Govaresh
Volume:24 Issue: 3, 2019

After a long time of searching for microbial agents responsible for gastric disorders, in 2005 the noble prize was given to Robin Warren and Barry Marshall for the isolation of Helicobacter pylori (H. pylori) from human stomach and discovering the association between H. pylori infection and gastritis, peptic ulcers, and gastric cancer. Currently, an important part of research on digestive diseases is concerned with microbiology of H. pylori and its control, with the aim of preventing peptic ulcers and gastric cancer. Reports indicate that peptic diseases are developed as the consequence of interaction between H. pylori infection, genetic background of the human host, and the lifestyle of individuals. As most of H. pylori-infected individuals are asymptomatic, the role of host genetics and lifestyle might be more important than what previously suggested. Up to now investigators have not been successful to show that H. pylori isolates from gastritis, ulcer, and cancer are different. H. pylori acquisition occurs during childhood and food ingestion and close contact of infant with mother are the most probable routes of bacterial transmission. High frequency of H. pylori infection in many human populations indicates that the bacterium might have been established in yeast as an environmental host. Inside yeast H. pylori is protected from environmental stresses and can have access to plenty of food. Furthermore, yeast can serve as a reservoir for H. pylori, which facilitates bacterial spread in the environment as well as within human hosts. It has been suggested that H. pylori could have jumped from an intermediate host to humans and migrated along with human host from Africa to different geographic regions of the world. Peptic ulcer and gastric cancer are the important consequences of H. pylori infection that can be treated or prevented, in most of the cases, by antimicrobial therapy. Reports indicate a considerable decrease in peptic ulcers; however gastric cancers is one of the important issues in medical practice. Reports show high incidence of gastric cancer in northern provinces of Iran including Mazandaran, Guilan, Golestan, and Ardabil. High-incidence regions of gastric cancer are located in Asia and comprise a cancer belt that passes through Japan, Korea, certain regions in China, and Northern Iran. In Iran gastric cancer is the most prevalent cancer in men and the third cancer in women. Ardabil is the highest in the incidence of gastric and esophageal cancers. Eradication of H. pylori has been recommended in cases of gastric ulcer and those patients at the risk of gastric cancer. Occurrence of a considerable number of H. pylori-infected individuals in different human populations without symptoms indicates that H. pylori might be a beneficial human commensal microorganism rather than a pathogen.

Gastric adenocarcinoma is the fourth most common type of cancers and it is the third leading cause of cancer-related death globally. Unfortunately, more than 40% of patients with gastric cancer (GC) have no response to chemotherapy. The rest resist chemotherapy, which leads to low survival and limited therapeutic options. Circulating tumor cells (CTCs) are originated from the primary tumor and are present in the blood stream. In recent years, CTCs have been discussed as a primary diagnostic marker for metastasis; therefore, it may act as a diagnostic and prognostic marker for GC. These cells have the ability of self-renewal and can replicate and grow in a manner similar to that of stem cells. To date, the CellSearch system is the only CTC diagnostic technique approved by U.S FDA. The purpose of this study was to provide a comprehensive overview of the methods for detection of CTCs as well as an insight into the clinical significance of CTCs in relation to GC and recent technical advances in identifying and isolating them.

Colorectal cancer is one of the most preventable cancers. Regular screening behaviors play an important role in reducing the incidence and deaths of this cancer. Therefore, in the present study we aimed to determine the factors associated with intention to perform fecal occult blood test (FOBT) among medical professionals using the protection motivation theory (PMT).

This descriptive-analytical study was conducted on 240 employees aged over 50 years in Hamadan University of Medical Sciences in 2018 using multistage random sampling. The data were collected using a questionnaire including demographic information and PMT constructs. Data were analyzed using SPSS software version 16. Chi-square and linear regression tests were used as appropriated.

In this study, 22.8% of the participants reported a history of FOBT. There was a significant correlation between the referring to the doctor for intestinal disease and performing FOBT (p < 0.05). Based on the PMT, perceived self-efficacy (β = 0.439) and response efficiency (β = 0.48) were predictive of protection motivation (intention) to conduct FOBT. In total, different structures of the PMT explained 24.6% of the variation of intention changes (R2 = 0.226).

Due to the low frequency of screening behavior among staff, the emphasis on the importance of early diagnosis of cancer is necessary. Also, consideration of perceived self-efficacy and the effectiveness of screening behaviors in designing staff training programs are recommended for increasing the intention to perform screening behaviors.

Celiac disease is an autoimmune disorder that can occur in genetically predisposed people who ingested gluten. The most effective treatment for celiac disease is lifelong adherence to a strict gluten-free diet. Therefore, patients with celiac disease need to provide gluten free products. On the other hand, the price of these products are higher than normal ones. Therefore, the aim of this study was to compare the cost of gluten free products with similar regular non-gluten free products.

All available gluten free and similar regular products were collected during 2018 in Tehran, Iran and their prices and weights were calculated. The gluten free and similar regular products were divided into 13 categories and the items were calculated based on the weight and the prices were compared according to the same weights. The data were analyzed using SPSS software version 21.

A total of 128 products, 36 local and 28 imported gluten free product and 64 similar regular products food samples were collected and their prices were calculated in the same amounts of food. Overall, gluten free products were significantly more expensive than regular products. Most of the daily food requirements for patients with celiac disease were in average less than 5,000 Tomans. Only 19.11% of these gluten free products had an average price more than 30000 Tomans.

Considering the significant increase in the price of gluten-free products compared with gluten-rich products, the cost of food preparation for people with celiac disease in Iran is high, which can also affect the adherence to a gluten free diet.

The aim of this study was to develop a therapeutic plan based on hypnotherapy for patients with irritable bowel syndrome (IBS) and determine the effectiveness of this treatment on the intensity of IBS symptoms and rumination of patients with IBS.

The research design was a quasi-experimental with a pre-test, a post-test, and 3 months of follow-up. Of the patients who were referred to gastroenterology clinics in Tehran, 32 patients with IBS were randomly divided into two groups; hypnotherapy group and control group. Medical treatment along with hypnotherapy was individually conducted for eight sessions in the intervention group and the control group received only medical treatment. IBS Symptom Severity Scale (IBS-SSS) and rumination were completed in pretest, post-test, and follow-up stages by the patients and data were analyzed with repeated measures analysis of variance.

The variable scores of symptoms severity and rumination in experimental group was significantly lower than the control group (p > 0.05) and the effect of the therapeutic plan persisted until the follow-up stage.

The results showed that hypnotherapy can be an effective treatment for patients with irritable bowel syndrome. Therefore, psychological treatment is essential for the management of these patients.

Colon cancer is the third most common cancer worldwide, responsible for more than half a million deaths every year. Metalloproteinases (MMP2 and MMP9) participate in tumor invasion and metastasis because of their ability to degrade the extracellular matrix (ECM).

The expression levels of MMP2 and MMP9 as well as tissue inhibitor metalloproteinases TIMP1 and TIMP2 were determined by immunohistochemistry in 42 Iraqi patients diagnosed with colon cancer as well as in 18 benign tissues.

Immunohistochemistry revealed that the protein expression levels of MMP2 ,MMP9, TIMP1 and TIMP2 increased by 83%, 72%, 64%, and 57%, respectively, in patients with colon cancer tissues compared with 19%, 28%, 23%, and 16%, respectively, in benign tissues.

MMP2, MMP9, TIMP1 and TIMP2 expression levels in Iraqi patients with colon cancer could be used as potential markers that can predict tumor behavior, progression, and prognosis.

Eosinophilic gastroenteritis is a rare disease with unknown etiology. It is characterized by the eosinophilic infiltration of one or more layers of the gastrointestinal tract. Recently, the authors visited a rare case of eosinophilic gastroenteritis. A 30-year-old woman was admitted to our hospital complaining of acute-onset excessive abdominal pain in the periumbilical region and chronic diarrhea. Physical examination revealed a distended abdomen with tenderness. Complete blood count showed moderate eosinophilia with elevated IgA serum levels. Computed tomography of the abdomen and pelvis was normal. Upper endoscopy (with taking biopsy samples from the stomach and duodenum) and total colonoscopy (with taking biopsy sample from the rectum and ascending colon) were performed. The pathological examination showed a non-destructive colitis with increased mucosal eosinophilia throughout the entire thickness of the ascending colon and duodenum. Rectal and gastric biopsy samples did not show any signs of eosinophilic infiltration. After ruling out of other causes of eosinophilia, eosinophilic gastroenteritis was diagnosed. The patient recovered well after treatment with prednisone (40 mg/day) over two weeks and was free from gastrointestinal symptoms at the time we reported her disease.

In the present report, a 68-year-old man with recurrent hematemesis and melena is described. Upper gastrointestinal (UGI) endoscopy and colonoscopy showed normal findings. Abdominal computed tomography showed an aneurysm of left common iliac artery and duodenum located at the superior part of the aneurysm without contrast extravasation. So the aortoenteric fistula was suspected and surgical management of aortoenteric fistula (AEF) was done and the patient recovered successfully without complications. The diagnostic evaluation and management of AEF are discussed.