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Coeliac Disease: Gluten Free Diet and… What Else?

Open Journal of Gastroenterology 2016年第11期6卷 319-332页

作者： Marina Taus elsa veronica mignini Daniele Fumelli Debora Busni Giulia Nicolai Carla Carletti Albano Nicolai Unit of Dietetic and Clinical Nutrition University Hospital of Ancona Ancona Italy

Coeliac Disease (CD) is a permanent gluten intolerance, whose pathogenesis involves multiple factors including genetics and environment. CD has different representations and non-specific symptoms such as diarrhea, bloating, pain, flatulence and constipation may sometimes be misleading. Once diagnosed of CD, patients must adhere to Gluten Free Diet, which consists in the lifelong avoidance of gluten containing foods and of those naturally gluten free but at risk of contamination. This dietary approach is considered the only therapy in order to avoid symptoms exacerbation and to reduce the digestive mucosa inflammation, which has been related to higher risks of lymphoproliferative malignancy and other immunological disorders. However, being on a Gluten Free Diet is not as resolving as it may seem since it has several criticalities. First of all, excluding gluten means limiting food variety so that coeliac patients may have unbalanced intake of several nutrients and develop clinical or subclinical deficiencies. This can be due to scarce attention to qualitative and quantitative composition of diets and poor information about gluten-containing foods, which only patient-tailored dietetic protocol and long-term follow-up can achieve. Secondly, Gluten Free Diet may not result in complete remission of mucosal damage or in resolution of symptoms. Unintentional contamination of gluten or poor adherence to diet are the main culprits of the incomplete mucosal healing but other triggers may be involved. Recent research has focused on the role of FODMAPs in changing gut microbiota and on the improvement of Irritable Bowel Syndrome (IBS) symptoms after their dietary avoidance or reduction. Since CD and IBS may share many clinical presentations, further studies are needed to evaluate if a subgroup of CD patients whose symptoms are not improved by Gluten Free Diet could benefit from a new therapeutic approach consisting in both gluten/wheat and FODMAPs avoidance.

关键词： Celiac Disease FODMAPs Diet Nutritional Deficiencies Gluten Free Diet

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Post-transcriptional mechanisms controlling neurogenesis and direct neuronal reprogramming

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Neural Regeneration Research 2024年第9期19卷 1929-1939页

作者： elsa Papadimitriou Dimitra Thomaidou Department of Neurobiology Hellenic Pasteur InstituteAthensGreece

Neurogenesis is a tightly regulated process in time and space both in the developing embryo and in adult neurogenic niches.A drastic change in the transcriptome and proteome of radial glial cells or neural stem cells towards the neuronal state is achieved due to sophisticated mechanisms of epigenetic,transcriptional,and post-transcriptional *** these neurogenic mechanisms is of major importance,not only for shedding light on very complex and crucial developmental processes,but also for the identification of putative reprogramming factors,that harbor hierarchically central regulatory roles in the course of neurogenesis and bare thus the capacity to drive direct reprogramming towards the neuronal *** major transcriptional programs that orchestrate the neurogenic process have been the focus of research for many years and key neurogenic transcription factors,as well as repressor complexes,have been identified and employed in direct reprogramming protocols to convert non-neuronal cells,into functional *** post-transcriptional regulation of gene expression during nervous system development has emerged as another important and intricate regulatory layer,strongly contributing to the complexity of the mechanisms controlling neurogenesis and neuronal *** particular,recent advances are highlighting the importance of specific RNA binding proteins that control major steps of mRNA life cycle during neurogenesis,such as alternative splicing,polyadenylation,stability,and *** from the RNA binding proteins,microRNAs,a class of small non-coding RNAs that block the translation of their target mRNAs,have also been shown to play crucial roles in all the stages of the neurogenic process,from neural stem/progenitor cell proliferation,neuronal differentiation and migration,to functional ***,we provide an overview of the most prominent post-transcriptional mechanisms mediated by RNA binding proteins and microRNAs during the

关键词： direct neuronal reprogramming in vivo glia-to-neuron conversion microRNAs neurogenesis post-transcriptional regulation RNA binding proteins

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Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

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World Journal of Gastroenterology 2024年第25期30卷 3143-3146页

作者： Raffaele Borriello Giorgio Esposto Irene mignini Antonio Gasbarrini Maria Assunta Zocco CEMAD Digestive Disease Center Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University of RomeRome 00168Italy

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of ***-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and *** only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social *** poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of *** this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase *** cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective *** is an urgent need for practical and e

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Liver cirrhosis Metabolic associated fatty liver disease Metabolic associated steatohepatitis Insulin resistance Self-management Self-management measurement Patient education

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Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第10期30卷 1450-1460页

作者： Giorgio Esposto Paolo Santini Linda Galasso Irene mignini Maria Elena Ainora Antonio Gasbarrini Maria Assunta Zocco CEMAD Digestive Disease Center Fondazione Policlinico Universitario“A.Gemelli”IRCCSCatholic University of RomeRome 00168Italy Fondazione Policlinico Universitario Agostino Gemelli IRCCS Fondazione Policlinico Universitario Agostino Gemelli IRCCS-UniversitàCattolica del Sacro CuoreRome 00168Italy Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterUniversitàCattolica del Sacro CuoreFondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

BACKGROUND Direct-acting antiviral agents(DAAs)are highly effective treatment for chronic hepatitis C(CHC)with a significant rate of sustained virologic response(SVR).The achievement of SVR is crucial to prevent additional liver damage and slow down fibrosis *** assessment of fibrosis degree can be performed with transient elastography,magnetic resonance elastography or shear-wave elastography(SWE).Liver elastography could function as a predictor for hepato-cellular carcinoma(HCC)in CHC patients treated with *** To explore the predictive value of SWE for HCC development after complete clearance of hepatitis C virus(HCV).METHODS A comprehensive literature search of clinical studies was performed to identify the ability of SWE to predict HCC occurrence after HCV *** accordance with the study protocol,a qualitative and quantitative analysis of the evidence was *** At baseline and after 12 wk of follow-up,a trend was shown towards greater liver stiffness(LS)in those who go on to develop HCC compared to those who do not[baseline LS standardized mean difference(SMD):1.15,95%confidence interval(95%CI):020-2.50;LS SMD after 12 wk:0.83,95%CI:0.33-1.98].The absence of a statistically significant difference between the mean LS in those who developed HCC or not may be related to the inability to correct for confounding factors and the absence of raw source *** was a statist-ically significant LS SMD at 24 wk of follow-up between patients who developed HCC vs not(0.64;95%CI:0.04-1.24).CONCLUSION SWE could be a promising tool for prediction of HCC occurrence in patients treated with *** studies with larger cohorts and standardized timing of elastographic evaluation are needed to confirm these data.

关键词： Shear-wave elastography Hepatocellular carcinoma Hepatitis C virus Sustained virologic response

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Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2804-2815页

作者： Giorgio Esposto Paolo Santini Fabrizio Termite Linda Galasso Irene mignini Maria Elena Ainora Antonio Gasbarrini Maria Assunta Zocco Department of CEMAD Digestive Disease Center Fondazione Policlinico Universitario A Gemelli IRCCSCatholic University of RomeRome 00168Italy Department of Fondazione Policlinico Universitario Agostino Gemelli IRCCS UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterFondazione Policlinico Universitario A Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(*** or metastasis)is highly challenging and definitive diagnosis still relies on histological *** patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical *** contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor *** To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver *** A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological *** accordance with the study protocol,a qualitative and quantitative analysis of the evidence was *** Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic *** DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early *** quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

关键词： Dynamic contrast enhanced ultrasound Hepatocellular carcinoma Intracellular cholangiocarcinoma Quantitative ultrasound Liver cancer Time-intensity curve

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Mindfulness Facets and Psychological Well-Being among Meditators:Serenity as a Mediating Process

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International Journal of Mental Health Promotion 2024年第3期26卷 177-187页

作者： Rebecca Y.M.Cheung Iris Yili Wang elsa Ngar-Sze Lau School of Psychology and Clinical Language Sciences University of ReadingReadingUK Department of Special Education and Counselling The Education University of Hong KongHong KongChina Department of Educational Administration and Policy The Chinese University of Hong KongHong KongChina

Guided by the theoretical processes of mindfulness and psychological well-being,this study examined serenity as a mediator between mindfulness facets and psychological well-being,as indexed by depressive symptoms and life *** were 133 mindfulness practitioners who took part in a 3-day transnational meditation event in Hong *** informed consent,participants completed a self-report *** findings from structural equation modeling showed that serenity mediated the relation between two facets of mindfulness,including describing and nonreacting to inner experience,and life *** also mediated the relation between the mindfulness facet of describing and depressive *** associations were indicated between two mindfulness facets,including observing and nonjudging of inner experience,and depressive *** together,the findings revealed mindfulness facets as major correlates of serenity and psychological outcomes among Chinese meditation *** foster psychological well-being,researchers,educators,and practitioners should pay attention to the role of serenity,describing,and nonreacting to inner experience in mental health.

关键词： Depressive symptoms mindfulness mindfulness practitioners satisfaction with life serenity

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Exosome-Transmitted miR-224-5p Promotes Colorectal Cancer Cell Proliferation via Targeting ULK2 in p53-Dependent Manner

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Biomedical and Environmental Sciences 2024年第1期37卷 71-84页

作者： YANG Le Mei ZHENG Qi LIU Xiao Jia LI Xian Xian veronica Lim CHEN Qi ZHAO Zhong Hua WANG Shu Yang Department of Pathology School of Basic MedicineFudan UniversityShanghai 200032China Department of Pathology Dunedin School of MedicineUniversity of OtagoDunedin 9054New Zealand Department of Pathology Huashan HospitalFudan UniversityShanghai 200040China Shanghai Cancer Institute Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Teladoc Health Inc Shanghai 200335China Shanghai Medical College Fudan UniversityShanghai 200032China Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention Shanghai 200032China

Objective To investigate the role and molecular mechanism of exosomal miR-224-5p in colorectal cancer(CRC).Methods The miR-224-5p expression in CRC patient tissues and cell-derived exosomes was measured by laser capture microdissection and qRT-PCR,***-luciferase reporter gene assay was used to determine the target gene of *** protein expressions of p53 and unc-51 like kinase 2(ULK2)in CRC cells were detected by western *** cytometry was used to detect cell cycle and *** proliferation was measured by CCK8 and EdU *** The miR-224-5p expression was upregulated in CRC tissues and increased progressively with the rise of CRC *** cells secreted extracellular miR-224-5p mainly in an exosome-dependent manner,and then miR-224-5p could be transferred to surrounding tumor cells to regulate cell proliferation in the form of autocrine or ***,ULK2 was characterized as a direct target of miR-224-5p and was downregulated in CRC ***,ULK2 inhibited CRC cell proliferation in a p53-dependent ***,exosome-derived miR-224-5p partially reversed the proliferation regulation of ULK2 on CRC *** Our findings demonstrate that exosome-transmitted miR-224-5p promotes p53-dependent cell proliferation by targeting ULK2 in CRC,which may offer promising targets for CRC prevention and therapy.

关键词： miR-224-5p Exosome ULK2 p53 Cell proliferation Colorectal cancer

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Literature Review of the Prevalence of Hypertension at Gulu University, Gulu City, Acholi Subregion, Northern Uganda

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World Journal of Cardiovascular Diseases 2024年第9期14卷 588-602页

作者： Lamwaka Alice veronica Mboowa John Bosco Department of Pharmacy Faculty of Medicine Gulu University Gulu City Uganda

Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Northern Uganda. A literature search on hypertension was done. It showed that, in Uganda, a representative number of 17,777 adult patients’ data were analyzed from January 2014 to February 2024. The epidemiological data on awareness of hypertension was found to be at 8%. Of this, 18.3% of the people with hypertension had it under control. The results of the findings were promising. Hypertension is an important public health challenge in Uganda particularly in Northern Uganda where Gulu University falls. In comparison with the two regions of Central Uganda and Northern Uganda, there was a significant number of populations that were not aware of their condition. Those diagnosed were on treatment but the treatment was not adhered to due to stock outs of medicines. Therefore, Measures are required to prevent hypertension, improve awareness, treatment and control within the community, especially at Gulu University where research has never been done.

关键词： Prevalence Hypertension Blood Pressure Knowledge Attitude Practices Cross Sectional Studies

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Bloom-forming cyanobacteria and dinoflagellates in five Argentinian reservoirs:Multi-year sampling

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Water Biology and Security 2024年第1期3卷 28-36页

作者： Florencia Soledad Alvarez Dalinger Borja Claudia Nidia veronica Laura Lozano Liliana Beatriz Morana María Monica Salusso Facultad de Ciencias Naturales Universidad Nacional de SaltaAvenida Bolivia 5150Salta4400Argentina Consejo Nacional de Investigaciones Científicas y T'ecnicas(CONICET) Godoy Cruz 2290Ciudad Autonoma de Buenos AiresArgentina

Harmful algal blooms are important threats to reservoir *** a 15-year period,we sampled five Argentinian reservoirs to identify the responsible species for harmful algal blooms and determine the water quality factors driving their *** reservoirs exhibit diverse morphological and hydrological characteristics and are distributed across varying climatic *** blooms included an array of species,including toxin producers such as Raphidiopsis raciborskii,Aphanizomenon gracile,and Microcystis *** contrast,dinoflagellate blooms were predominantly characterized by *** cyanobacterial blooms primarily occurred in the shallower reservoirs located in warmer regions,whereas dinoflagellate blooms occurred where temperatures were *** most intense blooms occurred during the summer,and although cyanobacterial and chlorophyte blooms co-occurred,they never coexisted with dinoflagellate *** identified cyanotoxins in the reservoirs over the past three years,a phenomenon previously unreported in the *** that these reservoirs are drinking water sources for human populations,ongoing and systematic monitoring is needed to protect public *** the proliferation of algae and cyanobacteria in reservoirs requires resource management at the watershed level,and in the case of the Itiyuro and El Limon,requires binational management with Bolivia.

关键词： HABs Freshwater South America Toxins

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Robotic management of urinary fistula

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Asian Journal of Urology 2024年第3期11卷 357-365页

作者： Luis G.Medina Randall A.Lee Valeria Celis veronica Rodriguez Jaime Poncel Aref S.Sayegh Rene Sotelo The Catherine and Joseph Aresty Department of Urology USC Institute of UrologyKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA Division of Urology Department of SurgeryFox Chase Cancer CenterTemple University Health SystemPhiladelphiaPAUSA

Objectives:To highlight critical preoperative and intraoperative considerations in approaching fistula repair ***:A search of the literature was conducted to identify relevant articles pertaining to robotic management of urinary ***:Fistulae of the genitourinary tract can be a challenging dilemma for urologists,as definitive management may require surgical *** of both enteric and non-enteric fistulae are multifactorial,and successful repair hinges on the meticulous perioperative evaluation,planning,and *** open techniques can subject patients to increased morbidity and prolonged *** its introduction,the robotic surgical platform has continued to expand its *** three-dimensional visualization and tremor free wristed instrument movements have made the robotic platform an attractive option for genitourinary fistula ***:Robotic management of complex urinary fistulae is feasible in expert hands;more studies are needed to define its role in the treatment algorithm of this devastating conditions.

关键词： Fistula Robotic surgery Rectourethral Rectovesical Vesicovaginal

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