ABSTRACT Cytomegalovirus (CMV) infection has been associated with ulcerative colitis (UC). The prevalence of CMV infection in UC patients ranges from 10% to 16%. It is particularly high in the patients with steroidrefractory UC and those treated with immunosuppressants. However, synchronous onset of CMV colitis and UC in an immunocompetent patient is rare. It was originally described in 1990 and since then sixteen cases have been reported, as far as we are aware. Here, we present a case of CMV colitis and UC synchronously developing in an elderly immunocompetent woman. She was diagnosed through tissue immunohistochemistry and successfully treated with intravenous ganciclovir. This case demonstrates that in patients with severe active UC, even with new onset of the disease, CMV infection needs to be ruled out before initiating an aggressive immunosuppressive therapy.

RESUMEN La infección por citomegalovirus (CMV) ha sido asociada con la colitis ulcerosa (CU). La prevalencia de infección por CMV en pacientes con CU oscila entre 10% y 16%. Es particularmente alta en los pacientes con CU refractaria a los esteroides y en aquellos tratados con inmunosupresores. Sin embargo, la aparición sincrónica de la colitis por CMV y la CU en un paciente inmunocompetente es rara. Fue originalmente descrita en 1990, y desde entonces se han reportado dieciséis casos, hasta donde sabemos. Presentamos aquí un caso de colitis por CMV y CU desarrolladas simultáneamente en una mujer mayor inmunocompetente. La paciente fue diagnosticada a través de inmunohistoquímica tisular y tratada éxitosamente con ganciclovir intravenoso. Este caso demuestra que en pacientes con CU activa severa, incluso con la reaparición de la enfermedad, la infección por CMV debe descartarse antes de iniciar un tratamiento inmunosupresor agresivo.

The objective of this study was to perform a systematic review and meta-analysis to assess the effectiveness of proton pump inhibitors (PPI) for reflux disease in adult patients with laryngopharyngeal symptoms. A comprehensive search of Cochrane Library, EMBASE, Ovid EBM Reviews, and PubMed was performed for English-language literature about laryngopharyngeal reflux (LPR), in September 2014. The papers were filtered using pre-defined inclusion and exclusion criteria. Eight papers were identified and included in this meta-analysis. The sample comprised a pooled total of 370 patients, of which 210 and 160 patients took PPIs and placebo, respectively. The difference between PPIs and placebo groups in overall improvement of symptoms in adult patients with LPR was not statistically significant (RR=1.22; 95%CI=0.93-1.58; P=0.149). The difference in cough improvement was also not significant between PPIs and placebo groups (RR=0.65; 95%CI=0.30-1.41; P=0.279).

The effects of treatment with 50 and 100 mM NaCl on cotyledon growth, nitrogen assimilation, and the activities of key nitrogen metabolism enzymes were investigated in developing Jatropha curcas cotyledons. Growth inhibition was observed, and relative water content in the developing cotyledons significantly decreased in the 100 mM NaCl treatment. Lower levels of NO3-, NO2-, and NH4+ in the cotyledons were recorded when they were supplied with 50 and 100 mM NaCl. Nitrate reductase activities decline by 9.5% to 31.8% with respect to the control groups. Salt treatment also led to a marked decrease in nitrite reductase activity compared with the controls. Glutamine synthase, glutamate synthetase and dehydrogenase, alanine aminotransferase (AlaAT) and aspartate aminotransferase (AspAT) were markedly induced by the addition of NaCl. These findings will be useful for elucidating the roles key enzymes involved in nitrogen assimilation pathway of J. curcas plant.