Duodenal Ulcer Research Articles

Infectious pathogens and risk of esophageal, gastric and duodenal cancers and ulcers in China: A case-cohort study.

Infection by certain pathogens is associated with cancer development. We conducted a case-cohort study of ~2500 incident cases of esophageal, gastric and duodenal cancer, and gastric and duodenal ulcer and a randomly selected subcohort of ~2000 individuals within the China Kadoorie Biobank study of >0.5 million adults. We used a bead-based multiplex serology assay to measure antibodies against 19 pathogens (total 43 antigens) in baseline plasma samples. Associations between pathogens and antigen-specific antibodies with risks of site-specific cancers and ulcers were assessed using Cox regression fitted using the Prentice pseudo-partial likelihood. Seroprevalence varied for different pathogens, from 0.7% for Hepatitis C virus (HCV) to 99.8% for Epstein-Barr virus (EBV) in the subcohort. Compared to participants seronegative for the corresponding pathogen,Helicobacter pylori seropositivity was associated with a higher risk of non-cardia (adjusted hazard ratio [HR] 2.73 [95% CI: 2.09-3.58]) and cardia (1.67 [1.18-2.38]) gastric cancer and duodenal ulcer (2.71 [1.79-4.08]). HCV was associated with a higher risk of duodenal cancer (6.23 [1.52-25.62]) and Hepatitis B virus was associated with higher risk of duodenal ulcer (1.46 [1.04-2.05]). There were some associations of antibodies again some herpesviruses and human papillomaviruses with risks of gastrointestinal cancers and ulcers but these should be interpreted with caution. This first study of multiple pathogens with risk of gastrointestinal cancers and ulcers demonstrated that several pathogens are associated with risks of gastrointestinal cancers and ulcers. This will inform future investigations into the role of infection in the etiology of these diseases.

The influence of nutrition on patients with digestive diseases

Abstract. Maintaining health, improving the quality of life is largely related to the way of eating and the quality of food consumption. The way of eating is a central life issue, because apart from the very important social activities and other recreational activities, man still has three meals daily. Diet and nutrition are of paramount importance in disease prevention and health promotion. In fact, a slight imbalance in the quantitative and/or qualitative consumption of food can and does have long-term effects on health. In order to determine how nutrition influences the lifestyle of people suffering from digestive diseases, a retrospective study was conducted at the Municipal Hospital, St. Ierah Dr. Luca,, Onești during the period 1.01.2015-31.03.2020. In this study, 1019 patients with digestive pathology (gastric ulcer, duodenal ulcer, acute haemorrhagic gastritis, gastritis, gastroduodenitis) were included. As indicated by the research, it was found that the 1019 tested patients were diagnosed with ulcers, gastritis and gastro-duodenitis. According to the research, we can conclude that improper eating habits are risk factors in triggering, maintaining, or aggravating digestive pathology.

Management of a Proximal and Distal Staple Line Leak Following Sleeve Gastrectomy and a Concurrent Duodenal Ulcer by Emergency Laparoscopic Conversion to a Roux-en-Y Gastric Bypass.

Management of a Proximal and Distal Staple Line Leak Following Sleeve Gastrectomy and a Concurrent Duodenal Ulcer by Emergency Laparoscopic Conversion to a Roux-en-Y Gastric Bypass.

Investigation of a set of flavonoid compounds as Helicobacter pylori urease inhibitors: insights from in silico studies

Helicobacter pylori (H. pylori) is a spiral, microaerophilic gram-negative bacterium, which is associated with the destruction of the lining of the stomach, leads to chronic inflammation of the stomach, which can cause stomach and duodenal ulcers. The problems caused by the treatment with antibiotics have caused researchers to use new approaches to treat infections caused by H. pylori, among them specific treatments with flavonoids. Urease enzyme, as one of the most important pathogenic and antigenic factors of this bacterium, is a suitable target for this purpose. In this study, the inhibitory effect of flavonoid compounds compared to acetohydroxamic acid on H. pylori urease enzyme was evaluated using molecular modeling methods. First, the interaction of flavonoids with urease enzyme compared with acetohydroxamic acid was investigated by molecular docking method to produce efficient docking poses. Then the physicochemical properties and toxicity of the best flavonoid compounds were analyzed using the swissadme server. Also, molecular dynamics calculations were performed to precisely understand the interactions between ligands and protein. The results of this study show that all the investigated flavonoid compounds are capable of inhibiting H. pylori urease. Among these compounds, six compounds chrysin, galangin, kaempferol, luteolin, morin and quercetin showed a greater tendency to bind to urease, compared to the acetohydroxamic acid inhibitor. These compounds are desirable in terms of physicochemical properties. This study also revealed that the flavonoids with their hydroxyl groups (–OH) play an important role during bond formation with amino acids Ala278, Ala169, His314, Asp362 and Asn168. Therefore, flavonoid compounds, due to their suitable location in the active site of the urease, create a more effective inhibition than the chemical drug acetohydroxamic acid and can be suitable candidates for the treatment of Helicobacter pylori under in vitro and in vivo investigations. Communicated by Ramaswamy H. Sarma.

Эффективность и безопасность пантопразола в лечении пациентов с кислотозависимыми заболеваниями в России: многоцентровое наблюдательное исследование

The aim – evaluate the clinical effect and adherence to pantoprazole (Nolpaza®) therapy in patients with acid-dependent diseases in real clinical practice. Pantoprazole occupies a special place among various representatives of proton pump inhibitors (PPI) due to the peculiarities of its pharmacokinetics and pharmacodynamics. Thus, the area under the curve (AUC), correlating with the severity of acid-suppressive effect, is significantly higher for pantoprazole than for other PPIs. In addition, pantoprazole has a longer-lasting antisecretory effect because it is the only PPI that binds to both cysteine 813 and deep-lying cysteine 822. Of all PPIs, pantoprazole least blocks the CYP2C19 isoenzyme involved in multidrug metabolism, ensuring minimal drug interactions. Material and methods. Data collection for further analysis was performed using specially designed electronic individual registration cards of two groups of patients: the first – patients with gastroesophageal reflux disease (GERD), receiving therapy with Nolpaza®; the second – patients with peptic ulcer disease (PU) / erosive gastritis and patients with an indication for Helicobacter pylori eradication, receiving therapy with Nolpaza® as part of the eradication therapy regimen. Conclusion. According to the results of the conducted study it was possible to evaluate the clinical effect and tolerability of Nolpaza® therapy using the data of more than 14 thousand patients with GERD, gastritis, duodenitis, gastric and duodenal ulcer, drug-induced gastropathy, 98% of whom had gastrointestinal complaints before the beginning of treatment, while by the end of therapy the complaints remained in full in less than 1% of patients. The results of esophagogastroduodenoscopy at the end of therapy with Nolpaza® confirmed positive dynamics in 99.8% of cases, and the vast majority of patients achieved complete endoscopic remission. Positive dynamics was also observed in the majority of patients who were tested for H. pylori infection. The efficacy of eradication therapy with Nolpaza® amounted to 88.2%. The study provided a high assessment of patient adherence throughout the follow-up period.

THE FEATURES OF ENDOVASCULAR SURGERY FOR DUODENAL ULCER BLEEDING

Aim of the research was to study improvement of the results of surgical treatment of duodenal ulcer bleeding based on the use of endovascular embolization. Gastrointestinal bleeding is a relatively common condition with a wide range of underlying causes. In most cases, this acute bleeding is effectively managed by conservative, medical or endoscopic procedures. However, the proportion of endoscopically unrecognized or controlled non-variceal gastrointestinal bleeding still requires alternative, sometimes surgical, treatment. The current S2k guideline Gastrointestinal Bleeding gives importance to interventional radiology in considering its minimally invasive endovascular interdisciplinary therapy options, guideline-oriented endovascular treatment of Gastrointestinal bleeding by embolization and implantation of covered stents is a treatment approach with good technical and clinical success rates and low complication rates. Gastrointestinal bleedings (GIBs) are pathological conditions associated with significant morbidity and mortality. Embolization without angiographic evidence of contrast media extravasation is proposed as an effective procedure in patients with clinical and/or laboratory signs of bleeding. The purpose of this systematic review is to define common clinical practice and clinical and technical outcomes of blind and preventive embolization for upper and lower gastrointestinal bleeding. Knowledge of vascular anatomy is essential to achieve adequate hemostasis. Endovascular embolization dramatically reduces the mortality rate in high-risk patients who require open surgery after failed endoscopy, further studies are needed to fully address these objectives.

PIN1 as a Predictive Biomarker for H. pylori Infection–Associated Gastric Cancer

Cancer is now one of the major causes of death across the globe. Peptidylprolyl cis/trans isomerase, NIMA-interacting 1 (PIN1), has recently emerged as a critical factor in various cancers. Numerous studies have shown that PIN1 is highly expressed in several cancer types and is significantly associated with the prognosis of patients with a certain type of tumor such as gastric cancer. Meanwhile, some studies have indicated that infection with Helicobacter pylori significantly increases the risk of developing duodenal and gastric ulcer disease and gastric cancer. In this article, we propose that PIN1 can play a vital role in the prognosis of Helicobacter pylori infection-associated with peptic ulcer disease and can be effective in order to provide the best cure and the choice for treatment.

From Selye's and Szabo's Cysteamine-Duodenal Ulcer in Rats to Dopamine in the Stomach: Therapy Significance and Possibilities.

We reviewed gastric ulcer healing by dopamine considering several distinctive duodenal key points. Selye and Szabo describe the cysteamine-induced duodenal ulcer in rats as a duodenal stress ulcer in patients. Szabo's cysteamine duodenal ulcer as the dopamine duodenal healing and cysteamine as a dopamine antagonist signifies the dopamine agonists anti-ulcer effect and dopamine antagonists ulcerogenic effect. From these viewpoints, we focused on dopamine and gastric ulcer healing. We mentioned antecedent studies on the dopamine presence in the stomach and gastric juice. Then we reviewed, in the timeline, therapy significance arising from the anti-ulcer potency of the various dopamine agonists, which is highly prevailing over the quite persistent beneficial evidence arising from the various dopamine antagonists. Meanwhile, the beneficial effects of several peptides (i.e., amylin, cholecystokinin, leptin, and stable gastric pentadecapeptide BPC 157, suggested as an acting mediator of the dopamine brain-gut axis) were included in the dopamine gastric ulcer story. We attempt to resolve dopamine agonists/antagonists issue with the dopamine significance in the stress (cysteamine as a prototype of the duodenal stress ulcer), and cytoprotection (cysteamine in small dose as a prototype of the cytoprotective agents; cysteamine duodenal ulcer in gastrectomized rats). Thereby, along with dopamine agonists' beneficial effects, in special circumstances, dopamine antagonists having their own ulcerogenic effect may act as "mild stress (or)" or "small irritant" counteracting subsequent strong alcohol or stress procedure-induced severe lesions in this particular tissue. Finally, in the conclusion, as a new improvement in further therapy, we emphasized the advantages of the dopamine agents' application in lower gastrointestinal tract therapy.

Formulation of Entandrophragma utile into an Herbal Emulgel for the Management of Inflammation.

Introduction: Globally, the incidence of inflammation and inflammatory disorders has continued to rise at an alarming rate. Entandrophragma utile is a species of flowering plant widely distributed in Africa and has been used for the management of sickle cell disease, rheumatism, ocular inflammation, duodenal and stomach ulcers. This research aims to formulate and evaluate an anti-inflammatory herbal emulgel using an extract from Entandrophragma utile stem bark (EUB). Method: Using a carrageenan-induced paw oedema model, the anti-inflammatory efficacy of EUB the extract was assessed. The formulated Entandrophragma utile emulgels (EUE) were characterized, and their anti-inflammatory activity was demonstrated, by utilizing diclofenac emulgel-treated rats with complete Freund's adjuvant (CFA)-induced arthritis model as the positive control group. Results: The emulgels formulated had characterization results within acceptable ranges; pH (4.25-5.80), viscosity (418.9-112.8 mPas), spreadability (25.00-31.82 gcm/s), extrudability (30.86-51.02 g/cm2), and a swelling index of (30-60%). The emulgel produced a concentration-dependent inflammatory inhibition with a peak effect (117.97%) at the end of the 4th week which was comparable to that of commercial diclofenac (127.19%). The phytochemical analysis led to the identification of saponins, flavonoids, phenols, and tannins as active secondary metabolites. Conclusions: The stem bark extract of E. utile possessed noteworthy (p < 0.05) reduction in inflammation in comparison to diclofenac and its emulgel formulation showed enormous potential for treating inflammation and pain.

Successful use of dupilumab for egg-induced eosinophilic gastroenteritis with duodenal ulcer: a pediatric case report and review of literature

BackgroundNon-esophageal eosinophilic gastrointestinal disorder (non-EoE-EGID) is a rare disease in which eosinophils infiltrate parts of the gastrointestinal tract other than the esophagus; however, the number of patients with non-EoE-EGID has been increasing in recent years. Owing to its chronic course with repeated relapses, it can lead to developmental delays due to malnutrition, especially in pediatric patients. No established treatment exists for non-EoE-EGID, necessitating long-term systemic corticosteroid administration. Although the efficacy of dupilumab, an anti-IL-4/13 receptor monoclonal antibody, for eosinophilic esophagitis, has been reported, only few reports have demonstrated its efficacy in non-EoE EGIDs.Case presentationA 13-year-old boy developed non-EoE-EGID with duodenal ulcers, with chicken eggs as the trigger. He was successfully treated with an egg-free diet, proton pump inhibitors, and leukotriene receptor antagonists. However, at age 15, he developed worsening upper abdominal pain and difficulty eating. Blood analysis revealed eosinophilia; elevated erythrocyte sedimentation rate; and elevated levels of C-reactive protein, total immunoglobulin E, and thymic and activation-regulated chemokines. Upper gastrointestinal endoscopy revealed a duodenal ulcer with marked mucosal eosinophilic infiltration. Gastrointestinal symptoms persisted even after starting systemic steroids, making it difficult to reduce the steroid dose. Subcutaneous injection of dupilumab was initiated because of comorbid atopic dermatitis exacerbation. After 3 months, the gastrointestinal symptoms disappeared, and after 5 months, the duodenal ulcer disappeared and the eosinophil count decreased in the mucosa. Six months later, systemic steroids were discontinued, and the duodenal ulcer remained recurrence-free. The egg challenge test result was negative; therefore, the egg-free diet was discontinued. Blood eosinophil count and serum IL-5, IL-13, and eotaxin-3 levels decreased after dupilumab treatment. The serum levels of IL-5 and eotaxin-3 remained within normal ranges, although the blood eosinophil counts increased again after discontinuation of oral prednisolone.ConclusionsSuppression of IL-4R/IL-13R-mediated signaling by dupilumab may improve abdominal symptoms and endoscopic and histologic findings in patients with non-EoE-EGID, leading to the discontinuation of systemic steroid administration and tolerance of causative foods.

Assessment of the condition severity and prediction of postoperative complications in elderly and senile patients with perforated gastric and duodenal ulcer

Aim. To assess the condition severity and predict postoperative complications and mortality in elderly and senile patients with perforated gastric and duodenal ulcer using the P-POSSUM score. Materials and methods. To conduct a scientific study, 80 (100.0 %) cases of treatment for patients aged 60 to 89 years with a diagnosis of gastric or duodenal ulcer perforation were analyzed. At the stage of hospitalization, the general condition was assessed using the variables of the P-POSSUM score. All patients underwent emergency surgery. Results. The obtained sum of points was compared with postoperative complications and mortality. We defined the discrimination point as &gt;43 points for postoperative complications and &gt;48 points for mortality. Based on the result, the patients were divided into group A with a sum of points up to 43 inclusive – 39 patients (48.8 %), and with a greater number of points – 41 patients (51.2 %) – group B. Evaluation of the detected complications in the postoperative period and comparison with the sum of points significantly confirmed an increase in their frequency in group B (sum of points &gt;43) as compared to group A (sum of points ≤43) – p = 0.0018, U = 474.0. To compare the mortality rate, all the patients were divided into group C – 48 (60.0 %) patients with a sum of points ≤48, and group D – 32 patients (40.0 %) with a sum of points ≥49. In the group of patients with a total score &gt;48 (group D), the mortality rate was significantly increased compared to group C with a score ≤48, p = 0.0002, U = 384.0. Conclusions. Our study has led to the following conclusions: the P-POSSUM score use in elderly and senile patients with perforated gastric and duodenal ulcers significantly confirms the increase in the frequency of postoperative complications, in group A – 6 (15.4 %) patients, while in group B – 23 (56.1 %), p = 0.0018, U = 474.0 and increased mortality, in group C – 6.3 %, in group D – 56.3 %, p = 0.0002, U = 384.0; the P-POSSUM score provides reliable prediction an increase in the risk of postoperative complications and mortality. This, in turn, makes it possible to predict and change treatment approaches and improve the quality of emergency surgical care for elderly and senile patients.

ASPECTS DIAGNOSTIQUES ET THERAPEUTIQUES DES PERFORATIONS DIGESTIVES NON TRAUMATIQUES AU CENTRE HOSPITALIER UNIVERSITAIRE DE LIBREVILLE (GABON).

ABSTRACT Introduction: Non-traumatic digestive perforations are digestive surgical emergencies. They are usually considered perforations in free peritoneum. The objective of this work is to study the epidemiological, diagnostic and therapeutic aspects of non-traumatic digestive perforations at the Visceral Surgery Department of the Libreville University Hospital. Patients and method: Retrospective study of patients hospitalized and operated on at the Visceral Surgery Department of the Libreville University Hospital from January 2016 to December 2020 for non-traumatic digestive perforations. Epidemiological, etiological and therapeutic data were studied Results: They represented 14.1% of digestive surgical emergencies. The average age of the patients was 34±13.7 years [16-70 years]. the sex ratio was equal to 2.3. Intraoperatively, duodenal perforations were found in 48.1% of patients (n=37). Among the perforations of the small intestine, 4 were probably of typhoid origin (5.1%). The only colonic perforation was of tumor origin. In case of perforation of duodenal ulcer, suture associated with omental plasty was performed. An appendectomy was performed in all patients with appendiceal perforation. Overall operative morbidity was 3.9%. Mortality was 1.3% (n=1). The average length of hospitalization was 8.3 days. Conclusion: Non-traumatic digestive perforations are frequent digestive surgical emergencies, occurring at all ages, especially in men. The etiologies are numerous. The surgical procedure depends on the etiology. Keywords: duodenal ulcer, small intestine, colon, perforation, Libreville

Causes of upper gastrointestinal bleeding in patients admitted to Erbil hospitals

Background and objectives: This study aimed to Find the causes of upper gastrointestinal bleeding in Erbil hospitals and to study these causes for the purpose of reducing their mortality. Methods: One hundred cases of upper gastrointestinal bleeding have been collected. All the cases have been admitted to Erbil hospitals from March 2019 to March 2021. Demographic data, blood investigation, ultrasound, and endoscopy with rapid urease test for Helicobacter pylori infection have been done for all patients to find the cause of upper gastrointestinal bleeding. Data analysis has been done by using a statistical package for Social Sciences -22. Results: A total number of fifty seven males and fourty three females, with upper gastrointestinal bleeding were included, eighty of them had positive rapid urease test by endoscopy, seventy five patients had duodenal ulcer, six cases had gastroesophageal varices, tumors found in five patients after histopathological investigation of the endoscopic biopsies, gastric erosions found in twelve patients. Ninty five of patients had first time bleeding, low hemoglobin found in fifty nine patients, that thiry of them presented in shock state, from these patients twenty two cases received more than five units of blood. Conclusion: Upper gastrointestinal bleeding mainly has been the cause duodenal ulcer bleeding which itself has been caused by infection with Helicobacter pylori. Secondly, drugs, which had been used, have been regarded as the main causes of bleeding.

Review on Gastroprotective Effect of Herbal Medicines

Herbal medicines are very important to cure the various ailments of human. Demands of the herbal&#x0D; medicines are increasing in both developed and under developed countries due to growing recognition of natural plants being lesser of side effect, easily available in surrounding place with low coast. Despite extensive research, the etiology ofpeptic ulcer disease remains unclear. Given the multiple processes that control acid and pepsin secretion and defense and repair of the gastroduodenal mucosa, it is likely that the cause of ulceration differs between individuals. Acid and pepsin appear to be necessary but not sufficient ingredients in the ulcerative process.. NSAIDs cause a significant number of gastric and duodenal ulcers; this is probably due to inhibition of prostaglandin production with loss of its protectiveeffects. In the absence of NSAIDs and gastrinoma, it appears that most gastric ulcers and all duodenal ulcers occur in the setting of H. pylori infection. Gastric ulcer often occurs with decreased acid-peptic activity, suggesting that mucosaldefensive impairments are more important. The combination of inflammation, protective deficiencies, and moderate amounts of acid and pepsin may be enough to induce ulceration. Many questions remain in understanding the pathophysiology of peptic ulcer disease. The physiology and pathophysiology of mucosal regeneration and the mechanisms by which H. pylori and inflammation disrupt normal gastroduodenal function will be fruitful areas of future investigation. In this review attempts have been made to know the antiulcer drug of natural origin with their suggestedmedicinal part.&#x0D; Key Words: Peptic ulcer , H.pylori , Herbal Medicines ,NSAID’s

METHODS FOR CLOSING PERFORATIONS OF GASTRIC AND DUODENAL ULCERS

This literature-based review analyzes different methods of closure of perforated gastric and duodenal ulcers. In addition, there have been determined the indications for the use of each method, the technique of performing, the advantages and disadvantages, as well as the prospects for use and their feasibility at the current level of abdominal surgery development.

Component composition and biological activity of essential oil of plant Zinnia elegans

By the method of steam distillation, samples of essential oil were obtained from a plant cultivated in the East Kazakhstan region. The essential oil was obtained with a yield in terms of air-dry raw materials. The method of gas-liquid chromatography carried out a quantitative analysis of the components of the essential oil. The quantitative content of essential oil components was calculated from the areas of gas chromatographic peaks without using correction factors. The main components of Zinnia elegans essential oil are α-terpineol, β-myrcene, myrtenal and camphene. Terpineol has a pleasant, lilac-like odor and is a common ingredient in perfumes, cosmetics, and fragrances. Pleasant smelling oily liquid. Myrcene has a large number of beneficial properties for the body, whether pure or in aromatherapy through the essential oils that contain it: Sedative and muscle relaxant, anti-inflammatory, interferon inhibition, gastric and duodenal ulcers, antalgic and antinociceptive, reduces sensitivity to pain by self-healing endogenous derivatives of morphine. Myrtenal - has an anti-inflammatory, resolving effect on acne, infiltrates. Increases the protective barrier of the epidermis. Antioxidant, rejuvenating. Camphene components are effective in the treatment of fungal, viral and bacterial infections that affect the respiratory system.

A Case Study of Primary Leiomyosarcoma of Bone with Duodenal Hemorrhage

&lt;p&gt;臨床上常見因長期使用非類固醇類消炎藥（non-steroidal anti-inflammatory drug, NSAID），造成上腹痛合併解黑便及頭暈症狀而至胃腸內科求治病患。本案例為62歲男性，近日因上腹悶痛合併頭暈持續3天故來院求治，初步臆斷為十二指腸糜爛性潰瘍併出血收治住院治療。身體評估發現右橈骨異常腫塊，詢問病史發現個案長期藉由服用NSAIDs緩解右前臂腫脹痠痛症狀，安排右手X光檢查及會診骨科進行右橈骨病灶處切片。十二指腸及右橈骨病灶處切片病理報告呈現相同異常梭形細胞，最終確診右橈骨骨源性平滑肌肉瘤（primary leiomyosarcoma of bone, LMSB）併十二指腸轉移。經跨團隊及院際醫療討論後，個案轉至醫學中心接受術前放射線、手術及化學藥物等治療。透過本案例探討，提醒入院時詳細完整病史詢問及身體評估有助於鑑別診斷，並可提供臨床更多元之考量，避免錯失治療黃金時間。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Patients who have been taking non-steroidal anti-inflammatory drugs (NSAIDs) for a long time are of-ten referred to the gastrointestinal clinics due to epigastric pain combined with melena and dizziness symptoms. The case in this study is a 62-year-old man who had epigastric pain and dizziness for three days. The initial diagnosis was duodenal erosive ulcer and hemorrhage, and the patient was admitted to hospital for treatments. The physical assessment revealed an abnormal mass in the right radius, and a medical history was found that NSAIDs were taken by the patient for a long period to relieve the swelling and soreness of the right forearm. An X-ray examination of the right hand was subsequently arranged and a consultation with the orthopaedic specialists was conducted for further conduct biopsy. The pathological report of the duodenum and right radius lesions showed the same abnormal spindle cells, therefore, the primary leiomyosarcoma of bone (LMSB) in right radius with duodenal metas-tasis was finally confirmed. Through multidisciplinary and inter-hospital medical discussions, the patient was immediately transferred to the medical center for preoperative radiotherapy followed by surgery and chemotherapy. This case study indicates the importance of performing a detailed medical history examination and physical assessment upon admission which are helpful for differential diag-nosis and can provide more clinical considerations for promptly treatments.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Chicken bone-induced ileal perforation peritonitis mimicking duodenal perforation peritonitis: a case report

Introduction: Foreign body ingestion can lead to bowel perforation and peritonitis. We present a case of a 54-year-old male who ingested a chicken bone, resulting in ileal perforation that mimicked duodenal perforation peritonitis. Case Presentation: The patient has a history of peptic ulcer disease and regularly used non-steroidal anti-inflammatory drugs over the counter, adding more evidence to the provisional diagnosis of duodenal perforation. Exploratory laparotomy revealed the ileal perforation and the chicken bone was successfully removed. Wedge resection of the perforated segment and ileo-ileal anastomosis were performed. Discussion: Although history, examination, and investigation were more in favor of duodenal ulcer, our patient had ileal perforation due to chicken bone. Prompt identification and early surgical intervention are crucial to prevent complications and reduce mortality rates. The patient had an uneventful recovery. Conclusion: Timely referral to a tertiary care center is essential for early surgical intervention and successful management of bowel perforation caused by a foreign body.

Abstract C079: H. pylori eradication for mitigating gastro-duodenal cancers: Modeling pharmacokinetics of levofloxacin niosomes in Sprague-Dawley rats

Abstract Eradication of Helicobacter pylori (H. pylori) and, hence, control of its associated conditions (peptic ulcer, gastric cancer, and lymphoma) still constitute major challenge to therapeutics. H. pylori has been implicated in 60% of gastric and 90 % of duodenal ulcers and has been classified as a Class 1 carcinogen in human by the International Agency for Research on Cancer and the World health Organization (Enerson et al, 2016; Vogiatzi et al, 2007; WHO). It affects 4million people world-wide of which 0.5million is from the US and 70% are of 25-64 y/o (Chung &amp; Shelat, 2017). Presently, gastric cancer is the second leading cause of neoplastic mortality globally (Contreras et al, 2014; Owen et al, 2018). The efficacy of currently used antibiotics (erythromycin, clarithromycin, levofloxacin, and azithromycin) in triple or quadruple combinations with proton pump inhibitor (PPI) is decreasing due to resistance development via lipopolysaccharide modification, increased drug efflux, and reduced porin pathway. Adaptive response by bacteria to specific signal due to antibacterial presence in its environment, leading to up-regulation of the efflux system (MexXY/OprM), and down-regulation of porin pathway (OprD) has been recognized as key factor in the resistance manifestation. In an earlier study, we reported that encapsulation of an anti-H. pylori drug (levofloxacin) molecules in niosomes (nano-size lipid vesicles) improved its molecular assimilation by drug-resistant E. coli and Ps. aeruginosa and produced approximately 50 % reduction in their minimum inhibitory concentrations (MIC) (Jankie et al, 2012). In this study, we investigated the in vivo bioavailability of levofloxacin niosomes administered intraperitoneally to Sprague Dawley rats. Plasma data modelling in Gastroplus PKTM for non-compartmental through 3-compartmental models, using Hooke &amp; Jeeves pattern search, indicated that pure levofloxacin obeyed two-compartment kinetic model, while levofloxacin niosomes demonstrated one-compartmental model. In addition, niosome encapsulation increased drug exposure (AUC) about 5 folds and duration of action (mean residence time, MRT) about 1.6 folds. Thus, niosome encapsulation changed distribution pattern and the values of PK parameter supported 2-compartmental and 1-compartmental models for levofloxacin and its niosomes respectively. The knowledge of in vivo rodent PK generated in this study is vital for the determination of test doses in a higher animal species and, subsequent, for the calculation of thee first in human dose of levofloxacin using allometric equations. Generally, the potential is quite high for niosomes encapsulation to enhance the efficacy of other anti-H. pylori drugs against drug-resistant bacterial strains and needs to be investigated. Citation Format: Amusa S. Adebayo, Satish Jankie. H. pylori eradication for mitigating gastro-duodenal cancers: Modeling pharmacokinetics of levofloxacin niosomes in Sprague-Dawley rats [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C079.

Academician Viktor Sergeyevich Savelyev (1928–2013) (on the 95th anniversary of his birth)

Outstanding surgeon, scientist, teacher and organizer of healthcare, founder of a large surgical school, Hero of Socialist Labor (1988), academician of the USSR Academy of Medical Sciences (1974), RAMS (1991) and RAS (1997), laureate of the USSR State Prize (1975), the State Prize of the Russian Federation (1992), Demidov Prize (2002) and the A. N. Bakulev Prize (2002), Professor Viktor Sergeevich Savelyev was born on February 24, 1928 in the village of Pakhotny Ugol of the Bondarsky district of the Tambov region in the family of Sergei Dmitrievich Savelyev, a wood sawmill worker, and Olga Kuzminichna, a housewife. In 1945, Viktor Sergeevich entered the 2nd Moscow Medical Institute (now the Pirogov Russian National Research Medical University). After graduating in 1951, he studied in residency at the Department of Faculty Surgery, which was headed by the academician A. N. Bakulev, and was stayed at the department as an assistant. After defending his PhD thesis in 1955, he was appointed a teacher. In 1959, V. S. Savelyev successfully defended his doctoral dissertation, in 1961, he passed the academic title of Professor, in 1967, he was elected the head of the Department of Faculty Surgery. Viktor Sergeevich fully became the successor of A. N. Bakuleva and made the very great contribution to the development of domestic cardiac surgery. The works of V. S. Savelyev played a huge role in the formation and rapid development of vascular surgery. The clinic he headed has accumulated the world’s largest experience in the treatment of acute thrombosis and embolism of the main arteries. Viktor Sergeevich is rightfully one of the founders of modern Russian phlebology. He also made a significant contribution to the development of surgery of the stomach, intestines, bile ducts and pancreas. He was one of the first in the country to use organ-preserving operations on the stomach for complicated duodenal ulcer. Many of Viktor Sergeevich’s works were devoted to various aspects of postoperative management of patients, infusion therapy and parenteral nutrition, pathogenesis, diagnosis and treatment of sepsis. V. S. Savelyev and his students made a significant contribution to the development of abdominal endoscopy. V. S. Savelyev was a major organizer of domestic healthcare, for 34 years he held the post of the chief surgeon of the Ministry of Health of Russia. He was the Chairman of the Scientific Society of Surgeons of Russia (ROH), founder and president of the Russian Association of Phlebologists, editor-in-chief of journals «Thoracic and Cardiovascular Surgery» and «Phlebolymphology». Under his leadership and with his participation as the scientific consultant, 70 doctoral and 180 candidate dissertations were defended. He was the author and co-author of more than 500 scientific papers, including 24 monographs and manuals. The academician Viktor Sergeevich Savelyev died on December 25, 2013 and was buried in Moscow at the Troyekurovo Cemetery.