Inflammatory bowel disease in primary immunodeficiency disorders is a heterogeneous clinical entity requiring an individualized treatment strategy: A systematic review

ObjectiveTo describe the prevalence, clinical presentation and current treatment regimens of inflammatory bowel disease (IBD) in patients with primary immunodeficiency disorders (PIDs).MethodsA systematic review was conducted. The following databases were searched: MEDLINE, Embase, Web of Science, the Cochrane Library and Google Scholar.ResultsA total of 838 articles were identified, of which 36 were included in this review. The prevalence of IBD in PIDs ranges between 3.4% and 61.2%, depending on the underlying PID. Diarrhea and abdominal pain were reported in 64.3% and 52.4% of the patients, respectively. Colon ulceration was the most frequent finding on endoscopic evaluation, while cryptitis, granulomas, ulcerations and neutrophilic/lymphocytic infiltrates were the most frequently reported histopathological abnormalities. Described treatment regimens included oral corticosteroids and other oral immunosuppressive agents, including mesalazine, azathioprine and cyclosporin, leading to clinical improvement in the majority of patients. In case of treatment failure, biological therapies including TNF- α blocking agents, are considered.ConclusionsThe overall prevalence of IBD in patients with PID is high, but varies between different PIDs. Physicians should be aware of these complications and focus on characteristic symptoms to reduce diagnostic delay and delay in initiation of treatment. Treatment of IBD in PIDs depends on severity of symptoms and may differ between various PIDs based on distinct underlying pathogenesis. An individualized diagnostic and therapeutic approach is therefore warranted.     

海藻酸钠-多聚赖氨酸-海藻酸钠微囊内细胞浓度与胰岛素和C肽的释放**

摘要 背景：微囊化已经普遍应用于各种实验研究,微囊包裹的干细胞治疗糖尿病问题也成为当今的热点,但是囊内包裹的细胞浓度与胰岛素释放量的关系成为目前需要解决的问题之一。 目的：运用海藻酸钠-多聚赖氨酸-海藻酸钠微囊包裹胰岛素产生细胞,观察细胞浓度对胰岛素和C肽释放情况的影响。 方法：制备大鼠胰腺损伤提取物,将小鼠骨髓间充质干细胞诱导分化为胰岛素产生细胞。免疫荧光和双硫腙染色鉴定诱导后细胞内胰岛素的表达。然后将胰岛素产生细胞制成浓度分别为1×107 L-1,5×107 L-1,1×108 L-1,5×108 L-1,1×109 L-1,5× 109 L-1的细胞悬液,气体吹喷法制成微囊,用6-羧基乙二酸荧光素检测囊内细胞活力,用葡萄糖刺激微囊内细胞检查其胰岛素和C肽的分泌情况。 结果与结论：胰腺损伤提取物诱导后双硫腙染色和细胞免疫荧光鉴定出胰岛素产生细胞内有胰岛素的表达;胰岛素产生细胞制成的微囊直径约为400 µm,大小均一,6-羧基乙二酸荧光素检测到囊内细胞的活力很好。用葡萄糖刺激不同细胞浓度的微囊,发现细胞浓度为1×108 L-1时,胰岛素和C肽的分泌达到最高。 关键词：微囊化;骨髓间充质干细胞;胰岛素产生细胞;胰岛素;C肽 doi:10.3969/j.issn.1673-8225.2011.03.046     

An epidemiological study to identify the risk factors with two different types of controls in high-grade cervical lesions including invasive cancer

A multidisciplinary study on pre-cancerous and early cancerous lesions of uterine cervix was carried out at our Institute from which the subjects (cases and one group of control) for the present study were selected with the objective to identify the possible risk factors related to high-grade cervical lesions including invasive cancer through an epidemiological study by selecting two different types of controls and to assess the feasibility whether the cancers of other organs could be taken as controls at the same time studying the risk factors associated with cervical cancer. One group of control was women with negative Pap smear and second group of control was the women with breast cancer but negative Pap smear. A total of 100 biopsy-proven cases of high-grade cervical intraepithelial lesions and Invasive cancer were recruited. The results of the study show that some of the risk factors associated with the cervical cancer get exaggerated when breast cancer cases were used as controls because risk factors of both cancers are opposite to each other. So it is concluded that in order to remove any bias, normal hospital controls or controls selected from multiple cancers should be taken to study the risk factors involved in cervical carcinogenesis.     

A preliminary investigation into the experience of symptoms of psychosis in mental health professionals: implications for the psychiatric classification model of schizophrenia

The psychiatric classification system regarding the discrete category of schizophrenia remains controversial. Key concerns regarding the legitimacy of the classification system for this presentation focus on issues of study design, the relevance and inter-relationship between symptom clusters and the lack of a coherent model of aetiology. A defining summary feature of the psychiatric model is the distinctiveness of psychotic symptoms in those with a diagnosis of schizophrenia compared with non-clinical samples. The current study sought to challenge the prevailing psychiatric system by exploring the occurrence and experience of psychotic symptoms in mental health practitioners who routinely engage in therapeutic work with clients with a primary diagnosis of schizophrenia. A total of 16% ( n  = 19) of the sample indicated that they experienced voice hearing while 21% ( n  = 26) indicated they experienced delusions as assessed by validated assessment tools. The findings are indicative of a continuum model of psychotic symptom experience and run counter to the contemporary model of psychiatric classification of this disorder. The direction of future research is indicated.     

Hardship, dedication and investment: an exploration of Irish mothers commitment to communicating with their children with cerebral palsy

This qualitative study investigated the experiences of mothers who have a child with communication difficulties resulting from cerebral palsy (CP). There is a dearth of information about parents' experiences of having a child with CP and communication difficulties. Three participants, whose children had moderate or severe CP and communication difficulties, were recruited from a voluntary organization. Participants were interviewed using an in-depth, semi-structured interview guide. Interviews were audio-recorded, then transcribed and subsequently analysed using Grounded Theory methods. Five main themes emerged, combining to form the core category of mothers dedicating their attention to their children . The information gleaned from this study could have important implications for nurses involved in facilitating communication, including speech and language therapists, occupational therapists and registered nurses. By becoming more aware of the experiences of parents with a child with CP and communication disorders, nurses may be better able to plan and implement therapy and also support communication aims. The study concludes with a discussion of further research avenues, suggesting that a study investigating the experiences of parents of children with other types of physical disabilities affecting communication should be conducted to determine the similarities and differences of parents of children with other kinds of disability. A similar study with a larger sample could be conducted to validate the findings of the current study.