ABSTRACT
The safety and health effects for celiac people of a novel beverage (SOFB) developed from sprouted oat flour by fermentation with Lactobacillus plantarum was explored. In vitro reactivity against anti-gliadin antibodies (AGA) and antioxidant/anti-inflammatory potential of SOFB in RAW 264.7 macrophages and Caco-2 cells were evaluated. Immunoreactivity against AGA and antioxidant activity were not detected in SOFB, but it exhibited significant anti-inflammatory activity. The tolerability and impact of SOFB consumption for 6 months on nutritional status and intestinal microbiota composition were investigated in 10 celiac adults (five treated and five control). SOFB consumption did not adversely affect duodenal mucosa nor the total IgA or anti-tissue transglutaminase antibody (IgA-tTG) levels in celiac participants, but it significantly decreased total cholesterol levels at all sampling times and folic acid levels at the end of the study compared to the placebo beverage. SOFB administration also shifted gut microbiota, leading to a higher relative abundance of some beneficial bacteria including the genera Subdoligranulum, Ruminococcus and Lactobacillus in the SOFB group. This study provides supporting evidence of the safety of health benefits of a novel functional beverage produced from sprouted oat.
Subject(s)
Avena , Celiac Disease/diet therapy , Fermented Foods , Seedlings , Animals , Anti-Inflammatory Agents , Antibodies/immunology , Antioxidants , Avena/immunology , Caco-2 Cells , Functional Food , Gastrointestinal Microbiome , Gliadin/immunology , Glutens/analysis , Humans , Immunoglobulin A/analysis , Immunoglobulin A/immunology , Lactobacillus plantarum/metabolism , Mice , Nutritional Status , RAW 264.7 CellsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Gastrointestinal Hemorrhage/complications , Endosonography , Duodenal Ulcer/diagnostic imaging , Embolization, Therapeutic/adverse effects , Gastrointestinal Hemorrhage/diagnostic imaging , Carcinoma, Hepatocellular/pathology , Cholecystostomy/methods , Cholangiography , Angiography , Duodenal Ulcer/complications , Celiac Artery/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Epidermal Cyst/diagnosis , Epidermal Cyst/pathology , Adenocarcinoma/diagnosis , Appendicitis/surgery , Gardner Syndrome/diagnosis , Polyps/diagnosis , Colonoscopy , Appendicitis/radiotherapy , Metastasectomy/methods , Fluorouracil/administration & dosage , Diagnosis, Differential , Cell Nucleus/pathologyABSTRACT
Background: Seronegative celiac disease (CD) poses a diagnostic challenge. Aims: Characterize and identify differences between seronegative and seropositive CD. Patients and methods: Retrospective cohort study examining adult patients diagnosed with CD (1980-2017). Clinical, analytical, histological, genetic and immunophenotypic data were compiled. Seronegative CD was defined as a anti-tissue transglutaminase type 2 IgA and endomysial antibodies (EMA) negative and HLA-DQ2 and/or DQ8 positive, showing clinical signs of CD plus an abnormal duodenal biopsy, and responding to a gluten-free diet (GFD). Factors associated with seronegative CD were identified through binomial logistic regression. Results: Of 315 CD patients, 289 were seropositive (91.7%) and 26 seronegative (8.3%). Among the seronegative patients, higher prevalence was observed for autoimmune thyroiditis (26.9% vs. 9.7%, p = .016), HLA-DQ8 heterozygosity (23.1% vs. 2.5%, p Ë .001) and Marsh I lesion (34.6% vs. 3.7%, p Ë .001). The two groups showed similar flow cytometry-determined duodenal immunophenotypes and rates of refractory CD. Conclusions: Seronegative CD differs mostly in genetic (more HLA-DQ8) and histologic (milder atrophy) features as compared with seropositive. Intestinal intraepithelial immunophenotype by flow cytometry, similar in both modalities, is a useful tool to diagnose seronegative CD.
Subject(s)
Celiac Disease/genetics , Celiac Disease/pathology , Duodenum/pathology , Lymphocytes/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Atrophy , Autoantibodies/blood , Biopsy , Celiac Disease/diagnosis , Celiac Disease/diet therapy , Diet, Gluten-Free , Duodenal Diseases/diagnosis , Duodenal Diseases/genetics , Duodenal Diseases/pathology , Female , Flow Cytometry , GTP-Binding Proteins/blood , HLA-DQ Antigens/genetics , Humans , Immunoglobulin A/immunology , Intestinal Mucosa/pathology , Logistic Models , Male , Middle Aged , Protein Glutamine gamma Glutamyltransferase 2 , Retrospective Studies , Transglutaminases/blood , Young AdultSubject(s)
Epidermal Cyst/pathology , Neoplastic Syndromes, Hereditary/diagnosis , Skin Diseases/pathology , Adenocarcinoma/diagnosis , Adenocarcinoma/genetics , Adenocarcinoma/therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendectomy , Appendiceal Neoplasms/diagnosis , Appendiceal Neoplasms/genetics , Appendiceal Neoplasms/therapy , Asymptomatic Diseases , Carcinoid Tumor/diagnosis , Carcinoid Tumor/genetics , Carcinoid Tumor/therapy , Chemotherapy, Adjuvant , Combined Modality Therapy , Diagnosis, Differential , Endoscopy, Digestive System , Epidermal Cyst/genetics , Epidermal Cyst/surgery , Fluorouracil/administration & dosage , Gardner Syndrome/diagnosis , Gardner Syndrome/genetics , Head , Hepatectomy , Humans , Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Liver Neoplasms/therapy , Male , Neoadjuvant Therapy , Neoplastic Syndromes, Hereditary/pathology , Oxaliplatin/administration & dosage , Rectal Neoplasms/diagnosis , Rectal Neoplasms/genetics , Rectal Neoplasms/surgery , Skin Diseases/genetics , Skin Diseases/surgerySubject(s)
Drainage/adverse effects , Endosonography/adverse effects , Gastrointestinal Hemorrhage/etiology , Ultrasonography, Interventional/adverse effects , Aged, 80 and over , Carcinoma, Hepatocellular/complications , Cholecystitis, Acute/complications , Cholecystitis, Acute/surgery , Cholecystostomy , Cholelithiasis/complications , Cholelithiasis/surgery , Drainage/methods , Duodenal Ulcer/complications , Embolization, Therapeutic , Gastrointestinal Hemorrhage/therapy , Hemostatic Techniques , Humans , Liver Neoplasms/complications , Male , Palliative Care , Peptic Ulcer Hemorrhage/etiology , Peptic Ulcer Hemorrhage/therapy , Sclerosing Solutions/therapeutic use , Sclerotherapy , Shock/etiology , Shock, Septic/etiology , Stents , Ultrasonography, Interventional/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Esophagus/injuries , Gastrointestinal Hemorrhage/diagnostic imaging , Gastrointestinal Hemorrhage/complications , Gastrointestinal Hemorrhage/drug therapy , Esophagoscopy/methods , Blood CoagulationABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Intestinal Perforation , Intestines/injuries , Celiac Disease , Lymphoma, Large B-Cell, Diffuse/complications , Intestinal Neoplasms , Intestines/diagnostic imaging , Tomography, Spiral Computed/methodsABSTRACT
BACKGROUND: Endoscopic sleeve gastroplasty is a safe and feasible treatment for obesity. This study is focused on our technique modification which suggests a different suturing pattern in order to distribute suture tension more evenly. METHODS: A retrospective study of 148 patients (121 women) who underwent this procedure and were monitored for 12 months was conducted. The average age was 41.53 ± 10 years. The average BMI was 35.11 ± 5.5 kg/m2 with the average initial weight being 98.7 ± 17 kg. A subgroup of the first 72 patients (60 women) were monitored for 18 months. A new running "Z" stitch pattern was used to provide gastric cavity reduction by means of 4 parallel suture rows. The stitch pattern was intended to provide a homogenous distribution of the disruptive force on the suture among all stitch points. RESULTS: %TWL was 17.53 ± 7.57 in 12 months and 18.5 ± 9% in 18 months indicating durability of the procedure. Patients with a BMI < 35 benefited most from an endoscopic gastroplasty. Leptin did not predict a response to endoscopic gastroplasty and decreased in all patients. In just one case there was a mild bleeding (0.67%) at the insertion point of the helix, which was resolved by sclerotherapy. CONCLUSIONS: Endoscopic gastroplasty offers a real choice for obese patients. This single-center experience with a modified suturing pattern provides a successful technique for weight loss.
Subject(s)
Endoscopy/methods , Gastroplasty/methods , Obesity/surgery , Suture Techniques , Adult , Body Mass Index , Female , Humans , Leptin/blood , Male , Retrospective Studies , Weight LossSubject(s)
Arteries/abnormalities , Esophagus/blood supply , Gastrointestinal Hemorrhage/etiology , Sclerotherapy , Combined Modality Therapy , Epinephrine/administration & dosage , Epinephrine/therapeutic use , Esophagoscopy , Fournier Gangrene/complications , Gastrointestinal Hemorrhage/therapy , Hemostasis, Surgical/instrumentation , Humans , Hypertension/complications , Male , Middle Aged , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/therapeutic useSubject(s)
Celiac Disease/complications , Intestinal Perforation/etiology , Jejunal Diseases/etiology , Lymphoma, Large B-Cell, Diffuse/complications , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Celiac Disease/diet therapy , Colectomy , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Diet, Gluten-Free , Disease Susceptibility , Down Syndrome/complications , Doxorubicin/administration & dosage , Humans , Intestinal Perforation/surgery , Jejunal Diseases/surgery , Jejunal Neoplasms/complications , Jejunal Neoplasms/drug therapy , Jejunal Neoplasms/prevention & control , Jejunal Neoplasms/surgery , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/prevention & control , Lymphoma, Large B-Cell, Diffuse/surgery , Male , Positron Emission Tomography Computed Tomography , Prednisone/administration & dosage , Rituximab/administration & dosage , Tomography, X-Ray Computed , Vincristine/administration & dosageABSTRACT
Ménétrier disease is a rare condition of an unknown origin, with a wide spectrum of clinical signs and symptoms at presentation. Diagnosis is made through the combination of clinical, analytical, endoscopic and histological data. Surgery is the classical treatment. However, new medical approaches have emerged.
Subject(s)
Anemia, Iron-Deficiency/etiology , Gastritis, Hypertrophic/complications , Anemia, Iron-Deficiency/diagnosis , Gastrectomy , Gastritis, Hypertrophic/diagnosis , Gastritis, Hypertrophic/surgery , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Female , Humans , Young Adult , Glutens/adverse effects , Diet, Gluten-Free , Ataxia/diet therapy , Celiac Disease/diet therapy , Feeding and Eating Disorders/diet therapy , Conduct Disorder/etiology , Celiac Disease/complicationsABSTRACT
No disponible
Subject(s)
Humans , Stomach/ultrastructure , Gastric Mucosa/ultrastructure , Stomach Diseases/diagnosis , Biomarkers/analysis , Diagnosis, DifferentialABSTRACT
INTRODUCCIÓN: La hemorragia digestiva de origen oscuro (HDOO) es aquella en la que no se consigue identificar su origen tras la evaluación mediante endoscopia digestiva alta y baja. En esos casos se sospecha un origen en intestino delgado. La HDOO puede ser oculta o manifiesta. El objetivo de este estudio es analizar las características clínico-analíticas, los hallazgos de la cápsula endoscópica e investigar qué factores se relacionan con la detección de lesiones en ambas formas de presentación. MÉTODOS: Estudio retrospectivo sobre las cápsulas endoscópicas realizadas entre noviembre de 2009 y noviembre de 2012 para el estudio de HDOO. RESULTADOS: Se analizaron 284 exploraciones de 272 pacientes. Inicialmente, 12 fueron no valorables y se repitieron, analizando finalmente las cápsulas evaluables (272). Ciento catorce (41,9%) fueron normales. Los pacientes con HDOO manifiesta tenían significativamente mayor edad (70,2 vs. 67,5 años; p = 0,04), consumían más AINE (24,2% vs. 11,9%; p = 0,01), tenían menores niveles de hemoglobina (9,3 vs. 10,4; p < 0,001) y requirieron más transfusiones (64,5% vs. 32,2%; p < 0,001) respecto a los pacientes con HDOO oculta. La detección de lesiones del tipo afta-úlcera y pólipo-masa no mostró diferencias significativas entre ambas formas de presentación. Las lesiones vasculares se detectaron con mayor frecuencia en la forma de HDOO manifiesta respecto a la forma oculta (40,3% vs. 25,7%, respectivamente), (p < 0,05). Considerando el total de diagnósticos realizados por la cápsula, no se observaron diferencias en la capacidad diagnóstica entre la forma manifiesta (57%) y la forma oculta (54%), (p = 0,6). El análisis multivariado mostró cómo el consumo de fármacos: AINE (OR 2,75; p = 0,01), antiagregantes y anticoagulantes (OR 2,64; p = 0,03), así como datos analíticos: hemoglobina (OR 3,23; p < 0,001) e INR (OR 1,8; p = 0,02) predijeron de forma estadísticamente significativa la detección de lesiones con la cápsula endoscópica en la forma de HDOO manifiesta. En la forma de presentación oculta, el análisis multivariado mostró que la edad (OR 1,9; p = 0,04) y el consumo de AINE (OR 2,1; p = 0,01) estaban estadísticamente relacionados con la detección de lesiones en la cápsula. CONCLUSIONES: La cápsula endoscópica es fundamental en la valoración de la HDOO. Aunque la capacidad diagnóstica fue similar entre ambas formas de presentación, las lesiones vasculares se detectaron con mayor frecuencia en el subtipo manifiesta. Teniendo en cuenta la forma de presentación de la HDOO (manifiesta vs. oculta) y algunas características clínico-analíticas de los pacientes (edad, consumo de fármacos, hemoglobina) se podría optimizar la capacidad diagnóstica de la cápsula
INTRODUCTION: Obscure gastrointestinal bleeding (OGIB) is defined as bleeding from the gastrointestinal tract with no obvious cause after assessment with upper and lower gastrointestinal endoscopy. In these cases, the source is suspected to be in the small bowel. Obscure bleeding can be occult or overt. The aim of this study was to analyze the clinical and analytical characteristics and findings on capsule endoscopy in patients with OGIB and to determine the factors related to the detection of lesions in both forms of presentation. METHODS: We performed a retrospective study of capsule endoscopies carried out between November 2009 and November 2012 for OGIB. RESULTS: We analyzed 284 capsule endoscopies in 272 patients. Initially, 12 procedures could not be evaluated and were repeated. A total of 272 procedures were finally included in the analysis. The results of 114 (41.9%) capsule endoscopies were normal. Compared with patients with occult OGIB, those with overt OGIB were significantly older (70.2 vs. 67.5 years; p = 0.04), consumed more NSAID (24.2% vs. 11.9%; p = 0.01), had higher hemoglobin levels (9.3 vs. 10.4; p < 0,001) and more frequently required transfusion (64.5% vs 32.2%; p < 0.001). No differences were found between the two forms of presentation in the detection of canker sores-ulcers and polyps-masses. Vascular lesions were more frequently detected in overt than in occult OGIB (40.3% vs. 25.7%, respectively), (p < 0.05). When the total number of diagnoses carried out by capsule endoscopy was analyzed, no differences were found in diagnostic yield between overt OGIB (57%) and occult OGIB (54%), (p = 0.6). In overt OGIB, multivariate analysis showed that the variables that significantly predicted the detection of lesions on capsule endoscopy were consumption of medication NSAID (OR 2.75; p = 0.01), antiplatelets and anticoagulants (OR 2.64; p = 0.03) and analytical data hemoglobin (OR 3.23; p < 0.001) and INR (OR 1.8; p = 0.02). In occult OGIB, multivariate analysis showed that the factors significantly related to the detection of lesions on endoscopy were age (OR 1.9; p = 0.04) and NSAID consumption (OR 2.1; p = 0.01). CONCLUSIONS: Capsule endoscopy is essential in the assessment of OGIB. Although the diagnostic yield was similar in both forms of presentation, vascular lesions were more frequently detected in overt OGIB. The diagnostic yield of capsule endoscopy could be optimized by taking into account the form of presentation (overt vs. occult) and certain clinical and analytic data (age, drug consumption, hemoglobin) (AU)
Subject(s)
Humans , Capsule Endoscopes , Capsule Endoscopy/methods , Gastrointestinal Hemorrhage/diagnosis , Retrospective Studies , Occult Blood , Melena/epidemiology , Endoscopy, Gastrointestinal/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Atrophy/complications , Diarrhea/complications , Diarrhea/diagnosis , Diet, Gluten-Free , Celiac Disease/diagnosis , Celiac Disease/etiology , Collagenous Sprue/complications , Collagenous Sprue/diagnosis , Collagenous Sprue/drug therapy , Adrenal Cortex Hormones/therapeutic use , Immunohistochemistry , Flow Cytometry , Diagnosis, Differential , Celiac Disease/chemically induced , Celiac Disease/physiopathology , Malabsorption Syndromes/complications , Duodenal Diseases/complications , Duodenal Diseases/diagnosis , Duodenum , Duodenum/pathologyABSTRACT
No disponible
