Correlation of ex vivo cytokine secretion profiles with scoring indices in ulcerative colitis.

BACKGROUND: In ulcerative colitis, the complexity of mucosal cytokine secretion profiles and how they correlate with endoscopic and clinical scores is still unclear. METHODS: In this study, we collected fresh biopsies from UC patients to investigate which cytokines are produced in ex vivo culture conditions, a platform increasingly used for testing of novel drugs. Then, we correlated cytokine production with several scoring indices commonly used to assess the severity of the disease. RESULTS: Increased levels of IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, TNFα and IFNÉ£ were produced by biopsies of UC patients compared to non-IBD controls. Our results show a better correlation of cytokine levels with Mayo Endoscopic Subscore (MES) and Mayo score, than the more complex Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Out of 10 measured cytokines, eight correlated with MES, six with Mayo score and only three with UCEIS, due to the partial increase in cytokine secretion observed in donors with UCEIS = 7-8. When we analysed individual subscores within the UCEIS, Vascular Network subscore showed a correlation similar to MES (7/10 cytokines), while Bleeding as well as Erosions and Ulcers subscores correlated with only 3/10 cytokines, similarly to the total UCEIS. CONCLUSIONS: Our findings suggest that choosing biopsies from donors with MES = 2-3 and UCEIS = 2-6 from areas with no bleeding and no superficial and/or deep ulcers could enable a deeper insight into the cytokine profile of the inflamed tissue and represent a better tool for studying potential therapeutic targets and evaluation of novel therapies.

[Obesity--a global public health problem]. / Pretilost--globalni javnozdravstveni problem.

Obesity and overweight, as a part of the metabolic syndrome, are well known risk factors for the development of diabetes, hypertension, coronary heart disease, hyperlipidemia, stroke, sleep apnea syndrome, osteoarthritis and certain forms of cancer. Cardiovascular disease remains the leading killer in industrialized countries, where it accounts for 40% of deaths. Obesity is defined either by increased waist circumference, waist to hip ratio, or body mass index. Obesity results from an interaction of genes and lifestyle. As people in both developed and developing countries eat more and more energy dense food, and have ever less physical activity, the number of overweight and obese people increases to epidemic proportions. Abdominal obesity plays a key role in the pathophysiology of metabolic disorders, is associated with insulin resistance, and predicts the development of type 2 diabetes and subsequent coronary artery disease. In the general population, obesity is associated with an increased mortality, but paradoxically, a positive correlation between body mass index and survival in congestive heart failure has been reported. In secondary prevention, obesity is underrecognized, underdiagnosed and undertreated in persons with cardiovascular diseases. Weight loss and prevention of weight gain have to be considered one of the most important strategies to reduce the incidence of cardiovascular disease. Increased physical activity and appropriate diet are the cornestones of treatment. Considering the high prevalence of overweight and obesity in Croatia, there is urgent necessity to improve the level of knowledge and skills in understanding obesity by health care services, and to implement appropriate professional strategy to achieve the desired lifestyle modifications.

[Specific characteristics of hypertension in postmenopausal women]. / Posebnosti arterijske hipertenzije zena u postmenopauzi.

Sex-specific differences in the incidence of cardiovascular diseases have long been known, and estrogens have been considered responsible for this dissimilarity. After the menopause, the consequences of hypertension in women change. Their risks of myocardial infarction and stroke rise, which has in part been ascribed to the loss of estrogen and onset of menopausal metabolic syndrome. Sex differences in the components of the renin-angiotensin system have been shown to exist, and may play a central role in the blood pressure control. Hypertensive menopausal women do not receive optimal treatment. They have poorer prognosis than men of the same age. Therefore, their antihypertensive management calls for special attention.

[Doxycycline induced esophageal ulcers: report of two cases and review of the literature]. / Vrijedovi jednjaka prouzroceni doksiciklinom: prikaz dvaju bolesnika i pregled literature.

Doxycycline-induced esophageal ulcers (DIEU) are rarely observed in endoscopy units. On the other hand doxycycline itself has been claimed as an offending drug in 1/4 out of about 1000 cases of drug induced esophageal ulcers reported in the literature so far. In this article we present two patients with typical history and endoscopic features of esophageal ulcers as an consequence of doxycycline therapy. The therapy consisted of doxycycline withdrawal along with treatment with proton pump inhibitors and sucralfate which had led to disappearance of chest discomfort within one week period. Fourteen days of the tratment beginning complete recovery of the mucosal defects has occurred in both patients. In conclusion, in case of chest pain and painful swallowing occurring in a person who takes doxycycline, DIEU has to be considered followed by the esophagoscopy which would confirm clinical suspicious with high specificity leading to correct diagnosis and treatment of this condition.