven reliable for the detection of retinal diseases and improving the diagnostic performance of the eye's posterior segment diseases. This review explored the possibility of implementing and using AI in establishing the diagnosis of retinal disorders. The benefits and limitations of AI in the field of retinal disease medical management were investigated by analyzing the most recent literature data. Furthermore, the future trends of AI involvement in ophthalmology were analyzed, as AI will be part of the decision-making regarding the scientific investigation, diagnosis and therapeutic management.
Keywords: OCT; artificial intelligence; convolutional neural networks; deep learning; image analysis; image processing; machine learning; ophthalmology.
Copyright: © Moraru et al.
supplementary info
Current diagnosis and management strategies in pachychoroid spectrum of diseases (Review)
- PMID: 32905090
- PMCID: PMC7464929
- DOI: 10.3892/etm.2020.9094
Abstract
This review presents a systematic analysis of the literature regarding the pachychoroid disease spectrum nomenclature, diagnosis criteria and therapeutic options. Pachychoroid related diseases are a new concept, introduced into the ophthalmological nomenclature in 2013 and evolving both as concept and as classification since then. The six disorders included in this phenotype have some common characteristics (thick choroid, pachyvessels, attenuation of the choriocapillaris), but also show individual features. The classification of the pachychoroid spectrum was revised many times, with the recent addition of the focal choroidal excavation (FCE) and peripapillary pachychoroid syndrome (PPS). As the terminology is developing, so is the number of case reports and case series from the initial report in 2013 to 57 reports in 2019. This review takes into account both the current literature and the clinical experience of the authors, emphasizing the understanding of the pathogenesis and aiming to update the therapeutic options available.
Keywords: OCT angiography; anti-VEGF therapy; choroidal hyperpermeability; choroidal neovascular membranes; pachychoroid; pachyvessels.
Copyright: © Moraru et al.
supplementary info
Conjunctival flap surgery in the management of ocular surface disease (Review)
- PMID: 32905115
- PMCID: PMC7465514
- DOI: 10.3892/etm.2020.8964
Abstract
Literature regarding conjunctival flap surgery was reviewed to describe and discuss the rationale for this type of procedure. The conjunctival flap is an acknowledged surgery for the treatment of various corneal diseases with a chronically compromised ocular surface, such as severe dry eye, neurotrophic or neuroparalytic disease, or bullous keratopathy. The purpose of this surgery is to restore the integrity of the corneal surface and thus to prevent gradual corneal ulceration and secondary infection, as well as to ameliorate pain, reduce the need for frequent medications, improve cosmetic appearance, and offer an alternative to invasive surgery or enucleation. Since the introduction of more effective methods of treating severe ocular surface diseases, conjunctival flap surgery has rarely been the primary modality of treatment and has usually followed a range of medical and surgical treatments. The availability of improved ocular lubricants, more effective antimicrobials, bandage contact lenses, tissue adhesives, and other corneal and conjunctival surgical interventions, has reduced the need for conjunctival flaps. However, conjunctival flaps remain extremely useful in selected cases and deserve a place in the ophthalmologist's repertoire for the management of ocular surface disease.
Keywords: conjunctival flap surgery; corneal perforation; pedicle conjunctival flap; refractory corneal ulcer; severe ocular surface disease.
Copyright: © Zemba et al.
supplementary info
JAK/STAT pathway in pathology of rheumatoid arthritis (Review)
- PMID: 32905201
- PMCID: PMC7465448
- DOI: 10.3892/etm.2020.8982
Abstract
Rheumatoid arthritis (RA) is classified as an inflammatory, chronic autoimmune and disabling disease based on the intricate interplay between environmental and genetic factors. With a prevalence ranging from 0.3 to 1%, RA is the most prevalent inflammatory joint disease observed in adults. Disruption of immune tolerance becomes evident when abnormal stimulation of the innate and adaptive immune system occurs. This cascade of events causes persistent joint inflammation, proliferative synovitis and, ultimately, damage of the underlying cartilage as well as the subchondral bone, leading to permanent joint destruction, deformity and subsequent loss of function. With cytokines being the key to a multitude of biological processes, including inflammation, hematopoiesis and overall immune response, one must inevitably look at the main pathways through which a significant number of those molecules exert their function. Janus kinase/signal transducers and activators of transcription (JAK/STATs) represent one such pathway and, recently, JAK inhibitors (JAKinibs) have shown promise in the treatment of several inflammatory diseases, including RA. This narrative review focuses on the intricate signaling pathways involved as well as on the clinical aspects and safety profiles of JAKinibs approved for the treatment of RA.
Keywords: JAK inhibitors; JAK/STAT pathway; cytokine signaling; interleukins; pharmacotherapy; rheumatoid arthritis.
Copyright: © Ciobanu et al.
supplementary info
New insights into IL-17/IL-23 signaling in ankylosing spondylitis (Review)
- PMID: 32905121
- PMCID: PMC7464928
- DOI: 10.3892/etm.2020.8981
Abstract
Ankylosing spondylitis (AS) is a progressive common autoimmune inflammatory disease, part of the spondylarthritis group, characterized, besides clinical spinal and peripheral joint inflammation, by enthesitis and new bone formation, that can lead to severe functional impairment. Beyond intensive and continuous research on the pathogenic process extensively performed in recent years, their impact on therapeutic management remains open to future development. Better knowledge of AS pathogenesis have shown results progressively and studies are being performed to advance our current understanding of the disease. It is well known that tumor necrosis factor (TNF) exerts a central role, along with interleukin-17 (IL-17) and interleukin-23 (IL-23), demonstrated by several clinical studies. Similar to other rheumatic inflammatory conditions, SA is associated with an early process of systemic bone loss, both trabecular and cortical, consecutive osteopenia, osteoporosis, and high fracture risk. Current personalized therapeutic options benefit from new published data, to prevent future complications and to improve quality of life.
Keywords: IL-17/IL-23 pathway; ankylosing spondylitis; bone loss; interleukin-17; interleukin-23.
Copyright: © Chisălău et al.
supplementary info
Expression of miR-495 and miR-326 in peripheral blood of rheumatoid arthritis patients and its significance
- PMID: 32904998
- PMCID: PMC7464994
- DOI: 10.3892/etm.2020.9124
Abstract
The aim of the present study was to investigate the expression of microRNA (miR)-495 and miR-326 in the peripheral blood of patients with rheumatoid arthritis (RA). A total of 107 RA patients, admitted to the Yidu Central Hospital of Weifang (Weifang, China) from February 2016 to February 2019, and 112 healthy subjects, who underwent physical examination during the same period, were selected as the research subjects for prospective analysis. The RA patients served as the study group and the healthy subjects as the control group. The expression levels of miR-495 and miR-326 in the peripheral blood of the two groups of subjects were compared. The association between miR-495 and miR-326 with RA clinical pathology and the diagnostic value of miR-495 and miR-326 for RA were analyzed. In the study group, miR-495 expression was significantly higher than that in the control group, and miR-326 expression was significantly lower than that in the control group (P<0.001). miR-495 and miR-326 combined diagnosis showed good predictive value for the occurrence of RA (P<0.001) and was closely related to RA clinical pathology (P<0.001). After treatment, miR-495 expression was significantly decreased in the study group, whereas miR-326 expression was significantly increased (P<0.001). Pearson's correlation coefficient analysis showed that rheumatoid factor (RF) was positively correlated with miR-495 expression and negatively correlated with miR-326 expression (P<0.001). In conclusion, miR-495 was highly expressed in patients with RA, whereas miR-326 was poorly expressed in RA patients, and the combined detection of miR-495 and miR-326 has good diagnostic value for RA.
Keywords: clinical screening; diagnosis; miR-326; miR-495; rheumatoid arthritis; rheumatoid factor.
Copyright: © Sui et al.
In silico identification of common and specific signatures in coronary heart diseases
- PMID: 32905032
- PMCID: PMC7464937
- DOI: 10.3892/etm.2020.9121
Abstract
Coronary heart disease (CHD) is on the increase in developing countries, where lifestyle choices such as smoking, bad diet, and no exercise contribute and increase the incidence of high blood pressure and high cholesterol levels to cause CHD. Through utilization of a biomarker-based approach for developing interventions, the aim of the study was to identify differentially expressed genes (DEGs) and their association and impact on various bio-targets. The microarray datasets of both healthy and CHD patients were analyzed to identify the DEGs and their interactions using Gene Ontology, PANTHER, Reactome, and STRING (for the possible associated genes with multiple targets). Our data mining approach suggests that the DEGs were associated with molecular functions, including protein binding (75%) and catalytic activity (56%); biological processes such as cellular process (83%), biological regulation (57%), and metabolic process (44%); and cellular components such as cell (65%) and organelle (58%); as well as other associations including apoptosis, inflammatory, cell development and metabolic pathways. The molecular functions were further analyzed, and protein binding in particular was analyzed using network analysis to determine whether there was a clear association with CHD and disease. The ingenuity pathway analysis revealed pathways related to cell cholesterol biosynthesis, the immune system including cytokinin signaling, in which, the understanding of DEGs is crucial to predict the advancement of preventive strategies. Results of the present study showed that, there is a need to validate the top DEGs to rule out their molecular mechanism in heart failure caused by CHD.
Keywords: coronary heart disease; differentially expressed genes; microarray.
Copyright: © Yang et al.
Mite allergy and atopic dermatitis: Is there a clear link? (Review)
- PMID: 32905207
- PMCID: PMC7465295
- DOI: 10.3892/etm.2020.9120
Abstract
Atopic dermatitis (AD) represents a widespread chronic skin disease associated with different atopic disorders and allergies. These associations, similar to overall AD pathophysiology, are entangled, multifactorial and they are yet to be clarified. IgE and non IgE mediated pathomechanisms appear to be implicated in AD. Allergens constitute key aspects in AD pathogenesis, as they may serve as trigger factors. This review emphasizes mainly house dust mites (HDM), as they are likely the most relevant airborne allergen for AD. Here we review in a concise form the mite allergens, the role of molecular diagnosis and the treatment strategies for HDM. Strategies of avoiding allergens, with a few exceptions, are not enough to control children's AD; recent studies show HDM avoidance procedures in diagnosed AD are insufficient. Regardless, some guidelines acknowledge the benefit of mattress and pillow covers in patients with dust mite sensitization that are unresponsive to optimal AD management. Most clinical trials investigating allergen-specific immunotherapy (AIT) as a potential treatment for AD were done with adult patients; a scarce number of studies looked into the efficacy of AIT as a treatment option in children suffering from AD, with conflicting data among them. One of the most feasible of these studies showed significant improvement of AD outcomes only in the mild/moderate group, but not in the severe group. Uncontrolled studies are hard to interpret, considering the natural history of remitting and relapsing of AD, in many of the patients, without clinical interventions. More AIT studies, especially pediatric studies, are required in order to either prove the reproducibility of positive results or to deny its effectiveness.
Keywords: allergen-specific immunotherapy; atopic dermatitis; avoidance strategies; mite allergens; molecular allergology.
Copyright © 2020, Spandidos Publications.
supplementary info
Involvement of proinflammatory cytokines in angiotensin II-induced hypertension in rat
- PMID: 32905116
- PMCID: PMC7465173
- DOI: 10.3892/etm.2020.9100
Abstract
Rightfully considered as essential for hydro-electrolytic homeostasis, angiotensin II (Ang II) is the main product of the renin-angiotensin system (RAS). Ang II is one of the most important factors that contribute to the regulation of systemic arterial blood pressure (ABP). This major role is based on the effects exerted by RAS: Upon the kidney (RAS involvement in the control of salt and water excretion), upon the brain (RAS involvement in the control of water intake), and upon the sympathetic nervous system. It is currently known that there is a tight bidirectional link between high ABP and chronic kidney disease (CKD). Ang II causes vasoconstriction in the renal microvasculature, predominantly in the preglomerular arterioles. High ABP affects the target organs (eyes, brain, heart, kidneys) and it is known both as a cause and as an effect of CKD. Thus, there is a positive feedback mechanism that contributes even more to the increase in ABP and the progression of CKD. Along with its main hemodynamic effects, Ang II has direct proinflammatory actions, that also affect the structure and function of the kidney and heart. This study investigated the role of RAS and Ang II in the inflammation that accompanies the hypertension experimentally induced by Ang II in rats. Our data support the hypothesis that anti-inflammatory medication might alleviate the morphological and/or functional changes of the kidneys and heart that are related to Ang II-induced hypertension.
Keywords: angiotensin II; blood pressure; heart; kidneys; proinflammatory cytokines.
Copyright © 2020, Spandidos Publications.
Capillary loss reflects disease activity and prognosis in patients with systemic sclerosis
- PMID: 32905140
- PMCID: PMC7465178
- DOI: 10.3892/etm.2020.8979
Abstract
Capillary density on nailfold capillaroscopy (NFC) is considered a promising instrument for assessing disease characteristics in patients with systemic sclerosis (SSc), however, there is no agreement yet over how to analyze and interpret the results. The objective of this study was to investigate the possible associations of the mean number of capillaries with disease characteristics, disease activity [measured by the European Scleroderma Study Group (EScSG) disease activity score] and survival in a single-center cohort of patients with SSc. Sixty-eight patients were included; 54 had follow-up at 6 months. Thirty-two images per patient were assessed independently by two raters, scoring the mean number of capillaries in all fingers (N), in the 3rd finger of the dominant hand (dN3) and in the 4th finger of the non-dominant hand (ndN4) for each patient. NFC 'early', 'active' and 'late' patterns were also assessed. Two thousand and seventy-six images were scored at baseline, 1,728 at follow-up. Baseline N was median (IQR) 5.1 (2.7) for rater 1, and 4.9 (1.7) for rater 2, respectively. N was significantly lower in patients with a history of digital ulcers (DUs), vs. those who never had DUs 4.8 (1.4) vs. 6.4 (3.1), P=0.016. A lower N was associated with higher disease activity at baseline and follow-up (linear regression adjusted for age, sex and history of DUs). A lower ndN4 was associated with increased mortality (logistic regression adjusted for age and sex). In conclusion, in patients with SSc, a lower mean number of capillaries assessed by NFC was associated with higher disease activity after 6 months of follow-up and with shorter survival.
Keywords: capillary density; digital ulcers; disease activity; nailfold capillaroscopy; survival; systemic sclerosis.
Copyright © 2020, Spandidos Publications.
Somatostatinoma: Beyond neurofibromatosis type 1 (Review)
- PMID: 32905002
- PMCID: PMC7465002
- DOI: 10.3892/etm.2020.8965
Abstract
Somatostatinoma is a tumour mainly originating from pancreas or duodenum; overall with an incidence of 1/40 million persons. We introduce a narrative review of literature of somatostatinoma including the relationship with neurofibromatosis type 1. Clinical presentation includes: Diabetes mellitus, cholelithiasis, steatorrhea, abdominal pain, and obstructive jaundice while papillary tumour may cause acute pancreatitis. The neoplasia may develop completely asymptomatic or it is detected as an incidental finding during an imaging or a surgical procedure. It may be sporadic or associated to genetic backgrounds especially for duodenal localisation as neurofibromatosis type 1 (NF1 gene with malfunction of RAS/MAPK pathway) or Pacak-Zhuang syndrome (EPAS1 gene encoding HIF). Surgery represents the central approach if feasible but the prognostic depends on location, and grading as indicated by WHO 2017 classification of neuroendocrine tumours. Previously known as Von Recklinghausen disease, neurofibromatosis type 1, the most frequent neurocutaneous syndrome, is an autosomal dominant disorder including: Café-au-lait spot, skin fold freckling on flexural zones, and neurofibromas as well as tumours such as gliomas of optic nerve, gastrointestinal stromal tumours (GISTs), iris hamartomas and brain tumours. Duodenal somatostatinoma is associated with the syndrome which actually involves more often a duodenal tumour of GIST type than a somatostatin secreting neoplasia. Other neuroendocrine tumours are reported: Gastrointestinal NENs at the level of rectum or jejunum and pheocromocytoma. Overall, one quarter of subjects have gastrointestinal tumours of different types. Somatostatinoma, when not located on pancreas but in duodenoum, may be registered in subjects with neurofibromatosis type 1 most probably in addition to other tumours. Overall, this type of neuroendocrine tumour with a challenging presentation has a poor prognosis unless adequate radical surgery is promptly offered to the patient.
Keywords: duodenal tumour; neuroendocrine; neurofibromatosis; somatostatin; somatostatinoma.
Copyright © 2020, Spandidos Publications.
supplementary info
Effects of levetiracetam and lacosamide on therapeutic efficacy and neural function in patients with epilepsy
- PMID: 32905038
- PMCID: PMC7465612
- DOI: 10.3892/etm.2020.9126
Abstract
The present study aimed to investigate the effects of levetiracetam tablets and lacosamide (LCM) on therapeutic efficacy and neural function in patients with epilepsy. We assigned 252 patients with refractory partial seizures admitted to our hospital to receive either levetiracetam tablets [120 patients, the control group (CG)] or levetiracetam tablets combined with LCM [132 patients, the joint group (JG)]. The bone mineral density and neural function between the two groups at 6 months before and after treatment were compared. The total response rate was higher in the JG than in the CG (P<0.05). There was no significant difference in the comparison of the multiple indexes between the two groups before treatment (P>0.05). The frequency of seizures was reduced after treatment in the two groups, however, it was lower in the JG compared with the CG (P<0.05). The levels of neurological indicators were significantly reduced after treatment in the two groups (P<0.05), however, the reduction was more marked in the JG than in the CG. The bone mineral density (BMD) of the femoral neck decreased after treatment in the two groups (P<0.05), but there was no difference between the two groups after treatment (P>0.05). The calcium content decreased after treatment in the two groups (P<0.05), but there was no difference between the two groups after treatment (P>0.05). The comparison of other bone metabolism markers between the two groups exhibited no significant differences. The combination therapy greatly increased the quality of life score and the 1-year drug retention rate. To sum up, levetiracetam tablets combined with LCM significantly enhanced the therapeutic effect and improved the neural function in patients with refractory partial seizures, however this therapy may cause a slight adverse effect on BMD and bone metabolism in the short term.
Keywords: bone mineral density; epilepsy; lacosamide; levetiracetam; neural function.
Copyright: © Liu et al.
Influence of phytochemicals in induced psoriasis (Review)
- PMID: 32905089
- PMCID: PMC7465111
- DOI: 10.3892/etm.2020.9013
Abstract
Cytokines involved in pathogenesis of psoriasis such as interleukins (IL-1β, IL-6, IL-17, IL-22, IL-23), interferon-α, tumor necrosis factor-α and interferon-γ can also become therapeutic targets. Research currently uses murine models of imiquimod-induced psoriatic-type dermatitis in order to analyze potentially helpful phytotherapeutics for psoriasis treatment: Curcuma longa, Aloe vera, Nigella sativa, Rubia cordifolia, Smilax china, Thespesia populnea, Wrightia tinctoria, Scutellaria baicalensis, Cassia tora, Pongamia pinnata and various Chinese herbal formulas. Psoriasis is a chronic inflammatory disease with complex pathogenic mechanisms that yield abnormal immune responses with clinical and morphological echoes (erythematous, scaly plaques with a histopathological basis made up of alterations i.e. keratinocyte aberrant proliferation, parakeratosis or chronic inflammation). The current therapeutic approach has only been able to manage the disease, without ensuring a certified treatment, thus giving rise to the need for better medications. This novel therapeutic approach has shown promising results in preclinical studies, giving hope for future phytochemical animal-based studies.
Keywords: curcumin; imiquimod; interleukins; phytotherapeutics; psoriasis.
Copyright © 2020, Spandidos Publications.
supplementary info
Angiotensin-converting enzyme gene D-allele and the severity of coronary artery disease
- PMID: 32905120
- PMCID: PMC7465281
- DOI: 10.3892/etm.2020.8978
Abstract
Coronary artery disease (CAD) is the first cause of morbidity and mortality worldwide. An important goal is to diagnose patients in early stages, in order to reduce acute cardiovascular events. The angiotensin-converting enzyme (ACE) is an important element for the cardiovascular system, through its actions on hydro-salin balance and vascular tone. ACE polymorphism consists of insertions (I)/deletions (D) and there are 3 genotypes: II, ID, DD. It is speculated that the DD genotype may be a genetic basis for severe CAD, while the II genotype may have a protective effect on the coronary arteries. The present study included 154 patients with acute coronary syndroms admitted to the Institute for Cardiovascular Disease 'George I.M. Georgescu', Iasi. The patients underwent coronary angiography in order to assess the severity of the lesions and the ACE genotypes were determined for each patient. The genotypes were correlated with the severity of the vessel-disease and the exposure to classic risk factors. It was concluded that the D-allele is associated with a greater risk for acute coronary events and severe coronary stenosis, especially when risk genotype and risk phenotype interact.
Keywords: D-allele; I-allele; acute myocardial infarction; angiotensin-converting enzyme gene; coronary artery disease; gene poly-morphism; unstable angina.
Copyright © 2020, Spandidos Publications.
Protective role of selenium on thyroid morphology in iodine-induced autoimmune thyroiditis in Wistar rats
- PMID: 32905063
- PMCID: PMC7465433
- DOI: 10.3892/etm.2020.9029
Abstract
Excess iodine may induce and exacerbate autoimmune thyroiditis (AIT) in humans and animals. In order to assess the potential protective mechanisms of selenium (Se) in thyroid autoimmunity, the effects of inorganic Se (sodium selenite) administration on thyroid morphology and follicular cytology were investigated in adult Wistar rats with iodine-induced AIT. A total of 48 adult Wistar rats (24 females, 24 males) were allocated to one of four dietary regimens: C0, control; C1, only potassium iodine (KI); C2, concomitant KI and Se; C3, only KI initially, followed by Se administration. For AIT induction the rats were fed with 0.05% KI for 56 days. Se-treated rats received 0.3 mg/l sodium selenite in drinking water. Thyroid tissues were collected for pathologic diagnosis after 7 days in C0 group, 56 days in C1 and C2 groups, and 112 days in C3 group. In C1 group, moderate to severe thyroiditis was observed in 83% of males and 50% of female rats (P=0.223). In C3 group 16.7% of male rats developed moderate thyroiditis and none in C2 group, whereas no females were identified with moderate to severe thyroiditis in C2 or C3 group. Thus, the administration of Se was proven to have protective effects against thyroiditis cytology in both male and female Wistar rats.
Keywords: experimental autoimmune thyroiditis; iodine-induced thyroid dysfunction; iodine-induced thyroiditis in Wistar rats; selenium; selenium effect on thyroid pathology.
Copyright: © Vasiliu et al.
Glucagonoma: From skin lesions to the neuroendocrine component (Review)
- PMID: 32905095
- PMCID: PMC7465236
- DOI: 10.3892/etm.2020.8966
Abstract
Glucagonoma is a hormonally active rare pancreatic neuroendocrine tumour causing an excess of glucagon. This is a narrative review based on a multidisciplinary approach of the tumour. Typically associated dermatosis is necrolytic migratory erythema (NME) which is most frequently seen at disease onset. Insulin-dependent diabetes mellitus, depression, diarrhoea, deep vein thrombosis are also identified, as parts of so-called 'D' syndrome. Early diagnosis is life saving due to potential aggressive profile and high risk of liver metastasis. NME as paraneoplastic syndrome may be present for months and even years until adequate recognition and therapy; it is remitted after successful pancreatic surgery. Thus the level of practitioners' awareness is essential. If surgery is not curative, debulking techniques may improve the clinical aspects and even the outcome in association with other procedures such as embolization of hepatic metastasis; ablation of radiofrequency type; medical therapy including chemotherapy, targeted therapy with mTOR inhibitors such as everolimus, PRRT (peptide receptor radiotherapy), and somatostatin analogues (including combinations of medical treatments). Increased awareness of the condition involves multidisciplinary practitioners.
Keywords: glucagon; glucagonoma; necrolytic migratory erythema; neuroendocrine; rush; somatostatin.
Copyright © 2020, Spandidos Publications.
supplementary info
Post-infectious irritable bowel syndrome after a laboratory-proven enteritis
- PMID: 32905134
- PMCID: PMC7464999
- DOI: 10.3892/etm.2020.9018
Abstract
There are scarce data on risk factors for post-infectious irritable bowel syndrome (PI-IBS). The objective of this study was to determine the risk factors of developing PI-IBS following an acute infectious gastroenteritis (AGE) episode in which, by laboratory tests, the etiological agent was isolated. The study was conducted on patients admitted to a tertiary center of infectious diseases during three consecutive years. The patients were divided into two groups: a group consisting of patients admitted with AGE (with an isolated etiological agent) and a control group consisting of patients admitted for an acute upper respiratory tract infection (URTI). The subjects were recalled in our center 6 months after the admission and were evaluated with Rome III IBS diagnostic questionnaire and Bristol Stool Form Scale. The questionnaires were paper printed and directly filled in by the subjects. The response rate in the case group was 5% and in the control group 100%. The prevalence of PI-IBS was higher in patients with AGE, presenting a relative risk (RR) of 4.16 [95% confidence interval (CI), 1.89-9.17], statistically significant (P<0.001) vs. URTI. From 28 female patients, 22 patients (79%) developed PI-IBS and from 17 male patients, 3 patients (18%) had developed PI-IBS with a risk of 4.4 (95% CI, 1.56-12.65), P<0.001. Regarding the infectious etiology of the AGE, Campylobacter jejuni had the highest risk of developing PI-IBS, RR=1.2 (95% CI, 0.13-3.11), P=0.04 compared with the other agents with a lower risk. The risk to develop PI-IBS after AGE infection is 4.16 higher than after URTI. Female sex is a risk factor for PI-IBS, 79% of the female patients developed PI-IBS after AGE. The incidence of PI-IBS is highest in patients with Campylobacter jejuni AGE compared with the other agents.
Keywords: acute infectious gastroenteritis; coproparasitological examination; enzyme-linked fluorescent assay; laboratory; microbiology; post-infectious irritable bowel syndrome.
Copyright: © Iacob et al.
Combination of cranberry extract and D-mannose - possible enhancer of uropathogen sensitivity to antibiotics in acute therapy of urinary tract infections: Results of a pilot study
- PMID: 32905041
- PMCID: PMC7465228
- DOI: 10.3892/etm.2020.8970
Abstract
Uncomplicated lower urinary tract infections are extremely common in women. Antibiotic treatment for acute episodes and for recurrence prophylaxis has its drawbacks and alternative therapies are sought in order to reduce the antimicrobial resistance phenomenon and the intestinal dismicrobism expansion. There are few studies on the effect of combination of cranberry extract with D-mannose in acute urinary tract infection management. In a pilot, randomized study 93 non-pregnant, otherwise healthy women, were enrolled with mean age of 39.77±10.36, diagnosed with uncomplicated lower urinary tract infection. Medical history, clinical examination, urine culture and a list of complaints were noted at the baseline visit. In a first phase of the study, treatment with either guideline recommended antibiotic alone or in association with the investigated product (cranberry extract plus D-mannose) was prescribed and all patients were clinically examined at day 7. All ameliorated and cured patients received in a second phase of the study, in a double-blind manner, prophylaxis with the investigated product or placebo for another 21 days, then a second clinical examination and a check of the list of complaints were performed. The cure rates were higher at day 7 when investigated product was added to antibiotic (91.6 vs. 84.4%). In resistant strains, a significantly higher cure rate was shown when the investigated product was added to antibiotic prescribed (88.8 vs. 37.5%, P<0.0001). The effect of cranberry extract plus D-mannose combination in acute urinary tract infection episodes seems to be promising. The significant cure rate registered in the patients with antibiotic-resistant urine cultures may be explained by a beneficial influence of the product on the antimicrobial sensitivity. Further studies are needed on this subject.
Keywords: Cranberry extract; D-mannose; antibiotic; lower urinary tract infection; sensitivity to antibiotics.
Copyright © 2020, Spandidos Publications.
Report of four cases of crowned dens syndrome: Clinical presentation, CT findings and treatment
- PMID: 32905161
- PMCID: PMC7465381
- DOI: 10.3892/etm.2020.9128
Abstract
The clinical manifestations of crowned dens syndrome (CDS) include acute neck pain and neck stiffness accompanied by restricted cervical range of motion. CDS is frequently misdiagnosed as meningitis, epidural abscess, rheumatoid arthritis, rheumatoid polymyalgia, giant cell arteritis, cervical spondylosis or metastatic bone tumor, and the incidence of CDS appears to be underestimated. The present study reported on four cases of CDS diagnosed by CT. They included one male and three females, aged from 67 to 78 years, and their major symptoms were acute neck pain and restricted cervical range of motion. Serum C-reactive protein levels and erythrocyte sedimentation rate were significantly increased in all cases. Cervical CT scan revealed calcified deposits surrounding the odontoid process in all cases. Non-steroidal anti-inflammatory drugs (NSAIDs) markedly reduced the levels of inflammatory indicators and rapidly relieved the symptoms. CT scan is considered the gold standard for CDS diagnosis, which may demonstrate calcification around the odontoid process. The patients' symptoms may be improved by treatment with NSAIDs.
Keywords: computed tomography; crowned dens syndrome; neck pain; non-steroidal anti-inflammatory drugs.
Copyright: © Tang et al.
Utility of indocyanine green injection in patients with cervical cancer besides the identification of sentinel lymph node (Review)
- PMID: 32905080
- PMCID: PMC7464865
- DOI: 10.3892/etm.2020.9095
Abstract
Due to the wide introduction of screening tests, patients with neoplastic diseases of the uterine cervix trend to be diagnosed in early stages of the disease, and less invasive surgical procedures are needed in certain cases. In this respect, the technique of sentinel lymph node dissection has been widely implemented as part of the therapeutic strategy, indocyanine green (ICG) being one of the most reliable markers for sentinel lymph node detection. However, it seems that this agent is extremely useful in order to achieve better short-term and long-term results after cervical cancer surgery, due to its capacity to determine the uterine vascular perfusion in cases in which conservative treatment, such as trachelectomy, is performed, as well as to prevent and treat lower limb lymphedema. A literature review was conducted of the studies which focused on the role of ICG utility in cervical cancer patients besides sentinel lymph node detection, special focus was given to vascularization preservation and lower limb lymphedema prevention and treatment.
Keywords: cervical cancer; indocyanine green; lower limb lymphedema; sentinel lymph node; vascularization.
Copyright © 2020, Spandidos Publications.
supplementary info
Is mucosa-associated lymphoid tissue lymphoma an infectious disease? Role of Helicobacter pylori and eradication antibiotic therapy (Review)
- PMID: 32905014
- PMCID: PMC7464990
- DOI: 10.3892/etm.2020.9031
Abstract
Mucosa-associated lymphoid tissue lymphoma (MALT) is seldom considered a diagnosis hypothesis in symptomatic patients. These lymphomas present as a main risk factor for chronic gastritis due to Helicobacter pylori infection. H. pylori leads to chronic inflammation, producing lymphoid tissue in the stomach mucosa (MALT) possibly leading to malignant transformation. Even though H. pylori remains one of the most important factors in the development of MALT lymphoma, it is not mandatory in the evolution of MALT lymphoma since high-grade lymphomas present a lower prevalence of H. pylori. The prevalence of H. pylori is indirectly proportional with the progression into the gastric wall. Mucosal and submucosal MALT lymphomas have a higher prevalence of the bacteria. However, genetic factors remain a risk factor especially if eradication treatment fails. Even though a low percentage of MALT lymphomas are H. pylori-negative, some respond to antibiotic eradication treatment. This can be explained either by the immunomodulatory effect of antibiotics or by other infectious sources such as Helicobacter heilmannii and Campylobacter jejuni (small bowel lymphoma). Treatment in MALT gastric lymphoma was a breakthrough since it was the first time in oncology where tumours were cured by antibiotic therapy, leading us to wonder if MALT lymphomas are infectious disease or not?
Keywords: Helicobacter pylori; MALT; infection; lymphoma; translation.
Copyright © 2020, Spandidos Publications.
supplementary info
Multiple sclerosis, human herpesvirus 4 and thyroid collision tumor: A case report
- PMID: 32905114
- PMCID: PMC7465335
- DOI: 10.3892/etm.2020.8975
Abstract
The role of interferon β-1b (IFNβ-1b), used for multiple sclerosis (MS) therapy, in cancer occurrence is uncertain. There is evidence supporting the role of human herpesvirus 4 [Epstein-Barr virus (EBV)] in thyroid cancer and MS. Simultaneous occurrence of papillary and medullary carcinomas is rare, and its association with MS in a young woman raises questions. A 46-year-old female patient was diagnosed with relapsing-remitting multiple sclerosis in 2008. In 2018, cervical MRI detected a thyroid nodule with right cervical adenopathy. Her thyroid function was normal, but increased calcitonin levels were found (70.53 pg/ml; normal value: <9.82 pg/ml). EBV serology tested positive. Paraclinical studies ruled out multiple endocrine neoplasia syndrome. Whole thyroid resection with whole cervical lymph node dissection was performed. To our knowledge, this is the first case that describes an association between MS and thyroid collision tumors. Histological examination ascertained both papillary and medullary thyroid cancer. After surgery, the calcitonin level normalized, and the patient received a therapeutic dose of iodine-131. IFNβ-1b therapy was discontinued. The coexistence of thyroid cancers in MS patients could be explained by immune-mediated inflammation. Although EBV is not the only agent responsible for the development of MS or thyroid cancers, it could be considered a contributory factor in our case. Further research on EBV involvement in the occurrence of simultaneous immune pathologies in various organs is needed to confirm these data.
Keywords: calcitonin; disease-modifying therapy; human herpesvirus 4; immunohistochemistry; interferon β-1b; medullary thyroid carcinoma; multiple sclerosis; papillary thyroid cancer; thyroglobulin; thyroid collision tumors.
Copyright © 2020, Spandidos Publications.
A decreasing trend in toxoplasma gondii seroprevalence among pregnant women in Romania - results of a large scale study
- PMID: 32905270
- PMCID: PMC7465070
- DOI: 10.3892/etm.2020.9012
Abstract
Toxoplasmosis is a zoonotic infection caused by the obligate intracellular apicomplexan parasite Toxoplasma gondii (T. gondii). T. gondii infection is a cause of congenital infection worldwide. Primary infection or the reactivation of latent infection during pregnancy may lead to fetal infection and to congenital toxoplasmosis syndrome. Seropositive pregnant women are generally protected from maternal-fetal transmission of T. gondii, although exceptions exist. The aim of our study was to analyze the dynamics of T. gondii seroprevalence during a 10-year period and to correlate it with age and demographic features of pregnant women. We tested 6,889 pregnant women in Timisoara, Romania, for IgG-anti-T. gondii antibodies, in two successive periods: i) 2008-2010 (group 1: 1,457 participants); and ii) 2015-2018 (group 2: 5,432 participants). For each participant, data on age and area of residence were collected. Our results showed that in the Western Region of Romania T. gondii seroprevalence in pregnant women declined from 43.79 to 38.81% in the last ten years. This trend was observed in both urban (40.53 vs. 34.85%) and rural areas (52.22 vs. 46.22%). A higher seroprevalence rate was found in rural than in urban areas. In addition, we found an increasing tendency of seroprevalence related to the age of pregnant women.
Keywords: Toxoplasma gondii; congenital toxoplasmosis syndrome; demography; pregnant women; seroprevalence.
Copyright: © Motoi et al.
Azithromycin combined with doxycycline in non-gonococcal urethritis
- PMID: 32905367
- PMCID: PMC7468211
- DOI: 10.3892/etm.2020.9125
Abstract
Non-gonococcal urethritis (NGU) is one of the most common sexually transmitted diseases caused by chlamydia or mycoplasma. The present study aimed to explore the clinical efficacy of azithromycin combined with doxycycline in patients with NGU and its effect on serum levels of inflammatory cytokine interleukin-6 (IL-6). A total of 98 patients with non-gonococcal urethritis were prospectively selected, of which 46 patients were assigned to an azithromycin group (treated with azithromycin alone), while the rest were assigned to a combination group (treated with azithromycin and doxycycline). The conditions of the patients were evaluated and compared between the two groups. The treatment efficacy in patients in the combination group was significantly better than that in the azithromycin group, and the time to symptom relief, period of medication, recurrence rate within 1 year of withdrawal and level of serum IL-6 in the combination group were significantly lower than those in the azithromycin group. The quality of life of patients in the combination group was significantly improved compared to those in the azithromycin group. However, there was no significant difference in the incidence of adverse reactions between the two groups. Azithromycin combined with doxycycline was revealed to be more effective than azithromycin monotherapy for NGU.
Keywords: IL-6; azithromycin; clinical efficacy; doxycycline; non-gonococcal urethritis.
Copyright © 2020, Spandidos Publications.
Aggressive behavior in psychiatric patients in relation to hormonal imbalance (Review)
- PMID: 32905000
- PMCID: PMC7465123
- DOI: 10.3892/etm.2020.8974
Abstract
Aggressive behavior is one of the main characteristics of different psychiatric disorders such as: personality disorders (antisocial personality disorder, borderline personality disorder), schizophrenia, intermittent explosive disorder, post-traumatic stress disorder, bipolar disorder, depression, alcohol/substance induced psychiatric disorders. Epidemiological evidence shows that always there is a higher risk of violence and aggressivity among patients with psychiatric disorders compared with general population. Researchers have tried many times to narrow the theories that can explain such a behavior, starting from models that involve a link between illness and aggression going up to external-environmental factors including the therapeutic relation in the hospital. Even if the majority of studies are centered on intoxications (with alcohol or other substances that potentiate the aggressive behavior) we will highlight another somatic dimension linked with this behavior. In the following review we summarize the hormonal imbalances that have been noted to accompany aggressive behavior in different psychiatric disorders. Several studies have been made starting even at the age of ten corelating hormone cortisol with increase aggression, but patients with psychiatric disorders have a higher sensitivity in linking hormonal imbalance with their behavior.
Keywords: aggressive behavior; hormonal imbalance; psychiatric patient; serotonin; thyroid hormones.
Copyright: © Trifu et al.
supplementary info
Acyclovir-induced immune thrombocytopenia: Case report and review of the literature
- PMID: 32905113
- PMCID: PMC7465056
- DOI: 10.3892/etm.2020.8971
Abstract
There are a number of medications which can serve as catalysts for drug-induced immune thrombocytopenia (DIPT). A minimum of six different mechanisms have been put forward as the means by which drug-induced antibodies can encourage platelet destruction, thus emphasising the complexity of the pathogenesis of DITP. Acyclovir, has been widely used because of its highly potent prohibitive properties for infections caused by HSV and VZV. The common adverse effects of this drug are well known, the severe adverse reactions are mostly related to high dose intravenous administrations. The immune thrombocytopenia induced by acyclovir is unusual. The authors present a rare clinical case of acyclovir-induced immune thrombocytopenia in a 72-year-old female patient with typical herpes zoster treated with acyclovir. The clinical and laboratory findings, taken together with the transitory relationship between acycolvir and the start of thrombocytopenia, combined with the elimination of the other know sources of thrombocytopenia, allowed us to reach the diagnosis of acyclovir-induced immune thrombocytopenia. An international database search was employed to complete an extensive review of the current literature. Contemporary information on acyclovir-induced immune thrombocytopenia was collected by the analysis of present day review articles and accessible case reports. The authors found five published cases of acyclovir-induced immune thrombocytopenia. Analyzing these articles it was concluded that immune thrombocytopenia induced by acyclovir is rare, and an unusual side effect, with good prognosis. Prompt diagnosis is vital to appropriate management, therefore clinicians need to be cognisant of this rare potential adverse reaction.
Keywords: acyclovir; adverse reactions; drug induced; herpes zoster; thrombocytopenia.
Copyright © 2020, Spandidos Publications.
Interleukin-1A and interleukin-1B gene polymorphisms in gastroesophageal reflux disease
- PMID: 32904982
- PMCID: PMC7465525
- DOI: 10.3892/etm.2020.9030
Abstract
Inflammation may play contradictory roles in the pathogenesis of gastroesophageal reflux disease (GERD): gastritis decreases gastric output and reduces the risk of esophagitis, while interleukins may favor mucosal inflammation. The inflammation may cause esogastric motility changes and thus increase the risk of esophagitis. Considering the genetic influence of inflammatory response, we looked for the genetic polymorphisms of IL-1 in GERD manifested as reflux esophagitis. This is a prospective study carried out in GERD and healthy controls. We assessed in these groups the following single nucleotide polymorphisms (SNPs): IL-1A (rs1800587), IL-1B (rs16944), IL-1B (rs1143634) and the VNTR for IL-1RN. Both groups were similar according to biographical data. Reflux esophagitis was confirmed by endoscopy and where necessary by pH-impedance monitoring. Reflux esophagitis was associated only with the polymorphism rs16944. No other correlations with the other three genetic polymorphisms were detected. These data suggest that the diverging effects of proinflammatory factors on the upper digestive tract may have deleterious effect on GERD. The IL-1B (rs16944) SNP correlates with reflux esophagitis.
Keywords: Gastroesophageal reflux disease; genetic polymorphisms; heartburn; interleukins; mucosal inflammation.
Copyright: © Picos et al.
Efficacy of antibiotic-impregnated shunt versus conventional shunts to reduce cerebrospinal fluid infections in children: A systematic review and meta-analysis
- PMID: 32905131
- PMCID: PMC7465504
- DOI: 10.3892/etm.2020.9122
Abstract
Hydrocephalus is among the most common pediatric conditions treated by neurosurgeons. An antibiotic-impregnated shunt (AIS) was designed to reduce the rate of shunt infections. The objective of this systematic review and meta-analysis was to assess the efficiency of AIS in reducing the rate of shunt infection compared with standard shunts (SSs). A systematic search of PubMed, EMBASE, Medline, Cochrane Library, TRIP Database, CINAHL and Google Scholar databases was performed. Eligible studies included observational studies and randomized controlled trials (RCT) that compared the effects of AIS and SS for preventing shunt infections in pediatric patients. Twelve observational studies and one RCT conducted from January 2005 through October 2019 involving 7,952 pediatric patients were included in the analysis. The use of AIS significantly decreased the risk of CRI [risk ratio (RR) 0.42; 95% confidence interval: 0.33 to 0.53; P<0.00001] with no statistical heterogeneity across the included studies (I2=42%). This analysis demonstrates that the use of AIS significantly reduces the risk of shunt infection in pediatric patients.
Keywords: antibiotic-impregnated shunt; cerebrospinal fluid infection; conventional shunts; meta-analysis.
Copyright: © Qiu et al.
Dormant cardiac stem cells: A promising tool in cardiac regeneration
- PMID: 32905130
- PMCID: PMC7465489
- DOI: 10.3892/etm.2020.9015
Abstract
Stem cells represent an old niche with various new potential therapeutics. Besides drug treatment, reperfusion procedures and surgical revascularization, stem cell therapy could be a good option in ischemic cardiac diseases. A study was performed on a small group of cases who died of cardiac arrhythmia secondary to scarring myocardial infarctions. Tissue cardiac samples were taken from these cases (from the anterior and lateral wall of the left ventricle), for microscopy examination, in order to investigate the presence of cardiac stem cells (CSC). Multiple series of histological sections were also performed and examined, along with immunohistochemical analysis (IHC). The cells were identified in close contact with the residual ischemic cardiomyocytes, in the proximity of the myocardial collagenous scar, in old myocardial infarctions. They were activated by hypoxic ischemia and were influenced by the capillary microvascular density and the interstitial micro-environment conditions. In chronic intermittent ischemia they seem to turn themselves from dormant quiescent cells into activated progenitor committed cells.
Keywords: CD117; CD34; CD56; cardiac stem cells; myocardial infarction.
Copyright: © Ceausu et al.
Klebsiella pneumoniae infection inhibits autophagy by alveolar type II epithelial cells
- PMID: 32905119
- PMCID: PMC7465052
- DOI: 10.3892/etm.2020.9123
Abstract
To investigate the molecular mechanism underlying the interaction between autophagosomes of alveolar type II epithelial (A549) cells and Klebsiella pneumoniae, an in vitro model of K. pneumoniae-infected A549 cells was established. Western blot analysis and immunofluorescence staining were used to detect the distribution of microtubule-associated protein 1A/1B-light chain 3 (LC3) and the expression of the LC3-phosphatidylethanolamine conjugate (LC3-II). K. pneumoniae-infected A549 cells were treated with different concentrations of an autophagy inhibitor or promoter for different time periods to assess the level of autophagy. Western blot analysis and immunofluorescence staining showed that K. pneumoniae could induce autophagy by A549 cells. With an increase in bacterial concentration and time of infection, autophagy gradually increased. The autophagy inhibitor significantly downregulated, while the promoter upregulated, expression of the autophagy-related protein LC3-II. Autophagy plays an important role in the resistance of alveolar type II epithelial (A549) cells to K. pneumoniae infection.
Keywords: Klebsiella pneumoniae; alveolar type II epithelial cells; autophagy.
Copyright: © Shi et al.
Prevalence of Helicobacter pylori infection among dyspeptic patients in Northwestern Romania: A decreasing epidemiological trend in the last 30 years
- PMID: 32905167
- PMCID: PMC7464870
- DOI: 10.3892/etm.2020.9024
Abstract
Infection with Helicobacter pylori (HP) has an unknown prevalence in several Romanian regions. Recent data are missing. The aim of this study was to estimate the prevalence of dyspepsia in the North-West part of Romania and to analyze the epidemiological trends of HP infection prevalence in a symptomatic population in this region by comparing with previous published data. Our study population consisted of 414 patients: 264 female (63.8%) and 150 male (36.2%), mean age 45.89±17.24 years (range, 6-97 years) who attended a single secondary center in Zalau, Salaj, North-West Romania, between 2014 and 2018 for dyspeptic symptoms, either by their own initiative or by referral from their general practitioner. Testing was performed by IgG anti-HP assessment G anti-HP antibodies were found in 169 individuals (40.8%). In females, the prevalence of HP infection was 40.53% (107/264) and in males 41.35% (62/150). There was a higher prevalence of positive antibodies in the rural areas compared with urban areas (42.29 vs. 39.75%). In conclusion, the prevalence of HP infection is 40.8%, without sex differences in dyspeptic patients from a representative population in North-Western Romania and the prevalence increases with age. Comparing our results with those of previous studies on the prevalence of HP infection from the same region, we were able to signal a decline in prevalence in HP infection over a 30-year interval.
Keywords: Helicobacter pylori; anti-Helicobacter pylori antibodies; dyspepsia; infection; prevalence.
Copyright: © Corojan et al.
Reconstruction of superior mesenteric artery by prostheses placement in a case of chronic mesenteric ischemia: A case report and literature review
- PMID: 32905147
- PMCID: PMC7464867
- DOI: 10.3892/etm.2020.9119
Abstract
Although superior mesenteric artery stenosis is a relatively common situation, it is rarely symptomatic due to the fact that in a significant number of cases an adequate collateral circulation exists. The aim of this study is to report a case in which arterial reconstruction was needed due to the absence of such a patent collateral circulation. The 47-year-old patient was investigated for chronic postprandial pain and was diagnosed with superior mesenteric artery stenosis. Percutaneous treatment was the initial option of choice but the patient rapidly became symptomatic again. Therefore surgery was performed, the segment of arterial stenosis was resected and the arterial continuity was re-established by using a synthetic prosthesis. The postoperative outcome was uneventful, the patient was discharged in the seventh postoperative day under anticoagulant therapy. In conclusion, superior mesenteric artery reconstruction by using a synthetic prosthesis can be useful in cases presenting chronic mesenteric ischemia and failure of percutaneous treatment.
Keywords: percutaneous treatment; prosthesis; reconstruction; stenosis; superior mesenteric artery.
Copyright © 2020, Spandidos Publications.
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