It is recommended to investigate the serology of hepatitis B virus (HBV) and vaccinate seronegative patients at the time of diagnosis in inflammatory bowel diseases (IBD). This study aimed to investigate the efficacy of HBV vaccine and factors affecting the response.In this retrospective, observational study, HBV-seronegative IBD patients were administered 3 doses (at months 0, 1, and 6) recombinant 20 μg HbsAg. Patients’ demographics, IBD attributes, and treatment methods were investigated as the factors with potential impacts on vaccination outcomes.One hundred twenty-five patients with IBD were evaluated. The number of patients with Anti-HBs >10 IU/L was 71 (56.8%), and the number of patients with anti-HBs >100 IU/L was 50 (40%). Age, disease activity, Crohn disease subtype, and immunosuppressive treatment (IST) were found to have significant effects on immune response (P = 0.011, P < 0.001, P = 0.003, and P < 0.001, respectively). With multivariate analysis, age < 45 years (OR 3.1, 95% CI 1.2–8.3, P = 0.020), vaccination during remission (OR 5.6, 95% CI 2.3–14, P < 0.001), and non-IST (OR 11.1, 95% CI 2.9–43.2, P = 0.001) had favorable effects on the occurrence of adequate vaccine response.The likelihood of achieving adequate immune response with standard HBV vaccination protocol in IBD is low. Selecting vaccination protocols with more potent immunogenicity is a better approach to achieve effective vaccine response in patients with multiple unfavorable factors.

BackgroundTo examine the activity of the mammalian target of rapamycin (mTOR) pathway and its regulators, transforming growth factor (TGF)-β1 and phosphatase and tensin homolog (PTEN), in minor salivary gland biopsies of Sjogren’s syndrome (SS) and systemic sclerosis (SSc) patients.MethodsWe retrospectively evaluated SS, SSc, and SS-SSc overlap patients admitted to our outpatient rheumatology clinic between January 2007 and December 2015 who underwent a minor salivary gland biopsy. Patient demographics and some clinical features were obtained from hospital records. Immunohistochemistry was used to analyze total mTOR, total PTEN, and TGF-β1 expression in the biopsied tissues. The biopsy specimens were also examined for the presence and degree of fibrosis.ResultsMinor salivary gland biopsies of 58 SS, 14 SSc, and 23 SS-SSc overlap patients were included in the study. There was no significant difference in mTOR expression between these groups (P = 0.622). PTEN protein was expressed in 87.2% of patients with SS, 57.9% with overlap syndrome, and 100% of the SSC patients, and these differences were statistically different (P = 0.023). Although ductal epithelial TGF-β1 expression was similar between the groups (P = 0.345), acinar cell expression was found to be more frequent in the SSc (72.7%) and overlap patients (85.7%) in comparison with the SS cases (58.2%; P = 0.004).ConclusionmTOR may be one of the common pathways in the pathology of both SS and SSc. Hence, there may be a role for mTOR inhibitors in the treatment of both diseases. Additionally, PTEN and TGF-β1 expression may be a distinctive feature of SSc.

Patients with FMF can be clustered into distinct patterns of clinical and genetic manifestations and these patterns may have different prognostic significance.

Ineffective esophageal motility (IEM), defined as minor esophageal motility disorder, is also the most common esophageal motility disorder. The relationship between gastro-esophageal reflux disease is still controversial. Our aim in this study is to evaluate whether there are differences in terms of demographic, endoscopic, or motility findings between IEM patients with pathological esophageal acid reflux and physiological reflux. Patients diagnosed with IEM according to the Chicago classification v3 with high-resolution manometry (HRM) before acid monitoring constituted the study group of our investigation. The patients were divided into 2 groups as patients with pathological esophageal reflux and patients with physiological reflux according to 24-hour acid monitoring. Demographic data, endoscopic findings, and HRM findings were compared between 2 groups. A total of 62 patients who were diagnosed with IEM according to the Chicago classification v3 were included in the study. Patients in the physiological reflux group were 7 years younger on average than the pathological reflux group. Esophagitis rates were significantly higher in the pathological reflux group ( P = .033). Lower esophageal sphincter resting pressure, integrated relaxation pressure, and the presence of hernia were found to be similar in the 2 groups ( P = 392, P = 182, P = 657, respectively). The rate of severe IEM was also similar between the 2 groups ( P = .143). The fact that the physiological reflux patient group is younger may suggest that the IEM develops in the early period and then reflux accompanies the picture with advancing age.

No abstract

Ganoderma lucidum ( Japoncada'da Reishi, Çince'de Lingzhi) popüler bir tıbbi mantardır ve Çin tıbbında yaklaşık 2.000 yıldır kullanılmaktadır Son 30 yılda, bu mantarlar, modern farmakologlar tarafından incelenmiştir . Pek çok çalışma, G. lucidum'un immün fonksiyonları düzenlediği ve tümör büyümesinin engellenmesinde etkili olduğunu göstermiştir. Bu etkilerin dışında G. lucidum ayrıca hipertansiyon, hiperlipidemi, diyabet, nefrit, astım, arterit, iltihaplı bağırsak hastalıkları ve diğer hastalıkların tedavisinde de kullanılabilir olduğu gösterilmiştir. Bu etkilerin belli mekanizması hala belirsizdir. Bu nedenle, G. lucidum bir terapötik madde olarak tavsiye edilmez. Çoğunlukla, bir bağışıklık arttırıcı ve sağlık için ek gıda olarak kullanılır. Bu olgu sunumunda, farklı klinik bulgularla kliniğimize başvuran akut pankreatitli bir olgu sunulmuştur.

No abstract

AIM: Extended rapid virologic response (eRVR) predicts sustained virologic response (SVR) and provides to determine shortening response guided treatment duration. P2/MS<45, an effective and noninvasive marker reflecting the degree of hepatic fibrosis, demonstrates serious hepatic fibrosis. In a retrospective observational study, we studied the relationship between P2/MS and eRVR among HCV genotype 1 (G1) infected patients who were treated with triple therapy patients. P2/MS was evaluated whether it is a predictor for treatment response by foreseeing eRVR. METHOD: Thirty one patients infected with HCV-G1and were treated with triple therapy involving telaprevir, pegylated interferon-α and ribavirin, were enrolled in the study. P2/MS values were calculated before the treatment. HCV-RNA levels were measured at the initiation period, the 4 th and 12 th weeks. RESULTS: Nine patients of 31 had detectable HCV-RNA in the 4 th week. Among 6 of these 9 patients had P2/MS<45. HCV-RNA was undetectable in 22 patients at the 4 th week of the treatment. Sixteen of them had P2/MS>45. Among 30 of 31 patients, HCV-RNA was undetectable at the 12 th week of the treatment. We found that eRVR success was 85% in patients with P2/MS score>45 and 45.4% in patients with P2/MS<45. CONCLUSION: P2/MS is a noninvasive marker for detecting hepatic fibrosis in HCV patients. A positive correlation between P2/ MS score and eRVR is demonstrated. We suggest that P2/MS should be used as a pretreatment predictive marker for HCV-G1 infected patients, estimating SVR and the patients suitable for shortening therapy.