Frequency and Related Risk Factors of Refeeding Hypophosphatemia in Patients with Liver Cirrhosis: A Pilot Study.

BACKGROUND AND AIM: Refeeding hypophosphatemia (RH) is associated with poor clinical outcomes and mortality. The presence of RH in patients with liver cirrhosis remains unclear. This study aims to determine the frequency of RH related to nutritional status and disease severity in liver cirrhosis. METHODS: This study was prospectively conducted in a-single center gastroenterology clinic. Malnutrition was identified by Subjective Global Assessment (SGA). The disease severity was defined using Child score and MELD score. Serum phosphate levels <2.0 mg/dl are defined as hypophosphatemia. RESULTS: Twelve of 50 cirrhotic patients (24%) had RH during hospitalization. The most common RH was determined in 4 patients on day 4 during study follow up. The sharpest decline of serum phosphate levels was on day 4 (median: 2.3mg/dL). The Child score and MELD score were not significantly different between RH and Non-RH groups (p>0.05). The rate of malnutrition according to SGA was 56.0%. A total of 82%, 4%, 8%, and 4% of participants received regular diet and oral nutritional supplements, only enteral tube feeding, only parenteral nutrition, and combined enteral and parenteral nutrition, respectively. In the RH group, 32% of participants received only parenteral nutrition and had a higher presence of RH than patients receiving only oral or enteral tube feding (p<0.05). CONCLUSIONS: RH developed in » of the study participants. This study also showed that artificial feeding carries a significant risk in terms of RH. Malnourished patients with liver cirrhosis receiving parenteral nutrition, closely monitored regarding high risk of RH.

Novel Anthocyanin-Based Colorimetric Assay for the Rapid, Sensitive, and Quantitative Detection of Helicobacter pylori.

Several different diagnostic tests have been reported for rapid, sensitive, and economical detection of bacterial pathogens, but most lack widespread and practical use in the clinic. In this study, we used anthocyanins from red cabbage (Brassica oleracea) as a natural pH indicator and, for the first time, incorporated this agent into a simple, rapid, and economical colorimetric strategy for the detection of Helicobacter pylori (H. pylori) (RCE@test). We prepared two sets of RCE@test solutions (test 1 is purple, and test 2 is blue) in different forms, including liquid, adsorbed filter paper, and agar, and investigated the performance of each RCE@test as a function of the test volume, H. pylori concentration, and reaction time. To elucidate the effect of the pathophysiological environment on these RCE@tests, H. pylori in an artificial gastric fluid was also detected. The 10 and 1 CFU/mL H. pylori suspensions were detected in 15 min and 3 h, respectively, and the limit of detection was determined down to 1 CFU/mL. We experimentally demonstrated the advantages of the RCE@test for detection of H. pylori by comparing it to a commercially available rapid urease test, the "CLO test (Campylobacter-like organism test)". In addition to colorimetric detection by the naked eyes, RGB (Red Green Blue) and Delta-E analysis in image-processing software was run to quantitatively monitor changes of color in the RCE@test using a smartphone application. Finally, we propose that this test provides simple, effective, rapid, and inexpensive detection and that it can be easily implemented for clinical use.

Best prognostic factor of neuroendocrine tumors: Grade or Stage? A multidisciplinary single-center study.

BACKGROUND/AIMS: Currently, there is no definite consensus about the prognostic factors of neuroendocrine tumors (NETs). We evaluate epidemiology, survival and especially prognostic factors in NETs. MATERIALS AND METHODS: Patients who had a NET and were diagnosed between 2000 and 2014 at a tertiary care center were included. Demographic data, tumor characteristics and survival rates were evaluated, retrospectively. RESULTS: Two-hundred and thirty-three patients (123 male, 110 female; median age, 55 years [16-92 years]) took part in the study. Primary NET sites were the lung (n=56), stomach (n=50), pancreas (n=39), colorectal (n=21), small intestine (n=19), and appendix (n=19). According to the NET classification by the WHO in 2010, 60% (n=140) of patients were grade-1, 15% (n=35) were grade-2, and 25% (n=58) were grade-3. According to TNM staging, 88 patients (37.8%) were stage I, 30 patients (12.8%) were stage II, 22 patients (9.5%) were stage III, and 93 patients (39.9%) were stage IV. Univariate analysis revealed significant associations between gender, age, grade, lymph node metastasis, distant metastasis, stage, and the number of organs impacted by metastases and overall survival. However, with multivariate analysis only age greater than 55 years, advancing grade, and inoperable tumors were significantly associated with shortened survival. Five-year survival was 81% in grade-1, 34% in grade-2, and 9% in grade-3 NETs. CONCLUSION: This study is the most comprehensive study in Turkey that has evaluated NETs using a multidisciplinary approach. Also, we suggest that age, operability and especially grade rather than stage are the most important prognostic factors in NETs.

AMINO ACID LEVELS IN CHILDREN WITH CELIAC DISEASE.

BACKGROUND & AIM: plasma amino acid levels may show differences in regard to physiological changes, diet and diseases. The aim of the study is to measure the amino acid levels in children with celiac disease and compare them with the controls. MATERIAL AND METHODS: sixty-two children with classic celiac disease and 62 age and sex matched healthy control were enrolled in this study. Plasma amino acid levels of the children were measured by using tandem mass spectrometry. RESULTS: celiac children had significant lower plasma levels of citrülline, glutamine and cystine than control (p.

Antecedentes y objetivo: los niveles de aminoácidos en plasma pueden mostrar diferencias en lo que se refiere a los cambios fisiológicos, la dieta y las enfermedades. El objetivo del estudio es medir los niveles de aminoácidos en los niños con enfermedad celíaca y compararlos con los controles. Material y métodos: en este estudio se inscribieron 62 niños con enfermedad celíaca clásica emparejados por edad y sexo con 62 controles sanos. Los niveles de aminoácidos en plasma de los niños se midieron utilizando la espectrometría de masas. Resultados: los niños celíacos tenían niveles significativamente inferiores plasmáticos de citrulina, glutamina y cistina que el grupo control (p < 0,05). Alanina, asparagina, ácido glutámico, hidroxiprolina, isoleucina, leucina, fenilalanina, prolina, serina, treonina y valina fueron significativamente mayores en los niños celíacos que en los controles (p < 0,05). Por otro lado, no hubo ninguna diferencia significativa en los niveles de arginina, argininosuccinato, ácido aspártico, glicina, homocisteína, lisina, hidroxilisina, metionina, ornitina, triptófano, tirosina, histidina entre los niños celíacos y los controles sanos (p > 0,05). Conclusiones: este estudio mostró que los niveles de aminoácidos en plasma pueden ser variables en la enfermedad celíaca. Se necesitan estudios con un tamaño mayor para conocer si los ensayos de aminoácidos en plasma ayudan a reflejar la lesión de la mucosa intestinal y para el seguimiento de la compatibilidad de la dieta libre de gluten en los pacientes celíacos.