Abdominal pain is a common symptom of gastroenterology examination. Chronic abdominal pain is present for >3 months.
Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal ...diseases encountered by both gastroenterologists and general practitioners. GERD is usually a chronic disease presented with a set of symptoms including heartburn and/or regurgitation, and less commonly epigastric pain. Epigastric pain syndrome is characterized by the following symptoms: epigastric pain and/or burning. It does not necessarily occur after meal ingestion, may occur during fasting, and can be even improved by meal ingestion. Duodenal ulcers tend to cause abdominal pain that is localized in the epigastric region and commence several hours after eating, often at night. Hunger provokes pain in most of the cases and decreases after meal. Gastric ulcer pain occurs immediately after eating, and consuming food increases pain. Pain is localized in the epigastrium and can radiate to the back. Abdominal pain in irritable bowel syndrome is related to defecation. A typical symptom of chronic pancreatitis is pain that radiates to the back. In Crohn's disease, inflammation causes pain. Key Messages: Pain can occur at different locations with diverse intensity and propagation and is often associated with other symptoms. For any gastroenterologist, abdominal pain is a big challenge.
Arsenic in drinking water presents a serious public health problem in Serbia, but its relationship with diabetes has not been studied previously. The aim of this study was to explore the association ...between exposure to arsenic in drinking water and the occurrence of type 2 diabetes in Middle Banat region, Serbia.
This cross-sectional study comprised two populations. Exposed population in Middle Banat region consumes drinking water with arsenic (mean=56μg/L); unexposed population from six regions in Central Serbia consumes arsenic below detection limit (2μg/L). Newly diagnosed cases of type 2 diabetes were obtained from the National Registry of Diabetes in 2008. The Registry included age, gender, family history of diabetes, presence of overweight, central obesity, cholesterol and triglyceride levels. In addition, the number of cases of diabetes reported in years 2006, 2007 and 2009 was used to calculate standardized incidence rates for both populations.
Two populations were comparable by age, family history of diabetes and prevalence of overweight persons. Unexposed population was more likely to have central obesity, and high total cholesterol and triglycerides. Standardized incidence rates of type 2 diabetes were higher in exposed population. Odds ratios for type 2 diabetes were significantly higher for the exposed population, both men and women, in the period from 2006 to 2009, when compared with the unexposed population.
The population from Middle Banat region, consuming drinking water with low levels of arsenic, was at higher risk for the occurrence of type 2 diabetes in comparison to the unexposed population in Central Serbia.
Mucosal gene expression have not been fully enlightened in inflammatory bowel disease (IBD). Aim of this study was to define IL23A, IL17A, IL17F and TLR9 expression in different IBD phenotypes.
...Evaluation of mRNA levels was performed in paired non-inflamed and inflamed mucosal biopsies of newly diagnosed 50 Crohn's disease (CD) and 54 ulcerative colitis (UC) patients by quantitative real-time PCR analysis.
IL17A and IL17F expression levels were significantly increased in inflamed IBD mucosa. Inflamed CD ileal and UC mucosa showed increased IL23A, while only inflamed CD ileal samples showed increased TLR9 mRNA level. Correlation between analysed mRNAs levels and endoscopic and clinical disease activity were found in UC, but only with clinical activity in CD.
Both CD and UC presented expression of Th17-associated genes. Nevertheless, expression profiles between different disease forms varies which should be taken into account for future research and therapeutics strategies.
•Upregulated IL17A and IL17F expression was demonstrated in inflamed IBD mucosa.•Upregulated TLR9 and IL23A expression was observed for inflamed CD ileum.•Upregulated IL23A expression was found in inflamed UC colon.•Analysed mRNA levels correlated with clinical and endoscopic disease activity scores.•Analysed mRNA levels in non-inflamed gut mucosa may indicate severe IBD course.
Purpose
– The purpose of the paper is to research local sustainable development strategic planning processes and practices in the Drina River Basin (geographical area delineated by the river Drina ...and shared among Bosnia and Herzegovina, Montenegro and Serbia).
Design/methodology/approach
– Research methodology included the analysis of the existing country-based strategic documents and processes, as well as the local strategic documents and processes of implementation in 21 municipalities in the Drina River Basin, including interviews with the representatives of central and local governments and civil sector and a questionnaire-based assessment of the situation and needs in municipalities.
Findings
– The paper argues that local sustainable development planning, although still lacking the proper methodological approach and facing insufficiencies in institutional and implementation capacities is becoming more appreciated by local authorities in the region.
Originality/value
– The findings should help better understand the interactions between local government institutions and civil society in the Drina River Basin municipalities in achieving local sustainable development, as well as the conditions enabling improved communication networks and capacity building.
This study analyzed poorly understood relationship of two overlapping conditions: metabolic syndrome (MeS) and inflammatory bowel disease (IBD), both associated with inflammation in the visceral ...adipose tissue.
Newly diagnosed 104 IBD patients, of which 50 Crohn's disease (CD) and 54 ulcerative colitis (UC), and 45 non-IBD controls were examined for MeS-related obesity and lipid markers. Th-17 immune genes
,
,
and
mRNAs were measured in intestinal mucosa by qRT-PCR. Subjects were genotyped for obesity-associated
variant rs9939609 by polymerase chain reaction-amplification refractory mutation system.
CD was associated with MeS (
= 0.01), while both CD and UC were associated with central obesity (
= 10
,
= 0.002, respectively) and low levels of high-density lipoprotein (HDL) cholesterol (
= 5 × 10
,
= 6 × 10
, respectively). IBD lipid profile was characterized by decreased total and HDL cholesterol, while low-density lipoprotein cholesterol was reduced only in CD. Negative correlations were found between total cholesterol and CD activity index (
= 0.005), waist circumference and
as well as
mRNA levels in inflamed CD colon (
= 0.003,
= 0.001, respectively). Carriers of
rs9939609 AA genotype showed increased risk of CD (OR 2.6,
= 0.01).
MeS, central obesity, and dyslipidemia could be important for IBD pathogenesis. This could influence therapeutic approaches and prevention strategies in high-risk groups.
Background: In 2009, Belgrade nephrologists and general practitioners from thirteen health centers carried out screening for chronic kidney disease (CKD). Three years later, medical records of ...patients from four health centers participating in the screening study were retrospectively analyzed in order to check whether general practitioners had continued to control patients at risk for CKD in accordance with the recommendations provided.
Methods: The study included 460 patients who visited their doctor at least once in the three-year period. Data on blood pressure, ACEI use, estimated glomerular filtration rate (eGFR) and comorbidities were taken from patients' medical records.
Results: Blood pressure was not recorded in any of the three years in 42.8% and eGFR in 36.7% of the patients, but blood pressure was registered every year in 7.8% and eGFR in 4.3% of them. Over the three years, the relative number of patients with recorded blood pressure decreased from 41.7% to 17.8%, and with recorded eGFR from 41.7% to 21.5%. Multivariate linear regression found that Health Center, systolic and diastolic blood pressure and presence of hypertension were negatively associated with number of years with recorded blood pressure. Health Center, systolic blood pressure and sum of years with recorded eGFR below 60 ml/min/1.73m
2
were associated with number of years with recorded eGFR.
Conclusions: Under-recording of blood pressure and eGFR in primary care health centers suggests lack of adherence to current guidelines and insufficient care of CKD patients. This implies the necessity for continuous education of physicians.
Two neutral enantiopure arene-ruthenium(II) complexes, (arene)Ru
II
(κ
2
(1S,3R)-Ar)Cl
2
(1, 2), arene = p-cymene, Ar = o-tolyl or mesityl, derived from the reaction of arene-ruthenium(II) dimers ...and 1,3-diamino camphor based derivatives, were synthesized. The N1-mesityl-2,2,3-trimethylcyclopentane-1,3-diamine ligand and complex 2 are characterized via X-ray crystallography. Single crystal X-ray structure analysis revealed that 2 crystallizes in monoclinic space group P21 with Z = 4, a = 7.7724(14), b = 14.262(3), c = 14.433(3) Å. Reactivity measurements using UV-Vis of the Ru
II
-arene complexes with guanosine-5′-monophosphate (5′-GMP), 9-methylguanine (9MeG), and L-methionine (L-Met) showed a high affinity towards these nucleophiles. Also, DFT calculations with 2 showed that the reaction with a guanine derivative is thermodynamically favored. Furthermore, the Ru
II
-arene complexes were found to interact with CT-DNA and HT-DNA, and protein BSA. The cytotoxicities of 1 and 2 have been evaluated against human breast cancer cell line (MDA-MB), human cancer colon cell line (HCT-116), human lung carcinoma epithelial cell line (A549), mouse melanoma cell line (B16F10), and mesenchymal stem cells (MSCs) and compared to cisplatin as standard analog. The complexes display relevant activities against all cancer cell lines.
To evaluate the extent to which families of children with developmental disabilities, in relation to parents of typically developing children, feel empowered and the way that their empowerment ...manifests itself.
The comparative research design was used in a quantitative, descriptive analysis of 99 families (57.6% were parents of children with developmental disabilities and 42.4% were parents of typically developing children). With regard to the research instrument, the Family Empowerment Scale was used based on a conceptual framework consisting of two dimensions: the level of empowerment and the way it is expressed.
Results: The highest levels of parental empowerment were observed in the Family domain (M = 3.9; SD = 0.6), while the lowest were in the Community domain (M = 2.9, SD = 0.9). The statistical differences between the comparing groups of parents were most pronounced in the Family domain (Mann-Whitney U = 693.00, p = 0.00). Parents of children with developmental disabilities have demonstrated a lower level of family empowerment associated with attitudes, as well as behaviours and knowledge about specific ways in which they can help their child.
Based on data obtained from this study, it can be concluded that parents of children with developmental disabilities require extra support and empowerment in order to take a more active part in working with their child and making decisions relevant to his/her development in order to utilize all community – based resources available.
•It is necessary to provide parental support so that they can be of use in pediatric nursing practice.
Insect silk has been widely studied for its application in regenerative medicine. However, the data about Plodia interpunctella silk as a biomaterial and its anticancer properties are insufficient. ...Thus, the aim of this study was to investigate native silk as a substrate for growing normal human fibroblasts MRC-5, and test potential cytotoxic effects of the two silk extracts (with DMSO and Trypsin for sericin isolation) on HCT-116 colorectal carcinoma cells and MRC-5 fibroblasts as a control. Fifth-instar larval silk, collected for 15 and 30 days, was used for testing of proliferation and adhesion of MRC-5, 24 h and 72 h after seeding. Light- and fluorescence-microscope showed cell adhesion and spread on silk, as well as enhanced number of cells after 72 compared to 24 h and nonsignificant percentage of apoptotic cells on the silk. Although insoluble, P. interpunctella silk showed remarkable cytotoxic activity on HCT-116 cells, without significant cytotoxity on normal fibroblasts after 24 h and weak effects after 72 h. This study provides significant information about P. interpunctella silk as a potential biomaterial and shows the presence of some active constituents with anticancer properties, thus pointing to the possibility for exploitation of this worldwide pest insect in biomedical application.
Crohn's disease (CD) is chronic inflammatory bowel disease with different phenotypic characteristics influencing disease prognosis and therapeutic strategies. The aim of this pilot study was to ...analyze selected inflammatory and apoptotic markers in non-inflamed and inflamed samples of ileal mucosa of non-stricturing/non-penetrating (NS/NP) and stricturing (S) CD mucosal phenotypes in order to characterize their distinct profiles.
From twenty CD patients (9 NS/NP, 11 S) paired non-inflamed and inflamed ileal biopsies were collected and used for analysis of cytokine (TNF and IL6) and apoptotic (Bcl2, Bax, Fas and FasL) genes' expression levels by real-time PCR, while NFκB transcriptional potency was assessed by electromobility gel shift assay.
Our results demonstrated significant upregulation of TNF and IL6 in inflamed area of both NS/NP (p = 0.03, p = 0.01) and S phenotypes (p = 0.04, p = 0.04), respectively. However, TNF increase was more prominent in NS/NP compared to S inflamed mucosa (p = 0.02). Also, level of proapoptotic Bax was significantly higher in NS/NP compared to S inflamed mucosa (p = 0.01). Opposing transcription potency of NFκB has been detected between two phenotypes: being decreased in NS/NP (p = 0.07) and increased in S (p = 0.1) inflamed compared to non-inflamed mucosa, demonstrating trend towards statistical significance.
We found that two distinct CD phenotypes have specific molecular signatures. Obtained results could direct improvement of current and development of new therapeutic strategies based on more specific molecular stratification of CD patients.
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