Gastroenterology and Hepatology From Bed to Bench Journal
Volume:16 Issue: 4, Autumn 2023

Because gastric ulcer is a psychosomatic disease in which many psychological factors are involved, this study aimed to investigate the effectiveness of emotion regulation training on pain intensity and quality of life in patients with peptic ulcer disease.

The research method was semi-experimental and based on the pretest-posttest control group design, with follow-up after three months. The sample included 46 participants who were selected by a purposeful sampling method and placed randomly in the experimental and control groups. At first, at the same time, and in the same conditions, all the participants responded to the Chronic Pain Grade questionnaire (CPG) and Quality of life Questionnaire (SF-12). The emotion regulation training was performed for the experimental group. In the end, both groups were evaluated by posttests, and then they were tracked after an interval of three months. In order to analyze data, ANCOVA test was applied through SPSS 22.

Findings showed that emotion regulation training was meaningfully effective in decreasing pain intensity and increasing life quality (p<0.01) and after three months, no significant changes were found in the results.

Due to the positive changes in the criteria of this protocol effectiveness, it is concluded that emotion regulation training has been successful in reducing the symptoms of pain intensity in PUD patients and increasing life quality, this treatment can be added to other treatments for PUD patients.

Underestimation is a common problem in cancer registries in developing countries. This study introduces a Bayesian approach as a method for correcting undercounts in cancer data, before population-based cancer registry program

The current study is a secondary study performed on data from the cancer registry system. Our analysis focused on utilizing data before the establishment of the population-based cancer registry program in Iran. We employed the Bayesian approach to correct undercounting from 2005 to 2010. The ratio of pathology to population-based in the cancer registry data of Golestan province for four age groups and each year was used as the initial value in the Bayesian method.

The results of this study showed that the lowest percentage of undercounting belonged to Khorasan Razavi province with an average of 21% and the highest percentage belonged to Sistan and Baluchestan province with an average of 38%.
The average age-standardized incidence rate (ASR) for all provinces of the country except Golestan province was equal to 105.72 per 100,000 and after Bayesian correction was 137.17 per 100,000. In 2010 the amount of ASR before Bayesian correction was 100.28 per 100,000 for women and 136.49 per 100,000 for men. Also, after implementing the Bayesian correction, ASR increased to 125.74 per 100,000 for women and 172.79 per 100,000 for men.

The study demonstrates the effectiveness of the Bayesian approach in correcting undercounting in cancer registries. By utilizing the Bayesian method, the average ASR after Bayesian correction with a 29.74 percent change was 137.17 per 100,000. These corrected estimates provide more accurate information on cancer burden and can contribute to improved public health programs and policy evaluation. The findings of this research highlight the appropriateness of using the Bayesian method to correct underestimation in cancer registries and underscore its significance for future studies.

 Hereditary hemochromatosis (HH) is an autosomal recessive metabolic disorder. Mutations in different encoding genes, mostly HFE, lead to iron overload in different organs of the body. We hereby report a case of HH caused by a novel variant in the HFE2 (HJV) gene.

 A 27-year-old man first sought medical care for impotence and was diagnosed with increased serum iron. He ceased the follow-up and was referred to our center with advanced symptoms of hemochromatosis, including central hypogonadism, heart failure, and ascites. The genetic test revealed that he was homozygote for a variant defined as c.950G>A (p.Cys317Tyr) in exon 4 of the HJV gene. The patient’s symptoms improved following the medical interventions. At a 4th year follow-up, he was alive and his clinical status was stable.

 The product of HJV, hemojuvelin is involved in iron metabolism. Pathogenic variants in this gene have been associated with hemochromatosis type 2A, also named juvenile hemochromatosis, which results in drastic iron loading and organ failure in affected individuals before 30 years of age.

 c.950G>A (p.Cys317Tyr) in exon 4 of the HJV gene is a novel pathogenic variant causing hemochromatosis type 2A.

Aim:

This review sought to evaluate the significance of a functional assessment for liver transplant candidates, i.e., frailty, in the pre-transplant setting and its association with mortality and morbidities.

Background:

 Liver transplantation (LT) remains the treatment of choice for patients with end-stage liver disease. Due to the shortage of organs for LT, a careful selection of suitable recipients is essential. Frailty, a measure of physiologic reserve and increased vulnerability to stressors, was initially used in geriatrics and then introduced to the field of transplantation for better patient selection.

Methods: 

PubMed, Scopus, and Web of Science databases were reviewed up until January 2023. The search terms included: “frail*”, “liver”, and “transplant*”. A Meta-analysis was conducted for the hazard ratios (HRs) obtained from the COX regression models. Fifty-four studies were included in this review; ten were included in the meta-analysis.

Results: 

The prevalence of frailty varied from 2.82% to 70.09% in the studies. Meta-analysis showed that overall frailty had a significant association with mortality ((pooled adjusted HR: 2.66 [1.96−3.63]). Subgroup analyses revealed that both the Liver Frailty Index and Fried Frailty Index were significantly associated with mortality. Furthermore, these studies have demonstrated that this population's frailty is associated with ascites, hepatic encephalopathy, and esophageal varices.

Conclusion: 

According to emerging evidence, frailty is associated with increased morbidity and mortality of the patients on the LT waiting list. Further randomized trials are required to determine the efficacy and safety of variable interventions in the frail population.

Subepithelial lesions formerly known as subepithelial tumors are incidentally discovered protrusions throughout the gastrointestinal tract with normal overlying mucosa. Studies related to the diagnosis and methods of therapy are limited due to the low incidence and low malignant potential of these lesions. They are commonly originating from the second, third and fourth layers (muscularis mucosa, submucosa and muscularis propria) of gastrointestinal wall. They are reported to be more prevalent in stomach and esophagus than small intestine and colon. Subepithelial lesions located in the stomach and duodenum are more prone to malignancy than the lesions in the esophagus. Despite the presence of different strategies in the management of subepithelial lesions based on their size and location, there is still not a unique consensus on the issue. In this review we have attempted to introduce the most practical approach to the management of gastrointestinal subepithelial lesions based on current guidelines.

Maintaining a healthy balance between commensal, and pathogenic bacteria within the gut microbiota is crucial for ensuring the overall health, and well-being of the host. In fact, by affecting innate, and adaptive immune responses, the gut microbiome plays a key role in maintaining intestinal homeostasis and barrier integrity. Dysbiosis is the loss of beneficial microorganisms and the growth of potentially hazardous microorganisms in a microbial community, which has been linked to numerous diseases. As the primary inducer of circadian rhythm, light can influence the human intestinal microbiome. Photobiomodulation therapy (PBMT), which is the use of red (630-700 nm), and near-infrared light (700 and 1200 nm), can stimulate healing, relieve pain, and reduce inflammation, and affect the circadian rhythm and gut microbiome beneficially. Our focus in this paper is on the effects of PBMT on gut microbiota, to provide an overview of how it can help control gut microbiota dysbiosis-related disorders.

Due to weak diagnosis and treatment of PDAC, detection of PDAC possible biomarkers in early stage is the main aim of this study.

Pancreatic ductal adenocarcinoma (PDAC) is known as an exocrine cancer with a 5-year overall survival of 11%.

Gene expression profiles of early stage of PDAC tissue and normal tissue are downloaded from gene expression omnibus (GEO) and evaluated via GEO2R. The significant differentially expressed genes (DEGs) are investigated via protein-protein interaction (PPI) network analysis and gene ontology.

 Among 104 DEGs, ALB, COL1A1, COL1A2, MMP1, POSTN, PLAU, and COL3A1 were pointed out as hub nodes. “Gelatin degradation by MMP1, 2, 3, 7, 8, 9, 12, 13” group of 52 biological terms were identified as the main affected terms.

In conclusion, ALB, MMP1, and COL1A1 genes were highlighted as possible biomarkers of early stage of PDAC. Dysfunction of extracellular matrix was identified as a main event in patients.

In this study, we aim to propose consensus-based interpretations to enhance both automatic, and manual analysis and then present our recommendations about reflux-related variables to enhance Multichannel Intraluminal (MII) measurements.

Multichannel Intraluminal Impedance-pH (MII-pH) monitoring is the most sensible option to evaluate Gastroesophageal Reflux Disease (GERD), specifically for the patients with normal endoscopy findings, and persistent symptoms without response to Proton Pomp Inhibitor therapy. There were only a few studies on the interpretation of reflux events in MII tracings.

Several 200 episodes of reflux events were reviewed during several meetings in five steps, to discuss and categorize unresolved issues within existing interpretations, and propose technical principles for accurate characterization of reflux events.

 In this study, we show that baseline impedance is determined using a moving average procedure to the impedance data of each channel with a time window of 60 seconds based on this finding; a liquid reflux event is defined as a retrograde 50% drop in baseline impedance, gas reflux event is defined as a rapid increase in impedance greater than 5 kΩ, Mixed liquid-gas reflux is defined as gas reflux occurring immediately before or during liquid reflux.

The reliability of final diagnosis is significantly dependent on the accurate detection of reflux events, which is currently confronting technical limitations. A pathological reflux event propagates to at least three of the impedance sites, according to the literature. We think that taking three impedance locations into account might be too strict.

 Antimicrobial peptides such as RT2 showed anticancer properties against wild range of tumors. Molecular mechanism of anticancer effect of RT2 is a challenging subject. 

 The goal of this study is to investigate the anticancer molecular mechanism of RT2 through protein-protein interaction (PPI) network analysis. For this aim, this bioinformatics evaluation of proteome profile of colon cancer is carried out. 

 By the application of Cytoscape V.3.9.1 and integrated apps, the profile of interaction network and related centrality is analyzed. Enrichment analysis of hub-bottlenecks was also performed and highlighted biological processes were visualized and determined. 

 A number of 207 differentially expressed proteins were retrieved by PPI network analysis that 10 hub-bottlenecks were introduced. Among these differentially expressed proteins (DEPs), only AKT1 is from the queried DEPs. Key biological processes contributing to RT2 targeting mechanism include “Regulation of fibroblast proliferation”, “Positive regulation of cyclin-dependent protein serine/threonine kinase activity”, “positive regulation of miRNA transcription”, and “fungiform papilla formation”. 

 In conclusion, central proteins Tp53, MYC, EGFR, AKT1, HDAC1, and SRC can be introduced as a targeted biomarker panel of bioactive peptide treatments. However, extensive research are required to establish this claim prior to clinical application.

 The useful effects of N-acetylcysteine ​​(NAC) in preventing progression of liver injury and improving liver function were investigated. The aim of this study is evaluation of the effects of NAC in patients with early stages cirrhosis compensation.

 All patients referred to the gastrointestinal department of Ayatollah Taleghani Hospital during 1 year with known etiology of cirrhosis and Child-Pugh score A, B or C were enrolled. In the intervention group, patients received NAC tablets at a dose of 600 mg daily and the control group will use placebo.  Demographic data, blood tests, liver function tests (bilirubin, albumin, prothrombin time, transaminases), kidney function tests (creatinine, urea and electrolytes), Child-Pugh score and MELD Score (baseline and end of 6 months) were recorded were compared between two groups.

 In the present study, 30 patients with mean age of 55.8 years were studied in the intervention group, 22 (73.3%) male and 8 (26.7%) females. In the control group, 30 patients with mean age 56.3 years were studied, of whom 13 (43.3%) were male and 17 (56.7%) were female. Hematologic variables and biochemical parameters were not significantly different before and after the intervention. In the intervention group, the hepatic variables under study decreased significantly after the intervention despite the control group. (P value = 0.01)

 N acetylcysteine ​​had a significant decreasing effect on renal function through serum urea, creatinine levels, liver enzymes, Child-Pugh score and MELD Score, but had no significant effect on hematological and biochemical parameters.

Atypical/complement-mediated hemolytic uremic syndrome (A-HUS/CM-HUS) is a hereditary or sporadic disease with thrombotic microangiopathy (TMA). Diarrhea is a trigger that can cause attacks of CM-HUS. Although there are opinions that complement system activation plays a role in intestinal inflammation in patients with inflammatory bowel disease, the association of TMA with inflammatory bowel disease (IBD) has rarely been reported. In our case, a CM-HUS case that developed without an additional triggering factor in the course of ulcerative colitis (UC) was successfully treated with eculizumab, and then UC remission was also achieved. In this context, we would like to point out that the irregularities in the alternative pathway of the complement system may cause clinical findings in extra-renal organs, and the complement system may also play a role in the pathogenesis of inflammatory bowel disease. In addition, we think that our case may guide further studies on the usability of anti-complement therapies in treating patients with IBD who are resistant to conventional treatments.