Irritable bowel syndrome is a disorder diagnosed on symptom-based criteria without inclusion of any objective parameter measurable by known diagnostic methods. Heterogeneity of the disorder and overlapping with more serious organic diseases increase uncertainty for the physician's work and increase the cost of confirming the diagnosis. This paper is an attempt to summarize the efforts to find adequate biomarkers for irritable bowel syndrome, which should shorten the time to diagnosis and reduce the cost. Most of the reviewed papers were observational studies from secondary care institutions. Since publication of the Rome III criteria in 2006, most recent studies use these for the recruitment of IBS patients. This is a positive step forward as future studies should use the same criteria, facilitating comparison of their results. Among the studied biomarkers, most evidence is provided for fecal calprotectin. Cutoff values for fecal calprotectin have still to be investigated prior to inclusion in the irritable bowel syndrome diagnostic algorithm.
-Opioids are considered the cornerstone of pain management in palliative care. Available data suggest that older patients use different analgesics and lower opioid doses compared to younger patients. however, it has not been elucidated yet whether such dosing is associated with worse pain levels or shorter survival in the palliative care setting. we evaluated the relationship among pain scores, quality of life, opioid dose, and survival in palliative care cancer patients in a hospice setting. A total of 137 palliative care cancer patients were analyzed prospectively. we divided patients into two groups using the age of 65 as a cutoff value. younger patients exhibited significantly higher pain ratings (5.14 vs. 3.59, p=0.01), although older patients used almost 20 mg less oral morphine equivalent (OMe) on arrival (p=0.36) and 55 mg OMe/day less during the last week (p=0.03). There were no differences in survival between the two groups (17.36 vs. 17.58 days). The elderly patients also used nonsteroidal analgesics less often and paracetamol more often. hence, using lower opioid doses in older palliative care cancer patients does not result in worse pain rating, and could be a plausible approach for pain management in this patient group.
Acute pancreatitis (AP) is common gastrointestinal disease of varied aetiology. The most common cause of AP is gallstones, followed by alcohol abuse as an independent risk factor. With the increased need for invasive techniques to treat pancreatic and bile duct pathologies such as endoscopic retrograde cholangiopancreatography (ERCP), AP has emerged as the most frequent complication. While severe AP following ERCP is rare (0.5%), if it does develop it has a greater severity index compared to non-ERCP AP. Development of a mild form of AP after ERCP is not considered a clinically relevant condition. Differences in the clinical presentation and prognosis of the mild and severe forms have been found between non-ERCP AP and post-endoscopic pancreatitis (PEP). It has been proposed that AP and PEP may also have different immunological responses to the initial injury. In this review, we summarise the literature on clinical and inflammatory processes in PEP vs non-ERCP AP.
This article provides an overview of the obstetric and gynecological manifestations of Crohn’s disease (CD). High incidence of the new onset of the disease in young women in their reproductive years demands special concern from physicians involved in their treatment. Pregnant women with CD are considered high-risk patients, regardless of disease activity index, due to associated complications. Predominately described complications are premature birth, low birth weight, and congenital anomalies. To minimize the risk for adverse pregnancy/birth outcomes, it is recommended that remission be achieved before conception. Treatment of CD in pregnant women is similar to that among the nonpregnant population, and there is no valid reason to terminate it, since most of the drugs are proven to be safe. Women with CD who wish to conceive or are already pregnant need to be properly advised according to the newest guidelines on the subject, given by the European Crohn’s and Colitis Organization. Gynecological manifestations are another special feature of CD. They are important in that they may facilitate early recognition of the underlying disease, which usually stays unrecognized for years before intestinal manifestation; in this way, the underlying manifestations are often mistreated.
This paper presents the most important morphological and
production-technological characteristics of newly created grapevine
varieties Vozd and Vladun, intended for the production of red wines. The
newly created varieties were compared with the standard variety Cabernet
Sauvignon during the three-year period of testing (2015-2017) in the
relation studied properties. The variety Vozd obtained from the crossing
combination Zacinak x Prokupac, and the variety Vladun from the crossing
combination Merlot x Zupski Bojadiser. The investigated varieties differed
considerably in terms of some morphological traits and represents unique
genotypes. The newly recognized varieties have a hermaphrodite type of
flower, dense bunch, globose berry shape and blue black color of berry skin.
The yield, bunch weight, bunch length and bunch width were higher at both
varieties than for the standard variety. The Vozd variety had a yield of
1.29 kg/m2 and a bunch weight of 174.3 g, and the Vladun variety had a yield
of 0.87 kg/m2 and a bunch weight of 153.7 g. For the standard variety the
grape yield was 0.78 kg/m2 and the bunch weight was 134.0 g. The content of
sugar and total acids in the must of the Vozd variety was 20.5% and 6.5 g/l,
while for the Vladun variety it was 21.8% and 6.0 g/l respectively. Wine of
both varieties was drinkable, harmonious, with a specific varietal of smell
and taste and contained 12.1 vol. % of alcohol (Vozd variety), or 12.6 vol.
% of alcohol (Vladun variety). Due to the many positive features of the
grapes and wines from the Vozd and Vladun varieties, their spread to the
production vineyards of Serbia is expected.
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