Evaluation of insulin resistance and beta cell activity in patients with inflammatory bowel disease.

OBJECTIVE: Insulin resistance is an important risk factor for developing metabolic syndromes that cause morbidity diseases such as diabetes and cardiovascular diseases. Interestingly, in chronic inflammatory diseases, some inflammatory mediators can play, either directly or indirectly, a pivot role in the development of insulin resistance. This can be considered as an additional factor causing increased mortality and morbidity in these patients. In this paper, we want to investigate and compare the insulin resistance status in patients with Inflammatory Bowel Disease (IBD) and healthy control, as well as different stages of patients with Ulcerative colitis (UC) and Crohn's Disease (CD). PATIENTS AND METHODS: A total of 180 patients were enrolled in this study; while 95 patients had inflammatory bowel disease [Crohn's Disease (n): 47, Ulcerative colitis (n): 48], 85 people were healthy controls. Insulin resistance status was evaluated with the HOMA-IR (hemostasis model of assessment of insulin resistance) index. p < 0.05 was accepted as significant. RESULTS: The mean HOMA-IR levels were found to be similar for both IBD and control, and Crohn's disease and control (p = 0.174, p = 0.96, respectively); but the mean HOMA-IR score in ulcerative colitis, one of the IBD subgroups, was significantly higher than the control group (p < 0.039). CONCLUSIONS: This study clearly showed that insulin resistance is increased in ulcerative colitis. Consequently, patients with ulcerative colitis should be followed and closely monitored for developing insulin resistance, metabolic syndromes, diabetes, and cardiovascular diseases. Consequently, all of them can cause an additional risk of morbidity and mortality in these patients.

The true prevalence of cervical inlet patch in a specific center dealing with esophageal diseases.

OBJECTIVE: Cervical Inlet Patch (CIP) is an interesting entity that is little known and often neglected by endoscopists. It has always been reported as less than expected. In this article, for the first time in the literature, we want to measure the true prevalence of CIP in a center dealing with specific esophageal diseases. PATIENTS AND METHODS: From October 2020 to October 2021, a total of 283 patients, aged 15-95 years, with mainly dyspeptic and reflux-like complaints were included in this study. All endoscopic procedures were performed carefully by a single endoscopist. Patients were examined for any possible presence of CIP, with adequate sedation and time. RESULTS: The prevalence of CIP, which was the primary aim of our study, was detected at a rate of 14.8%. Most CIP was observed as a single lesion (73.8%), and many of them (45.2%) were larger than 10 mm. Plenty of patients had upper endoscopy due to dyspeptic complaints, but only 2.5% of them presented with a preliminary diagnosis of laryngeal reflux. CONCLUSIONS: The true CIP prevalence is higher than reported before. Our result is the highest prevalence rate of CIP was detected in Turkey. In this regard, data coming from centers dealing with specific esophageal diseases may be more reliable and true.

Primary epiploic appendagitis: evaluation of computed tomography findings in the differential diagnosis of patients that presented with acute abdominal pain.

OBJECTIVE: Primary epiploic appendagitis (PEA) is a rare cause of abdominal pain revealed by torsion of colonic structures called epiploic appendices. In this paper, we present our clinical data and experience regarding this rare condition that may be confused with many diseases, such as acute appendicitis, diverticulitis, salphingitis, renal colic that may require emergency surgery. MATERIALS AND METHODS: A total of 39 consecutive patients diagnosed as PEA confirmed by abdominal computed tomography with a clinical course. Basic demographic data, abdominal pain characteristics, physical examination findings, laboratory results, treatment methods, and clinical course of the patients were retrospectively evaluated. Statistical analysis was performed using SPSS (18.0; Chicago, IL, USA), using the χ2-test and Fisher's exact test. RESULTS: Of the 39 patients diagnosed with PEA, 35 were male and 4 were female; the mean age of the patients was 36.0 ± 10.3. The main complaints were 69.2% abdominal pain, 12.8% groin pain, 5.1% flank pain with nausea and vomiting (2.6%), and abdominal swelling and dysuria. The average time of symptom was 5.3 days (1-15 days). In the computed tomography scan images, PEA was located in the sigmoid colon (21, 53.8%), descending colon (10, 25.6%), ascending colon (5, 12.8%), cecum (2, 5.1%), and hepatic flexure (1, 2.6%). No patient underwent surgical treatment. However, 9 of 39 patients were hospitalized for medical treatments, such as antibiotics and analgesic drugs intravenously. All patients were followed-up for a period of 1-year and there were no recurrence symptoms. CONCLUSIONS: When patients with localized lower abdominal pain and tenderness do not have associated symptoms or laboratory abnormalities, a high index of suspicion for PEA and early radiologic examinations are required.