Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Κυριακή 22 Ιανουαρίου 2023

Vitamin D levels in the assessment of Crohn's disease activity and their relation to nutritional status and inflammation

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Abstract

Background

Crohn's disease (CD) is frequently associated with malnutrition, inflammation, and a deficiency of vitamin D (VD) with the relationships between these symptoms being poorly defined. Vitamin D is a modulator of the immune system and is associated with the onset of CD and disease activity. The level of serum VD may have potential in the assessment of CD activity. This study aimed to evaluate the relationships between VD, nutritional status, and inflammation, and to identify more accurate VD thresholds.

Methods

The study included 76 outpatients with CD diagnosed between October 2018 and October 2020 and 76 healthy volunteers. Levels of serum 25(OH)D and nutritional indicators, as well as biochemical and disease activity assessments were conducted.

Results

Patients with CD and healthy participants were found to differ significantly in their 25(OH)D levels as well in levels of nutritional and inflammatory indicators. The optimal VD cut-off value was found to be 46.81 nmol/L for CD development and 35.32 nmol/L for disease activity. Levels of 25(OH)D were correlated with both nutritional status and inflammation.

Conclusions

The VD level is likely to be a useful additional tool in the evaluation of CD patients and predicting the disease activity and clinical response. The VD level may relate both to the nutritional status and levels of inflammation in CD patients, as well as disease progression.

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Does baseline EEG activity differ in the transition to or from a chronic pain state?

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Abstract

Background and aim

Identifying EEG brain markers might yield better mechanistic insights into how chronic pain develops and could be treated. An existing longitudinal EEG study gave us the opportunity to determine whether the development of pain is accompanied by less alpha power—ie, a 'relaxed' brain state—and vice versa.

Methods

Five-minute resting EEG with the eyes open was measured 2 times in 95 subjects at T0 (baseline) and T1 (6 months later). Based on the Short-Form Health Survey and Brief Pain Inventory questionnaire, subjects were divided into 4 groups: staying pain-free (n = 44), developing chronic pain (n = 8), becoming pain-free (n = 15), and ongoing chronic pain (n = 28). The EEG data of 14 electrodes were analyzed by multilevel regression.

Results

The group that developed chronic pain demonstrated less power in the lower-frequency bands over time during the resting state EEG, whereas the transition to a pain-free state had the opposite pattern. Thus, the a priori hypothesis was confirmed.

Conclusions

Transitions in pain states are linked to a change in baseline EEG activity. Future research is needed to replicate these results in a larger study sample and in targeted clinical populations. Further, these results might be beneficial in optimizing neurofeedback algorithms for the treatment of chronic pain.

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Spinal cord stimulation and return to work of patients with failed back surgery syndrome

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Abstract

Objectives

Chronic pain has a substantial negative impact on work-related outcomes, which underlines the importance of interventions to reduce the burden. Spinal cord stimulation (SCS) efficiently relieves pain in specific chronic pain syndromes and is recommended for treating failed back surgery syndrome (FBSS) or post-surgical chronic back pain that is refractory to other treatments. To examine the impact of SCS in patients with FBSS on the return to work (RTW), we determined the RTW rate and the factors positively associated with the RTW.

Materials and Methods

Among 106 patients with FBSS who benefitted from SCS at a single institution in France between September 1999 and March 2010, we retrospectively included 59 who had stopped work at the time of SCS because of disability or sick leave and evaluated the RTW (rate and predictors, estimating odds ratios [ORs] and 95% confidence intervals [CIs]).

Results

The mean (SD) post-surgery follow-up for the 59 patients (34 men; mean [SD] age 46.9 [7.4] years) was 7.5 (3.6) years (range 5–15). The RTW rate was 30.5%, with a median [IQR] recovery time of 5.5 months [3–8.5]. RTW was improved with functional improvement evolution (OR 1.1, 95% CI [1.01–1.1], p=0.02) and was reduced with unemployment > 3 years (OR 0.1, 95% CI [0.01-0.7], p=0.02).

Conclusions

Our protocol for SCS for patients with FBSS, including a strict selection of patients and a multidisciplinary approach, led to good results, especially for the RTW. RTW should be a therapeutic goal, directly affecting indirect costs related to FBSS.

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Regulatory B cells (Bregs) in Helicobacter pylori chronic infection

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Abstract

Background

Helicobacter pylori (H. pylori) infection is linked with a wide variety of diseases and was reported in more than half of the world's population. Chronic H. pylori infection and its final clinical outcome depend mainly on the bacterial virulence factors and its ability to manipulate and adapt to human immune responses. Bregs blood levels have been correlated with increased bacterial load and infection chronicity, especially Gram-negative bacterial infection. This study aimed to identify prevalence and virulence factors of chronic H. pylori infection among symptomatic Egyptian patients and to examine its possible correlation to levels of regulatory B cells (Bregs) in blood.

Materials and Methods

Gastric biopsies and blood samples from each of 113 adult patients, who underwent upper endoscopy, were examined for the detection of H. pylori by culture and PCR methods. Conventional PCR was used to determine various virulent genes prevalence and association to clinical outcome. Flow cytometry was used to evaluate Bregs levels.

Results

Helicobacter pylori prevalence was 49.1% (55/112). Regarding virulence genes incidence, flaA gene was detected in 73% (40/55), vir B11 in 56.4% (31/55), hopZ1 in 34.5% (19/55), hopZ2 in 89% (49/55), babA2 in 52.7% (29/55), dupA jhp917 in 61.8% (34/55), vacA m1/m2 in 70.9% (39/55), and vacA s1/s2 in 69% (38/55) strains. Bregs levels were significantly lower in H. pylori-infected patients (p = 0.013), while total leukocyte count (TLC) showed no significant differences.

Conclusion

Helicobacter pylori infection prevalence was almost 49%, and the infection was found to be related to inflammatory conditions as gastritis and ulcers rather than malignant transformations. Also, we found that CD24+CD38+ B cells were downregulated in Hpylori-infected patients.

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Developmental Outcomes in Children Born to Women with Possible Subclinical Rubella Exposures During Pregnancy

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Abstract

This study investigated outcomes of children born to women who seroconverted to rubella immune during pregnancy.

In a prior 2012-2013 study of 296 women who were rubella non-immune, 26 (8.8%) seroconverted to rubella immune during pregnancy. These same women and their now 8-9 years-old children were queried as to the children's developmental health. After removing exclusions and those lost to follow-up, the total response rate was 115/204 (56.4%). Three sets of twins in the non-immune group increased the total to 118. The seroconversion group had more autism (12.5% versus 3.9%, P=.19), ADHD (37.5% versus 18.6%, P=.10), and any developmental disability (43.8% versus 31.4%, P=.39) but none showed a statistical difference between the two groups. Compared to Autism and Developmental Disabilities Monitoring data, the seroconversion group had a greater prevalence of autism (OR 6.07, P=0.051, nonsignificant); and to data derived from the National Health Interview Survey, a nonsignificant higher odds of autism (OR 5.57, P=0.060), higher odds of ADHD (OR 5.65, P=0.0027) and of an y developmental disability (OR 3.59, P=0.014).The non-immune group also demonstrated a statistically significant increase for both ADHD and any developmental disability, but not for autism.

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Significant neutralizing escapes of Omicron and its sub‐lineages in SARS‐CoV‐2‐infected individuals vaccinated with inactivated vaccines

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Abstract

In China, most SARS-CoV-2-infected individuals had been vaccinated with inactivated vaccines. However, little is known about their immune resistances to the previous variants of concerns (VOCs) and the current Omicron sub-lineages. Here, we collected convalescent serum samples from SARS-CoV-2-infected individuals during the ancestral, Delta and Omicron BA.1 waves, and evaluated their cross-neutralizing antibodies (nAbs) against the previous VOCs and the current Omicron sub-lineages using VSV-based pseudoviruses. In the convalescents who had been unvaccinated and vaccinated with two doses of inactivated vaccines, we found infections from either the ancestral or the Delta strain elicited moderate cross-nAbs to previous VOCs, but very few cross-nAbs to the Omicron sub-lineages, including BA.1, BA.2, BA.3 and BA.4/5. The individuals who had been vaccinated with two doses of inactivated vaccines before Omicron BA.1 infection had moderate nAbs to Omicron BA.1, but weak cross-nAbs to the other Omicron sub-lineages. While three doses of inactivated vaccines followed Omicron BA.1 infection induced elevated and still weak cross-nAbs to other Omicron sub-lineages. Our results indicate that the Omicron sub-lineages show significant immune escape in the previously SARS-CoV-2-infected individuals and thus highlights the importance of vaccine boosters in this population.

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