No abstract

Human papillomavirus (HPV) has been considered to be an etiological agent for anogenital cancers, such as cervical cancer and possibly a subset of cancers of the aerodigestive tract. The aim of the study was to evaluate the presence of human papillomavirus DNA in colorectal carcinomas and adenomas. Formalin-fixed and paraffin-embedded archival tissue samples were used for DNA extraction. One hundred and six colorectal carcinomas and 62 adenomas were screened by nested polymerase chain reaction (PCR) for HPV DNA with a control group of 49 cervical tissues with invasive cervical carcinoma and cervical intraepithelial neoplasia (CIN). In the study group, we did not find HPV DNA positivity in any of all the colorectal carcinomas and adenomas. In the control group with cervical lesions, 34 out of 49 (69.4%) samples were positive for the HPV DNA. These results indicated that there was no correlation between HPV infection and colorectal carcinomas and adenomas.

Abstract. The study was planned to determine the efficacy and safety of adding rosiglitazone to a combination of glimepiride and metformin therapy with insufficiently controlled type 2 diabetes. This was an open-label study with a follow-up period of 26 weeks. Thirty patients were taking 3 mg glimepiride two times and 850 mg metformin two times per day. Patients were told to take one rosiglitazone 4 mg tablet before breakfast additionally. The primary efficacy measure was the mean change in HbA 1 c from baseline to the end of the study. Secondary efficacy parameters included the mean changes from baseline to the end of the study in fasting plasma glucose (FPG) and insulin levels, as well as total cholesterol, HDL-C, LDL-C, triglycerides, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Mean HbA 1 c levels decreased significantly from 7.54 ± 0.9% to 6.57 ± 0.7% (p<0,001) at 26th week. FPG levels fell from 169.39 ± 37.8 mg/dl to 135.69 ± 28.0 mg/dl (p<0.001), respectively. Insulin levels decreased from 19.60 ± 9.8 U/L to 14.66 ± 11.6 U/L (p = 0,026) at 26th week. No one experienced elevations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels greater than 2.5 times the upper limit of the reference range. This study confirms that the addition of rosiglitazone (4 mg/day) to sulphonylurea and metformin treatment for patients with type 2 diabetes improves glycemic control, is safe, and generally well tolerated.

Objectives:Celiac disease, an autoimmune disease, is related to immune mediated intolerance to gluten. Some studies suggest that Celiac Disease was 20 times more frequent in type 1 patients with diabetes. The objective of our study was to evaluate the prevalence of celiac disease in hospital based type 1 diabetic adults.Methods:Our study was carried out retrospectively in Medeniyet University Goztepe Training and Educational Hospital in Istanbul between 2012–2013. The cohort comprised 482 type 1 patients with diabetes attending the diabetes outpatient clinic. The data were analyzed by SPSS 10.5 package program. Student’s t tests is used for comparative analyses. A p-value less than 0.05 was considered statistically significant.Results:The cohort included 482 type 1 patients with diabetes. Fifty seven of them were not evaluated for Endomysium antibody positivity. Fifteen of the remaining 425 patients were positive for anti endomysial antibody (3.5%). The prevalence of biopsy proven celiac disease was 2.3% (10/425). There was no significant difference between Endomysial antibody positive and negative groups in regard of age, sex, or duration of the disease.Conclusion:This study confirms that the celiac disease is common in type 1 diabetic patients. Since a small proportion of celiac patients are symptomatic this disorder should be screened in all adult type 1 patients with diabetes by antiendomysium antibody.

An 85-year-old male patient with a history of hypertension, old anterior wall myocardial infarction and atrial fibrillation was placed on warfarin one year previously. However, he did not comply with regular international normalized ratio (INR) measurements, but kept taking warfarin (5 mg) on a daily basis for almost a year without any problems. After watching a television program about herbal remedies, he decided to take St John's wort on his own initiative. One month later, he reported to the emergency service of our hospital with upper gastrointestinal bleeding. Initial blood work revealed hemoglobin (Hb): 7.9 g/dl, hematocrit (htc): 23%, and INR: 6.2. With supportive treatment of fresh frozen plasma and blood transfusions, the bleeding ceased. Later, an esophagogastroduodenoscopy showed no significant pathology. The patient was instructed not to use herbal remedies with prescription medications on discharge.Herbal remedies are frequently used worldwide without medical or government control. Many toxic effects due to herbal remedies have been reported in the medical literature, especially when they are used in combination with prescribed medications. Some have life-threatening side effects, as seen in our patient (1).It is interesting to note that the combined use of St John's wort and warfarin usually causes neutralization of the effect of warfarin by increasing its metabolism via the P450 enzyme system (2). However, in our patient, reverse events occurred: the INR was increased and the patient developed a severe bleeding diathesis, which manifested itself with hematemesis and melena. This is a rare event (3).It is thought that since St John's wort contains many active ingredients, namely hyperforin, flavonols, flavonol glycosides, biflavones, naphthodianthrones, acylphloroglucinols, and phenylpropanes, one or more combinations of these active ingredients might affect the drug metabolism of warfarin in sensitive individuals by potentiating its effect on the clotting cascade (4).Herbal remedies should be considered as toxic as any other drug, and the public should be warned and informed about these effects via accumulation of such reports in the medical literature.