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Objectives: Bilirubin is a potent endogenous antioxidant and immunomodulating substance, which is also implicated in both cell signalling and various metabolic pathways. Mild elevation of systemic bilirubin concentrations provides substantial protection against many diseases of civilization. Rare published reports have suggested that serum bilirubin might also be relevant to sports performance. The purpose of the current study was to evaluate serum bilirubin concentrations and the prevalence of Gilbert syndrome (GS) in elite athletes., Methods: The study was carried out in 536 consecutive healthy elite athletes and in 2594 individuals of the Czech post-MONICA study representing the general Czech population. Serum bilirubin concentrations, the prevalence of benign hyperbilirubinemia > 17 µmol/L (1 mg/dL, a phenotypic sign of GS), and a variant of the UGT1A1 gene promoter responsible for GS manifestation in Caucasians (rs81753472) were evaluated in study subjects., Results: Compared to the general Czech population, significantly higher serum bilirubin concentrations were found in elite athletes (9.6 vs. 11.6 µmol/L, p < 0.001), both in men (11.3 vs. 12.6 µmol/L, p < 0.001) and women (8.3 vs. 10.5 µmol/L, p < 0.001). Furthermore, the prevalence of GS was also significantly higher in elite athletes (9.6 vs. 22%, p < 0.001) together with the tendency to higher frequencies of the genotypes (TA) 7/7 and (TA) 6/7 UGT1A1., Conclusion: Elite athletes have significantly higher concentrations of serum bilirubin, the most potent endogenous antioxidant substance known. Simultaneously, the prevalence of GS syndrome is also much higher in elite athletes, suggesting that a mild elevation of serum bilirubin might predispose to better sports performance., (© 2022. The Author(s).)

Background: The aim of this study was to examine the diurnal and exercise-related changes in red blood cell variables which serve as indirect markers of doping in sports., Methods: Ten men and 7 women, all undoped highly trained endurance athletes aged 19-34 years, were included in the study. Before and on the day with single and repeated bouts of exercise, blood samples were collected at 07:00, 09:00, 13:00, 18:00, and 21:00, at least 2 hours after exercise. Hemoglobin (Hb), hematocrit (Hct), and the reticulocytes % (Ret%) were determined by flow cytometry. Changes in OFF-hr score were also calculated and repeated-measures ANOVA was used to compare diurnal differences., Results: In overall, the mean Hb decreased continuously by 4.5 and 3.3% (all P<0.001) over the day with single and repeated bouts of exercise, respectively. Corresponding values for the decline in Hct were 4.2 and 5.9% (all P<0.001). In contrast, the Ret% showed no apparent diurnal rhythm but single and repeated bouts of exercise increased the relative Ret% in the evening by 12.4 and 16.7% (P<0.01), respectively. Then the calculated OFF-hr score was reduced by 6.2 and 9.8% (all P<0.01) at the end of the day., Conclusions: These results confirmed the normal diurnal pattern in the examined red blood cell variables in response to exercise in highly trained athletes. Furthermore, they showed noticeable between-subject variability and the possible risk of a false suspicion of blood doping in undoped athletes after repeated bouts of exercise.

Background: Unwarranted administration of antibiotics in acute pancreatitis presents a global challenge. The clinical reasoning behind the misuse is poorly understood. Our aim was to investigate current clinical practices and develop recommendations that guide clinicians in prescribing antibiotic treatment in acute pancreatitis., Methods: Four methods were used. 1) Systematic data collection was performed to summarize current evidence; 2) a retrospective questionnaire was developed to understand the current global clinical practice; 3) five years of prospectively collected data were analysed to identify the clinical parameters used by medical teams in the decision making process, and finally; 4) the UpToDate Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was applied to provide evidence based recommendations for healthcare professionals., Results: The systematic literature search revealed no consensus on the start of AB therapy in patients with no bacterial culture test. Retrospective data collection on 9728 patients from 22 countries indicated a wide range (31-82%) of antibiotic use frequency in AP. Analysis of 56 variables from 962 patients showed that clinicians initiate antibiotic therapy based on increased WBC and/or elevated CRP, lipase and amylase levels. The above mentioned four laboratory parameters showed no association with infection in the early phase of acute pancreatitis. Instead, procalcitonin levels proved to be a better biomarker of early infection. Patients with suspected infection because of fever had no benefit from antibiotic therapy., Conclusions: The authors formulated four consensus statements to urge reduction of unjustified antibiotic treatment in acute pancreatitis and to use procalcitonin rather than WBC or CRP as biomarkers to guide decision-making., (Copyright © 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

In recent years, gastroenterologists focused their interest on finding the genetic background of inflammatory bowel disease and colon cancer. NOD2/ CARD15 gene is still the most investigated gene of all known genes and its mutations can explain approximately 20% of genetic predisposition to Crohns disease. From later identified genes that play an important role in the etiology of Crohns disease, the IL23R and ATG16L1 genes have a perspective place. In the case of hereditary colorectal cancer, we can select by the help of genetic diagnostics, the group of patients with high risk of colon cancer, which requires more intensive monitoring. The aim is to find out the colon cancer in the early, treatable stage. In practical terms, genetic diagnostics of inflammatory bowel disease and colon cancer has no screening and only poor prognostic importance. It is pleasant, that the Slovak genetic workplaces are interested in this issue and in accordance with modern trends they try to expand its diapason.

For the primary prophylaxis of variceal bleeding endoscopic band ligation has been shown to be as effective as non-selective beta-blockers (carvedilol), but variceal injection sclerotherapy is not generaly recommended in this setting because of higher rate of complications and lower effect in reducing either bleeding or mortality. Endoscopic management of acutely bleeding gastroesophageal varices includes injection sclerotherapy, rubber band ligation, and variceal obturation with tissue adhesives. Variceal injection sclerotherapy remains a quick, simple and cheap technique for the control of active bleeding from esophageal varices, but is associated with more rebleeding than variceal band ligation, which is now preferred also for lower rate of complications. Endoscopic sclerotherapy has increasingly been replaced by ligation also in secondary prophylaxis of variceal bleeding. The studies showed that band ligation can eradicate varices in fewer sessions, re-bleeding and complications were fewer in comparison with variceal injection sclerotherapy. Because of the reduced efficacy, severe complications, and the high mortality associated with using conventional sclerosants in acute bleeding gastric varices, the technique of injecting tissue adhesives has been studied, described and used despite numerous complications. Endoscopic injection sclerotherapy of esophageal varices remains usable as an oldest method in arresting of this hemorrhage only in rare cases when the band ligation is not available.

Background & Aims: Comparative data on budesonide vs mesalamine for the treatment of mild-to-moderately active Crohn's disease (CD) are sparse. We assessed the efficacy and safety of each therapy in patients with mildly to moderately active CD., Methods: We performed a randomized, double-blind, double-dummy, 8-week, multicenter study in which 309 patients with mildly to moderately active CD received pH-modified-release oral budesonide (9 mg/day once daily or 3 mg/day 3 times daily) or Eudragit-L-coated oral mesalamine (4.5 g/day)., Results: The primary efficacy variable, clinical remission (defined as Crohn's Disease Activity Index ≤150), at the final visit occurred in 69.5% (107 of 154) of patients given budesonide vs 62.1% (95 of 153) of patients given mesalamine (difference, 7.4%; 95% repeated confidence interval, -4.6% to 18.0%; P = .001 for noninferiority). Clinical remission rates did not differ significantly between the 2 budesonide groups. Treatment response, defined as Crohn's Disease Activity Index of 150 or less and/or a decrease of 70 or more (Δ70) or 100 or more (Δ100) points from baseline to final visit, did not differ significantly between patients given budesonide vs mesalamine (Δ70, P = .11; Δ100, P = .15), or between the 2 budesonide groups (Δ70, P = .38; Δ100, P = .78). No other efficacy end points differed significantly between groups. Discontinuation because of adverse events occurred in 3% and 5% of budesonide- and mesalamine-treated patients, respectively. There were no clinically relevant differences in adverse events between the 2 budesonide groups., Conclusions: Budesonide (9 mg/day) was numerically, but not statistically, more effective than Eudragit-L-coated mesalamine (4.5 g/day) in patients with mildly to moderately active CD. Budesonide (9 mg/day), administered once daily, was as effective as the standard (3 times daily) regimen., (Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Involvement of genetic factors in the aetiology of inflammatory bowel disease (IBD) has been known for a long time. Our aim was to investigate the prevalence of polymorphisms in NOD2, ICAM-1 and CCR5 genes in Czech and Slovak patients with IBD in comparison with healthy controls. The frequency of well-known mutations (R702W, G908W and 1007fs in the NOD2 gene; K469E in the ICAM-1 gene, and Delta32 in the CCR5 gene) involved in IBD was tested in 45 patients with CD and 22 patients with UC. The allele frequency of these mutations was determined and genotype-phenotype correlation was specified. Isolated DNA was genotyped, and allele frequency was counted and statistically verified. Significant differences between the healthy control group and CD patients were observed in mutation 1007fs of the NOD2 gene (P = 0.0203). We also associated allele E469 of the ICAM-1 gene with CD (P = 0.0024). No significant association between other alleles and CD was found, and no gene variation was linked to UC. The number of mutations and mutated genes was higher among patients with CD than among patients with UC. Our results support previous findings about participation of mutations of NOD2 and ICAM-1 genes in IBD. We confirmed that both CD and UC are polygenic diseases with a genedosage effect. This observation strengthens the opinion that genetic factors play a more important role in CD than in UC.

Background: Reactive types of oxygen play an important part also in carcinogenesis. Antioxidant enzymes are the primary defence against their damage. The objective of the present work was to glutathione peroxidase in the mucosa and polyps of the colon in subjects with colorectal adenoma and idiopathic proctocolitis., Methods and Results: The authors examined 18 controls, 43 patients with colorectal adenoma and 12 subjects with idiopathic proctocolitis. During endoscopy bioptic specimens of the mucosa and from polyps were taken for histological and enzymological examination: Cu/Zn superoxide dismutase, catalase, glutathione peroxidase. In subjects with colorectal adenoma a raised glutathione peroxidase activity was found in the colon and an elevated activity of superoxide dismutase in the adenoma. In patients with idiopathic proctocolitis in the stage of clinical remission in the mucosa a lower glutathione peroxidase activity was found but a high activity of all enzymes was recorded in the inflamed polyps., Conclusions: The cause of elevated activities of antioxidant enzymes in subjects with colorectal adenoma in the colonic mucosa and in adenomas is not known and calls for further studies. In patients with idiopathic proctocolitis the increased level of antioxidant enzymes in the mucosa is probably produced by a higher production of reactive oxygen types by activated leucocytes in the inflamed tissues.

Background: The etiopathogenic relationship of Helicobacter pylori (HP) infection to chronic active antrumgastritis and peptic ulcer disease has been confirmed by a number of studies. The key role in the development of peptic lesions belongs to hypergastrinemia. This is supposed to be related to ammonium synthesis in the antral area influenced (promoted by HP and resulting in interruption) weakening of the negative feedback mechanism maintaining intraluminal acidity., Objectives: In our present study we focus our attention to the effectiveness of triple antimicrobial therapy in HP positive patients with chronic active antrumgastritis residing in the lowering of the level of serum gastrin., Methods: There was a group of 15 patients in our current study with HP positivity as well as chronic active antrumgastritis documented by endoscopy, histology, microbiology and serology respectively. Endoscopical and histological findings were classified according to "The Sydney System". The whole group was evaluated on an ambulatory basis, those with active ulcer, endocrinopathy and biliary tract disorders were excluded. The basal level of serum gastrin was evaluated by RIA-test-gastrin before and after successful antimicrobial therapy., Results: In our group of 15 patients with HP infection in coexistence with chronic active antrumgastritis we have found a significant decrease in the basal level of serum gastrin (p = 0,01) after successful therapy., Conclusion: The decrease in the basal level of serum gastrin after eradication of HP confirms the importance of HP infection in the pathogenesis of peptic lesions in stomach and duodenum. We consider the antimicrobial therapy in chronic active antrumgastritis in HP positive patients to be a fully indicated therapeutic approach. (Tab. 1, Fig. 1, Ref. 10.).

Most colon carcinomas are preceded by an adenomatous polyp--adenoma-carcinoma sequence. Active oxygen species (AOS) can play a role in the pathogenesis of this process. Antioxidant enzymes (AE) are the primary defense against the deleterious effect of AOS. Activities of AE in 56 individuals with colorectal adenoma (CA), 29 individuals with colorectal carcinoma (CC) and in 24 control subjects were examined. Biopsy specimens from the non-neoplastic colonic mucosa and from the CA and CC were taken during colonoscopy for histological and enzymological analysis. Activities of following AE were estimated: CuZn-superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GPx). It was found that individuals with CA and CC were characterized by: (1) increased activities of CAT and GPx in non-neoplastic mucosa, that persisted in some of the patients even after removal of tumors; (2) increased activities of CuZn-SOD, CAT and PGx in CA and CC tissues. It can be inferred that the accumulation of peroxides in the non-neoplastic colonic mucosa induced higher activities of CAT and GPx. The reasons of high activities of all AE in the tissues of CA and CC and their relation to carcinogenesis are not clear and require further studies.

A group of patients younger than 40 years of age, who had been subdued to endoscopic large intestine adenoma polypectomy were compared with the rest of the patients regarding the adenoma occurrence according to sex, localisation, histologic character, frequency of recurrence, and carcinoma formation in the large intestine in the site of previous polypectomy. The compared groups of patients differed merely in time of recurrence. In patients over 40 years of age the adenomas reoccurred most frequently in the first and fifth years following the primary polypectomy. In patients after primary polypectomy regular colonoscopic controls were suggested, namely after the first year and subsequently after every two years. This scheme is appropriate also for patients under the age of 40 years. Therefore the recommended intervals of colonoscopic controls at this age category do not require to be subdued to alteration. (Tab. 14, Ref. 5.)

Background: The primary defense against oxidation damage of tissues are anti-oxidant enzymes, e.g. superoxide dismutase, catalase and glutathione peroxidase. Some non-enzymatic substances have a significant anti-oxidant action (e.g. vitamin C, E, beta-carotene and others). The objective of the present work was to follow up the Cu/Zn superoxide dismutase activity, catalase and glutathione peroxidase (anti-oxidant enzymes of the gastric mucosa) in subjects with the risk of developing gastric cancer, e.g. those suffering from atrophic gastritis, hyperplastic polyps and gastric adenoma., Methods and Results: The authors examined 80 subjects (50 men and 30 women) aged 25 - 71 years. In all during endoscopic examination bioptic specimens of the mucosa were taken at standard sites of the gastric corpus and antrum for histological and enzymological examination. Enzymological examination: activity of Cu/Zn-superoxide dismutase (Randox Lab. Ltd. GB kit), catalase activity (modified method of Cavarocchia et al.) and glutathione peroxidase activity (method according to Paglia and Valentine). The Cu/Zn-superoxide dismutase activity was elevated in the group of patients with gastritis after gastrectomy (67%) and with gastric adenoma (35%), the catalase activity in patients with gastritis after gastrectomy (40%) and the glutathione peroxidase activity in patients with the diagnosis of gastritis after gastrectomy (185%), atrophic gastritis (46%) hyperplastic polyp (50%) and gastric adenoma (50%)., Conclusions: The increased activity of anti-oxidant enzymes was due to a higher concentration of the superoxide anion radical, hydrogen peroxide and organic peroxides (lipoperoxides); the source of active types of oxygen are phagocytic leucocytes in the chronically inflamed gastric mucosa.

Bile acids (BAs) and bilirubin, primarily known for their role in lipid metabolism and as heme catabolite, respectively, have been found to have diverse effects on various physiological processes, including oxidative stress and inflammation. Indeed, accumulating evidence showed that the interplay between BAs and bilirubin in these processes involves intricate regulatory mechanisms mediated by specific receptors and signaling pathways under certain conditions and in specific contexts. Oxidative stress plays a significant role in the development and progression of cardiovascular diseases (CVDs) due to its role in inflammation, endothelial dysfunction, hypertension, and other risk factors. In the cardiovascular (CV) system, recent studies have suggested that BAs and bilirubin have some opposite effects related to oxidative and inflammatory mechanisms, but this area of research is still under investigation. This review aims to introduce BAs and bilirubin from a biochemical and physiological point of view, emphasizing their potential protective or detrimental effects on CVDs. Moreover, clinical studies that have assessed the association between BAs/bilirubin and CVD were examined in depth to better interpret the possible link between them. [ABSTRACT FROM AUTHOR]

In a prospective study based on contemporary knowledge of the problem of gastrooesophageal varices the authors submit the algorithm of the therapeutic procedure. Sclerotization treatment holds a dominant position, as it can be used in all stages of the disease and in all three groups of patients classified according to Child. In case of gastric varicosities which cannot be treated by sclerotization the method of choice in patients of groups Child A, B are ablative operations and selective portosystemic anastomoses, in concurrent hypersplein: azygo-portal separation.

Copyright of Folia Pharmaceutica Cassoviensia is the property of University of Veterinary Medicine & Pharmacy in Kosice and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The authors performed from 1983 86 gastrofiberoscopic diathermocoagulations and 132 colonoscopic polypectomies. The finding of the high number of adenomas in the stomach - 22.35%/63.15% in diameter to 10 mm/-is surprising. As to complications they recorded in one case mucosal bleeding after gastrofiberoptic polypectomy and in one case a covered perforation of the sigmoid at the site of colonoscopic polypectomy. The discussion is devoted to the present views of the importance of the endoscopic polypectomy in the diagnosis and treatment of polyps in the gastrointestinal tract with the accentuation of the problems of the endoscopic polypectomy from the proximal part of the digestive tube. The authors state the necessity to keep this method for removal of the gastric hyperplasiogenous polyps and the polyps to 10 mm in diameter. Finally, the advantages of the endoscopic polypectomy: unpretentiousness, no risk for patient, high diagnostic and therapeutic value and the economy, as compared with transabdominal surgical approach, are stressed.

The authors present their experience with the outcome of gastrofibroscopic sclerotherapy of oesophageal varices, performed in a total of 70 patients with portal hypertension. All patients were classified in classes B and C according to Child's criteria, and 68 of them had variceal bleeding before receiving sclerotherapy. Acute bleeding was successfully arrested in seven cases, and elective sclerotherapy in between bleeding episodes was carried out in 60 cases. To date, complete obliteration has been noted in 34 patients. An effect of previous sclerotherapy was observed during the next therapeutic session in 18, and eight patients died from progressive hepatic insufficiency. In the discussion section, the authors analyse current concepts on the technique of sclerotherapy related to complications, on instrumentarium and sclerosing solutions, and on the significance of prophylactic, acute and elective sclerotherapy, with the importance of endoscopic sclerotherapy of oesophageal varices perceived mainly in comparison with the results of surgery from the point of view of long-term patient survival.

The authors report on their experience with endoscopic treatment of choledocholithiasis. Out of a total of 363 successful procedures of endoscopic papillosphincterotomy (EPS), choledocholithiasis was the indication for EPS in 270 patients (74.4%). Most often, EPS and extraction were performed in patients after cholecystectomy (79.6%) and those with choledocholithiasis and an in situ gallbladder, but free of stones (13.4%). In patients with concomitant cholecystolithiasis, EPS was carried out only in those cases in which surgery was contraindicated. EPS was performed in four cases of acute biliary pancreatitis. Removal of stones from the choledochus was successful in 95.5%. Of the total of 363 successful EPS's, complications were observed in 17 cases (4.7%), with a mortality of 1.1% (4 deaths). Most frequently, the causes included bleeding (1.9%) and perforation (1.1%). Of other complications, the authors noted acute pancreatitis, acute cholangitis and impaction of stone in the hepatocholedochus in two cases each. The complications required emergency surgery in six patients (35.3%).

The authors performed a total of 288 successful endoscopic gastroduodenal polypectomy procedures in 129 patients. Drawing on literary data and the results of follow-up of their own patients, they regard endoscopic gastroduodenal polypectomy as a successful and relatively low-risk method for secondary prevention of gastric cancer. Recurrence of adenomas, with malignant degeneration in 6-75%, was noted, only in the first year after primary polypectomy, in 8% of patients. Four percent of patients after adenoma polypectomy developed gastric carcinoma. Removal of gastroduodenal adenomas by endoscopy represents a final therapeutic procedure significantly reducing the possibility of these originally benign variants transforming into malignant ones. Even polyps smaller than 10 mm in diameter may be adenomas possessing a rather high malignant potential. The authors regard endoscopic polypectomy of hyperplastic polyps as a justified procedure since the literary data compiled and their own experience suggest polyp susceptibility to development of dysplasia. While this tendency gets manifest only rarely, it would be medically wrong to dismiss it as negligible. In case of removal of an early polypoid gastric carcinoma, endoscopic polypectomy is a therapeutic procedure only in clearly defined and histologically well classified cases. In other cases involving prominence of the gastroduodenal mucosa, it is an invaluable diagnostic method whose benefit is that it removes an entire polyp for histologic examination.

OBJECTIVE: The goal of our research was to determine the impact of clinical nutrition in the form of home parenteral nutrition (HPN) in patients with nutritional disorders, most often caused by diseases of the digestive tract, with the risk of developing malnutrition. PATIENTS AND METHODS: We retrospectively evaluated 39 patients from the Gastroenterology Clinic and the Home Parenteral Nutrition Center of the University Hospital Bratislava, whose nutritional status was evaluated based on the determination of the body mass index (BMI), the completed nutritional risk screening (NRS) questionnaire and the determination of performance status. Subsequently, after fulfilling the criteria for HPN, the initiation of parenteral nutrition (PN) followed, implemented in a domestic environment for the following two years as HPN. During this period, we did a monthly check-up of the objective condition and laboratory parameters of the enrolled patients, which were the basis for adjusting the nutritional treatment. We also evaluated the occurrence of infectious and thrombotic complications clinically and on the basis of laboratory parameters focused on culture and hemocoagulation examination. After two years, we performed control exit examinations, which we compared with the entrance examinations and statistically evaluated the success of the treatment. We evaluated the obtained data using standard statistical methods. RESULTS: During HPN, there was a statistically significant elevation of the individual monitored values ​​(BMI, absolute lymphocytes count, cholesterol, cholinesterase, total proteins, albumins), which clearly proves correctly indicated and managed HPN. We recorded vein thrombosis in v. subclavia and v. jugularis in 6 (15 %) patients. Subsequent catheter extraction was necessary after unsuccessful catheter insertion. In 13 (33 %) patients, tunneled catheter replacement was required due to infection. The mortality rate in our group was 8 % (3 patients). These were female patients aged 39, 42, and 66 years. The cause of death in all of these patients was the underlying diagnosis (oncohematological disease, systemic connective tissue disease, and repeated resections of the digestive tract for inflammatory GIT disease with the development of severe malnutrition). We recorded a positive effect of applied HPN in all three patients until death. We did not register any factors that would have a relevant influence on the success of administered HPN. CONCLUSION: Based on our results, we can conclude that the patients included in the HPN were correctly indicated, and all of them, based on the monitored parameters (regardless of gender, age, initial diagnosis, or BMI value), benefited from the applied treatment, which was correctly chosen based on their individual needs. Our results clearly document the irreplaceable role of HPN in the management of patients with nutritional intake disorders leading to the development of malnutrition. [ABSTRACT FROM AUTHOR]

Background: Studies about the association between bilirubin and migraine were few. Therefore, the purpose of this study was to investigate the association between serum total bilirubin and the prevalence of severe headaches or migraine., Methods: A multivariable logistic regression was used to assess the association between serum total bilirubin concentration and severe headaches or migraine. We also performed stratified analyses, interaction analyses and multiple interpolations in the sensitivity analysis., Results: This cross-sectional study included 12,552 adults from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. The overall incidence of migraine was 19.99% (2,509/12,552). With every 1 mg/dl increase in bilirubin, the prevalence of migraine decreased by 23% (95% CI: 0.64, 0.93) after adjustment of all related covariates. Similarly, the risk of migraine was reduced by 17% (95% CI: 0.72, 0.97) in the Q4 group (the fourth quartile, highest serum total bilirubin level) compared with the Q1 group (the lowest level). Furthermore, interaction effects by age groups were significant in this relationship (P for interaction = 0.0004). In the Q4 group compared with Q1, inverse associations were observed in those aged ≥40 years (OR: 0.71,95% CI: 0.59, 0.85) in the stratified analysis., Conclusion: These findings support an association between serum total bilirubin and severe headaches or migraine, revealing an inverse association between serum total bilirubin quartiles and severe headaches or migraine in American adults. Age could play an important role in this association., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The main aim of this paper is to summarise the roles of m SP 6 sp A RNA methylation in post-TBI BGA to further highlight the possible regulatory mechanisms of m SP 6 sp A modification in TBI-induced BGA dysfunction, and, finally, to discuss the outcome of considering m SP 6 sp A as a therapeutic target to improve the recovery of the brain and gut dysfunction caused by TBI. Keywords: m6A RNA modification; brain-gut axis; traumatic brain injury EN m6A RNA modification brain-gut axis traumatic brain injury N.PAG N.PAG 26 08/29/22 20220801 NES 220801 1. Multiple lines of evidence from studies have shown that m SP 6 sp A modification influences almost all aspects of RNA metabolism, including RNA expression, splicing, nuclear output, translation, decay and RNA protein interactions [[73], [75]]. [Extracted from the article]

In the article, we point out the volume training indicators that determined the sports performance of the race walker at 20 and 50 km. The basis of the analysis were the training volume indicators and the annual sport performance. Nonparametric procedures were chosen according to the assessment of the normality of file layout. Differences between the completed volume were evaluated statistically (Z) and substantively ("r"). The nonparametric algorithm CHAID was used for the construction of the regression trees. By the trees method were selected training indicators which showed in the individual training cycles high tightness with race walking performance. The regression model in training cycles YTC 2017/2018 introduced the indicator of intense tempo endurance (walking 4:41-5:00 min.km-1), extensive aerobic endurance (walking 6:00 and more min.km-1) and the running volume indicator. Extended aerobic endurance (walking 5:41-6:00 min.km-1), extensive tempo endurance (walking 5:01-5:20 min.km-1), intense special endurance (walking 4:06-4:20 min.km-1), number of starts and regeneration have been enforced between the predictors of the walking performance in training cycles YTC 2018/2019. The analysis points to the training resources which were most involved in the improvement of the sport performance. Their exact identification will allow the rationalization of the training process in the future, coordinate the conceptual bases of sport preparation and to improve the system of shaping the top condition towards the 2021 Olympics in Tokyo. [ABSTRACT FROM AUTHOR]

Copyright of Florence (1801-464X) is the property of Care Comm s.r.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Useful indices to determine whether to reduce the dose of 5-aminosalicylic acid (5-ASA) in patients with ulcerative colitis (UC) during remission remain unclear. We aimed to analyze the rate and risk factors of relapse after reducing the dose of oral 5-ASA used for maintenance therapy of UC. Methods: UC patients whose 5-ASA dose was reduced in clinical remission (partial Mayo score of ≤ 1) at our institution from 2012 to 2017 were analyzed. Various clinical variables of patients who relapsed after reducing the dose of oral 5-ASA were compared with those of patients who maintained remission. Risk factors for relapse were assessed by univariate and multivariate logistic regression analyses. Cumulative relapse-free survival rates were calculated using the Kaplan–Meier method. Results: A total of 70 UC patients were included; 52 (74.3%) patients maintained remission and 18 (25.7%) patients relapsed during the follow-up period. Multivariate analysis indicated that a history of acute severe UC (ASUC) was an independent predictive factor for clinical relapse (p = 0.024, odds ratio: 21, 95% confidence interval: 1.50–293.2). Based on Kaplan–Meier survival analysis, the cumulative relapse-free survival rate within 52 weeks was 22.2% for patients with a history of ASUC, compared with 82.0% for those without. the log-rank test showed a significant difference in a history of ASUC (p < 0.001). Conclusions: Dose reduction of 5-ASA should be performed carefully in patients who have a history of ASUC. [ABSTRACT FROM AUTHOR]

Severe acute pancreatitis represents about 20% of all pancreatitis diagnosis and it has a high mortality rate when associated with a lung dysfunction. The aim of this research was to investigate the use of a wild spectrum metabolic drug (Cytoflavin®) for the treatment of acute lung injury in experimental pancreatitis. A l-arginine-induced acute pancreatitis (groups II and III) was simulated experimentally in a rat population. A combined metabolic drug was used as treatment. We determined the levels of amylase, medium molecules (MM 254 and 280), malonic aldehyde (MA), diene conjugates (DC), interleukin-8 (IL-8), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) in the blood and we performed a histologic examination of the lungs and pancreas of the rat population. The activation of lipid peroxidation peaks at 24–48 h from the onset of the disease. The level of malonic aldehyde in groups II and III was higher (39.09% and 30.99%, respectively) than that in the control group I (p < 0.02; p < 0.01), the diene conjugates level was higher by 43.66% and 42.03% respectively (p < 0.01). With medical correction after 72 h (group III), the level of malonic aldehyde and diene conjugates decreased by 17.0% and 30.5% when compared with group II (no medical correction) (p < 0.05). The level of medium molecules peaked after 72 h of the disease induction (p < 0.001). A correlation was established between the level of endogenous intoxication with the membrane-destructive processes in the lung tissue 48 h after modeling of acute experimental pancreatitis. The use of the proposed medicament correction reduces the manifestations of endogenous intoxication. [ABSTRACT FROM AUTHOR]

Introduction:Clostridium difficile infection (CDI) is the most common infectious cause of diarrhoea in hospitalised patients. It is a severe issue with increasing incidence in healtcare facilities and commmunities. Early and appropriate testing of CDI is very imortant. There are many different approaches that can be used in the CDI laboratory diagnostics. Recently performed studies evaluated diagnostic algorithms to optimize laboratory CDI diagnostics. The aim of the work was to implement an optimal algorithm of testing methods in CDI diagnostics. Materials and methods: The retrospective analysis of patients' samples suspected on CDI was carried out in 2017. The data was analysed from the Laboratory Klinicka Biochemia in Zilina. The application of ESCMID re -commendation criteria for algorithm of testing, together with procedures in laboratory practice was carried out. Results: The analysis of the data showed that the applied algorithm or testing in CDI and highlighted the importance of preanalytic phase, and the evaluation of testing methods and results, together with clinical findings. Two- and three- step algorithm together with cultivation methods were applied. 87,6% of samples could be eva -luated with positive or negative results according to the 2-step algorhitm. Further samples were assessed and tested by ELISA test or PCR method. Conclusion: CDI represents a significant burden in healthcare facilities. An early diagnostics and interpretation helps to start the early treatment and helps in surveillence of the infection. [ABSTRACT FROM AUTHOR]

In this study, we examined a novel method of microencapsulation with calcium alginate-chitosan and Eudragit S100 nanoparticles for the improving viability of probiotic bacteria, Lactobacillus acidophilus and Lactobacillus rhamnosus. Extrusion technique was carried out in microencapsulation process. The viability of two probiotics in single coated beads (with only chitosan), double coated beads (with chitosan and Eudragit nanoparticles), and as free cells (unencapsulated) were conducted in simulated gastric juice (pH 1.55, without pepsin) followed by incubation in simulated intestinal juice (pH 7.5, with 1% bile salt). In case of single coated beads, presumably, lack of sufficient strength of chitosan under simulated gastric condition was the main reason of 4-log and 5-log reduction of the counts of the L. acidophilus and L. rhamnosus respectively. The results showed that with the second coat forming (Eudragit nanoparticles) over the first coat (chitosan), the strength of the beads and then viability rate of the bacteria were increased in comparison with the single coated beads. [ABSTRACT FROM AUTHOR]

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Presents an subject index for a 2005 issue of the "Alimentary Pharmacology and Therapeutics".

Inflammatory bowel diseases (IBD) have developed to become a major global health problem. Ulcerative colitis (UC) is one of two main types of IBD, and >90% of patients suffering from mild or moderate forms of UC are treated with mesalazine, a well-tolerated and cost-effective drug. To allow oral administration, the drug has to be protected from resorption before it can reach the affected sites in the colon. The drug is therefore released from most currently used medications either constantly slow (time-dependent) or triggered by an increased pH during gastrointestinal transition. Both variants are widely used in clinical practice and it is surprising that they have not yet been compared directly in a large clinical study. In this overview, the evidence that may suggest preferential use of one type of mesalazine formulation over the other in general or for defined subgroups of patients is summarized and evaluated. Data from in vitro modelling of drug release and measurements of drug concentrations in colonic mucosa suggest that in many cases, constant release and pH-dependent formulations are of similar therapeutic efficiency; however, pH-triggered release may be superior in patients with proctitis-type UC or sites of inflammation in the proximal colon. Additionally, patients with a long gastric residence time, slow small intestinal transition, disease-related diarrhea or sensitivity to systemic adverse effects may benefit more from pH-dependent release formulations. In general, medications based on both concepts show similar efficacies, but the pH-dependent release formulations seem to be more robust in the treatment of a not further classified group of patients with UC. Future comparative clinical studies are required to clearly define the subgroups of patients that should be treated preferably with constant or pH-dependent release formulations of mesalazine. [ABSTRACT FROM AUTHOR]

Background: Clostridioides (Clostridium) difficile is the most common nosocomial pathogen and antibiotic-related diarrhea in health-care facilities. Over the last few years, there was an increase in the incidence rate of C. difficile infection cases in Slovakia. In this study, the phenotypic (toxigenicity, antimicrobial susceptibility) and genotypic (PCR ribotypes, genes for binary toxins) patterns of C. difficile isolates from patients with CDI were analyzed, from July to August 2016, taken from hospitals in the Horne Povazie region of northern Slovakia. The aim of the study was also to identify hypervirulent strains (e.g., the presence of RT027 or RT176). Methods: The retrospective analysis of biological samples suspected of CDI were analyzed by GDH, anaerobic culture, enzyme immunoassay on toxins A/B, multiplex "real-time" PCR and PCR capillary-based electrophoresis ribotyping, and by MALDI TOF MS. Results: C. difficile isolates (n = 44) were identified by PCR ribotyping, which revealed five different ribotypes (RT001, 011, 017, 081, 176). The presence of hypervirulent RT027 was not identified. The C. difficile isolates (RT001, 011, 081, 176) were susceptible to metronidazole and vancomycin. One isolate RT017 had reduced susceptibility to vancomycin. A statistically significant difference between the most prevalent PCR ribotypes, RT001 and RT176, regarding variables such as albumin, CRP, creatinine, the length of hospitalization (p = 0.175), and glomerular filtration (p = 0.05) was not found. Conclusion: The results of PCR capillary-based electrophoresis ribotyping in the studied samples showed a high prevalence of RT176 and 001. [ABSTRACT FROM AUTHOR]

Background and aim: Oral mesalazine and sulfasalazine (SASP) are key drugs for treating ulcerative colitis (UC). The efficacy of switching from one of the several mesalazine formulations to another is largely unknown. This study assessed the efficacy of switching among three types of mesalazine formulation and SASP for UC therapy. Methods: UC patients receiving high-dose mesalazine/SASP who switched to other formulations due to disease activity were considered eligible. Efficacy was evaluated 2, 6, and 12 months after switching. Results: A total of 106 switches in 88 UC patients were analyzed. The efficacy at 2 months after switching was observed in 23/39 (59%) cases from any mesalazine formulation to SASP, in 18/55 (33%) cases from one mesalazine to another, and in 2/12 (17%) cases from SASP to any mesalazine formulation. Nine of 43 effective cases showed inefficacy or became intolerant post-switching. Delayed efficacy more than two months after switching was observed in four cases. Steroid-free remission was achieved in 42/106 (39%) cases—within 100 days in 35 of these cases (83%). Conclusions: Switching from mesalazine to SASP was effective in more than half of cases. The efficacy of switching between mesalazine formulations was lower but may be worth attempting in clinical practice from a safety perspective. [ABSTRACT FROM AUTHOR]