[Functional dyspepsia: approved equal to approved therapy?].
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The main source of circulating immunoreactive somatostatin (IRS) seems to be the gastrointestinal tract. We therefore investigated plasma IRS in patients with various gastrointestinal diseases. Mean basal IRS oscillated between 46 and 73 pg/ml. A postprandial rise was observed in all patients and age-matched controls. However, the increment was significantly higher in patients with duodenal ulcer (159 ± 20 pg/ ml), active ulcerative colitis (176 ± 17 pg/ml), and irritable bowel syndrome (194.4 ± 20.4 pg/ml). Patients with duodenal ulcers who underwent vagotomy showed a decreased postprandial increment (107 ± 10 pg/ml) when compared with active duodenal ulcer patients. No difference was demonstrable between controls and individuals with gastric ulcer, and patients with inactive ulcerative colitis. These results suggest that vagal innervation plays a role in postprandial IRS stimulation, whereas gastric hyperacidity, acute lesions of the colonic mucosa, and hypermotility of the gastrointestinal tract are associated with an exaggerated postprandial IRS response. Since somatostatin is known to influence many gastrointestinal functions, these variations in circulating IRS concentrations may be of pathophysiologic importance.
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Abstract Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver disorders worldwide . Acute cholangitis (AC) is a serious and life-threatening illness . We aimed to determine whether NAFLD is a risk factor for severity of AC. Methods: We retrospectively studied hospitalized patients with diagnosis of AC over the span of 5 years. Subjects were divided into a NAFLD group and Non NAFLD group. We compared between the two groups in terms of demographic characteristics, comorbidities, laboratory data, and severity of AC (including Charlson Comorbidity index and Tokyo Consensus meeting criteria). Results: 298 of 419 patients who had AC and were hospitalized met the inclusion criteria and were included in the study. Of them, 73/298 (24.5%) were included in NAFLD group. NAFLD group patients were younger, diabetic and more obese than non NAFLD group. Subjects in the NAFLD presented with higher serum C-reactive protein and higher liver enzymes (p<0.05, for each parameter) and suffered more events of organ dysfunction(p<0.001) and bacteremia (p<0.005). Regarding the severity of AC according to Tokyo classification, among the NAFLD group more subjects presented with Grade II (39.7 Vs 33.3%, p <0.001) and Grade III (23.3 vs 18.3, p<0.001) cholangitis, as opposed more Grade I cholangitis among the non-NAFLD group (48.4 vs 37%, p<0.001). Multivariate logistic regression analysis showed that NAFLD is independently associated with severe AC, grade III (OR 3.25, 95% CI 1.65-6.45, p=0.038). Conclusions: NAFLD is as an independent risk factor for severity of AC.
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Steatosis
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Objective To investigate the frequency and characteristics of hepatopancreatobiliary(HPB) complications among patients with Crohn`s disease(CD) and ulcerative colitis(UC).Methods A total of 606 inflammatory bowel disease(IBD) patients(68 CD,538 UC) treated by our hospital between 1990 and 2010 and 606 healthy subjects matched for age,sex,and body mass index(BMI) were enrolled.Frequency of HPB complications including gallstone disease(GD),nonalcoholic fatty liver disease(NAFLD),primary biliary cirrhosis(PBC),primary sclerosing cholangitis(PSC),autoimmune hepatitis(AIH),and chronic pancreatitis(CP) were compared between the IBD group and the control group.OR,95% confidence intervals(95%CI),and P values were calculated.P0.05 was considered statistically significant.Results The frequency of gallstone disease was 51.47%(35/68) among CD patients[OR=10.96,95%CI(4.181,28.724)] and 34.01%(183/538) among UC patients[OR=5.79,95%CI(4.053,8.264)],significantly different from that among the control group(P0.01).The frequency of NAFLD was 64.71%(44/68) among CD patients[OR=8.56,95%CI(3.854,18.994)] and 69.33%(373/538) among UC patients[OR=8.41,95%CI(6.378,11.084)],significantly different from that in the control group(P0.01).Screening for IBD in Patients with uncommon HPB diseases showed that the frequency of PBC,PSC,AIH,and CP were 2.25%(7/311),4.49%(4/89),3.33%(2/60),and 0.93%(2/213),respectively.Conclusion GD and NAFLD are among the most common extraintestinal manifestations of IBD,especially in patients with CD or UC.We suggest that the diseased of IBD and HPB be reciprocally screened under a normalized system.
Primary Sclerosing Cholangitis
Primary Biliary Cirrhosis
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Abstract Background Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Researchers have tried to develop indices to assess liver fibrosis in NAFLD patients to avoid liver biopsy. In this study we aimed to compare fibrosis-4 (FIB-4), aspartate aminotransferase (AST) to platelet ratio index (APRI), and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio with FibroScan for the assessment of hepatic fibrosis in patients with NAFLD. Methods This cross-sectional study included patients with NAFLD or non-alcoholic steatohepatitis (NASH) referred to the Gastroenterology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran, in 2019. Demographic features of the participants including age and gender were recorded. All participants underwent FibroScan and had their AST, ALT, and platelet count measured in a random blood sample, taken within 1 month of the FibroScan. Results Of the 205 NAFLD patients included in this study with a mean age of 42.95 ± 10.97 years, 144 (70.2%) were male. Fibroscan results revealed that 94 patients (45.9%) had F1, 67 (32.7%) F2, 29 (14.1%) F3, and 15 (7.3%) F4 liver fibrosis. A significant correlation was found between FibroScan score and FIB-4 (r = 0.572), APRI (r = 0.667), and AST/ALT (r = 0.251) ( P < 0.001). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of APRI at the 0.702 cut-off for the differentiation of F3 and F4 from F2 and F1 were 84.1, 88.2, 66.1, 95.3, and 87.3%, FIB-4 at the 1.19 cut-off 97.7, 72.7, 49.4, 99.2 and 78%, and AST/ALT at the 0.94 cut-off 61.4, 77, 42.2, 87.9, and 73.7% respectively. Moreover, the area under the receiver operating curve of APRI, FIB-4, and AST/ALT for the differentiation of F3 and F4 from F2 and F1 was 0.923, 0.913, and 0.720, respectively. Conclusions Based on these results, APRI appears to be the most appropriate substitute of FibroScan for the detection of significant fibrosis in NAFLD patients. FIB-4 was the second best, suggesting that in case of FibroScan unavailability, APRI and FIB-4 are the best indices to assess liver fibrosis in NAFLD patients.
Steatohepatitis
Shahid
Aspartate transaminase
Liver disease
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The basal acid output (BAO), post-pentagastrin acid output (MAO), fasting and post-prandial gastrin levels in 40 patients with proven cirrhosis of the liver were compared with those in 20 normal controls. The mean BAO and MAO were significantly lower than normal, the mean fasting gastrin level was significantly higher than normal, and the postprandial gastrin response was significantly increased and prolonged. These differences were still significant even when the patients were divided into cryptogenic and alcoholic subgroups. A significant inverse relationship between MAO and the integrated gastrin response to meal was observed both in the normal controls and in the cirrhotic patients. The MAO and integrated gastrin response of the cirrhotic patients did not correlate with the degree of liver function impairment. In five cirrhotic patients fasting and postprandial gastrin levels were unchanged after splenorenal shunt operation. A more consistent abnormality of the gastric mucosa as assessed by endoscopy and biopsies appeared to be mucosal congestion with occasional atrophic gastritis. the severity of mucosal abnormality, however, was unrelated to the degree of hypoacidity. these results indicate, firstly, that the hypergastrinaemia in cirrhotic patients is a reflection of gastric hypoacidity and bears no direct relationship to hepatic dysfunction. Secondly, the gastric hypoacidity does not accrue solely from mucosal abnormality. It is suggested that this hypoacidity may result from the presence of excessive amounts of circulating acid-inhibiting intestinal peptides, which the diseased liver fails to metabolise.
Abnormality
Pentagastrin
Basal (medicine)
Atrophic gastritis
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Electrogastrogram
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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The nationally-recognized Susquehanna
Chorale will delight audiences of all
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music making, successful in their
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working at an extremely high
musical level.AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA¢AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA Experience choral
singing that will take you to new
heights!
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