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Burden of celiac disease in the Mediterranean area

World Journal of Gastroenterology 2011年第45期17卷 4971-4978页

作者： Luigi Greco Laura Timpone Abdelhak Abkari Mona Abu-Zekry Thomas Attard Faouzi Bouguerrà Paskal Cullufi Aydan Kansu dusanka micetic-turk Zrinjka Miak Eleftheria Roma Raanan Shamir Selma Terzic European Laboratory for Food Induced Diseases Federico Ⅱ University of Naples Hopital des Enfant Ibn Rochd de Casablanca Children's Hospital Gastrointestinal Unit Cairo University University of Malta Medical School Hopital des Enfants de Tunis Department of Gastroenterology and Hepatology University Hospital Center "Mother Teresa" Department of Pediatric Gastroenterology Ankara University Dikimevi/Mamak University Medical Centre Paediatric Department Children's Hospital Zagreb Athens University Aghia Sophia Children's Hospital Schneider Children's Medical Center of Israel Tel-Aviv University University Clinical Center Tuzla Children's Hospital

AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available conf idence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic prof iles amongst Mediterranean countries. RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortality: about 600 000 celiac patients will die in the next 10 years, with an exc

关键词：地中海地区负担腹腔疾病医疗费用世界卫生组织死亡率总人口

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Variability of anti-human transglutaminase testing in celiac disease across Mediterranean countries

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World Journal of Gastroenterology 2017年第24期23卷 4437-4443页

作者： Andrea Smarrazzo Giuseppe Magazzù Mongi Ben-Hariz Maria Legarda Tamara Virtut Velmishi Elefhteria Roma Aydan Kansu dusanka micetic-turk Enzo Bravi Pio Stellato Carmela Arcidiaco Luigi Greco Department of Translational Medical Sciences School of MedicineSection of PediatricsUniversity of Naples“Federico II” European Laboratory for Food Induced Diseases Celiac Regional Centre Pediatric Gastroenterology and Cystic Fibrosis UnitUniversity of Messina Pediatric Unit Mongi SLIM’s Hospital of Tunis Paediatric Gastroenterology Unit Cruces University Hospital Service of Pediatric Gastroenterology"Mother Teresa"Hospital First Department of Pediatrics University of Athens Department of Pediatric Gastroenterology School of MedicineAnkara University University Medical Centre Paediatric Department Eurospital SpA

AIM To verify the precision and accuracy of transglutaminase antibodies(TGA)assays across Mediterranean countries.METHODS This study involved 8 referral centres for celiac disease(CD)in 7 Mediterranean countries.A central laboratory prepared 8 kits of 7 blinded and randomized serum samples,with a titrated amount of Human TGA Ig A.Each sample was analysed three times on three different days,with each centre running a total of 21tests.The results were included in a blindly coded report form,which was sent to the coordinator centre.The coordinator estimated the mean coefficient of Variation(Co Var=σ/μ),the mean accuracy(Accur=Vobserved-Vreal)and the mean percent variation(Var%=[(Vobserved-Vreal)/Vreal]×100).RESULTS The analysis showed that 79.17%of the mean variation fell between-25%and+25%of the expected value,with the accuracy and precision progressively increasing with higher titres of TGA.From values 1.25 times greater than the normal cut-off,the measurements were highly reliable.CONCLUSION TGA estimation is a crucial step for the diagnosis of CD;given its accuracy and precision,clinicians could be confident in establishing a diagnosis.

关键词：腹的疾病面筋 Transglutaminase 非侵略的测试精确性精确

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Molecular insights into clinical trials for immune checkpoint inhibitors in colorectal cancer:Unravelling challenges and future directions

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World Journal of Gastroenterology 2024年第13期30卷 1815-1835页

作者： Samantha Sharma Naresh Singh Anita Ahmed turk Isabella Wan Akshay Guttikonda Julia Lily Dong Xinna Zhang Mateusz Opyrchal Department of Medical and Molecular Genetics Indiana University School of MedicineIndianapolisIN 46202United States Division of Hematology/Oncology Department of MedicineIndiana University School of MedicineIndianapolisIN 46202United States Melvin and Bren Simon Comprehensive Cancer Center Indiana University School of MedicineIndianapolisIN 46202United States

Colorectal cancer(CRC)is a complex disease with diverse etiologies and clinical outcomes.Despite considerable progress in development of CRC therapeutics,challenges remain regarding the diagnosis and management of advanced stage metastatic CRC(mCRC).In particular,the five-year survival rate is very low since mCRC is currently rarely curable.Over the past decade,cancer treatment has significantly improved with the introduction of cancer immunotherapies,specifically immune checkpoint inhibitors.Therapies aimed at blocking immune checkpoints such as PD-1,PD-L1,and CTLA-4 target inhibitory pathways of the immune system,and thereby enhance anti-tumor immunity.These therapies thus have shown promising results in many clinical trials alone or in combination.The efficacy and safety of immunotherapy,either alone or in combination with CRC,have been investigated in several clinical trials.Clinical trials,including KEYNOTE-164 and CheckMate 142,have led to Food and Drug Administration approval of the PD-1 inhibitors pembrolizumab and nivolumab,respectively,for the treatment of patients with unresectable or metastatic microsatellite instability-high or deficient mismatch repair CRC.Unfortunately,these drugs benefit only a small percentage of patients,with the benefits of immunotherapy remaining elusive for the vast majority of CRC patients.To this end,primary and secondary resistance to immunotherapy remains a significant issue,and further research is necessary to optimize the use of immunotherapy in CRC and identify biomarkers to predict the response.This review provides a comprehensive overview of the clinical trials involving immune checkpoint inhibitors in CRC.The underlying rationale,challenges faced,and potential future steps to improve the prognosis and enhance the likelihood of successful trials in this field are discussed.

关键词： Colorectal cancer Immune checkpoint inhibitors Clinical trials Immunotherapy Microsatellite instability Microsatellite stability DNA mismatch repair

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Metabolic syndrome and the urinary microbiome of patients undergoing percutaneous nephrolithotomy

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Asian Journal of Urology 2024年第2期11卷 316-323页

作者： Ryan A.Dornbier Chirag P.Doshi Shalin C.Desai Petar Bajic Michelle Van Kuiken Mark Khemmani Ahmer V.Farooq Larissa Bresler Thomas M.T.turk Alan J.Wolfe Kristin G.Baldea Loyola University Medical Center Department of UrologyMaywoodILUSA Loyola University Chicago Department of Microbiology and ImmunologyMaywoodILUSA

Objective:To identify possible stone-promoting microbes,we compared the profiles of microbes grown from stones of patients with and without metabolic syndrome(MetS).The association between MetS and urinary stone disease is well established,but the exact pathophysiologic relationship remains unknown.Recent evidence suggests urinary tract dysbiosis may lead to increased nephrolithiasis risk.Methods:At the time of percutaneous nephrolithotomy,bladder urine and stone fragments were collected from patients with and without MetS.Both sample types were subjected to expanded quantitative urine culture(EQUC)and 16 S ribosomal RNA gene sequencing.Results:Fifty-seven patients included 12 controls(21.1%)and 45 MetS patients(78.9%).Both cohorts were similar with respect to demographics and non-MetS comorbidities.No controls had uric acid stone composition.By EQUC,bacteria were detected more frequently in MetS stones(42.2%)compared to controls(8.3%)(p=0.041).Bacteria also were more abundant in stones of MetS patients compared to controls.To validate our EQUC results,we performed 16 S ribosomal RNA gene sequencing.In 12/16(75.0%)sequence-positive stones,EQUC reliably isolated at least one species of the sequenced genera.Bacteria were detected in both“infectious”and“non-infectious”stone compositions.Conclusion:Bacteria are more common and more abundant in MetS stones than control stones.Our findings support a role for bacteria in urinary stone disease for patients with MetS regardless of stone composition.

关键词： Nephrolithiasis Urolithiasis Metabolic syndrome Urinary microbiome Percutaneous nephrolithotomy

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Breast Cancer Diagnosis Using Feature Selection Approaches and Bayesian Optimization

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Computer Systems Science & Engineering 2023年第5期45卷 1017-1031页

作者： Erkan Akkur Fuat turk Osman Erogul Department of Biomedical Engineering TOBB University of Economics and TechnologyAnkara06560Turkey Deparment of Computer Engineering Karatekin UniversityÇankırı18100Turkey

Breast cancer seriously affects many women.If breast cancer is detected at an early stage,it may be cured.This paper proposes a novel classification model based improved machine learning algorithms for diagnosis of breast cancer at its initial stage.It has been used by combining feature selection and Bayesian optimization approaches to build improved machine learning models.Support Vector Machine,K-Nearest Neighbor,Naive Bayes,Ensemble Learning and Decision Tree approaches were used as machine learning algorithms.All experiments were tested on two different datasets,which are Wisconsin Breast Cancer Dataset(WBCD)and Mammographic Breast Cancer Dataset(MBCD).Experiments were implemented to obtain the best classification process.Relief,Least Absolute Shrinkage and Selection Operator(LASSO)and Sequential Forward Selection were used to determine the most relevant features,respectively.The machine learning models were optimized with the help of Bayesian optimization approach to obtain optimal hyperparameter values.Experimental results showed the unified feature selection-hyperparameter optimization method improved the classification performance in all machine learning algorithms.Among the various experiments,LASSO-BO-SVM showed the highest accuracy,precision,recall and F1-score for two datasets(97.95%,98.28%,98.28%,98.28%for MBCD and 98.95%,97.17%,100%,98.56%for MBCD),yielding outperforming results compared to recent studies.

关键词： Breast cancer machine learning Bayesian optimization feature selection

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Aberrant cholesterol metabolism in colorectal cancer represents a targetable vulnerability

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Genes & Diseases 2023年第4期10卷 1172-1174页

作者： Jingwu Xie Chi Mai Nguyen Anita turk Hongmei Nan Thomas F.Imperiale Michael House Kun Huang Jing Su Wells Center for Pediatric Research Department of PediatricsIndiana University School of MedicineIndianapolisIN 46202USA Department of Statistics and Data Science Indiana University School of MedicineIndianapolisIN 46202USA Division of Medical Oncology Department of MedicineIndiana University School of MedicineIndianapolisIN 46202USA Department of Global Health Richard M.Fairbanks School of Public HealthIndiana UniversityIndianapolisIN 46202USA Division of Gastroenterology and Hepatology Department of MedicineIndiana University School of MedicineIndianapolisIN 46202USA Department of Surgery Indiana University School of MedicineIndianapolisIN 46202USA

Colorectal cancer(CRC)is the second most deadly adult cancer in men and women combined,accountable 9.2%of all cancer deaths.^(1)Drug resistance to chemotherapies,such as 5-FU-related regimens,remains a major cause of cancer recurrence and death in patients with CRC.Aberrant metabolic changes in cancer cells are a significant cancer hallmark.

关键词： metabolism cancer colorectal

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Last Interglacial-Glacial Cycle and an Attempt to Reconstruct Würmian Paleohumidity of the European Alps

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Journal of Mountain Science 2012年第3期9卷 322-330页

作者： Janez turk Karst Research Institute ZRC SAZU Postojna 6230 Slovenia

A lot of paleoenvironmental surveys have been carried out in the Alpine region to elucidate glacier extension during the Last Glacial or the Würmian (115 - 12 ka BP). However, the evidence of past glaciations differs greatly between Western and Eastern Alps, while contrast between Southern and Northern Alps is not evident. The main purpose of this paper is to interpret variability of humidity during the last interglacial-glacial cycle in the Alpine region, based on results of various surveys performed in the Alpine region. Results show that distribution of moisture throughout the Alps was most even during the Late Würmian, while precipitation was mainly concentrated in the (North)Western Alps during the Early Würmian and in the (North)Western and along all the Southern Alps during the Middle Würmian. The Eastern Alps were rather dry during both episodes. Such moisture distribution can be explained by paths of prevailing winds. Moisture distribution is directly linked with atmospheric and oceanic circulation.

关键词：阿尔卑斯山末次间冰期冰期旋回欧洲水分分布冰川作用末次冰期环境调查

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Point-of-care ultrasound in diagnosis and management of congestive nephropathy

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World Journal of Critical Care Medicine 2023年第2期12卷 53-62页

作者： Michael turk Thomas Robertson Abhilash Koratala Department of Medicine Allegheny Health NetworkPittsburghPA 15222United States Division of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

Congestive nephropathy is kidney dysfunction caused by the impact of elevated venous pressures on renal hemodynamics.As a part of cardiorenal syndrome,the diagnosis is usually made based on history and physical examination,with findings such as jugular venous distension,a third heart sound,and vital signs as supporting findings.More recently,however,these once though objective measures have come under scrutiny for their accuracy.At the same time,bedside ultrasound has increased in popularity and is routinely being used by clinicians to take some of the guess work out of making the diagnosis of volume overload and venous congestion.In this mini-review,we will discuss some of the traditional methods used to measure venous congestion,describe the role of point-of-care ultrasound and how it can ameliorate a clinician’s evaluation,and offer a description of venous excess ultrasound score,a relatively novel scoring technique used to objectively quantify congestion.While there is a paucity of published large scale clinical trials evaluating the potential benefit of ultrasonography in venous congestion compared to gold standard invasive measurements,more study is underway to solidify the role of this objective measure in daily clinical practice.

关键词： Ultrasound Point-of-care ultrasonography Doppler Venous excess ultrasound score Congestion Hemodynamics Heart failure Nephrology

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Giant saccular aneurysm of the left main coronary artery

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Journal of Geriatric Cardiology 2013年第1期10卷 110-112页

作者： Esref Tuncer Ugur Onsel turk Emin Alioglu Department of Cardiology Central Hospital 2/2 Bayrakli Izmir 35050 Turkey

Coronary aneurysms represent anomalies identified in 0.15%–4.9%of patients undergoing coronary angiography. At present, there is no uniform definition of this pathology. Aneurysms of the left main coronary artery (LMCA) are extremely uncommon, with an incidence of 0.1%. It has been demonstrated that atherosclerosis is the main cause of these anomalies in adults, and Kawasaki disease in children and adolescents. Other causes include connective tissue disorders, trauma, vasculitis, congenital, mycotic, and idiopathic. These dilated sections of the coronary artery are not benign pathology because they are subject to spasm, thrombosis, and subsequent distal embolism, spontaneous dissection and rupture. Treatment options include anticoagulation, custom-made covered stents, reconstruction, resection, and exclusion with bypass. Our report on an old case illustrates the giant saccular LMCA aneurysm leading to myocardial ischemia due to coronary steal phenomenon.

关键词： Coronary aneurysm Coronary angiography Coronary artery disease

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Stathmin as a surrogate marker of phosphatidylinositol-3-kinase pathway activity:Towards precision medicine in HPV-negative head&neck squamous cell carcinoma

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Genes & Diseases 2022年第3期9卷 820-825页

作者： Andrew T.turk Dario Garcia-Carracedok David T.Kent Elizabeth Philipone Juana Maria Garcia-Pedrero Salvatore M.Caruana Lanny G.Close Gloria H.Su Department of Pathology and Cell Biology and Columbia UniversityNew YorkNY 10032USA Department of Otolaryngology Columbia UniversityNew YorkNY 10032USA Department of Otolaryngology Vanderbilt UniversityNashvilleTN 37232USA Department of Otolaryngology Hospital Universitario Central de Asturias and Instituto Universitario de Oncologia Del Principado de AsturiasOviedo 33006Spain

In order to assess Stathmin as an immunohistochemical(IHC)indicator of phosphatidylinositol 3-kinase(PI3K)pathway activity in HPV-negative head&neck squamous cell carcinoma(HNSCC),we compared Stathmin IHC to expression of other pathway components.We also evaluated the relationship between Stathmin IHC and the mutational status of four key pathway genes.Finally,we ascertained whether Stathmin IHC correlates with tumor grade or primary site.Correlation exists between high Stathmin expression and high pAKT1 expression,indicating a role for Stathmin IHC as a marker of pathway activity.Our analysis did not show correlation between Stathmin IHC and mutation of the four genes evaluated.We also observed an association between high Stathmin expression and oropharyngeal primary site.Our results suggest utility of Stathmin IHC as an indicator of PI3K pathway activity,and thereby demonstrate potential relevance of Stathmin IHC in the context,of HNSCC.

关键词： Cancer Head&neck squamous cell carcinoma Pathology Stathmin

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