Neutrophil volume distribution width as a new marker in detecting inflammatory bowel disease activation.

INTRODUCTION: We sought to investigate the value of neutrophil volume distribution width in detecting inflammatory bowel disease activation. METHODS: Patients with infection and accompanying inflammatory disease were excluded. All the patients were diagnosed and classified according to Porto criteria and Paris classification, respectively. Physician global assessment, pediatric Crohn's disease and pediatric ulcerative colitis activity indexes and fecal calprotectin were used to define disease activation. RESULTS: A total of 34 pediatric patients with Inflammatory bowel diseases (IBD) and 29 controls were enrolled in the study. Neutrophil volume distribution width (NVDW) was significantly higher in patients with IBD compared to healthy controls (P < 0.001). An increased NVDW level was observed in IBD patients in activation (22.42 ± 2.13) compared to those in remission (19.22 ± 1.63) (P < 0.001). There was no statistically significant difference between IBD patients in remission and healthy controls. The best cutoff of NVDW for prediction of disease activation in Crohn's disease and ulcerative colitis in this series was 20.39 with a sensitivity of 90.9% and a specificity of 75% (AUC: 0.852 CI: 0.698-1.000 P < 0.001) and 19.74 with a sensitivity of 92.9% and a specificity of 90.9% (AUC: 0.961, CI: 0.889-1.000, P < 0.001), respectively. CONCLUSIONS: As a quantitative, objective, and sensitive parameter, we believe that the NVDW has a potential to be an additional test detecting disease activation in IBD.

Leaching of nano-ZnO in municipal solid waste.

Despite widespread use of engineered nanomaterials (ENMs) in commercial products and their potential disposal in landfills, the fate of ENMs in solid waste environments are still not well understood. In this study, the leaching behavior of nano ZnO -one of the most used ENMs- in fresh municipal solid waste (MSW) was investigated. Batch reactors containing municipal solid waste samples were spiked with three different types of nano ZnO having different surface stabilization. The leaching of ZnO was examined under acidic, basic and elevated ionic strength (IS) conditions. The results of the 3-day batch tests showed that the percent of the added nano-ZnO mass retained within the solid waste matrix ranged between 80% and 93% on average for the three types of nano-ZnO tested. The pH and IS conditions did not significantly influence the leaching behavior of ZnO. To further analyze the behavior of ZnO in the MSW matrix, a kinetic particle deposition/detachment model was developed. The model was able to reproduce the main trends of the batch experiments. Reaction rate constants for the batch tests ranged from 0.01 to 0.4 1/hr, reflecting the rapid deposition of nano-ZnO within the MSW matrix.

Leaching potential of nano-scale titanium dioxide in fresh municipal solid waste.

With the rapid development in nanotechnology in recent years, the number of commercially available products containing engineered nanomaterials (ENMs) has increased significantly. It is expected that large fractions of these ENMs will end up in landfills for final disposal. Despite the wide use of ENMs, little data is available on their fate within landfills. This study examined the leaching behavior of nanoscale titanium dioxide (nano-TiO2), one of the mostly used ENMs, in fresh municipal solid wastes (MSWs). Batch reactors containing municipal waste samples were spiked with a range of nano-TiO2 concentrations at different pH and ionic strength conditions. The Ti concentrations in leachate decreased rapidly and reached steady state after about 12-24 h. Results suggest that, for the environmental conditions considered, approximately 3-19% of the added nano-TiO2 remained in leachate. Batch tests conducted with individual synthetically-prepared solid waste components also showed low leaching potential (5.2% for organic waste, 3.3% for glass, 1.7% for both textile and paper and 0.6% for metal), indicating that all components of MSW contributed to the retention of the nano-TiO2 mass within the solid matrix.

Dilated cardiomyopathy in celiac disease: role of carnitine deficiency.

Celiac disease (CD) is an immune-mediated enteropathy in genetically susceptible persons and the disease can present with manifestations in the intestine and in organs outside the gut. An increased prevalence of CD in patients with idiopathic dilated cardiomyopathy or secondary cardiomyopathy and some other cardiac disorders has been reported. Here is described a case of dilated cardiomyopathy in a patient with CD and secondary carnitine deficiency. Dilated cardiomyopathy due to carnitine deficiency may occur in CD patients and carnitine deficiency may present not only at the time of diagnosis of CD but it may also develop during gluten-free diet, particularly in patients with fast weight gain and without carnitine supplementation.

Helicobacter pylori infection in Turkish children: comparison of diagnostic tests, evaluation of eradication rate, and changes in symptoms after eradication.

BACKGROUND: Helicobacter pylori infection is most frequently acquired in childhood. After this organism is eradicated, the rate of reinfection is low. Thus, it is very important to diagnose and treat the disease appropriately in childhood, and to be able to assess eradication with certainty. Eradication of H. pylori infection is reported to reduce or eliminate abdominal pain and dyspeptic symptoms in children. PATIENTS AND METHODS: The study involved 102 children who had already been diagnosed with symptomatic H. pylori infection based on gastric histopathological examination, urea breath test, rapid urease test, serology and culture. Each patient's symptoms and family history of gastrointestinal problems were recorded. Using histology as the gold standard for identifying H. pylori infection, we determined the diagnostic sensitivity of each of the other methods. Omeprazole or lansoprazole, amoxicillin and clarithromycin were administered as eradication treatment, and each patient was re-evaluated by urea breath test 8 weeks later. Each child was re-interviewed about symptoms after treatment. These answers and the results of drug sensitivity testing were recorded. Cases of failed eradication were re-treated with a quadruple-drug regimen of tetracycline, metronidazole, bismuth subsalicylate and omeprazole. RESULTS: The most frequent symptom was abdominal pain (89.2%). Fifty-four per cent of the subjects had a family history of dyspeptic symptoms. Sixty-six patients (64.7%) exhibited nodularity in the antral mucosa. The sensitivities of the diagnostic tests in histologically proven cases were as follows: urea breath test 100%, rapid urease test 89.2%, serology 71.9%, and culture 54.9%. Metronidazole had the highest frequency of resistance (36.4%) and the rate of clarithromycin resistance was 18.2%. The eradication rate after first-line therapy was 75.5%, and abdominal pain and dyspeptic symptoms were reduced or completely resolved in 75.7% of the successful-eradication cases. The proportion of failed-eradication cases that responded well to quadruple-drug therapy was 93.8%. CONCLUSION: Symptomatic H. pylori infection in a child should always be treated. The urea breath test is an accurate and reliable way to identify H. pylori-positive patients and to determine the response to treatment. Triple-agent therapy is effective for eradicating H. pylori infection in children and usually helps reduce or eliminate dyspeptic symptoms. The level of H. pylori resistance to metronidazole is high in our region. The significant rate of resistance to clarithromycin (18.1%) may explain the treatment failure observed in this study.