MSB as a supplemental therapy can reduce the frequency of selected clinical symptoms in patients with IBS, without significant influence on reducing symptom severity.

BackgroundChronic anal fissure (CAF) is a linear split of the anoderm. The minimally invasive management of CAF such as botulinum toxin (BT) injection is recommended. However, the exact efficient dose of BT, number of injections per session and the injection sites are still debatable. The aim of this analysis was to assess the dose-dependent efficiency of botulinum toxin injection for CAF. MethodsPubMed and Web of Science databases were searched for terms: “anal fissure” AND “botulinum toxin.” Studies published between October 1993 and May 2015 were included and had to meet the following criteria: (1) chronic anal fissure, (2) prospective character of the study, (3) used simple BT injection without any other interventions and (4) no previous treatment with BT.ResultsA total of 1577 patients from 34 prospective studies used either Botox or Dysport formulations were qualified for this meta-analysis. A total number of BT units per session ranged from 5 to 150 IU, whereas the efficiency across analyzed studies ranged from 33 to 96 %. Surprisingly, we did not observe a dose-dependent efficiency (Spearman’s rank correlation coefficient, ρ = 0.060; p = 0.0708). Moreover, there were no BT dose-dependent postoperative complications or fecal incontinence and significant difference in healing rates compared BT injection into the anal sphincter muscles.ConclusionsBT injection has been an accepted method for the management of CAF. Surprisingly, there is no dose-dependent efficiency, and the postoperative incontinence rate is not related to the BT dosage regardless the type of formulation of botulinum neurotoxin used. Moreover, no difference in healing rate has been observed in regard to the site and number of injections per session.

The high antigenicity of skin components of composite tissue allografts is the most challenging factor in achieving long-term viability after composite tissue allografts transplantation. The vascularization pattern of vascularized skin allografts (VSA) and nonvascularized skin allografts (NVSA) differs significantly and these differences may alter host immune responses. We hypothesized that vascularized grafts contribute to better engraftment and long-term survival. We have tested our hypothesis by transplantation of different sizes (2 x 2 cm, 4 x 4 cm, 6 x 6 cm) of VSA and NVSA across major histocompatibility complex barrier between LBN (RT1(1+n)) and Lewis (RT1(1)) rats. Correlation of revascularization process with development of donor-specific chimerism was tested. We found that the highest chimerism levels (8%-12.2% in VSA groups; 2.53%-3.92% in NVSA groups) were reached as early as 7 days in both VSA and NVSA. Chimerism decreased in both groups during 100-day follow-up and higher chimerism was found only in VSA in late posttransplant period. Revascularization, assessed by the presence of CD31 positive vessels, was significantly higher in VSA compared with NVSA and to controls (P < 0.05). A direct correlation was seen between increased skin diameter and donor chimerism in VSA, whereas inverse correlation was tested in NVSA. We have confirmed that allograft size and vascularization pattern contribute to donor chimerism development and maintenance.

BackgroundMicroencapsulated sodium butyrate (MSB) has been previously associated with anti-inflammatory and regenerative properties regarding large bowel mucosa. We aimed to examine a role of MSB in patients with diverticulosis, hypothesizing its potential for reduction of diverticulitis episodes and diverticulitis prevention.MethodsSeventy-three patients with diverticulosis (diagnosed in colonoscopy or/and barium enema or/and CT colography) were recruited for the study and randomized. The investigated group was administered MSB 300 mg daily; the control group was administered placebo. After 12 months, a total of 52 patients completed the study and were subject to analysis (30 subjects and 22 controls). During the study, the number of episodes of diverticulitis (symptomatic diagnosis with acute pain, fever, and leukocytosis), hospitalizations, and surgery performed for diverticulitis were recorded. Additionally, a question regarding subjective improvement of symptoms reflected changes in quality of life during the analysis.ResultsAfter 12 months, the study group noted a significantly decreased number of diverticulitis episodes in comparison to the control group. The subjective quality of life in the study group was higher than in the control group. There were no side effects of the MSB during the therapy.ConclusionsMSB reduces the frequency of diverticulitis episodes, is safe, and improves the quality of life. It can play a role in the prevention of diverticulitis.