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1.
Hydrogen breath tests are widely used to explore pathophysiology of functional gastrointestinal (GI) disorders. Small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption are disorders detected by these tests that have been proposed to be of great importance for symptoms of GI diseases. Glucose hydrogen breath test is more acceptable for diagnosis of SIBO whereas lactose and fructose hydrogen breath tests are used for detection of lactose and fructose maldigestion respectively. Lactulose hydrogen breath test is also used widely to measure the orocecal transit time for GI motility. These methods are noninvasive and inexpensive. Many patients with functional gut disorders are unaware of the relationship between diet and GI symptoms they present. In particular, patients with chronic symptoms may regard their condition as normal and may not be aware that their symptoms can be effectively managed following a proper diagnosis. Patients with symptoms of abdominal pain, bloating, flatulence and altered bowel movements (diarrhea and constipation), or with a medical diagnosis of irritable bowel syndrome or celiac disease, may have undiagnosed carbohydrate malabsorption or SIBO. Hydrogen breath tests are specific and sensitive diagnostic tests that can be used to either confirm or eliminate the possibility of carbohydrate malabsorption or SIBO in such patients. Breath tests, though valuable tools, are underutilized in evaluating dyspepsia and functional bloating and diarrhea as well as suspected malabsorption. However, because of their simplicity, reproducibility and safety of procedure they are now being substituted to more uncomfortable and expensive techniques that were traditionally used in gastroenterology.  相似文献   

2.
IntroductionFecal calprotectin is a biomarker for monitoring inflammatory bowel disease (IBD) activity. Our aim, therefore, was to evaluate two new assays, the point of care test Quantum Blue and the Liaison Calprotectin with respect to the Calprest, commonly used assay, and to determine their performance for IBD diagnosis.Materials and methodsWe included 73 prospective patients with IBD. Fecal calprotectin was measured and analysed with the routine Calprest assay and two recently introduced assays, the Quantum Blue and the Liaison Calprotectin. Furthermore, we compared the results by Bland and Altman analysis, and Passing-Bablok regression.ResultsWe observed no difference in median calprotectin values obtained by the Calprest (94.6 µg/g, 95%CI 66.5 to 166.1) and Liaison assay (101.0 µg/g, 95%CI 48.1 to 180.1) whereas significantly higher concentrations were obtained with the Quantum Blue assay (240.0 µg/g, 95%CI 119.9 to 353.2). The mean absolute and relative difference between the Calprest and Quantum Blue methods was statistically significant (- 162.3 µg/g and
- 143.1%). Mean absolute difference between the Calprest and Liaison calprotectin methods was positive (2.2 µg/g). The agreement between assays revealed that Quantum Blue and Calprest have fair agreement with Kappa coefficient of 0.38 (95%CI 0.26 to 0.51). Liaison Calprotectin and Calprest revealed moderate agreement with a weak Kappa coefficient of 0.47 (95%CI 0.32 to 0.62).ConclusionClinicians should be aware of these differences between the assays and avoid comparison of their respective results.  相似文献   

3.
Inflammatory bowel disease (IBD) is a heterogeneous group of chronic inflammatory disorders of the gastrointestinal tract with two main distinguishable entities, Crohn’s disease (CD) and ulcerative colitis (UC). IBD-unclassified (IBD-U) is a diagnosis that covers the “grey” zone of diagnostic uncertainty between UC and CD. Current diagnosis of IBD relies on the clinical, endoscopic, radiological, histological and biochemical features, but this approach has shortcomings especially in cases of overlapping symptoms of CD and UC. The need for a diagnostic tool that would improve the conventional methods in IBD diagnosis directed the search towards potential immunological markers, since an aberrant immune response against microbial or endogenous antigens in a genetically susceptible host seems to be implicated in IBD pathogenesis. The spectrum of antibodies to different microbial antigens and autoantibodies associated with IBD is rapidly expanding. Most of these antibodies are associated with CD like anti-glycan antibodies: anti-Saccharomices cerevisiae (ASCA) and the recently described anti-laminaribioside (ALCA), anti-chitobioside (ACCA), anti-mannobioside (AMCA), anti-laminarin (anti-L) and anti-chitin (anti-C) antibodies; in addition to other antibodies that target microbial antigens: anti-outer membrane porin C (anti-OmpC), anti-Cbir1 flagellin and anti-I2 antibody. Also, autoantibodies targeting the exocrine pancreas (PAB) were shown to be highly specific for CD. In contrast, UC has been associated with anti-neutrophil cytoplasmic autoantibodies (pANCA) and antibodies against goblet cells (GAB). Current evidence suggests that serologic panels of multiple antibodies are useful in differential diagnosis of CD versus UC and can be a valuable aid in stratifying patients according to disease phenotype and risk of complications.  相似文献   

4.
Before 1980, most people experiencing common nervous problems and who sought medical help complained of anxiety and were treated for anxiety. Similar experiences increasingly led to complaints of or treatment for panic attacks in the late 1980s and early 1990s, and to complaints of or treatment for mood disorders by the mid-1990s. Today, such patients seem once again increasingly likely to complain of and be treated for anxiety. This paper reviews a series of mechanisms whereby company marketing can both transform the perceptions of physicians and shape the experiences of those seeking treatment and the self-understanding of those not in treatment. These include the standard ploys of company sales departments to increase demand for products, including celebrity endorsements, the sponsoring of educational events and a host of reminders. The portfolio of marketing manoeuvres has grown, though, by translating educational events and celebrity events into the arena of scientific research: clinical trials have increasing become part of the marketing of disorders and their treatments; ghost-written scientific papers are authored by celebrity researchers. The portfolio of marketing manoeuvres has also grown to encompass new ways of creating fashion through medical activism, by setting up patient groups and disease awareness campaigns. The result is a transformation and growth in disorders tailor-made to fit ever more visible drugs.  相似文献   

5.
BackgroundIn order to study the influence of long-term growth process and evolution environment on intestinal bacteria of different breeds, the intestinal bacteria and volatile fatty acids among the faeces of Min, Landrace and Yorkshire pigs were analysed by Illumina high-throughput sequencing of the 16S-rDNA and gas chromatography.ResultsThe shared core microbiota of Landrace, Yorkshire and Min pig were 1273, accounting for 69.56% of total abundance of organisms. The proportion of Firmicutes in Min pig faeces (57.89%) was significantly higher than that in Landrace and Yorkshire pig faeces (47.01% and 46.40%, respectively) (P < 0.05), but that of Bacteroidetes was exactly opposite. Moreover, Min pig presented more highly efficient membrane transport, environmental adaptation, carbohydrate transport, and metabolism than Yorkshire pig (P < 0.05). The acetic acid/total volatile fatty acid ratio in Min pig was significantly higher than that in Landrace pig (P < 0.05), and the isobutyric acid/ total volatile fatty acid ratio in Min pig was significantly larger than that in Yorkshire pig (P < 0.05). Furthermore, the content of branched chain volatile fatty acids in Min pig was significantly higher than that in Yorkshire pig (P < 0.05).ConclusionsThis study demonstrated that Min pig, as an excellent breed in the cold area of China, possessed special intestinal floral structure compared to the imported pigs in order to satisfy their physiological and metabolic demands, which may influence their characteristics such as resistance to cold, diseases, and crude feeding, and the ability to deposit intramuscular fat.How to cite: Yang Y, Sun C, Li F, et al. Characteristics of faecal bacterial flora and volatile fatty acids in Min pig, Landrace pig, and Yorkshire pig. Electron J Biotechnol 2021;53. https://doi.org/10.1016/j.ejbt.2021.05.002  相似文献   

6.
【目的/意义】中医医案中包含的隐性知识具有巨大的价值,通过数据挖掘技术对中医医案进行分析,挖掘 临床医案中的隐性知识,有利于知名中医个人知识经验的传承和中医理论知识的积累和拓展。【方法/过程】收集中 医医案中患者的主诉和现病史,并对主诉和现病史进行数据清洗,通过基于cart算法的数据挖掘技术挖掘中医医案 中的隐性知识,探究病症与患者症候各个属性之间的关系。【结果/结论】本文以胃脘痛为例,发现了胃脘痛与患者 症候各个属性之间的相关程度,为数据挖掘技术在中医医案隐性知识挖掘研究提供借鉴。【创新/局限】本文采用的 cart算法判断胃脘痛与患者属性之间的相关性与医案中确诊结果进行比较,得出该方法相关性准确率高于ID3算 法、C4.5算法和SLIQ算法,判断相关性最高。  相似文献   

7.
Free radicals play an important role in the pathogenesis of tissue damage in many clinical disorders, including atherosclerosis. Antioxidants protect the body from damage caused by free radicals. In this study we investigated oxidative stress, antioxidants and inflammatory molecules in patients with acute myocardial infarction. This study has been carried out on 106 patients with acute myocardial infarction, (89 men and 17 females). The control group consisted of 50 healthy, age-matched subjects (40 men and 10 females). Levels of Glucose, lipid profile, glutathione reduced, glutathione peroxidase, Superoxide dismutase, Glycosylated hemoglobin, fibrinogen, vitamin C, vitamin E, malondialdehyde, ceruloplasmin, adenosine deaminase, lysozyme and sialic acid were measured. Malondialdehyde and ceruloplasmin levels were significantly high and antioxidants such as vitamin C, vitamin E, glutathione reduced, glutathione peroxidase and superoxide dismutase were significantly decreased in diabetic and non-diabetic AMI patients as compared with control (p<0.001). Inflammatory markers showed significant rise in diabetic patients as compared with controls. Our results clearly show increased inflammation and oxidative stress in patients with acute myocardial infarction. Depression of antioxidant system in these patients confirms this conclusion.  相似文献   

8.
Inflammation     
  相似文献   

9.
Age-related macular degeneration (AMD) is a complex, degenerative and progressive disease involving the multiple genetic and environmental factors that can result in severe visual loss. The etiology of AMD is not well understood. Many theories exist and feature mechanisms of oxidative stress, atherosclerotic-like changes, genetic predisposition and inflammation. The most recent clinical studies appointed to a great role of inflammation and C-reactive protein (CRP) in the pathogenesis of AMD. There is a large body of evidence indicating the association of CRP with endothelial dysfunction, oxidative stress and production of reactive oxygen species (ROS), as well as with lipid status disorder in AMD patients. According to recent studies, CRP is definitely not only the inflammatory marker but also a mediator of development of the vascular disorders in the retinal circulation. The results obtained from the present studies may help our understanding the pathogenesis of the retinal vascular disease associated with high levels of CRP.  相似文献   

10.
The supply of oxygen is limited in certain intra abdominal conditions due to direct vascular invasion or inflammatory process, resulting in high lactate levels. Aim of this study was to find the predictive value of lactate levels in the peritoneal fluid (PF) and blood of patients with acute abdomen. The study comprised of fifty patients with acute abdominal conditions, admitted in emergency ward of tertiary care hospital, thirty patients were with surgical abdomen (group I) and twenty patients with non surgical abdomen (group II). Lactate was estimated in PF and blood on Blood Gas Analyzer (NOVA, M-7). The mean lactate levels in PF were significantly higher in group I as compared to group II (14.65 ± 1.195 vs. 5.92 ± 0.97 mmol/L, p < 0.001). There was no significant difference in blood lactate levels in both the groups. When PF and blood lactate levels were compared within groups, we found that PF levels were significantly higher than blood in group I (14.65 ± 1.195 vs. 3.85 ± 0.54 mmol/L, p < 0.001) but not in group II (5.92 ± 0.97 vs. 4.36 ± 0.95 mmol/L). Diagnostic value was obtained using ROC curve. Cut off values obtained for PF lactate, difference and ratio of PF and blood lactate (≥6.4 mmol/L, ≥3.3 and ≥2.1 respectively) are at very high degree of sensitivity and specificity. So it can be useful marker of surgical emergency in patients with acute intra abdominal pathology, especially in clinically ill patients or in whom physical examination is not yielding because of neurologic disorders or unresponsiveness.  相似文献   

11.
We describe a case of poorly differentiated adenocarcinoma of stomach, which did not present typical symptoms of gastrointestinal malignancy on first visit. The patient, a 62 year old smoker presented with shortness of breathe and pain in right lumbar region with no history of fever. Bone scans revealed multiple hot spots in skull, sternum, lumbar vertebrae and both iliac crests. A series of tumor markers were ordered which include PSA, CEA, CA19.9, CA 72.4 and AFP. Serum PSA and AFP concentrations were within normal range. Serum CEA and CA 72.4 were raised significantly. Markedly elevated levels of serum CA19.9 were found (>45000 U/ml) in this patient. CT chest and bronchoscopic examination ruled out the possibility of cancer lung. Upper GI tract endoscopy was done to find out lesion in GI tract. An ulcerative lesion was found in lesser curvature of stomach. Histopathological examination of endoscopic biopsy revealed a poorly differentiated adenocarcinoma of stomach. An unusually high serum CA19.9 (>45000U/ml) in case of gastric carcinoma has not been reported earlier.  相似文献   

12.
In this study, we use a hybrid sentiment analysis approach to identify and assess service quality dimensions (i.e., technical and functional quality) in unstructured textual reviews and employ econometric methods to theorize and test the impact of these service quality signals on online physician selection. By analyzing a data set with 246,294 reviews based on 5,452 physicians in 8 disease markets from an online health consultation platform, this study reports that technical and functional quality cues are important market signals used by patients to select online physicians. More importantly, this study provides strong evidence that the effects of these signals on online physician selection are substantially contingent on disease market competition intensity. Furthermore, this market competition effect is moderated by the level of disease risk. This study contributes insight into patients' physician choice behavior by introducing the role of market-level characteristics. It also guides online health consultation platforms in developing operational strategies to increase patient engagement.  相似文献   

13.
The mechanical properties of extracellular matrix (ECM) and connective tissues is largely dependent on the collagen and elastin structure. Lysyl oxidase (LOX) plays a critical role in the formation and repair of the ECM by oxidizing lysine residues in elastin and collagen, thereby initiating the formation of covalent cross linkages which stabilize these fibrous proteins. Due to its multiple functions both extracellularly and intracellularly, lysyl oxidase is involved in several processes in the tumorigenic pathway, in many different cancer types and stages. Alteration in LOX activity is implicated in many diseases and disorders including inflammation and inflammatory diseases, fibrosis of distinct organs and fibrotic disorders, cancer promotion and progression. There are only sparse reports of mutations or epigenetic alterations in the LOX gene. This review provides the recent clinical developments in the molecular mechanisms and pathologic process, pointing out LOX as a potential therapeutic target in translational medicine.  相似文献   

14.
Dengue fever (DF) is characterized by systemic inflammatory response including neutrophil activation leading to uncontrolled elastase activity. This study was aimed to measure the activity of plasma neutrophil elastase (NE), its endogenous inhibitors α1-antitrypsin (α1-AT) and α2-macroglobulin (α2-MG) and elastase in complex with α1-AT (NE–α1-AT complex) in DF. 50 dengue patients [39 DF and 11 dengue hemorrhagic fever (DHF)] and 52 healthy subjects were included in the study. NE was measured using N-succinyl-tri-alanine-p-nitroanilide as substrate. α1-AT, α2-MG and NE–α1-AT complex were estimated by ELISA. The result analysis indicated that the dengue patients had significantly higher elastase activity with significantly reduced inhibitor levels compared to controls. Between DF and DHF patients, DHF group had significantly higher elastase activity. In conclusion, significantly elevated NE and reduced inhibitors level in dengue fever indicate these parameters could be of significance in DF particularly for the assessment of progression of inflammatory processes.  相似文献   

15.
Aminotransferase assay is often used as a screening test as well as an endpoint for resolution of disease in nonalcoholic fatty liver disease (NAFLD). Aim of the study was to evaluate the relationship of transaminase level with metabolic variables and histology in NAFLD. Single center observational study was conducted in a gastroenterology clinic at Cuttack in coastal Odisha. Subjects were consecutive patients presenting with functional bowel disease and undergoing abdominal sonography. All participants were evaluated for the presence of metabolic syndrome (MS), insulin resistance, liver function test and lipid profile. Various parameters were compared between NAFLD subjects and controls. 53.5 % of NAFLD had normal serum transaminases, whereas 20.8 % of healthy controls had transaminitis. NAFLD patients had significantly higher BMI, fasting plasma glucose, serum transaminases, serum triglycerides, serum insulin and homeostatic model assessment (HOMA) IR than controls. NAFLD patients who had transaminitis had significantly higher incidence of MS and higher mean HOMA IR than those without. There was no significant difference in histopathological features between NAFLD with and without transaminitis. To conclude, over half of NAFLD subjects do not have transaminitis while transaminitis is present in a fifth of healthy people without fatty liver. Hence serum transaminase should not be used as screening test for NAFLD. NAFLD patients with transaminitis had a higher incidence of MS and insulin resistance than those without. However, there was no significant difference in histopathological features between these two groups.  相似文献   

16.
方如梦 《大众科技》2016,(7):101-103
目的:探讨中医个性化心理护理对肝硬化腹水患者一般症状,临床疗效,以及生活质量的影响。方法:在广西中医药大学第一附属医院肝病科住院病人70例,随机分为中医个性化心理护理组(38例)和普通护理组(32例)。其中中医个性化心理护理组在常规治疗和护理基础上,仅给予中医个性化心理护理;常规护理组仅进行常规的治疗和护理。分析比较两组干预前后的腹围、尿量、疗效,以及生活质量。结果:中医个性化心理护理可有效降低肝硬化腹水病人腹围、尿量,且中医个性化心理护理组的有效率和生活质量均高于普通护理组(均为P0.05)。结论:针对肝硬化腹水患者给予中医个性化心理护理,可有效提高疗效,提高生活质量,具有重要的临床推广价值。  相似文献   

17.
Lactoferrin, an iron-binding protein, has been proposed to act as an anti-infective agent and has been used as a diagnostic marker in several inflammatory disorders. A sensitive enzyme-linked immunosorbent assay developed earlier was used for lactoferrin estimation in cervical mucus. A brief study was undertaken to observe if lactoferrin is detectable in cervical mucus and to correlate its level with reproductive tract infection, if present. One hundred and twelve cervical mucus samples were collected from healthy as well as infected females. Some of these females were using CuT-200 intrauterine copper devices for contraception. Women were at different phases of their menstrual cycle. The presence of detectable amount of lactoferrin in cervical mucus was confirmed. The average level of lactoferrin in cases either with clinical symptoms of cervicitis or with proven infection by PAP smear was significantly (t=7.6, P<0.01) higher than the normal controls. CuT users have higher (P<0.01) mean level of lactoferrin than corresponding non-users.  相似文献   

18.
目的:通过对南充综合医院门诊病人的抑郁障碍和焦虑障碍的发生率及共病现象研究,提高焦虑障碍与抑郁障碍的识别率。方法:随机抽取1000例门诊患者进行焦虑自评量表(SAS)和抑郁自评量表(SDS)的问卷调查,通过数据统计分析,阳性筛查焦虑障碍和抑郁障碍的患病情况。结果:门诊中有8.56%的患者存在焦虑障碍,6.03%的患者存在抑郁障碍,2.96%的患者存在焦虑障碍与抑郁障碍共病现象。女性焦虑障碍患病率大于男性患病率,女性抑郁障碍患病率大于男性患病率。结论:综合医院提高焦虑障碍与抑郁障碍的识别率的过程中应注意性别的影响,加强综合门诊对焦虑障碍及抑郁障碍的识别率。  相似文献   

19.
This study was undertaken to determine the association of inflammatory biomarker, oxidative stress and antioxidant capacity marker with fetal haemoglobin (HbF) level among sickle cell trait and sickle cell disease (SCD) patients in Chattisgarh. The study group consisted of 51 SCD (SS) patients with painful episode, 49 SCD (SS) patients with steady state, 50 sickle cell trait (AS) and 50 controls. Malondialdehyde (MDA), CRP, total antioxidant power (FARP), total thiol and HbF levels were quantified. We found a significant positive (p < 0.0001) association between CRP and MDA levels and its inverse association with HbF level in SS patients. We also observed that antioxidant capacity had significantly positively (p < 0.0001) associated with HbF level. The protective effect of HbF was found, because the increase in HbF levels resulted in decrease in lipid peroxidation and inflammation in SCD patients. A decrease in the HbF level and its antioxidant capacity has been associated with the pathogenesis of SCD. These finding may explain the high level of HbF is ameliorating oxidative stress and inflammation in SCD patients.  相似文献   

20.
High altitude hypoxia is known to induce an inflammatory response in immune cells. Hypoxia induced inflammatory chemokines may contribute to the development of high altitude pulmonary edema (HAPE) by causing damage to the lung endothelial cells and thereby capillary leakage. In the present study, we were interested to know whether chronic inflammation may contribute to HAPE susceptibility. We examined the serum levels of macrophage inflammatory protein-1α (MIP-1α), monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 in group (1) HAPE Susceptible subjects (n = 20) who had past history of HAPE and group (2) Control (n = 18) consist of subjects who had stayed at high altitude for 2 years without any history of HAPE. The data obtained confirmed that circulating MCP-1, MIP-1α were significantly upregulated in HAPE-S individuals as compared to the controls suggestive of chronic inflammation. However, it is not certain whether chronic inflammation is cause or consequence of previous episode of HAPE. The moderate systemic increase of these inflammatory markers may reflect considerable local inflammation. The existence of enhanced level of inflammatory chemokines found in this study support the hypothesis that subjects with past history of HAPE have higher baseline chronic inflammation which may contribute to HAPE susceptibility.  相似文献   

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