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BACKGROUND: Inflammatory bowel disease is a group of pathologies characterised by chronic inflammation of the intestine and an unclear aetiology. Its main manifestations are Crohn's disease and ulcerative colitis. Currently, biopsies are the most used diagnostic tests for these diseases and metabolomics could represent a less invasive approach to identify biomarkers of disease presence and progression. OBJECTIVES: The lipid and the polar metabolite profile of plasma samples of patients affected by inflammatory bowel disease have been compared with healthy individuals with the aim to find their metabolomic differences. Also, a selected sub-set of samples was analysed following solid phase extraction to further characterise differences between pathological samples. METHODS: A total of 200 plasma samples were analysed using drift tube ion mobility coupled with time of flight mass spectrometry and liquid chromatography for the lipid metabolite profile analysis, while liquid chromatography coupled with triple quadrupole mass spectrometry was used for the polar metabolite profile analysis. RESULTS: Variations in the lipid profile between inflammatory bowel disease and healthy individuals were highlighted. Phosphatidylcholines, lyso-phosphatidylcholines and fatty acids were significantly changed among pathological samples suggesting changes in phospholipase A2 and arachidonic acid metabolic pathways. Variations in the levels of cholesteryl esters and glycerophospholipids were also found. Furthermore, a decrease in amino acids levels suggests mucosal damage in inflammatory bowel disease. CONCLUSIONS: Given good statistical results and predictive power of the model produced in our study, metabolomics can be considered as a valid tool to investigate inflammatory bowel disease.
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Aminoácidos/sangue , Ácidos Graxos não Esterificados/sangue , Glicerofosfolipídeos/sangue , Doenças Inflamatórias Intestinais/sangue , Adulto , Idoso , Aminoácidos/química , Estudos de Coortes , Ácidos Graxos não Esterificados/química , Feminino , Glicerofosfolipídeos/química , Humanos , Doenças Inflamatórias Intestinais/metabolismo , Doenças Inflamatórias Intestinais/patologia , Itália , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Extração em Fase Sólida , Adulto JovemRESUMO
PURPOSE: To critically discuss adhesive materials and oral cariogenic biofilm in terms of their potential relevance to the failures of adhesive restorations in the oral environment. METHODS: The literature regarding adhesive restoration failures was reviewed with particular emphasis on the chemistry of adhesive resins, weakness in dentin bonding, water fluids, cariogenic oral biofilm and the relations that influence failures. Particular attention was paid to evidence derived from clinical studies. RESULTS: There was much evidence that polymerization shrinkage is one of the main drawbacks of composite formulations. Stress results in debonding and marginal leakage into gaps with deleterious effects in bond strength, mechanical properties and the whole stability of restorations. Changes in resins permit passage of fluids and salivary proteins with a biological breakdown of the restorations. Esterases enzymes in human saliva catalyze exposed ester groups in composite producing monomer by-products, which can favor biofilm accumulation and secondary caries. Adhesive systems may not produce a dense hybrid layer in dentin. Very often this is related to the high viscous solubility and low wettability in dentin of the hydrophobic BisGMA monomer. Thus, dentin hybrid layer may suffer from hydrolysis using both the Etch&Rinse and Self-Etching adhesive systems. In addition, exposed and non-resin enveloped collagen fibers may be degraded by activation of the host-derived matrix metalloproteinase. Plaque accumulation is significantly influenced by the surface properties of the restorations. Biofilm at the contraction gap has demonstrated increased growth of Streptococcus mutans motivated by the chemical hydrolysis of the adhesive monomers at the margins. Streptococcus mutans is able to utilize some polysaccharides from the biofilm to increase the amount of acid in dental plaque with an increase in virulence and destruction of restorations. Stability of resin restorations in the oral environment is highly dependent on the structure of the monomers used in composite and adhesive systems. Still, the issues related to microleakage of fluids into the gap and bacteria leaching from the surface of composites represent the main causes of failure of adhesive restorations. CLINICAL SIGNIFICANCE: Modifications of adhesive materials are necessary to address their instability in the oral environment.
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Biofilmes , Restauração Dentária Permanente , Adesivos Dentinários , Resinas Compostas , Colagem Dentária , Preparo da Cavidade Dentária , Cimentos Dentários , Esmalte Dentário , Infiltração Dentária , Dentina , Humanos , Teste de Materiais , Cimentos de ResinaRESUMO
In contrast to large GWA studies based on thousands of individuals and large meta-analyses combining GWAS results, we analyzed a small case/control sample for uric acid nephrolithiasis. Our cohort of closely related individuals is derived from a small, genetically isolated village in Sardinia, with well-characterized genealogical data linking the extant population up to the 16(th) century. It is expected that the number of risk alleles involved in complex disorders is smaller in isolated founder populations than in more diverse populations, and the power to detect association with complex traits may be increased when related, homogeneous affected individuals are selected, as they are more likely to be enriched with and share specific risk variants than are unrelated, affected individuals from the general population. When related individuals are included in an association study, correlations among relatives must be accurately taken into account to ensure validity of the results. A recently proposed association method uses an empirical genotypic covariance matrix estimated from genome-screen data to allow for additional population structure and cryptic relatedness that may not be captured by the genealogical data. We apply the method to our data, and we also investigate the properties of the method, as well as other association methods, in our highly inbred population, as previous applications were to outbred samples. The more promising regions identified in our initial study in the genetic isolate were then further investigated in an independent sample collected from the Italian population. Among the loci that showed association in this study, we observed evidence of a possible involvement of the region encompassing the gene LRRC16A, already associated to serum uric acid levels in a large meta-analysis of 14 GWAS, suggesting that this locus might lead a pathway for uric acid metabolism that may be involved in gout as well as in nephrolithiasis.
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Proteínas de Transporte/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla/métodos , Nefrolitíase/genética , Ácido Úrico/metabolismo , Estudos de Casos e Controles , Estudos de Coortes , Interpretação Estatística de Dados , Loci Gênicos , Gota/genética , Humanos , Itália , Proteínas dos Microfilamentos , Linhagem , Polimorfismo de Nucleotídeo Único , Ácido Úrico/sangueRESUMO
BACKGROUND: Diverticular disease (DD) and irritable bowel syndrome (IBS) share a similar symptom pattern. However, comparative studies are flawed by different age at onset of symptoms. We aimed to verify whether clinical features distinguish DD from IBS. MATERIALS AND METHODS: Patients with DD or IBS, matched for age and gender (1/1) were consecutively recruited. Data on demographic parameters, voluptuary habits, inheritance of disease and symptoms were collected. Moreover, the association between pain > 24 h, and clinical parameters were evaluated. RESULTS: Ninety patients with DD and 90 patients with IBS (DD: F/M: 46/44; age: 50.9 years; IBS: 46/44; 50.4) were selected from an overall population of 1275 patients. Only nine patients with DD (10%) fulfilled the criteria for IBS diagnosis. Abdominal pain > 24 h was more prevalent in SDD than in patients with IBS (20 vs. 6 patients; P < 0.01). Furthermore, compared with IBS, patients with DD showed more episodes of pain > 24 h requiring medical attention (80% vs. 33%; P < 0.01). CONCLUSIONS: Abdominal pain lasting for more than 24 h discriminates patients with DD compared with those with IBS. Identifying this symptom could be an appropriate strategy to define the diagnosis and management.
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Doença Diverticular do Colo/diagnóstico , Síndrome do Intestino Irritável/diagnóstico , Dor Abdominal/etiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Constipação Intestinal/etiologia , Diagnóstico Diferencial , Diarreia/etiologia , Feminino , Flatulência/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
This review summarizes recent literature on advances regarding renal and ureteral calculi, with particular focus in areas of recent advances in the overall field of urolithiasis. Clinical management in everyday practice requires a complete understanding of the issues regarding metabolic evaluation and subgrouping of stone-forming patients, diagnostic procedures, effective treatment regime in acute stone colic, medical expulsive therapy, and active stone removal. In this review we focus on new perspectives in managing nephrolitihiasis and discuss recentadvances, including medical expulsive therapy, new technologies, and refinements of classical therapy such as shock wave lithotripsy, give a fundamental modification of nephrolithiasis management. Overall, this field appears to be the most promising, capable of new developments in ureterorenoscopy and percutaneous approaches. Further improvements are expected from robotic-assisted procedures, such as flexible robotics in ureterorenoscopy.
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Nefrolitíase/terapia , Ureterolitíase/terapia , Alopurinol/uso terapêutico , Citratos/uso terapêutico , Humanos , Litotripsia , Nefrolitíase/diagnóstico , Robótica , Tiazidas/uso terapêutico , Ureterolitíase/diagnóstico , Ureteroscopia , Xantina Oxidase/antagonistas & inibidoresRESUMO
PURPOSE: Clinical features of symptomatic uncomplicated diverticular disease are poorly investigated. Abdominal symptoms may be similar to those of irritable bowel syndrome. This survey aimed to assess clinical features associated with symptomatic uncomplicated diverticular disease. METHODS: This multicenter survey included consecutive outpatients with symptomatic uncomplicated diverticular disease to whom a detailed clinical questionnaire regarding demographic, lifestyle, and clinical features was administered. Diagnosis was based on the presence of diverticula and abdominal pain/discomfort. Irritable bowel syndrome and functional dyspepsia were assessed according to Rome III criteria. RESULTS: A total of 598 patients (50 % female, age 69 years), 71 % with newly diagnosed symptomatic uncomplicated diverticular disease and 29 % with history of colonic diverticula, were recruited. Diverticula were localized in the left colon in 78 % of the patients. Recurrent short-lived abdominal pain (<24 h) was present in 70 % (relieved by evacuation in 73 %), prolonged abdominal pain (>24 h) in 27 %, and recurrent abdominal bloating in 61 % of the patients. Normal, loose, or hard stools were reported by 58, 29, and 13 % of patients, respectively. Irritable bowel syndrome (IBS)-like and functional dyspepsia-like symptoms were recorded in 59 and 7 % of patients, respectively. IBS-like symptoms (odds ratio, 4.3) were associated in patients with prolonged abdominal pain. CONCLUSIONS: Symptomatic uncomplicated diverticular disease is associated with a gender ratio of 1:1 and an unspecific clinical picture mainly characterized by normal stools, short-lived abdominal pain, abdominal bloating, IBS-like symptoms, while functional dyspepsia-like symptoms are not commonly present. These findings suggest that symptomatic uncomplicated diverticular disease often shows similar findings rather than overlaps IBS.
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Diverticulite/epidemiologia , Diverticulite/patologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Dor Abdominal/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Demografia , Diverticulite/complicações , Dispepsia/complicações , Fezes , Feminino , Humanos , Síndrome do Intestino Irritável/complicações , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: There are little data on the epidemiological and clinical features of adult patients with ulcerative colitis (UC) in the different Italian regions, mainly derived from the absence of a national registry. This prevents correct interpretation of the disease burden. AIM: To assess the main clinical and epidemiological features of adult patients diagnosed with UC in Sardinia, Italy. METHODS: We performed a multicenter, observational, cross-sectional study that included adult patients with UC enrolled in seven gastroenterology unit centers in Sardinia. Data were obtained from the patients' medical records and from a questionnaire administered at the inclusion visit. RESULTS: Four hundred and forty-two patients with UC were included. The median age at diagnosis was 39 years (interquartile range 28-48). After a median disease duration of 10 years, 53 patients experienced proximal extension of proctitis or left-sided colitis. Seventy-five patients developed extraintestinal manifestations. Nineteen patients (4.3%) developed cancer: two with colorectal cancer and seventeen with extracolonic cancers. Mesalazine (5-ASA) remains the mainstay of treatment for UC. Overall, 95 patients (21.5%) were treated with one or more biologic agents, whereas 15 patients (3.4%) underwent surgery, mostly colectomy. CONCLUSION: Our results provide important insights into the clinical and epidemiological features of patients with UC, and while waiting for a national Italian registry, present eligible data on the UC population in Sardinia.
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BACKGROUND: This study aims to evaluate relationship between three different clinical conditions: Major Depressive Disorders (MDD), Hashimoto Thyroiditis (HT) and reduction in regional Cerebral Blood Flow (rCBF) in order to explore the possibility that patients with HT and MDD have specific pattern(s) of cerebral perfusion. DESIGN: Analysis of data derived from two separate data banks. SAMPLE: 54 subjects, 32 with HT (29 women, mean age 38.8 ± 13.9); 22 without HT (19 women, mean age 36.5 ± 12.25). ASSESSMENT: Psychiatric diagnosis was carried out by Simplified Composite International Diagnostic Interview (CIDIS) using DSM-IV categories; cerebral perfusion was measured by (99 m)Tc-ECD SPECT. Statistical analysis was done through logistic regression. RESULTS: MDD appears to be associated with left frontal hypoperfusion, left temporal hypoperfusion, diffuse hypoperfusion and parietal perfusion asymmetry. A statistically significant association between parietal perfusion asymmetry and MDD was found only in the HT group. CONCLUSION: In HT, MDD is characterized by a parietal flow asymmetry. However, the specificity of rCBF in MDD with HT should be confirmed in a control sample with consideration for other health conditions. Moreover, this should be investigated with a longitudinally designed study in order to determine a possible pathogenic cause. Future studies with a much larger sample size should clarify whether a particular perfusion pattern is associated with a specific course or symptom cluster of MDD.
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Doença Celíaca/fisiopatologia , Circulação Cerebrovascular/fisiologia , Transtornos Cerebrovasculares/diagnóstico , Transtorno Depressivo Maior/fisiopatologia , Bócio/fisiopatologia , Doença de Hashimoto/fisiopatologia , Adolescente , Adulto , Idoso , Doença Celíaca/complicações , Doença Celíaca/diagnóstico por imagem , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico por imagem , Cisteína/análogos & derivados , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico por imagem , Feminino , Bócio/complicações , Bócio/diagnóstico por imagem , Doença de Hashimoto/complicações , Doença de Hashimoto/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único/métodosRESUMO
BACKGROUND AND AIMS: The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn's Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. METHODS: CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. RESULTS: Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. CONCLUSIONS: PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBD patients during periods of limited access to outpatient clinics.
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Smell strongly contributes to food choice and intake, influencing energy balance and body weight; its reduction or loss has been related to malnutrition problems. Some patients with inflammatory bowel disease (IBD), mainly Crohn's disease (CD) and ulcerative colitis (UC), are underweight, while others are overweight. Some studies suggest that changes in eating habits could be linked to specific disorders of the olfactory functions. We assessed the olfactory performance in 199 subjects (healthy control (HC) n = 99, IBD n = 100), based on the olfactory Threshold, Discrimination and Identification score (TDI score), measured with the "Sniffin' Sticks" test. Subjects were genotyped for the rs2590498 polymorphism of the OBPIIa gene. IBD patients showed both a slightly, but significantly, lower olfactory function and a higher BMI compared to HC subjects. Threshold (in both population) and Discrimination (in IBD patients) olfactory score were affected by the OBPIIa genotype. BMI was influenced by both health status and OBPIIa genotype. A lower olfactory function may delay the satiety sensation and thus increase meal duration and body weight in IBD patients. However, the AA genotype of the OBPIIa seems to "protect" IBD patients from more severe olfactory dysfunction.
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Índice de Massa Corporal , Doenças Inflamatórias Intestinais/metabolismo , Polimorfismo Genético , Receptores Odorantes/genética , Olfato/fisiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes , Limiar Sensorial , Olfato/genéticaRESUMO
BACKGROUND: Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract, with periods of latency alternating with phases of exacerbation, and include 2 forms: Crohn disease (CD) and ulcerative colitis (UC). Although the etiology of IBD is still unclear, the identification and understanding of pathophysiological mechanisms underlying IBD could reveal newly targeted intestinal alterations and determine therapeutic approaches. METHODS: In this study, by using gas chromatography-mass spectrometry, we characterized plasma and biopsies from the metabolomics profiles of patients with IBD compared with those of a control group. RESULTS: The results showed a different metabolomics profile between patients with CD (nâ =â 50) and patients with UC (nâ =â 82) compared with the control group (nâ =â 51). Multivariate statistical analysis of the identified metabolites in CD and UC showed changes in energetic metabolism, and lactic acid and ornithine in particular were altered in both plasma and colon biopsies. Moreover, metabolic changes were evidenced between the normal ileum and colon tissues. These differences disappeared when we compared the inflamed ileum and colon tissues, suggesting a common metabolism. CONCLUSIONS: This study showed how the metabolomics profile could be a potential tool to identify intestinal alterations associated with IBD and may have application in precision medicine and for better defining the pathogenesis of the disease.
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Colite Ulcerativa , Doença de Crohn , Metaboloma , Biópsia , Colite Ulcerativa/metabolismo , Doença de Crohn/metabolismo , Humanos , Plasma/metabolismoRESUMO
BACKGROUND & AIMS: Malnutrition with the accumulation of fat tissue and nonalcoholic fatty liver disease (NAFLD) are conditions associated with inflammatory bowel disease (IBD). Visceral fat and NAFLD-related liver dysfunction can both worsen intestinal inflammation. Because the Mediterranean diet (Md) has been shown to ameliorate both obesity and NAFLD, the aim of this study was to analyze the impact of Md on the nutritional state, liver steatosis, clinical disease activity, and quality of life (QoL) in IBD patients. METHODS: Patients with IBD, both Crohn's disease (CD) and ulcerative colitis (UC), followed Md for 6 months. Their body mass index (BMI), body tissue composition, liver steatosis and function, serum lipid profile, clinical disease activity, and inflammatory biomarkers (C-reactive protein and fecal calprotectin) were collected at baseline (T0) and compared with those obtained after 6 months (T180) to evaluate the impact of Md. RESULTS: One hundred forty-two IBD patients, 84 UC and 58 CD, followed Md for 6 months. At T180, diet-adherent CD and UC improved BMI (UC -0.42, P = 0.002; CD -0.48, P = 0.032) and waist circumference (UC -1.25 cm, P = 0.037; CD -1.37 cm, P = 0.041). Additionally, the number of patients affected by liver steatosis of any grade was significantly reduced in both groups (UC T0 31 of 84 [36.9%] vs T180 18 of 84 [21.4%], P = 0.0016; CD T0 27 of 58 [46.6%] vs T180 18 of 58 [31.0%], P < 0.001) after dietary intervention. Finally, after 6 months of the diet, fewer UC and CD patients with stable therapy had active disease (UC T0 14 of 59 [23.7%] vs T180 4 of 59 [6.8%], P = 0.004; CD T0 9 of 51 [17.6%] vs T180 2 of 51 [3.0%], P = 0.011) and elevated inflammatory biomarkers. Mediterranean diet improved QoL in both UC and CD, but neither serum lipid profile nor liver function were modified by the diet. CONCLUSIONS: A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers.
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Colite Ulcerativa/dietoterapia , Doença de Crohn/dietoterapia , Dieta Mediterrânea , Adulto , Biomarcadores/metabolismo , Proteína C-Reativa/análise , Colite Ulcerativa/complicações , Colite Ulcerativa/fisiopatologia , Doença de Crohn/complicações , Doença de Crohn/fisiopatologia , Fígado Gorduroso/dietoterapia , Fígado Gorduroso/etiologia , Fezes/química , Feminino , Humanos , Complexo Antígeno L1 Leucocitário/análise , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Estudos Prospectivos , Qualidade de Vida , Resultado do TratamentoRESUMO
BACKGROUND: The aim was to verify whether the density of particulate matter (PM10), the climate, and the mobility of people can influence the pandemic in the 19 regions and in the two autonomous Italian provinces as incidence rate and lethality. DESIGN AND METHODS: The incidence rates per 100,000 inhabitants and the case fatality ratio (CFR) (dependent variables) in all Italian regions were calculated in January 2021 at John Hopkins University Coronavirus Center. The independent variables were: Minimum average temperatures in the same month (January) of 2020; average pollution of PM10 in the air in each region in the last year available reported on a 0-10 scale to 0 = total absence of PM10 to 10 maximum pollutions; number of places in hotels occupied per inhabitants in 2020. Linear regression and Multiple Regression Analysis were carried out. RESULTS: The spread of the COVID-19 in the Italian regions seems to be related to pollution of PM10, the number of beds occupied in hotels (as an index of mobility and temperature (indirect correlation). On the contrary, the CFR correlates inversely with temperature but not with pollution. Measuring the concomitant effect of two independent variables by means of Multiple Regression Analysis, temperature and pollution show a synergistic effect on COVID-19 incidence. CONCLUSIONS: The study seems to confirm the literature on the influence of temperature on the lethality of COVID-19 but adds the new results of an inverse relationship between the spread of the virus and low temperature in regions between the Mediterranean area (which includes southern Italy and Sicily and Sardinia islands) and the cold European temperate zone which includes the northern regions under the Alps. A new date also concerns the summation effect of the risk between cold weather and PM10 air pollution was found. Due to several methodic weaknesses, the study has an exploratory than conclusive relevance.
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The three-dimensional ultrastructure of over 1000 mitochondria in human Leydig cells (from twelve sexually mature patients) was examined by high resolution scanning electron microscopy (HRSEM) of osmium-macerated specimens, as well as by transmission electron microscopy of conventional ultrathin sections. The stereo-pair imaging of the osmium-macerated specimens by HRSEM is also very useful for investigating the three-dimensional structure of cytoplasmic membranous organelles with great clarity. The mitochondria, which mainly are elongated (although some are ovate), possess cristae that are almost exclusively tubular and that occasionally display constrictions and terminal bulbules. Lamelliform cristae are quite rare. Occasionally, the tubular cristae are joined together to form a simple network. Classic crista junctions could not be identified with certainty, although the base of the tubular cristae might correspond functionally to such junctions. As a whole, in line with the identical and common embryological origin of adrenal cortex and gonads, mitochondria of human Leydig cell closely resemble those of steroidogenic cells of human suprarenal cortex treated by the same maceration method.
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Células Intersticiais do Testículo/ultraestrutura , Microscopia Eletrônica de Varredura/métodos , Mitocôndrias/ultraestrutura , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Humans can accurately discern thousands of odorants, although there is a considerable inter-individual variability. Individuals can be classified as normosmic, hyposmic or anosmic, depending on their olfactory sensitivity or blindness. In this research we studied the olfactory sensitivity to banana head-space as a complex odor mixture in a group of 53 subjects classified for their olfactory status, by means of the "Sniffin' Sticks" extended test. Using the coupled Gas Chromatography-Mass Spectrometry/ Olfactometry (GC-MS/O) technique, the single components of the banana flavor mixture were separated, identified and verbally evaluated by each subject. For each compound both the "odor type" (i.e., odor quality: fruity, floral, green, etc.) and "odor descriptor" (i.e., name used by subjects for odor identification) were reported, so that we could identify molecules that were defined as smelling of banana. The results show that: (a) the threshold olfactory performance is linearly correlated with the number of odor-active compounds (total or smelling of banana) for each subject; (b) the intensity reported by each subject during the sniffing of the pen containing the banana aroma in the identification test is positively correlated both with its hedonic valence and the number of odor-active compounds smelling of banana. In conclusion, our findings show that human perception of single compounds is conditioned by the threshold olfactory performance of the subject and that his/her ability to detect single molecular components, which smell as the mixture, affects the intensity and hedonism for the complex aroma.
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Transtornos do Olfato , Olfato , Feminino , Frutas , Humanos , Masculino , Odorantes , Restrição FísicaRESUMO
The low Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has demonstrated excellent results in terms of symptom control and health-related quality of life (HRQoL) in irritable bowel syndrome (IBS) sufferers, but patients have complained about unsatisfying taste, difficulty in following the diet, and time consumption. To investigate the feasibility of the low FODMAP diet in an Italian (Sardinian) cohort, sixty consecutive eligible outpatients (11 men and 49 women) with IBS were enrolled and followed a low FODMAP diet (gluten allowed, restriction phase of four weeks, reintroduction phase of four weeks). Food habits were assessed using 24-hour dietary recall, Bristol Stool Scale for stool consistency, Visual Analogue Scale for abdominal bloating, VAS (Visual Analogue Scale) for abdominal pain, IBS Severity Scoring System for perceived disease severity, and a 12-item Short Form Survey for HRQoL (psychological component summary + mental component summary) were applied at baseline (T0) and at the end of each phase (T1-four weeks and T2-eight weeks). Statistical analysis was performed by dividing the cohort into diarrhoea-dominant IBS (IBS-D) and other IBS subtypes (selected IBS-others). Comparisons between T1 and T2 vs. T0 and T2 vs. T1 were performed. The low FODMAP diet lowered VASp (VAS pain), VASb (VAS bloating), and IBS SSS (IBS Severity Scoring System), and increased PCS (Physical Component Summary) and MCS (Mental Component Summary) in both subgroups. Bristol Stool Scale (BSS) only improved in the IBS-D subgroup. The dropout mean values for MCS were higher than treated subjects and the percentage of unemployment was lower in the dropouts. According to the dropout features, the low FODMAP diet seems to show greater feasibility for patients with more time to dedicate to the diet (unemployed, homemakers, housewives, or students), more motivation, and more severe clinical features, independent of their place of residence.
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Dieta com Restrição de Carboidratos/métodos , Comportamento Alimentar/psicologia , Síndrome do Intestino Irritável/dietoterapia , Cooperação do Paciente/psicologia , Qualidade de Vida , Adulto , Inquéritos sobre Dietas , Dieta com Restrição de Carboidratos/psicologia , Dissacarídeos/análise , Estudos de Viabilidade , Feminino , Fermentação , Humanos , Síndrome do Intestino Irritável/psicologia , Itália , Masculino , Monossacarídeos/análise , Oligossacarídeos/análise , Polímeros/análise , Resultado do TratamentoRESUMO
Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract resulting from interactions among various factors with diet being one of the most significant. IBD-related dietary behaviors are not clearly related to taste dysfunctions. We analyzed body mass index (BMI) and perception of six taste qualities and assessed effects of specific taste genes in IBD patients and healthy subjects (HC). BMI in IBD patients was higher than in HC subjects. Taste sensitivity to taste qualities was reduced in IBD patients, except for sour taste, which was higher than in HC subjects. Genetic variations were related to some taste responses in HC subjects, but not in IBD patients. Frequencies of genotype AA and allele A in CD36 polymorphism (rs1761667) were significantly higher in IBD patients than in HC subjects. The taste changes observed could be explained by the oral pathologies and microbiome variations known for IBD patients and can justify their typical dietary behaviors. The lack of genetic effects on taste in IBD patients indicates that IBD might compromise taste so severely that gene effects cannot be observed. However, the high frequency of the non-tasting form of CD36 substantiates the fact that IBD-associated fat taste impairment may represent a risk factor for IBD.
Assuntos
Antígenos CD36/genética , Anidrases Carbônicas/genética , Doenças Inflamatórias Intestinais/genética , Polimorfismo Genético , Percepção Gustatória/genética , Paladar/genética , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Frequência do Gene , Genótipo , Humanos , Doenças Inflamatórias Intestinais/complicações , Masculino , Fenótipo , Distúrbios do Paladar/genéticaRESUMO
Several studies have reported some efficacy of diets low in fermentable carbohydrates (Fermentable Oligo-, Di-, Monosaccharides and Polyols (FODMAPs)) in Irritable Bowel Syndrome (IBS). There is no evidence of its superiority compared to gluten-free and balanced diets in improving IBS patients' quality of life (QoL). The aim of this study is to assess whether different diets can improve QoL in IBS. Forty-two patients with IBS, according to Rome IV criteria, were enrolled. Low-FODMAP, gluten-free and balanced diets were proposed to each patient in the same succession. Each diet was followed for 4 weeks. The Bristol Stool Scale, the Visual Analogue Scale (VAS) for bloating and abdominal pain, and the SF12 questionnaire for health-related quality of life were applied at the beginning and at the end of each diet. Twenty-eight of the forty-two patients completed all the three diets. All the three diets reduced symptom severity (p < 0.01), bloating (p < 0.01) and abdominal pain (p < 0.01), and improved quality of life (p < 0.05); 3% of patients expressed a preference for the low-FODMAP diet, 11% for the gluten-free and 86% for the balanced diet (p < 0.01). The balanced diet improves QoL and VAS pain, provides an adequate quantity of FODMAPs and is more appreciated by patients. For these reasons, the balanced diet could be recommended to patients with irritable bowel syndrome.
Assuntos
Dieta Livre de Glúten , Dieta Mediterrânea , Síndrome do Intestino Irritável/dietoterapia , Monossacarídeos/administração & dosagem , Dor Abdominal , Adulto , Fezes , Feminino , Humanos , Masculino , Qualidade de Vida , Adulto JovemRESUMO
Olfactory function varies by several orders of magnitude among healthy individuals, who may exhibit a reduced sensitivity (hyposmia), a high sensitivity (hyperosmia), or an olfactory blindness (anosmia). Environmental and genetic factors seem to account for this variability. Most of odorant molecules are hydrophobic and it has been suggested that odorants are transported to the olfactory receptors by means of odorant binding proteins (OBPs). Aim of this study was to evaluate the presence of a relationship between the olfactory performance of healthy subjects and the polymorphism in the odor binding-protein (OBPIIa) gene, the only OBP found in the olfactory epithelium of humans. Using the "Sniffin' Sticks" Extended Test we assessed the olfactory performance in 69 subjects, who were genotyped for the rs2590498 polymorphism of the OBPIIa gene, whose major allele A has been associated with a higher retronasal perception as compared to the minor allele G. We found that subjects homozygous for the A-allele exhibited threshold scores higher than subjects homozous for the G-allele or heterozygous. In addition, subjects classified as normosmic and hyposmic differed on the basis of genotype distribution and allelic frequencies. In fact, a normosmic condition was associated with genotype AA and allele A and a hyposmic condition was associated with genotype GG and allele G. In conclusion, our results show that a relationship exists between the physiological variations of olfactory performance and the OBPIIa gene polymorphism.
Assuntos
Lipocalinas/genética , Olfato/genética , Adulto , Alelos , Feminino , Frequência do Gene/genética , Voluntários Saudáveis , Humanos , Lipocalinas/metabolismo , Masculino , Pessoa de Meia-Idade , Odorantes , Transtornos do Olfato/genética , Transtornos do Olfato/fisiopatologia , Neurônios Receptores Olfatórios/fisiologia , Polimorfismo de Nucleotídeo Único/genética , Receptores Odorantes/genética , Limiar Sensorial/fisiologiaRESUMO
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a frequently reported condition in patients with inflammatory bowel disease (IBD). Both intestinal inflammation and metabolic factors are believed to contribute to the pathogenesis of IBD-associated NAFLD. AIM: To evaluate the prevalence of steatosis and liver fibrosis (LF) in a cohort of IBD patients and the identification of metabolic- and IBD-related risk factors for NAFLD and LF. METHODS: IBD patients were consecutively enrolled from December 2016 to January 2018. Demographic, anthropometric and biochemical data were collected so as eating habits. Abdominal ultrasound and transient elastography were performed to evaluate the presence of NAFLD and LF respectively. RESULTS: A total of 178 consecutive patients were enrolled and included in the analysis (95 Ulcerative colitis, 83 Crohn's disease). NAFLD was detected by imaging in 72 (40.4%) patients. Comparison between patients with and without NAFLD showed no significant differences in terms of IBD severity, disease duration, location/extension, use of IBD-related medications (i.e., steroids, anti-TNFs, and immunomodulators) and surgery. NAFLD was significantly associated with the presence of metabolic syndrome [MetS; odds ratio (OR): 4.13, P = 0.001] and obesity defined by body mass index (OR: 9.21, P = 0.0002). IBD patients with NAFLD showed higher caloric intake and lipid consumption than those without NAFLD, regardless disease activity. At the multivariate analysis, male sex, advanced age and high lipid consumption were independent risk factors for the development of NAFLD. An increased liver stiffness was detected in 21 patients (16%) and the presence of MetS was the only relevant factor associated to LF (OR: 3.40, P = 0.01). CONCLUSION: In this study, we demonstrate that risk factors for NAFLD and LF in the IBD population do not differ from those in the general population.