E-cadherin (CDH1) gene expression is strictly regulated. The transcriptional factors SNAIL and ZEB1 are involved in its repression, whereas activation of vitamin D receptor (VDR) by vitamin D induces its transcription. We study the expression and functional correlation of SNAIL, CDH1, VDR and ZEB1 genes and examine their possible involvement in colon cancer. The expression of these four genes was measured by real time-PCR in 114 patients with colorectal cancer, and tumor characteristics were analyzed in each patient. SNAIL expression was associated with downregulation of CDH1 (P < 0.001) and VDR (P < 0.001) gene products. We also found a positive correlation between CDH1 and VDR expressions. However, the association between SNAIL and CDH1 was not found in patients with high expression of ZEB1. We observed a correlation between downregulation of: a) ZEB1 and presence of polyps in surgical resections; b) VDR and poor differentiation and c) CDH1 and poor differentiation, vascular invasion, presence of lymph node metastases and advanced stages; as well as a trend toward a correlation between SNAIL expression in tumors and vascular invasion. The correlations between SNAIL, CDH1, VDR and ZEB1 and the association between reduced expression of CDH1 and VDR and aggressive tumor characteristics emphasize the value of analyzing these genes in colon cancer patients for prognostic purposes and for predicting response to possible therapies with vitamin D or its analogs.

Inadequate bowel cleansing negatively affects the efficiency of colonoscopy in routine clinical practice. The aim of this study was to design and validate a predictive model for inadequate bowel cleanliness. The model was built from 667 consecutive outpatients (development cohort) who were prospectively scheduled for colonoscopy between June and September 2014. The validation cohort included 409 outpatients who underwent colonoscopy between October and December 2014. Cleansing was evaluated using the Boston Bowel Preparation Scale (BBPS). Bowel preparation was administered on the same day as the examination. In the development cohort, BBPS was adequate in 541 patients (81.1 %). At multivariate analysis, antidepressants (odds ratio [OR] 4.25, 95 % confidence interval [CI] 1.91 - 9.47), co-morbidity (OR 3.35, 95 %CI 2.16 - 5.18), constipation (OR 2.09, 95 %CI 1.29 - 3.40), and abdominal/pelvic surgery (OR 1.60, 95 %CI 1.03 - 2.47) were independent predictors for inadequate cleansing. The model built with these variables showed an area under the curve of 0.72 in the development cohort and 0.70 in the validation cohort. A cutoff of 1.225 predicted inadequate bowel preparation with a sensitivity, specificity, positive predictive value, and negative predictive value of 60.3 % (95 %CI 51.6 - 68.4), 75.4 % (95 %CI 71.6 - 78.9), 36.4 % (95 %CI 30.1 - 43.1), and 89.1 % (95 %CI 85.9 - 91.6) in the development cohort, and 50.0 % (95 %CI 38.1 - 61.9), 80.0 % (95 %CI 75.3 - 84.2), 35.7 % (95 %CI 26.4 - 45.6), and 87.9 % (95 %CI 83.7 - 91.3) in the validation cohort. A simple score may assist the clinician in predicting which patients are at high risk of inadequate bowel cleanliness. This may guide changes in bowel preparation strategy accordingly.

Background The aim of this study was to assess whether a 3-day low-residue diet (LRD) improved bowel cleansing quality compared with a 1-day LRD regimen. Methods Consecutive patients scheduled for outpatient colonoscopy were randomized to the 1-day LRD or 3-day LRD groups. All patients received a 2-L split-dose of polyethylene glycol plus ascorbic acid. The primary outcome was bowel cleansing quality as evaluated using the Boston Bowel Preparation Scale (BBPS) (adequate cleansing ≥ 2 points per segment). Secondary outcomes were adherence to and level of satisfaction with the LRD, difficulty following the dietary recommendations, and willingness to repeat the same LRD in the future. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the primary outcome. A superiority analysis was performed to demonstrate that a 3-day LRD regimen was superior to a 1-day LRD regimen with a margin of 10 %. Results 390 patients (1-day LRD group = 196, 3-day LRD = 194) were included. The cleansing quality was not significantly different between the groups: ITT analysis 82.7 % (95 % confidence interval [CI] 77.4 to 88.0) vs. 85.6 % (95 %CI 80.7 to 90.5), with odds ratio (OR) 1.2 (95 %CI 0.72 to 2.15); PP analysis 85.0 % (95 %CI 79.9 to 90.1) vs. 88.6 % (95 %CI 84.0 to 93.2), with OR 1.4 (95 %CI 0.88 to 2.52). No differences were found regarding adherence to the diet or cleansing solution, satisfaction or difficulty with the LRD, and the polyp/adenoma detection rates. Conclusion 3-day LRD did not offer advantages over 1-day LRD in preparation for colonoscopy.

Selenium has been recognized as essential for all mammals; therefore, its concentration level and speciation are of great concern. Plants are one of the main sources of selenium in the diet. Thus, inorganic selenium uptake and its transformation in different species were evaluated in Indian mustard (Brassica juncea), sunflower (Helianthus annus), and white lupine (Lupinus albus). More than 1.2 g x kg(-)(1) (dry matter) of Se was found in the aerial part of Indian mustard when growing on 1 mg x L(-)(1) of Se as Na(2)SeO(4), and approximately half this amount was determined in the leaves of the lupine, which is still quite high. Selenomethionine was the main selenium-containing amino acid identified in most of the extracts by HPLC-ICP-MS. The higher values were 6.8 and 14.5 mg x kg(-)(1) (expressed as Se in dry matter) in the leaves of lupine and sunflower, respectively. This is of great importance because some authors have considered the combination of this enriched material with non-enriched food as a source of selenium supplementation.

After 3-day low-residue diet and oral bisacodyl before colonoscopy, colon cleansing with 4-L split-dose PEG was superior to 2-L split-dose PEG+Asc in patients with previous inadequate cleansing. (EUDRACT: 2013-002506-31, NCT02073552).

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Our objective was to analyze the prevalence of peripheral arterial disease (PAD) in HIV patients at risk and to compare them with the general population. All HIV patients older than 50 years who attended our unit from October 2005-July 2006 and all persons attending for an annual medical checkup at an employees' insurance association during the same period were invited to participate in the study. Of the latter (n = 407), a person of the same sex and age (+/-5 years) was included for each HIV patient. PAD was assessed by the ankle-brachial index (ABI) in all subjects, and all completed the Edinburgh questionnaire. Ninety-nine HIV patients and 99 persons from the general population of the same age and sex were included in the study. The HIV patients had a greater prevalence of dyslipidemia, diabetes, and PAD, which was symptomatic in five of them and in one subject from the general population. Patients with HIV infection older than 50 had a high prevalence of PAD, and as it was asymptomatic in half the cases, an ABI may be performed in this population to actively look for PAD. Control of cardiovascular risk factors and the use of such drugs as platelet antiaggregation agents should therefore be optimized in this population.

(sVCAM, sICAM, CRP), and manual methods were used on the other assayed selectins. A few measurements do not fit any discernable pattern, notably plasma sVCAM-1 on day 3 at 4 and 21°C; plasma sE-selectin on day 1 at 4°C and day 3 at all temperatures, whole blood sE-selectin at 4°C on day 1 and after freeze-thaw cycle 4; and plasma CRP on day 1 at 4°C and after freeze-thaw cycle 3. These aberrant values were likely analytic artifacts, because removal of values Ͼ4 SDs from the mean or adjustment for run-to-run variability did not change the results qualitatively. The large CRP difference observed after freeze-thaw cycle 3 but not after cycles 4 or 5 suggests assay error or possibly CRP release from LDL and complement factors. It has been demonstrated that a portion of systemic CRP is bound to cholesterol in modified LDL particles (17 ) and to different complement factors (18 ). Interaction of CRP with cholesterol and complement factors might hamper the detection of CRP in the assay used. No data were available for sE-selectin, but it is possible that some sE-selectin is bound to different circulating leukocyte types or microvesicles derived from endothelial cells. Freeze-thaw cycles might release these bound forms of sE-selectin, leading to an increase in detectable sE-selectin.Possible effects of residual platelets in the plasma on marker values obtained are not addressed in our study. sVCAM-1, sICAM-1, and sE-selectin, however, are derived mainly from endothelial cells and not from platelets. Although the presence of platelets in EDTA plasma might contribute to the absolute amounts of these markers, it does not influence their stability. In contrast, sP-selectin is mainly derived from platelets, a characteristic that may explain the variance observed in sP-selectin at different time and temperature points.Our results show that sP-selectin is unstable under all storage conditions and requires immediate assay. The other cardiovascular risk markers evaluated were stable when stored in whole blood samples for several days at room temperature. sVCAM-1, sICAM-1, and CRP were stable at 4 and 21°C in plasma or whole blood for 5 days and sE-selectin for 2 days. These findings have important implications for clinical studies measuring these markers, reducing the need for immediate transfer of samples to a laboratory for processing and analysis.