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Peer pressure and academic stress among junior high school students:a cross-sectional study

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Frontiers of nursing 2024年第2期11卷 191-199页

作者： Rika Sarfika I Made MohYanuar Saifudin Hema Malini Nursyirwan Effendi Bunga Permata Wenny Mental Health and Community department Faculty of NursingUniversitas AndalasPadangWest Sumatra 25163Indonesia department of Medicine and Health Faculty of MedicinePublic Healthand NursingUniversitas Gadjah MadaYogyakarta 55281Indonesia department of Medical Surgical Faculty of NursingUniversitas AndalasPadangWest Sumatra 25163Indonesia Anthropology department Faculty of Social and Political SciencesUniversitas AndalasPadangWest Sumatra 25163Indonesia

Objective:The objective of the study was to explore the connection between peer pressure and academic stress among junior high school ***:This descriptive correlational study was conducted to investigate the link between perceived peer pressure and academic *** study involved a total of 525 adolescents,aged 14-19 years,drawn from 6 public junior high schools(PJHS)in Padang,Indonesia,using purposive *** stress and perceived peer pressure were assessed using the Educational Stress Scale for Adolescents(ESSA)and the Perceived Peer Pressure Scale(PPPS).Results:The findings indicated significant variations in stress levels among students in different grade levels(7th,8th,and 9th grades)(P0.05).Additionally,there was a positive correlation observed between perceived peer pressure and academic stress(r=0.14,Pacademic stress among adolescents,with class level and parents’educational background mediating the relationship between academic stress and adolescent behavioral ***:These findings underscore the importance of addressing both external and internal factors at the individual,family,school,and societal levels to enhance adolescents’psychological resilience and mitigate problem behaviors.

关键词： academic stress adolescents behavioral problem Indonesia peer pressure students

Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

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World Journal of gastroenterology 2024年第28期30卷 3418-3427页

作者： Anja H W M Lemlijn-Slenter Karolina AP Wijnands Gijs van der Hamsvoort Luuk P van Iperen Nico Wolter Angelique E de Rijk Ad AM Masclee department of Social Medicine Faculty of HealthMedicine and Life sciencesCare and Public Health Research Institute Maastricht UniversityMaastricht 6200 MDLimburgNetherlands Division of gastroenterology and Hepatology Department of Internal MedicineSchool of Nutrition and Translational Research in MetabolismMaastricht 6200 MDLimburgNetherlands Social Medical Affairs Employee Insurance Agency(UWV)Heerlen 6400 ACLimburgNetherlands department of Research Academic Knowledge Center Work and Health South-East Netherlands(AKAG-ZON)Heerlen 6400 ACLimburgNetherlands

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of *** approach is especially relevant for patients with chronic *** gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ *** impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ *** To describe and quantify the dimensions of PH in patients with chronic GI-HPB *** Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient department of the Maastricht University Medical *** questionnaires and data from patient files were used to quantify the six dimensions of *** consistency was tested with McDonald’s ***-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered *** The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general *** quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB *** scores between the six dimensions were only very weak to weak,forcing us to quantify each domain *** All six dimensions of PH are impaired in the GI-HPB *** and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

关键词： Positive health Chronic gut disorders Gastrointestinal disorders Hepato-pancreatico-biliary disorders Integrated care

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临床专科护士培训迁移影响因素的研究

International Journal of nursing Sciences 2024年第3期11卷 308-314,I0001页

作者： Ardani Latifah Hanum 胡秋兰魏维马芳 School of nursing Faculty of MedicinePublic Health and NursingUniversitas Gadjah MadaYogyakartaIndonesia Geriatric department The First Affiliated Hospital of Kunming Medical UniversityKunmingChina gastroenterology department The First Affiliated Hospital of Kunming Medical UniversityKunmingChina department of nursing The First Affiliated Hospital of Kunming Medical UniversityKunmingChina

目的探讨临床专科护士培训后培训迁移的影响因素,以及这些因素如何随时间变化,为提高临床专科护士培训迁移水平提供理论依据。方法采用量性纵向研究方法。于2018年6月-2019年12月,选取参加云南省专科护士培训的46名护士为研究对象,其中... 详细信息

目的探讨临床专科护士培训后培训迁移的影响因素,以及这些因素如何随时间变化,为提高临床专科护士培训迁移水平提供理论依据。方法采用量性纵向研究方法。于2018年6月-2019年12月,选取参加云南省专科护士培训的46名护士为研究对象,其中参加静脉治疗专科护士培训的护士30名,参加伤口、造口专科护士培训护士16名。采用培训迁移影响因素问卷分别在专科护士培训后1个月、3个月、6个月及1年对护士进行调查,问卷包括管理支持(20个条目),组织障碍因素(6个条目),培训项目有效性(10个条目),组织和个人的促进因素(11个条目),个人对培训迁移的态度(6个条目),共5个维度,53个条目。结果专科护士培训迁移影响因素随时间推移而下降,其中管理支持、组织障碍因素、培训项目有效性、个人对培训迁移的态度随时间变化有统计学意义(P<0.05),组织和个人的促进因素随时间变化无统计学差异(P=0.229)。在培训后初期(培训后1个月和3个月),组织障碍是培训迁移最大的阻碍因素。培训后期(培训后6个月和1年),管理层支持是培训迁移最大的影响因素。整体培训迁移水平,静疗护士于培训后3个月显著下降(P<0.001),伤口、造口护士于培训后1年显著下降(P<0.001)。结论培训迁移影响因素随时间的推移而下降。了解培训迁移的状态及其影响因素,有助于护理管理者开展护士专科培训,同时提高培训效果。

关键词：临床专科护士培训迁移影响因素

The Emotional Intelligence and the Associated Factors among nursing Students

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Open Journal of nursing 2024年第3期14卷 114-126页

作者： Ahmad Batran faculty of Allied Medical Sciences Department of Nursing Palestine Ahliya University Bethlehem Palestine

Introduction: Emotional intelligence, or the capacity to cope one’s emotions, makes it simpler to form good connections with others and do caring duties. nursing students can enroll a health team in a helpful and beneficial way with the use of emotional intelligence. Nurses who can identify, control, and interpret both their own emotions and those of their patients provide better patient care. The purpose of this study was to assess the emotional intelligence and to investigate the relationship and differences between emotional intelligence and demographic characteristics of nursing students. Methods: A cross-sectional study was carried out on 381 nursing students. Data collection was completed by “Schutte Self Report Emotional Intelligence Test”. Data were analyzed with the Statistical Package for Social Science. An independent t test, ANOVA, and Pearson correlation, multiple linear regression were used. Results: The results revealed that the emotional intelligence mean was 143.1 ± 21.6 (ranging from 33 to 165), which is high. Also, the analysis revealed that most of the participants 348 (91.3%) had higher emotional intelligence level. This finding suggests that nursing students are emotionally intelligent and may be able to notice, analyze, control, manage, and harness emotion in an adaptive manner. Also, academic year of nursing students was a predictor of emotional intelligence. Furthermore, there was positive relationship between the age and emotional intelligence (p nursing grades. Conclusion: This study confirmed that the emotional intelligence score of the nursing students was high. Also, academic year of nursing students was a predictor of emotional intelligence. In addition, a positive relationship was confirmed between the emotional intelligence and age of nursing students. .

关键词： Students nursing Emotional Intelligence

Real-world Effectiveness and Tolerability of Interferonfree Direct-acting Antiviral for 15,849 Patients with Chronic Hepatitis C:A Multinational Cohort Study

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Journal of Clinical and Translational Hepatology 2024年第7期12卷 646-658页

作者： Fanpu Ji Sally Tran Eiichi Ogawa Chung-Feng Huang Takanori Suzuki Yu Jun Wong Hidenori Toyoda Dae Won Jun Liu Li Haruki Uojima Akito Nozaki Makoto Chuma Cheng-Hao Tseng Yao-Chun Hsu Masatoshi Ishigami Takashi Honda Masanori Atsukawa Hiroaki Haga Masaru Enomoto Huy Trinh Carmen Monica Preda Phillip Vutien Charles Landis Dong Hyun Lee Tsunamasa Watanabe Hirokazu Takahashi Hiroshi Abe Akira Asai Yuichiro Eguchi Jie Li Xiaozhong Wang Jia Li Junping Liu Jing Liang Carla Pui-Mei Lam Rui Huang Qing Ye Hongying Pan Jiajie Zhang Dachuan Cai Qi Wang Daniel Q.Huang Grace Wong Vincent Wai-Sun Wong Junyi Li Son Do Norihiro Furusyo Makoto Nakamuta Hideyuki Nomura Eiji Kajiwara Eileen L.Yoon Sang Bong Ahn Koichi Azuma Kazufumi Dohmen Jihyun An Do Seon Song Hyun Chin Cho Akira Kawano Toshimasa Koyanagi Aritsune Ooho Takeaki Satoh Kazuhiro Takahashi Ming-Lun Yeh Pei-Chien Tsai Satoshi Yasuda Yunyu Zhao Yishan Liu Tomomi Okubo Norio Itokawa Mi Jung Jun Toru Ishikawa Koichi Takaguchi Tomonori Senoh Mingyuan Zhang Changqing Zhao Raluca Ioana Alecu Wei Xuan Tay Pooja Devan Joanne Kimiko Liu Ritsuzo Kozuka Elena Vargas-Accarino Ai-Thien Do Mayumi Maeda Wan-Long Chuang Jee-Fu Huang Chia-Yen Dai Ramsey Cheung Maria Buti Junqi Niu Wen Xie Hong Ren Seng Gee Lim Chao Wu Man-Fung Yuen Jia Shang Qiang Zhu Yoshiyuki Ueno Yasuhito Tanaka Jun Hayashi Ming-Lung Yu Mindie H.Nguyen department of Infectious Diseases The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxiChina Division of gastroenterology and Hepatology Department of MedicineStanford University Medical CenterPalo AltoCAUSA department of General Internal Medicine Kyushu University HospitalFukuokaJapan Hepatobiliary Division Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung Hepatitis Research Center College of Medicine and Center for Liquid Biopsy and Cohort ResearchKaohsiung Medical UniversityKaohsiung department of gastroenterology and Metabolism Nagoya City University Graduate School of Medical SciencesNagoyaJapan gastroenterology&Hepatology Changi General HospitalSinghealthSingapore Singhealth Duke-NUS Medicine academic Clinical Program Singapore department of gastroenterology Ogaki Municipal HospitalOgakiJapan department of Internal Medicine Hanyang UniversityCollege of MedicineSeoulKorea Hanyang Institute of Bioscience and Biotechnology Hanyang UniversitySeoulKorea department of Hepatology The Third People's Hospital of Kunming CityKunmingYunnanChina department of gastroenterology Internal MedicineKitasato University School of MedicineSagamiharaJapan Gastroenterological Center Yokohama City University Medical CenterYokohamaJapan Division of gastroenterology and Hepatology Department of Internal MedicineE-Da Cancer HospitalKaohsiung department of gastroenterology and Hepatology Nagoya University Graduate School of MedicineNagoyaJapan Division of gastroenterology and Hepatology Nippon Medical SchoolTokyoJapan department of gastroenterology Yamagata University Faculty of MedicineYamagataJapan department of Transfusion Medicine and department of Hepatology Osaka Metropolitan University Graduate School of MedicineOsakaJapan San Jose gastroenterology San JoseCAUSA gastroenterology&Hepatology department Clinic Fundeni InstituteBucharestRomania Division of gastroenterology and Hepatology University of WashingtonSeattleWAUSA department of

Background and Aims:As practice patterns and hepatitis C virus(HCV)genotypes(GT)vary geographically,a global real-world study from both East and West covering all GTs can help inform practice policy toward the 2030 HCV elimination *** study aimed to assess the effectiveness and tolerability of DAA treatment in routine clinical practice in a multinational cohort for patients infected with all HCV GTs,focusing on GT3 and ***:We analyzed the sustained virological response(SVR12)of 15,849 chronic hepatitis C patients from 39 Real-World Evidence from the Asia Liver Consortium for HCV clinical sites in Asia Pacific,North America,and Europe between 07/01/2014–07/01/***:The mean age was 62±13 years,with 49.6%*** demographic breakdown was 91.1%Asian(52.9%Japanese,25.7%Chinese/Taiwan residents,5.4%Korean,3.3%Malaysian,and 2.9%Vietnamese),6.4%White,1.3%Hispanic/Latino,and 1%Black/***,34.8%had cirrhosis,8.6%had hepatocellular carcinoma(HCC),and 24.9%were treatment-experienced(20.7%with interferon,4.3%with direct-acting antivirals).The largest group was GT1(10,246[64.6%]),followed by GT2(3,686[23.2%]),GT3(1,151[7.2%]),GT6(457[2.8%]),GT4(47[0.3%]),GT5(1[0.006%]),and untyped GTs(261[1.6%]).The overall SVR12 was 96.9%,with rates over 95%for GT1/2/3/6 but 91.5%for ***12 for GT3 was 95.1%overall,98.2%for GT3a,and 94.0%for ***12 was 98.3%overall for GT6,lower for patients with cirrhosis and treatment-experienced(TE)(93.8%)but≥97.5%for tretment-naive patients regardless of cirrhosis *** multivariable analysis,advanced age,prior treatment failure,cirrhosis,active HCC,and GT3/4 were independent predictors of lower SVR12,while being Asian was a significant predictor of achieving ***:In this diverse multinational realworld cohort of patients with various GTs,the overall cure rate was 96.9%,despite large numbers of patients with cirrhosis,HCC,TE,and GT3/***12 for GT3/6 with cirrhosis and TE was lower but st

关键词： Hepatitis C virus Liver cirrhosis Hepatocellular carcinoma Genotype DAA REAL-C

A novel saliva-based miRNA profile to diagnose and predict oral cancer

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International Journal of Oral Science 2024年第1期16卷 97-109页

作者： Jaikrishna Balakittnen Chameera Ekanayake Weeramange Daniel F.Wallace Pascal H.G.Duijf Alexandre S.Cristino Gunter Hartel Roberto A.Barrero Touraj Taheri Liz Kenny Sarju Vasani Martin Batstone Omar Breik Chamindie Punyadeera Saliva&Liquid Biopsy Translational Laboratory Griffith Institute for Drug DiscoveryGriffith UniversityNathanQLDAustralia department of Medical Laboratory Sciences Faculty of Allied Health SciencesUniversity of JaffnaJaffnaSri Lanka Menzies Health Institute Griffith UniversityGold CoastQLDAustralia School of Biomedical Sciences Faculty of HealthQueensland University of TechnologyBrisbaneQLDAustralia Centre for Cancer Biology Clinical and Health SciencesUniversity of South Australia&SA PathologyAdelaideSAAustralia Institute of Clinical Medicine Faculty of MedicineUniversity of OsloOsloNorway department of Medical Genetics Oslo University HospitalOsloNorway Griffith Institute for Drug Discovery Griffith UniversityNathanQLDAustralia QIMR Berghofer Medical Research Institute Statistics UnitBrisbaneQLDAustralia School of Public Health The University of QueenslandBrisbaneQLDAustralia School of nursing Queensland University of TechnologyBrisbaneQLDAustralia eResearch Research InfrastructureAcademic DivisionQueensland University of TechnologyBrisbaneQLDAustralia department of Anatomical Pathology Royal Brisbane and Women’s HospitalHerstonQLDAustralia faculty of Medicine The University of QueenslandBrisbaneQLDAustralia Royal Brisbane and Women’s Hospital Cancer Care ServicesHerstonQLDAustralia department of Otolaryngology Royal Brisbane and Women’s HospitalHerstonQLDAustralia department of Oral and Maxillofacial Surgery Royal Brisbane and Women’s HospitalHerstonQLDAustralia

Oral cancer (OC) is the most common form of head and neck cancer. Despite the high incidence and unfavourable patient outcomes, currently, there are no biomarkers for the early detection of OC. This study aims to discover, develop, and validate a novel saliva-based microRNA signature for early diagnosis and prediction of OC risk in oral potentially malignant disorders (OPMD).The Cancer Genome Atlas (TCGA) miRNA sequencing data and small RNA sequencing data of saliva samples were used to discover differentially expressed miRNAs. Identified miRNAs were validated in saliva samples of OC (n=50), OPMD (n=52), and controls(n=60) using quantitative real-time PCR. Eight differentially expressed miRNAs (miR-7-5p, miR-10b-5p, miR-182-5p, miR-215-5p,miR-431-5p, miR-486-3p, miR-3614-5p, and miR-4707-3p) were identified in the discovery phase and were validated. The efficiency of our eight-miRNA signature to discriminate OC and controls was:area under curve (AUC):0.954, sensitivity:86%, specificity:90%,positive predictive value (PPV):87.8%and negative predictive value (NPV):88.5%whereas between OC and OPMD was:AUC:0.911,sensitivity:90%, specificity:82.7%, PPV:74.2%and NPV:89.6%. We have developed a risk probability score to predict the presence or risk of OC in OPMD patients. We established a salivary miRNA signature that can aid in diagnosing and predicting OC,revolutionising the management of patients with OPMD. Together, our results shed new light on the management of OC by salivary miRNAs to the clinical utility of using miRNAs derived from saliva samples.

关键词： specificity salivary diagnosis

Psychiatric comorbidities in epilepsy:population co-occurrence,genetic correlations and causal effects

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General Psychiatry 2024年第1期37卷 103-111页

作者： Viktor H Ahlqvist Christina Dardani Paul Madley-Dowd Harriet Forbes Jessica Rast Caichen Zhong Renee M Gardner Christina Dalman Kristen Lyal cRAIG Newschaffer Torbjorn Tomson Michael Lundberg Daniel Berglind Neil M Davies Brian K Lee Cecilia Magnusson Dheeraj Rai department of Global Public Health Karolinska InstitutetStockholmSweden Medical Research Council Integrative Epidemiology Unit Bristol Medical SchoolUniversity of BristolBristolUK Centre for academic Mental Health Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK faculty of Epidemiology and Population Health London School of Hygiene and Tropical MedicineLondonUK A.J.Drexel Autism Institute Drexel UniversityPhiladelphiaPAUSA department of Epidemiology and Biostatistics School of Public HealthDrexel UniversityPhiladelphiaPAUSA College of Health and Human Development Pennsylvania State UniversityState CollegePAUSA department of Clinical Neuroscience Karolinska InstitutetStockholmSweden Centre for Epidemiology and Community Medicine Region StockholmStockholmSweden K.G Jebsen Center for Genetic Epidemiology Department of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway Division of Psychiatry University Collge LondonLondonUK department of Statistical Sciences University Cllge LondonLondonK NIHR Biomedical Research Centre University of BristoBristolUK Avon and Wiltshire Partnership NHS Mental Health TrustBristolUK

Background Psychiatric comorbidities are common in patients with *** for the co-occurrence of psychiatric conditions and epilepsy remain poorly *** We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these *** Using nationwide Swedish health registries,we quantified the lifetime prevalence of psychiatric disorders in patients with *** then used summarydata from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score ***,we assessed the potential bidirectional relationships using two-sample Mendelian *** In a cohort of 7628495 individuals,we found that almost half of the 94435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime(adjusted lifetime prevalence,44.09%;95%confidence interval(Cl)43.78%to 44.39%).We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric *** example,we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder(r,=0.18,95%Cl 0.09 to 0.27,p<0.001)—a correlation that was more pronounced in focal epilepsy(r=0.23,95%CI 0.09 to 0.36,p<0.001).Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric *** Psychiatric comorbidities are common in patients with *** correlations may partially explain some comorbidities;however,there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric *** findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psy

关键词： epilepsy Psychiat lifetime

Overview of dyslipidemia and metabolic syndrome in myeloproliferative neoplasms

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World Journal of Clinical Oncology 2024年第6期15卷 717-729页

作者： Mihnea-Alexandru Găman Bahadar Singh Srichawla Yong-Feng Chen Poulami Roy Arkadeep Dhali Ahmed Nahian Muhammad Romail Manan Vincent Kipkorir Richard Christian Suteja Lakshmi Venkata Simhachalam Kutikuppala Amelia Maria Găman Camelia Cristina Diaconu faculty of Medicine “Carol Davila”University of Medicine and PharmacyBucharest 050474Romania department of Hematology Center of Hematolog department of Cellular and Molecular Pathology Stefan S Nicolau Institute of VirologyRomanian AcademyBucharest 030304Romania department of Neurology University of Massachusetts Chan Medical SchoolWorcesterMA 01655United States department of Basic Medical Sciences School of Medicine of Taizhou UniversityTaizhou UniversityTaizhou 318000Zhejiang ProvinceChina department of Medicine North Bengal Medical College and HospitalWest Bengal 734012India academic department of gastroenterology Sheffield Teaching Hospitals NHS Foundation TrustSheffield S57AUUnited Kingdom Lecom at Seton Hill GreensburgPA 15601United States faculty of Medicine Services HospitalLahore 54000Pakistan department of Human Anatomy and Physiology University of NairobiNairobi 00100Kenya faculty of Medicine Udayana UniversityDenpasarBali 80361Indonesia department of General Surgery Dr.NTR University of Health SciencesVijayawada 520008Andhra PradeshIndia department of Pathophysiology University of Medicine and Pharmacy of CraiovaCraiova 200349Romania Clinic of Hematology Filantropia City HospitalCraiova 200143Romania department of Internal Medicine Faculty of Medicine“Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Internal Medicine Clinic Clinical Emergency Hospital of BucharestBucharest 105402Romania

Myeloproliferative neoplasms(MPNs)occur due to the abnormal proliferation of one or more terminal myeloid cell lines in peripheral *** suffering from MPNs display a high burden of cardiovascular risk factors,and thrombotic events are often the cause of death in this population of ***,we provide a brief overview of dyslipidemia and metabolic syndrome and their epidemiology in MPNs and examine the common molecular mechanisms between dyslipidemia,metabolic syndrome,and MPNs,with a special focus on cardio-vascular risk,atherosclerosis,and thrombotic ***,we investigate the impact of dyslipidemia and metabolic syndrome on the occurrence and survival of thrombosis in MPN patients,as well as the management of dyslipidemia in MPNs,and the impact of MPN treatment on serum lipid concentrations,particularly as side/adverse effects reported in the context of clinical trials.

关键词： Polycythemia vera Essential thrombocythemia Myelofibrosis Cardiovascular disease Hypercholesterolemia Hypertriglyceridemia Obesity Diabetes Inflammation Oxidative stress

Microscopic colitis as a missed cause of chronic diarrhea

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World Journal of gastroenterology 2011年第15期17卷 1996-2002页

作者： Nooroudien Mohamed Monique Marais Juanita Bezuidenhout department of Pathology Division of Anatomical Pathology Faculty of Health Sciences University of Stellenbosch National Health Laboratory Services Tygerberg Academic Hospital Tygerberg 7505 South Africa department of Medicine Division of Gastroenterology Faculty of Health Sciences University of Stellenbosch Tygerberg Academic Hospital Tygerberg 7505 South Africa

AIM: To determine the prevalence of increased intraepithelial lymphocytes, using immunohistochemistry in patients with normal colonoscopy and near normal biopsy. METHODS: We retrospectively reviewed all non-malignant colon mucosal biopsies between 2005 and 2007, reported as normal, chronic inflammation or melanosis coli in patients who were undergoing routine colonoscopy. Immunohistochemistry using CD3 was performed on all mucosal biopsies and an intraepithelial lymphocyte count (IEL) was determined. Cases with an IEL count of ≥ 20 IELs per 100 surface epithelial cells were correlated with demographic, clinical and follow-up data. A further subgroup was evaluated for lymphocytic ***: Twenty (8.3%) of 241 cases revealed an IEL count ≥ 20. Six (2.5%) patients were identified as having lymphocytic colitis (P < 0.001), of whom, five were missed on initial evaluation (P = 0.01). Four of these five patients were labeled with diarrhea-predominant irritable bowel syndrome (IBS). On follow-up, three of the remaining 20 cases were diagnosed with malignancy (renal cell carcinoma and myelodysplastic syndrome) and one had an unknown primary tumor with multiple liver metastases. Two cases of collagenous colitis with an IEL count < 10 were included in this study. Increased IELs were not confined to patients with diarrhea as a primary presenting symptom, but were also present in patients with abdominal pain (n = 7), constipation (n = 3) and loss of weight (n = 1). CONCLUSION: Immunohistochemistry using CD3 is of value in identifying and quantifying IELs for the presence of microscopic colitis in patients with diarrheapredominant IBS.

关键词： Microscopic colitis Lymphocytic colitis Collagenous colitis CD3 immunohistochemistry Intraepithelial lymphocytes