Epiploic appendagitis is a rare cause of abdominal pain. Diagnosis of epiploic appendagitis, although infrequent, is easily made with CT or ultrasonography in experienced hands. As reported in the literature, most patients with primary epiploic appendagitis are treated conservatively without surgery, with or without anti-inflammatory drugs. A small number of patients are treated with antibiotics and some patients require surgical intervention to ensure therapeutic success. Symptoms of primary epiploic appendagitis usually resolve with or without treatment within a few days. A correct diagnosis of epiploic appendagitis with imaging procedures enables conservative and successful outpatient management of the condition and avoids unnecessary surgical intervention and associated additional health-care costs. Gastroenterologists and all medical personnel should be aware of this rare disease, which mimics many other intra-abdominal acute and subacute conditions, such as diverticulitis, cholecystitis and appendicitis. This article reviews epiploic appendagitis and includes discussion of clinical findings, pathophysiology, diagnosis and therapeutic possibilities.

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This study investigated the influence of age, body composition, physical fitness, training volume and intensity, and underlying systemic inflammation on exercise-induced inflammation and innate immune function in a heterogeneous group of cyclists. Subjects included 31 male cyclists (mean ± standard deviation, age 38.8 ± 10.6 years, body fat 17.8%± 5.6%, VO(2max) 55.8 ± 8.4 mL kg(-1) min(-1)) who cycled for 1.75 h at 60% watts(max) followed by a 10-km time trial (18.3 ± 0.3 min). Blood samples were collected pre-, post-, and 1-h-postexercise, and analyzed for WBCs, 9 cytokines [interleukin (IL)-6, tumor necrosis factor-alpha, granulocyte-macrophage colony-stimulating factor, interferon-γ, IL-1β, IL-2, IL-8, IL-10, and IL-12p70], and granulocyte and monocyte phagocytosis (GR-PHAG and MO-PHAG) and oxidative burst activity (GR-OBA and MO-OBA). Exercise-induced changes varied widely, with significant increases measured for 8 of 9 cytokines, GR-PHAG (mean change 99%) (95% confidence limits, 69%, 128%) and MO-PHAG (43%) (28%, 58%), and WBC (160%) (133%, 187%), and decreases for GR-OBA (-30%) (-43%,-16%) and MO-OBA (-23%) (-36%,-10%). Correlation and stepwise regression analysis revealed that changes in these variables were not related to age, body fat percentage, VO(2max), training volume, or pre-exercise C-reactive protein. Performance measures, specifically the average heart rate and rating of perceived exertion, were correlated with changes in several variables, including IL-8 (r=0.68 and 0.67, respectively, P<0.001) and IL-6 (r=0.51, P=0.004, and r=0.46, P=0.011, respectively). In summary, variance in exercise-induced inflammation and innate immunity in male cyclists in response to 2 h of endurance exercise is best explained by exercise intensity.

articlesBehavior and Psychology cingulate cortex, caudate nucleus, putamen, hippocampus, hypothalamus, thalamus, insula, and medial prefrontal cortex.

BackgroundZeolites are crystalline compounds with microporous structures of Si-tetrahedrons. In the gut, these silicates could act as adsorbents, ion-exchangers, catalysts, detergents or anti-diarrheic agents. This study evaluated whether zeolite supplementation affects biomarkers of intestinal wall permeability and parameters of oxidation and inflammation in aerobically trained individuals, and whether it could improve their performance.MethodsIn a randomized, double-blinded, placebo controlled trial, 52 endurance trained men and women, similar in body fat, non-smokers, 20–50 years, received 1.85 g of zeolite per day for 12 weeks. Stool samples for determination of intestinal wall integrity biomarkers were collected. From blood, markers of redox biology, inflammation, and DNA damage were determined at the beginning and the end of the study. In addition, VO2max and maximum performance were evaluated at baseline and after 12 weeks of treatment. For statistical analyses a 2-factor ANOVA was used.ResultsAt baseline both groups showed slightly increased stool zonulin concentrations above normal. After 12 weeks with zeolite zonulin was significantly (p < 0.05) decreased in the supplemented group. IL-10 increased tendentially (p < 0.1) in the zeolite group. There were no significant changes observed in the other measured parameters.ConclusionsTwelve weeks of zeolite supplementation exerted beneficial effects on intestinal wall integrity as indicated via decreased concentrations of the tight junction modulator zonulin. This was accompanied by mild anti-inflammatory effects in this cohort of aerobically trained subjects. Further research is needed to explore mechanistic explanations for the observations in this study.