Showing papers in "Open Journal of Gastroenterology in 2011"

HBs antigene prevalence in blood donors and the risk of transfusion of hepatitis b at the central hospital of yaounde, cameroon

Abstract: Parenteral transmission of hepatitis B virus (HBV) during blood transfusion is not insignificant. Although blood transfusion safety has greatly improved over the last 15 years, the transfusion risk of HBV remains high in developing countries. In the context where blood transfusion safety is limited in some hospitals in Cameroon, the development of good and quality practice for blood donation, based on the use of the most sensitive techniques for the detection of infectious risk of blood donation should be a priority of health authorities. The aim of this paper is to document the epidemiology of HBV infection in the population of blood donors and to assess the risk of infection during blood transfusions at the Central Hospital Yaounde (CHY), Ca- meroon. Methods: During a seven months period, 1000 volunteer donors were recruited prospectively at the blood bank of the CHY. Those included in the study were people aged from 18 years to 55 years without any particular medical history. Data collection was done through an investigation form. Samples were first analysed at the CHY and then Centre Pasteur of Cameroon. Results: Of the 1000 samples tested 108 (10.8%) were positive for HBs Ag. The male and the female sex represented 83.1% and 16.9% respectively. According to the age groups, 56.2% were 18 to 27 years, 30.5% were 28 years to 37 years, 10.4% were 38 years to 47 years and 29% were 48 years to 55 years. The 892 negative sera were analyzed for total anti-HBc antibodies of which 75.78% were positive and 24.56% negative. The 676 samples positive for anti-HBc antibody were retested for HBs Ag using enzyme immunoassay with a confidence level of 95%, between 52 and 82 positive tests were still positive, a proportion that vary between 7.64% and 12.14% (9.89% ± 2.25%). Conclusion: The prevalence rate of 10.8% found in our series is consistent with data in Cameroon. The infectious risk of transmission of HBV among blood donors remains a major problem (9.89% ± 2.25%) related to the test used.

Effect of zinc supplementation in patients with type C liver cirrhosis

Abstract: Zinc is often deficient in patients with liver cirrhosis, and treatment with zinc provides short-term improvement in protein metabolism. However, the long-term effects of zinc have not been fully clarified. The present study aimed to analyze the effect of zinc on the long-term clinical course, especially hepatocarcinogenesis, in type C liver cirrhosis. Am- ong patients with type C liver cirrhosis visiting our hospital between June 1998 and January 2009, th- ose with a serum albumin level ≤3.5 g/dL and a serum zinc level ≤70 μg (1.07 μmol)/dL were selected. Thirty-seven patients were randomly divided into 2 groups: group B (12 g/day branched-chain amino acid granules) and group BZ (same as group B plus 100 mg/day - 600 mg/day zinc sulfate or 150 mg/day - 225 mg/day polaprezinc). Multivariate analysis revealed that the administration of zinc was not a significant determinant, but pretreatment serum zinc levels (hazard ratio [HR], 0.921; 95% confidence interval [CI], 0.853–0.994) and serum zinc levels less than 80 μg (1.22 μmol)/dL 12 months after beginning this study (HR, 6.866; 95% CI, 1.399 - 33.707) were significant determinants of carcinogenesis and death. Serum albumin levels in patients whose serum zinc levels had not increased up to 80 μg/dL by the third year of this study were significantly lower (p = 0.023) than those of patients that had increased up to 80 μg/dL. Conclusions: In type C liver cirrhosis with zinc deficiency, administration of zinc does not improve cancer-free survival. However, serum zinc levels can predict outcomes in patients with type C liver cirrhosis. However, although zinc may play a role in hepatocarcinogenesis, the precise implications remain to be clarified.

Role of constitutive nitric oxide synthase in regulation of Helicobacter pylori-induced gastric mucosal cyclooxygenase-2 ac-tivation through S-nitrosylation: mechanism of ghrelin action

Abstract: Gastric mucosal inflammatory responses to H. pylori lipopolysaccharide (LPS), are characterized by the excessive NO and prostaglandin (PGE2) generation due to the disturbances in nitric oxide synthase (NOS) and cyclooxygenase (COX) systems. Here, we report that the LPS-induced enhancement in gastric mucosal inducible (i) iNOS) activity and up-regulation in PGE2 production was associated with the suppression in Akt kinase activity and the impairment in constitutive (c) cNOS activation. The stimulatory effect of the LPS on PGE2 production, furthermore, was susceptible to suppression by COX-2 inhibitor, NS-398, and iNOS inhibitor, 1400 W. Further, we show that the countering effect of peptide hormone, ghrelin, on the LPS-induced changes was reflected in up-regu- lation in Akt activity and the increase in cNOS activation through phosphorylation, and accompanied by the suppression in iNOS expression and the reduction in COX-2 activity associated with the loss in COX-2 protein S-nitrosylation. Moreover, the effect of ghre-lin on the LPS-induced COX-2 S-nitrosylation was subject to repression by Akt inhibition. Our findings demonstrate that induction in iNOS with H. pylori in- fection leads to COX-2 activation through S-nitro- sylation and up-regulation in PGE2 generation, and that ghrelin counters these untoward consequences of the LPS through Akt-mediated up-regulation in cNO- S activation required for the iNOS gene repression.

The pathogenesis of primary pouchitis following ileal pouch-anal anastomosis: a review of current hypotheses

Abstract: Primary pouchitis is a common complication of ileal pouch-anal anastomosis following proctocolectomy in patients treated for ulcerative colitis (UC), but is un-usual for those treated for familial adenomatous polyposis (FAP) While a number of theories as to the pathogenesis of this inflammatory condition have been proposed, no single one has been wholly satis-factory Much research has been devoted to investi-gating a link between the pathogenic factors involved in UC, but not FAP, and those underlying pouchitis The contribution of sulfate-producing bacteria has also been explored The role of other intraluminal factors, such as short chain fatty acids and unconju-gated bile salts, has also been investigated A unifying theory of a multi-step process might explain the pathogenesis of pouchitis, but further research is re-quired to proof causation It is likely that pouchitis develops as a result of a combination of genetic, im-munological, microbial and metabolic factors Future insight into the causes of pouchitis may eventually allow for the development of more effective treat-ments

Emergency gastrectomy for gastric necrosis 5 years after laparoscopic adjustable gastric banding (LAGB)

Abstract: Laparoscopic adjustable gastric banding (LAGB) is currently one of the most common bariatric surgical procedures performed worldwide for the treatment of morbid obesity. Among bariatric surgeries, the percentage of LAGB has increased from 24.4% to 42.3%. In North America alone, the number of LAGB procedures has increased exponentially by 944.2% (from 9,270 to 96, 800 cases). Though early and late complications following LAGB are well-understood, data regarding long term complications remains indefinite due to the limited follow-up periods. We report a case of acute gastric necrosis associated with band slippage presenting as a surgical emergency five years after LAGB. Gastric necrosis represents a rare, but life threatening complication of gastric banding that has been reported in the early post-operative period. To the best of our knowledge, this case report is the longest time-interval reported between LAGB and the diagnosis of this very rare complication. Accurate diagnosis is often delayed due to its rarity and nonspecific clinical presentation. Increased awareness of this delayed complication should facilitate early recognition as it often requires urgent surgical intervention to prevent fatal outcomes.