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Volume 75 - 2012 - Fasc.3 - Original articles

Comparison of the antiviral effects of entecavir and adefovir dipivoxil in chronic HBV infection : a randomized control trial

Aims : The purpose of this study is to compare the antiviral efficacy of entecavir (ETV) and adefovir dipivoxil (ADV) at vari- ous time points during the treatment. Methods : A randomized, controlled, open-label study was designed to analyze the kinetics of HBeAg seroconversion, HBV DNA level, and liver and renal functions in 72 ETV-treated chron- ic hepatitis B (CHB) patients and 66 ADV-treated CHB patients. The data was collected every 12 weeks up to 96 weeks after drug administration. Results : The negative rate of HBeAg seroconversion was signif- icantly increased at 24 weeks in ETV-treated patients, whereas in ADV-treated patients, these changes were not significant. The serum HBV DNA levels were significantly decreased from 24 weeks in both ETV- and ADV-treated patients. Other than ETV showing significantly decreased levels of HBV DNA at 24 weeks when com- pared with ADV, there was no difference in virological response between two treatments at any other time points. The serum alanine aminotransferase (ALT) and total bilirubin (TBIL) levels were significantly decreased 12 weeks after either ETV- or ADV- treated patients without differences between two treatments. The urea nitrogen levels were in normal range and there was no differ- ence between two groups. Conclusions : Our study suggested that both ETV and ADV could be used as monotherapy for nucleotide-naive patients, but ETV has displayed potential efficacy in HBeAg seroconversion. (Acta gastroenterol. belg., 2012, 75, 316-321).

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Hepatitis E seroprevalence in East and West Flanders, Belgium

Background and study aim : Hepatitis E virus (HEV) infection is increasingly recognized as a cause of hepatitis in developed coun- tries. The goal of this study is to provide an estimate of the sero- prevalence of HEV in Belgium, more precisely in East and West Flanders, since data for this country are currently lacking. Patients and methods : One hundred patients presenting at the gynecological (mainly fertility center) or orthopedic clinics of our hospital were randomly selected to be tested for anti-HEV IgG antibodies using a sensitive indirect ELISA and, in the case of a borderline result, a strip immunoassay. Results : The anti-HEV IgG seroprevalence was found to be 14%. Conclusions : The observed seroprevalence rate suggests that HEV infection is not an uncommon occurrence in Belgium. Comparisons with published seroprevalence data of other Western European countries should be made with caution due to differences in the analytical performance of anti-HEV IgG assays. (Acta gastro- enterol. belg., 2012, 75, 322-324).

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Seroprevalence of celiac disease in Belgian children and adolescents

Background : Celiac Disease (CD) has a high prevalence world- wide. Because the disease may be underdiagnosed in Belgium, we wanted to evaluate the seroprevalence of CD in children and ado- lescents. Patients and methods : Serum samples from 1159 apparently healthy children and adolescents aged between 1-19 years, were prospectively collected in 2006 by 15 Belgian diagnostic laborato- ries. In September 2009, all samples were analyzed for human tissue transglutaminase IgA antibodies (IgA tTG) and total IgA lev- els by, respectively a commercial ELISA and immunonephelome- try. Sera, found positive, were assessed by immunofluorescence for the presence of IgA and IgG antiendomysium antibodies (IgA/IgG EMA). In patients with IgA deficiency IgG antibodies against deamidated gliadin peptides (IgG DGP) and IgG antiendomysium antibodies (IgG EMA) were determined. Results : Ten of the 1159 individuals (0.86%) tested positive for IgA tTG. A further 0.86% showed borderline IgA tTG results. In almost two percent (1.98%) of the analyzed samples total IgA lev- els below the lower limit of normal were observed. Four out of eight positive IgA tTG samples tested positive for IgA EMA. All samples with borderline IgA tTG results were negative for IgA EMA. Twenty-six percent (6/23) of the IgA deficient samples showed positive IgG DGP antibodies, but none of those tested pos- itive for IgG EMA. Conclusion : The seroprevalence of IgA tTG in this non-IgA deficient population (n = 1136) in Belgium is 1:114. The combined seroprevalence of IgA tTG and IgA EMA in that same population is 1:284. The seroprevalence based on positive IgA tTG or DPG IgG in ,respectively, non-IgA deficient and IgA deficient subjects is 1:72 (n = 1159). These seroprevalences are similar to those found in neighbouring countries. (Acta gastroenterol. belg., 2012, 75, 325- 330).

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Effect of Linum usitatissimum (Linseed-Flaxseed) Fixed oil on Experimental Esophagitis in Albino Rats

Introduction : The present study was undertaken to elucidate the effect of Linum usitatissimum fixed oil on experimental esophagitis in albino rats. Methods : Group of rats (n = 6), treated with vehicle control (0.9% NaCl, 3 mL/kg, i.p.) or L. usitatissimum fixed oil (1, 2, 3 mL/kg, i.p.) or omeprazole (30 mg/kg, i.p.). Rats were subjected to pylorus and forestomach ligation to induce esophagitis and were compared to a control sham group. Animals were sacrificed after 6 h and evaluated for the gastric pH, gastric volume, total acidity and esophagitis index. Esophageal tissues were further subjected to estimations of sialic acid, collagen, thiobarbituric acid reactive sub- stances, tissue glutathione, catalase and superoxide dismutase. Results : Treatment with fixed oil significantly inhibited the gastric secretion, total acidity and esophagitis index. The oil also altered the levels of sialic acid and collagen towards normal with significant antioxidant activity in esophageal tissues. Conclusion : The lipoxygenase inhibitory, histamine antagonis- tic, antisecretory (anticholinergic) and antioxidant activity of the oil was attributed for its effect in reflux esophagitis. (Acta gastro- enterol. belg., 2012, 75, 331-335).

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Protective effect of ethyl pyruvate on liver injury in streptozotocin-induced diabetic rats

Background and aims : Diabetes Mellitus, leading to an increase in oxidative stress, can cause liver damage. Our aim was to investi- gate the antioxidant effects of Ethyl Pyruvate (EP) on the liver tis- sue in diabetic rats. Materials and methods : Thirty-two Wistar albino rats were sep- arated into four equal groups. Groups were assigned as follows : (1) Non-diabetic group ; (2) EP-treated non-diabetic group ; (3) diabetic group ; and (4) EP-treated diabetic group. In order to induce diabetes mellitus, 45 mg/kg b.w. streptozotocin was admin- istered intraperitoneally to the rats in groups 3 and 4 . On the 3rd day, blood glucose was assessed. Rats with blood glucose levels higher than 300 mg/dl were considered to be diabetic. The EP solu- tion was administered intraperitoneally at a dose of 50 mg/kg b.w. twice daily for 14 days to the rats in groups 2 and 4. The other rats were simultaneously given the same amount of Ringer's lactate solution intraperitoneally. Liver tissue was obtained for malondi- aldehyde (MDA) analyses and histopathological examination. Results : In group 4, Total Antioxidant Status (TOS) and MDA levels were significantly lower as compared to group 3 . AlsO. mor- phological abnormalities occurred in group 3 when compared with non-diabetic groups (groups 1 and 2), whereas the disorders result- ing from diabetes improved significantly in group 4. Conclusions : These findings show that EP has protective effects against diabetes-induced liver injury. (Acta gastroenterol. belg., 2012, 75, 336-341).

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A comparative study of two kinds of small bowel cleaning score system for capsule endoscopy

Aim : The study is aim to compare two kinds of cleaning score system for capsule endoscopy, with a view of these two cleaning score system can help to evaluate small bowel cleanliness. Methods : Three readers evaluated these two cleaning score system by assessing the inter-observer, intra-patient, and intra- observer agreement. Results : The assessment of the reliability and concordance, inter-observer agreement and intra-patient agreement of System1 and System2 was excellent with the intraclass correlation coeffi- cient (ICC) values of 0.873, 0.821, 0.863 and 0.772. The data regarding the assessment on intra-observer agreement and intra- patient agreement of System1 and System2 were available and the results were also excellent with ICC values of 0.887, 0.846, 0.870 and 0.809. The overall adequacy assessment of System1 and System2, there was no significant difference among the three read- ers of inter-observer agreement (X2 = 0.051, P = 0.822, X2 = 0.085, P=0.081, X2=0.048, P=0.827) and intra- patient agreement (X2=0.196, P=0.658, X2=0.208, P=0.648, X2=0.054, P= 0.817), neither was intra-observer agreement (X2=0.208, P= 0.648, X2 = 0.223, P = 0.637, X2 = 0.484, P = 0.487) and intra- patient agreement (X2 = 0.054, P = 0.817, X2 = 0.054, P = 0.817, X2 = 0519, P = 0.471). Conclusion : The two system both are simple, operable, and can be used in clinical practice. (Acta gastroenterol. belg., 2012, 75, 342- 348).

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Premedication with peppermint oil capsules in colonoscopy : a double blind placebo-controlled randomized trial study

Background : Colonic spasm is an important problem in colonoscopy for endoscopists to advance the colonoscope and visu- alize the mucosa. Study aims : In the present study, we evaluated the efficacy of enteric-coated peppermint oil capsules (Colpermin®) as an orally administered antispasmodic premedication in colonoscopy. Patients and Methods : Sixty-five adult patients undergoing colonoscopy were randomized to receive either Colpermin (n = 33) or placebo capsules (n = 32) as premedication, 4 hours before the procedure. An experienced endoscopist performed colonoscopy. Outcome measures included cecal intubation and total procedure time, spasm score, pain score, endoscopist satisfaction and patients' willingness to repeat colonoscopy. Results : Duration of both total procedure time and cecal intuba- tion time in patients in the Colpermin group were shorter than that in ones in the placebo group. Scores for colonic spasm and pain were significantly lower in the Colpermin group. The endoscopist satisfaction score was higher in the Colpermin group and patients in the Colpermin group were more willing to repeat colonoscopy in the future. Conclusions : Premedication with Colpermin was beneficial in terms of the time required for cecal intubation and total procedure time, reducing colonic spasm, increasing endoscopist satisfaction and decreasing pain in patients during colonoscopy. (Acta gastro- enterol. belg., 2012, 75, 349-353).

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