Urotensin II levels in patients with inflammatory bowel disease

BACKGROUNDPatients with inflammatory bowel disease (IBD) are associated with increased cardiovascular risk and have increased overall cardiovascular burden. On the other hand, urotensin II (UII) is one of the most potent vascular constrictors with immunomodulatory effect that is connected with a number of different cardiometabolic disorders as well. Furthermore, patients with ulcerative colitis have shown increased expression of urotensin II receptor in comparison to healthy controls. Since the features of IBD includes chronic inflammation and endothelial dysfunction as well, it is plausible to assume that there is connection between increased cardiac risk in IBD and UII.AIMTo determine serum UII levels in patients with IBD and to compare them to control subjects, as well as investigate possible associations with relevant clinical and biochemical parameters.METHODSThis cross sectional study consecutively enrolled 50 adult IBD patients (26 with Crohn’s disease and 24 with ulcerative colitis) and 50 age and gender matched controls. Clinical assessment was performed by the same experienced gastroenterologist according to the latest guidelines. Ulcerative Colitis Endoscopic Index of Severity and Simple Endoscopic Score for Crohn’s Disease were used for endoscopic evaluation. Serum levels of UII were determined using the enzyme immunoassay kit for human UII, according to the manufacturer’s instructions.RESULTSIBD patients have significantly higher concentrations of UII when compared to control subjects (7.57 ± 1.41 vs 1.98 ± 0.69 ng/mL, P < 0.001), while there were no significant differences between Crohn’s disease and ulcerative colitis patients (7.49 ± 1.42 vs 7.65 ± 1.41 ng/mL, P = 0.689). There was a significant positive correlation between serum UII levels and high sensitivity C reactive peptide levels (r = 0.491, P < 0.001) and a significant negative correlation between serum UII levels and total proteins (r = -0.306, P = 0.032). Additionally, there was a significant positive correlation between serum UII levels with both systolic (r = 0.387, P = 0.005) and diastolic (r = 0.352, P = 0.012) blood pressure. Moreover, serum UII levels had a significant positive correlation with Ulcerative Colitis Endoscopic Index of Severity (r = 0.425, P = 0.048) and Simple Endoscopic Score for Crohn’s Disease (r = 0.466, P = 0.028) scores. Multiple linear regression analysis showed that serum UII levels retained significant association with high sensitivity C reactive peptide (β ± standard error, 0.262 ± 0.076, P < 0.001) and systolic blood pressure (0.040 ± 0.017, P = 0.030).CONCLUSIONIt is possible that UII is involved in the complex pathophysiology of cardiovascular complications in IBD patients, and its purpose should be investigated in further studies.     

Prognosis in monoclonal gammopathy of undetermined significance

Eighty-seven patients with monoclonal gammopathy of undetermined significance (MGUS) were followed for a period of 1–20 years, median 91 months. Transformation to multiple myeloma occurred in 14 patients of whom seven died as a consequence of the disease. There were 13 unrelated deaths. The actuarial probability of survival was 80% at 10 years and 44% at 15 years and the probabilities of malignant conversion for the same periods were 17% and 30% respectively. The most significant factor influencing the probability of malignant conversion was the increase of monoclonal protein above the level of 30 g/l during the observation period ( P <0.001), followed by an increase of M-protein to more than 50% above the baseline level ( P =0.02) and a decreased level of uninvolved immunoglobulins ( P =0.054).     

Bone morphogenetic protein-7 reduces cold ischemic injury in rat kidney

Background

Deceased donor kidneys have a high incidence of delayed graft function attributable to ischemia–reperfusion injury. Although preservation solution and cold storage reduce cold ischemic injury, the depletion of cellular energy and oxidative signalling leads to cellular damage. Because bone morphogenetic protein-7 has renoprotective effect, we have hypothesized that recombinant human bone morphogenetic protein-7 (rh BMP-7) will better preserve kidney tissue exposed to prolonged cold ischemia in comparison with University of Wisconsin (UW) solution. We evaluated how the duration of cold ischemia influences the cold ischemic injury.

Methods

Levels of lipid peroxidation, protein carbonyl content, as well as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were determined in the kidneys by spectrophotometry after 6, 12, and 24 hours of cold ischemia.

Results

Time-dependent increases in the levels of lipid peroxidation and protein carbonyl content at all time points were significantly lower in rhBMP-7–perfused kidneys versus the UW-treated group. SOD activity after 6 hours, as well as GSH-Px activity after 24 hours of cold ischemia was significantly higher in the kidney tissue perfused by rhBMP-7 than in UW group.

Conclusion

rhBMP-7 significantly decreases cellular damage in rat kidney versus UW preservation solution and this is attributed to lowering of cold ischemia injury and maintaining prolonged tissue antioxidant activity.     

Impact of the COVID-19 pandemic on inflammatory bowel disease patients: A review of the current evidence

Since the initial coronavirus disease 2019 (COVID-19) outbreak in China in December 2019, the infection has now become the biggest medical issue of modern medicine. Two major contributors that amplified the impact of the disease and subsequently increased the burden on health care systems were high mortality among patients with multiple co-morbidities and overcapacity of intensive care units. Within the gastroenterology-related community, particular concern was raised with respect to patients with inflammatory bowel disease (IBD), as those patients are prone to opportunistic infections mainly owing to their immunosuppressive-based therapies. Hence, we sought to summarize current knowledge regarding COVID-19 infection in patients with IBD. Overall, it seems that IBD is not a comorbidity that poses an increased risk for COVID-19 acquisition, except in patients treated with 5-aminosalicylates. Furthermore, outcomes of the infected patients are largely dependent on therapeutic modality by which they are treated, as some worsen the clinical course of COVID-19 infection, whereas others seem to dampen the detrimental effects of COVID-19. Finally, we discussed the present and the future impact of COVID-19 pandemic and concomitantly increased health care burden on IBD-management.     

Accuracy of linear intraoral measurements using cone beam CT and multidetector CT: a tale of two CTs

Objectives

The aim was to compare the accuracy of linear bone measurements of cone beam CT (CBCT) with multidetector CT (MDCT) and validate intraoral soft-tissue measurements in CBCT.

Methods

Comparable views of CBCT and MDCT were obtained from eight intact cadaveric heads. The anatomical positions of the gingival margin and the buccal alveolar bone ridge were determined. Image measurements (CBCT/MDCT) were performed upon multiplanar reformatted data sets and compared with the anatomical measurements; the number of non-assessable sites (NASs) was evaluated.

Results

Radiological measurements were accurate with a mean difference from anatomical measurements of 0.14 mm (CBCT) and 0.23 mm (MDCT). These differences were statistically not significant, but the limits of agreement for bone measurements were broader in MDCT (−1.35 mm; 1.82 mm) than in CBCT (−0.93 mm; 1.21 mm). The limits of agreement for soft-tissue measurements in CBCT were smaller (−0.77 mm; 1.07 mm), indicating a slightly higher accuracy. More NASs occurred in MDCT (14.5%) than in CBCT (8.3%).

Conclusions

CBCT is slightly more reliable for linear measurements than MDCT and less affected by metal artefacts. CBCT accuracy of linear intraoral soft-tissue measurements is similar to the accuracy of bone measurements.     

Erbium:YAG laser versus ultrasonic in preparation of root-end cavities

The aim of this in vitro study was to compare the sealing effectiveness of the Erbium:YAG laser to the sealing effectiveness of an ultrasonic device in the preparation of similar retrograde cavities using different retrograde filling materials. After root-canal instrumentation and filling, apices of 60 single-rooted teeth were resected. Retrograde class I cavities 3 mm deep were prepared using an ultrasonic device (group A) and Er:YAG laser (group B). An ultrasonic unit was used with CT-5 retrotip at the frequency of 32 KHz. Laser beam parameters were a pulse of very short duration (100 micros), energy of 280 mJ, and repetition rate of 10 Hz. Cavities of each group of 10 samples were filled with mineral trioxide aggregate (MTA), Super-EBA, and IRM. Microleakage was measured using a fluid transport model. The results showed that cavities prepared with Er:YAG laser have significantly lower microleakage for all tested materials.     

Leiomyosarcoma of the breast

A 62-year old patient was treated at our hospital for a palpable change in the upper part of the left breast. The clinical finding was preoperatively confirmed by radiologic, ultrasound and cytology studies, however, the potential biologic process (malignant/benign) was not thus verified. Considering undefined diagnostic nature of the process, biopsy, pathohistology and immunoanalysis were performed to indicate leiomyosarcoma mammae. The incision interspace at certain sites was less than two centimeters, indicating radical breast excision in toto (ablation with evacuation of the contents of the axilla). At the time of scheduled surgery, the patient sustained cardiologic discomfort, so tumorectomy was supplemented by locoregional radiotherapy. Leiomyosarcoma of the breast is a very rare primary malignant breast tumor, with only 14 cases reported in the literature. Considering the rare occurrence of leiomyosarcoma of the breast, in radical surgery we used attitudes like in other breast tumors and leiomyosarcoma of other localizations.     

Effects of Olive Oil and Its Components on Intestinal Inflammation and Inflammatory Bowel Disease

With the rising global burden of inflammatory bowel disease (IBD) and the rising costs of novel biological drugs, there is an increasing need for dietary approaches and functional foods that could modulate the course of IBD. The Mediterranean diet has proven to be efficacious in managing chronic inflammatory diseases, and recent studies have also shown its benefits in the setting of IBD. Since olive oil and its compounds have been shown to provide a considerable anti-inflammatory effect, in this review, we aim to discuss the latest evidence concerning the impact of olive oil and its bioactive compounds on IBD. Numerous preclinical studies have exhibited solid evidence on the mechanisms by which polyphenol-rich extra-virgin olive oil (EVOO) or specific polyphenols like hydroxytyrosol (HT) provide their anti-inflammatory, antioxidative, antitumour, and microbiota-modulation effects. Accordingly, several human studies that explored the effects of olive oil on patients with IBD further confirmed the evidence brought forward by preclinical studies. Nevertheless, there is a need for larger-scale, multicentric, randomized control trials that would finally elucidate olive oil’s level of efficacy in modulating the course of IBD.