Canadian Journal of Gastroenterology and Hepatology

Background. Incidence of inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is increasing worldwide; nevertheless, it is still unknown if this is the case in Mexico. Thus, the aim of this study was to analyze the distribution and trends of hospital discharges (HD) (for the period between 2004 and 2015) and deaths (for the period between 2004 and 2013) reported for UC and CD in Mexico. Methods. Quantitative cross-sectional study was performed. Secondary data sources analysis was performed through Dynamic Cubes of the General Direction of Health Information; variables were categorized by diagnosis, age, sex, and state. The Mann–Whitney U test was used to analyze the differences between the first and last years that were studied. Statistical analysis was performed in SPSS v.24. Results. The number of HD increased by 98.9% between 2004 and 2015 (IBD: , CD: , UC: ); it was more frequent, for both sexes and diagnoses, between 15 and 44 years, with a second peak for men with UC (between 45 and 64 years). Deaths increased by 96.2% from 2004 to 2011 (IBD: , CD: , UC: ). UC is three times more frequent than CD. Mexico City has the highest number of HD (4,179; 22.7%) while the state of Veracruz has the highest number of deaths (273; 38.2%). Conclusions. HD for IBD in Mexico is increasing significantly; the number of deaths increased until 2011, but from then on, they are apparently decreasing. IBD affects Mexican people without any gender predominance, often affecting patients between 15 and 44 years of age. UC is three times more frequent than CD.

Read the full article

Background. Direct-acting antivirals (DAAs) are highly effective treatments against hepatitis C virus (HCV), with sustained virologic response (SVR) rates of 93–100% against all genotypes. In most patients, viral load (VL) becomes undetectable four weeks into treatment, but rarely a low positive VL may be observed at the end of treatment (EOT). This study was conducted to determine the effect of low positive EOT VLs with DAA therapies on SVR at 12 and 24 weeks. Methods. A retrospective chart review was conducted from January 2014 to December 2018 on 1256 HCV patients of all genotypes (1–6) who had received DAA therapy at two large hepatology referral centers. Baseline demographic data, along with VL at week four, EOT, and SVR12/24 time points were collected for patients that had positive EOT VL. Treatment outcome for any patient with positive EOT VL was noted. Results. Eight out of 1256 patients treated with varying DAA therapies were observed to have low positive EOT VLs ranging from <15 to 235 IU/mL. One patient had a negative EOT VL, but 23 IU/mL at week four after EOT. All eight patients who had low positive EOT VLs and one patient who had a low positive VL at four weeks after EOT achieved SVR at weeks 12 and 24. One of the eight patients had cirrhosis. The majority of patients were genotype 1a. Conclusion. In the DAA treatment era, low levels of detectable HCV RNA at EOT does not predict treatment failure.

Read the full article

Background. We previously reported that the granulocyte colony stimulating factor (G-CSF) ameliorated hepatic steatosis with the enhancement of β-oxidation-related gene expression. However, the mechanisms underlying this process remain unclear. This study aimed to determine whether the improvement of hepatic steatosis by G-CSF was associated with autophagy in a rat model of diabetes. Methods. Eight rats were fed a standard diet, and 16 rats were fed high-fat diet (HFD) for 5 weeks. All HFD-fed rats were then injected with streptozotocin (STZ). One week later, HFD rats injected with STZ were randomly treated with either G-CSF (200 μg/kg/day; diabetes mellitus (DM)/G-CSF) or saline (DM/saline) for 5 consecutive days. Four weeks later, serum biochemical and histology analyses were conducted. The expression of autophagy-associated proteins was determined by Western blotting. The mRNA expression of β-oxidation-related genes was determined by quantitative real-time polymerase chain reaction. HepG2 cells were cultured under high glucose (HG) conditions with G-CSF treatment, followed by Oil Red O staining for quantification of lipids. Results. Histological analysis showed lower lipid accumulation in the DM/G-CSF group than in the DM/saline-treated rats. Protein levels of LC3 and beclin-1 were higher, and those of p62 were lower in the DM/G-CSF rats than in the DM/saline-treated rats. The mRNA expression of β-oxidation-related genes was higher in DM/G-CSF rats than in the DM/saline-treated rats. Quantification of lipid levels in HepG2 cells cultured with HG and G-CSF treatment revealed no significant differences. Conclusions. Our data suggested that G-CSF potentially improves hepatic steatosis and autophagy in the liver of diabetic rats.

Read the full article

Objective. To observe the effects of thalidomide on 2,4,6-trinitrobenzenesulfonic acid- (TNBS-) induced experimental colitis in rats and to explore the possible mechanism of thalidomide in the treatment of CD. Methods. Forty SD rats were randomly assigned into a healthy control group and TNBS-induced colitis groups, including an untreated TNBS-induced colitis group, a low-dose thalidomide group, and a high-dose thalidomide group, with 10 rats in each. After 7 days, the disease activity index (DAI), colon macroscopic damage index (CMDI), and tissue damage index (TDI) were evaluated. The colonic protein and mRNA expression levels of interleukin-6 (IL-6), IL-17, IL-23, and retinoic acid receptor-related orphan nuclear receptor gamma t (RORγt) were determined using immunohistochemistry, western blot, and qRT-PCR. Results. Relative to the untreated TNBS-induced colitis group, the DAI, CMDI, and TDI were all reduced following the administration of thalidomide. Analytical testing (immunohistochemistry, western blot, and qRT-PCR) shows that IL-6, IL-17, IL-23, and RORγt protein and mRNA expression levels were significantly reduced by thalidomide ( for all) and that these levels were significantly lower in the high-dose thalidomide group than in the low-dose thalidomide group ( for all). Conclusions. Thalidomide effectively alleviated the symptoms and intestinal inflammatory injury induced by TNBS in rats, the effect of which was dose-dependent. The underlying mechanism may be a reduction in the expression levels of IL-6, IL-17, IL-23, and RORγt in colonic tissue and then subsequent inhibition of the differentiation and function of Th17 cells, thus further alleviating the intestinal inflammatory response.

Read the full article

Background. Following the collapse of the Union of Soviet Socialist Republic (USSR) in 1991, trans-border mobility increased within the former Soviet Union (FSU) countries. In addition, drug-trafficking and injection drug use began to rise, leading to the propagation and transmission of blood-borne infections within and across the FSU countries. To examine the transmission of blood-borne infections within this region, we analyzed the phylogenetic relationship of publically available sequences of two blood-borne viruses, hepatitis C virus (HCV) and human immunodeficiency virus (HIV), from FSU countries. Methods. We analysed 614 and 295 NS5B sequences from HCV genotypes 1b and 3a, respectively, from 9 FSU countries. From 13 FSU countries, we analysed 347 HIV gag and 1282 HIV env sequences. To examine transmission networks and the origins of infection, respectively, phylogenetic and Bayesian analyses were performed. Results. Our analysis shows intermixing of HCV and HIV sequences, suggesting transmission of these viruses both within and across FSU countries. We show involvement of three major populations in transmission: injection drug user, heterosexual, and trans-border migrants. Conclusion. This study highlights the need to focus harm reduction efforts toward controlling transmission of blood-borne infections among the abovementioned high-risk populations in the FSU countries.

Read the full article

Sclerosing http://mts.hindawi.com/update/) in our Manuscript Tracking System and after you have logged in click on the ORCID link at the top of the page. This link will take you to the ORCID website where you will be able to create an account for yourself. Once you have done so, your new ORCID will be saved in our Manuscript Tracking System automatically."?>hepatic carcinoma (SHC) is a rare subtype of hepatic carcinoma that can be caused by various pathogeneses. The histological characteristics of SHC demonstrate its high resistance to chemoembolization and thermal ablation; thus, surgical resection represents the primary option for the majority of patients. However, a small proportion of patients who cannot withstand surgery or who have inoperable tumors may not receive adequate treatment, causing the progression of cancer and related high mortality. To overcome the high puncture resistance, high thermal resistance, and poor thermal conductivity of microwave ablation, we developed percutaneous no-touch multiple-site microwave ablation (NTMSWA) to ablate SHC lesions. In this retrospective study, 96 and 41 patients underwent NTMSWA and surgery, respectively. In the NTMSWA group, tumor size and histological classification were determined by medical imaging and tissue biopsy before ablation, and then a personalized ablation regimen was performed. Complete ablation was achieved in a single session in 81 out of 96 (84.4%) patients. The median survival (MS) of the 90 patients who underwent NTMSWA was 51 months, and the overall survival (OS) rate at 5 years was 49.1%. In contrast, the MS in the control group was 57 months, and the OS rate at 5 years was 56.3%. There was no significant difference between the two groups, indicating that SHC <50 mm in size can be effectively ablated with NTMSWA. By adopting no-touch, multiple-site, low-power, intermittent ablation, SHC less than 50 mm in size can be completely ablated.

Read the full article