Gastroenterology and Hepatology from Bed to Bench

Ulcerative colitis and Crohn's disease are chronic, relapsing, inflammatory conditions defined by their phenotypic features. Family studies have identified a clear genetic influence on disease susceptibility and expression. Molecular studies have identified specific genes that predispose individuals to the development of inflammatory bowel disease. Some of these genes are specific to either ulcerative colitis or Crohn's disease, others are common to both conditions. The identification of susceptibility genes provides insight into the mechanisms that underlie these conditions. Furthermore it raises the possibility of anticipating disease outcome and tailoring treatment for an individual.

Aim: This study aims to investigate some clinical and pathologic factors associated with the prognosis of patients with colon and rectum cancers separately.

Background: Colorectal cancer is the most common cancer of the digestive system and also the fourth cause of cancer-related deaths around the world. Different studies indicate that survival of patients with colorectal cancer has improved in some areas of the world. However, it remains unclear which factors are involved in this improvement.

Patients and methods: Data for 1194 patients with colorectal cancer registered in the Cancer Registry Center of the Research Center of Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences were used in this study. Data analysis was performed using competing risks model. Software used for data analysis included STATA, Version11, and significance level was regarded as p<0.05.

Results: Body mass index (BMI), alcohol consumption, tumor site, inflammatory bowel disease, metastasis to lymph nodes and distant metastasis had a significant effect on death from colon cancer, while body mass index, distant metastasis and type of the first treatment had a significant effect (p<0.05) on death from rectum cancer. Also, median survival was 7.75 ± 1.118 and 3.917 ± 0.26 years for patients with colon cancer and rectum cancer, respectively.

Conclusion: According to the results of this study, some variables may have a different impact on colon and rectum carcinoma; therefore, the effects of these factors on different parts of the large bowel must be considered separately in future studies.

Aim: The aim of this study was to provide quantitative estimations of the burden of death in term of years of life lost (YLL) due to colorectal cancer (CRC) in Iran and a temporal trend analysis.

Background: Colorectal cancer is the third most common cause of cancer-related deaths in the world. YLL is a tool for quantifying the burden of disease according to mortality rates. The aim of this study was to provide quantitative estimations of the burden of death in term of YLL due to colorectal cancer in Iran and a trend analysis.

Patients and methods: National death Statistic Reported by the Ministry of Health and Medical Education (MOH&ME) from 1995 to 2003, stratified by age group, sex, and cause of death were included in this analysis. YLL for CRC were expressed as the annual rates per 100,000 of the general population, gender and age group.

Results: The general rate of YLL for CRC increased during the years under study from 4.52 to 32.20 per 100,000 of the general population and YLL mortality was higher for older aged males.

Aim: The aim of this study was to determine the prevalence of soil-transmitted helminth infections (STHs) infection and other intestinal parasites in patients with gastrointestinal (GI) symptoms in Tehran Province, Iran.

Background: The World Health Organization (WHO) suggests that many people in the world are chronically affected by STHs and intestinal parasites. Furthermore infection is closely correlated with poverty, poor environmental hygiene and impoverished health services.

Patients and methods: In this cross-sectional study, random stool samples from 912 patients with GI symptoms were collected and examined using light microscopy and the formalin-ether concentration method for detection of protozoa and of STH eggs. Also modified acid-fast staining was used to identify Cryptosporidium parvum.  Agar plate cultures were used for the recovery of Strongyloides stercoralis larvae.

Results: STH infections found in these patients were Ascaris lumbricoides 5(0.5%), hookworm 3(0.3%), Hymenolepis nana 14(1.5%), Enterobius vermicularis 3(0.3%). The prevalence of protozoan parasites were 46 (5.1%), for Entamoeba coli, 31 (3.4%) for Blastosystis hominis, 27 (3%) for Giardia lamblia, 25 (2.74%) for Endolimax nana, 20 (2.2%) for Entamoeba histolytica/Entamoeba dispar complex, 12 (1.31%) for Iodomoeba butchelii 9, (1%) for Chilomastix mesenelli, and 7 (0.8%) Cryptosporidium parvum.

In recent decades, there has been a dramatic increase in the incidence of colorectal cancer in Iran, especially in patients less than 50 years old. A national colorectal cancer screening program is the best solution for identifying patients in high risk populations. The Research Center of Gastroenterology and Liver Disease of Shahid Beheshti University, M.C., in collaboration, with the Ministry of Health for the Islamic Republic of Iran set up in national screening program. The Research Center of Gastroenterology and Liver Disease designed the information network and semi-intelligent software for required to manage this program in Tehran (the capital of Iran), other provinces and centers providing colorectal cancer screening services.

Iran is an important endemic focus area of cystic hydatid disease where several intermediate host species are commonly infected with Echinococcus granulosus. Annually, most livers are shipped out, stored away, or destroyed due to contamination among livestock. For instance, in Aleshtar (Lorestan province), liver and lung losses due to hydatid cysts during 2002-2003 were approximately 864,360,000 Rials and 35,530,000 Rials for sheep and cow, respectively. In other words, given the risk of human contamination with this parasite, the costs associated with diagnosis, treatment, and surgery are important. Epidemiology studies have been performed in different part of Iran, but there is no international estimate of infection in livestock. Molecular studies have indicated the presence of G1 and G6 genotypes in different parts of Iran. We discuss these molecular studies in this article.