Atrophic gastritis is associated with increased sucrose permeability related to chronic inflammation

BACKGROUND: Different theories have been presented to explain how atrophic gastritis may lead to gastric cancer development. One contributing factor could be impaired function of the gastric mucosal barrier. The aim of this study was to investigate if there are changes in gastric mucosal permeability to sucrose in atrophic gastritis. METHODS: The study comprised 22 patients with atrophic gastritis and 21 normal controls. Gastritis was classified according to the Sydney system from endoscopic biopsies of the gastric corpus and antrum. All subjects were exposed to oral sucrose load (100 g), and the fraction of sucrose excreted in urine was measured by gas chromatography-mass spectrometry. RESULTS: The fraction of sucrose excreted in urine after oral load was significantly increased in atrophic gastritis compared with controls (median 0.08 vs. 0.04%; p = 0.003). Sucrose excretion was positively related to the degree of chronic inflammation (median fraction excreted: mild inflammation 0.06%, moderate inflammation 0.08%, severe inflammation 0.18%; p = 0.04) rather than to the degree of atrophy in the gastric mucosa. Occurrence of intestinal metaplasia was also associated with significantly higher sucrose excretion. However, in multivariate analysis, including intestinal metaplasia, only the degree of inflammation was positively related to sucrose excretion. CONCLUSION: Atrophic gastritis is associated with increased sucrose permeability, suggesting paracellular leakage of the gastric mucosa. This leakage seems to be related to the degree of inflammation rather than the degree of atrophy. The findings may have implications for the diseases and complications associated with atrophic gastritis.     

Large-scale epidemiological data on vascular disorders of the intestine

Abstract

Objectives: This article aims to provide updates on the worldwide epidemiology of vascular disorders of the intestine.

Methods: A comprehensive search for obtaining worldwide epidemiologic information on the burden of vascular disorders of the intestine was carried out in the Global Health Data Exchange (GHDx) repository. The condition ‘vascular intestinal disorders’ was associated with other epidemiologic variables such as year, sex, age, location and socioeconomic status.

Results: The current global incidence and mortality of vascular disorders of the intestine are 8.11 per 100,000 cases/year and 1.26 per 100,000 deaths/year, respectively, translating into a death rate of 15.5%. Both global incidence and mortality are 32% higher in the female sex and have both displayed a continuous increase during the past 20 years (+29.3% and +18.4% since 1998, respectively). Incidence and mortality curves appear similar between sexes, with the incidence increasing after the age of 40 years and mortality after the age of 50 years, respectively. The peak of both worldwide incidence and mortality was seen in very elderly people. The death rate increased in parallel with incidence and mortality, from ～1% to 3% in childhood up to ～50% after the age of 95 years. Both incidence and mortality displayed a positive association with socioeconomic status. Future projections suggest that incidence and mortality will display 44% and 24% growths by the year 2050.

Conclusions: Our analysis demonstrates that the clinical and societal burden of vascular disorders of the intestine is especially higher in women, in the elderly and in people with higher socioeconomic status.     

Reinforcement of Single Implant‐Retained Mandibular Overdenture with a Cobalt‐Chromium Framework before Implant Surgery

Previous clinical research has shown promising results in oral rehabilitation of elderly adults by a single implant‐retained mandibular overdenture; however, the high incidence of fracture in the anterior region of these overdentures is a concern for clinicians. To minimize catastrophic overdenture fracture, we propose a technique to insert an individualized metal framework in single implant‐retained overdentures prior to implant surgery.     

Formation of Pseudomonas aeruginosa inhibition zone during tobramycin disk diffusion is due to transition from planktonic to biofilm mode of growth

Pseudomonas aeruginosa PAO1 (tobramycin MIC?=?0.064 µg/mL) was used to perform agar diffusion tests employing tobramycin-containing tablets. Bacterial growth and formation of inhibition zones were studied by stereomicroscopy and by blotting with microscope slides and staining with methylene blue, Alcian blue and a fluorescent lectin for the P. aeruginosa PSL, which was studied by confocal laser scanning microscopy. Diffusion of tobramycin from the deposit was modelled using a 3D geometric version of Fick's second law of diffusion. The time-dependent gradual increase in the minimum biofilm eradication concentration (MBEC) was studied using a Calgary Biofilm Device. The early inhibition zone was visible after 5 h of incubation. The corresponding calculated tobramycin concentration at the border was 1.9 µg/mL, which increased to 3.2 µg/mL and 6.3 µg/mL after 7 h and 24 h, respectively. The inhibition zone increased to the stable final zone after 7 h of incubation. Bacterial growth and small aggregate formation (young biofilms) took place inside the inhibition zone until the small aggregates contained less than ca. 64 cells and production of polysaccharide matrix including PSL had begun; thereafter, the small bacterial aggregates were killed by tobramycin. Bacteria at the border of the stable inhibition zone and beyond continued to grow to a mature biofilm and produced large amount of polysaccharide-containing matrix. Formation of the inhibition zone during agar diffusion antimicrobial susceptibility testing is due to a switch from a planktonic to biofilm mode of growth and gives clinically important information about the increased antimicrobial tolerance of biofilms.     

Recent updates on worldwide gout epidemiology

Clinical Rheumatology - To provide recent statistics on worldwide gout epidemiology. Current and prediction data on gout epidemiology were retrieved from the Global Health Data Exchange (GHDx)...     

Spontaneous clostridial myonecrosis after pregnancy – emergency treatment to the limb salvage and functional recovery: a case report

Clostridial myonecrosis (CM) is a rare, life threatening necrotizing infection of a skeletal muscle caused by Clostridium perfringens in the majority of cases. The diagnosis may be difficult because of few diagnostic and cutaneous signs early in its course. Standard therapy involves surgical debridements of a devitalized tissue and high‐dose organism‐specific antibiotic therapy. The hyperbaric oxygen has also showed its usefulness in the treatment of these infections. Autograft systems as tissue replacement, based on bioengineered materials, have been demonstrated to be safe and effective treatments for chronic wounds and a suitable physiotherapy is recommended for the recovery of functional impairments of upper extremities. We present a rare case of CM of right upper limb treated with a combination of standard treatments and new techniques.