Gastrointestinal Pathology Research Articles

Effect of Probiotics on Gastrointestinal Health Through the Aryl Hydrocarbon Receptor Pathway: A Systematic Review

Probiotics are living microorganisms recognized for conferring health benefits on the host by modulating the gut microbiota. They interact with various signaling pathways, including the aryl hydrocarbon receptor (AhR), which plays a crucial role in maintaining intestinal homeostasis and immune function. The activation of AhR by probiotics has been associated with benefits such as improved intestinal barrier function, reduced inflammation, and modulation of immune responses. This systematic review aims to summarize current knowledge on the signaling of AhR, mediated by probiotics in physiological conditions and gastrointestinal pathologies. We conducted a comprehensive search across databases, including PubMed and Embase, up until July 2024. Out of 163 studies screened, 18 met the inclusion criteria. Our findings revealed in healthy populations that probiotic consumption increases the production of AhR ligands promoting intestinal immune tolerance. Furthermore, in populations with gastrointestinal pathologies, probiotics ameliorated symptoms through AhR activation by Trp metabolites, leading to the upregulation of the anti-inflammatory response.

Histopathological patterns of gastrointestinal lesions: Insights from a Tertiary Care Centre

Gastrointestinal (GI) lesions are a common clinical concern with significant implications for patient health, particularly in cases involving malignancies. Understanding the histopathological spectrum of these lesions is crucial for improving diagnosis and treatment strategies. This study aimed to investigate the histopathological spectrum of gastrointestinal lesions at a tertiary care center, focusing on the prevalence of different types of lesions and their distribution according to clinicopathological parameters. Methods: This cross-sectional study was conducted over a one-year period, from November 2022, to October 2023, at the Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, UP. A total of 100 patients with clinically suspected GI lesions were included. Biopsy specimens were collected and analyzed using standard histopathological techniques. The data were analyzed to determine the frequency of different types of GI lesions and their correlation with clinical features. Results: The study found that inflammatory lesions were the most prevalent, accounting for 57% of the cases. Malignant lesions were identified in 35% of the patients, with adenocarcinoma being the most common malignancy, especially in the colon, representing 57.14% of malignant cases. The small intestine was the most frequently affected anatomical site, involved in 33% of the cases, followed by the appendix at 22%. The majority of patients were middle-aged males, with a significant correlation between the type of lesion and gender. Conclusion: This study highlights the significant burden of gastrointestinal lesions, particularly inflammatory and malignant lesions, in the studied population. The findings underscore the importance of early detection and intervention to prevent the progression of these lesions, particularly in high-risk groups such as older males. Enhanced clinical management strategies are needed to address the substantial impact of GI pathologies on patient health.

Risk factors for infectious endocarditis of prosthetic valves: a systematic review

Introduction: valve endocarditis is a major health challenge; its etiology is varied, and it can cause multiple complications or death.Objective: to identify risk factors for infective endocarditis in prosthetic valves. Methods: systematic and retrospective review of the available literature using records from Pubmed, Epistemonikos, Cochrane library, Uptodate.Results: in Argentina, from September 2013 to March 2016, 502 patients with infective endocarditis (IE) were studied in 48 medical centers. The majority were men (69,9 %) with a mean age of 60,7 years. The main risk factors were known underlying heart disease (45,36 %), diabetes (23,5 %), chronic renal failure (16,5 %), neoplastic disease (12,1 %) and history of previous IE (8,96 %). The most frequent predisposing events were endovascular (31,9 %) and dental (12,6 %) procedures. New causes of IE related to gastrointestinal pathologies were also identified.Conclusion: patients with IE have a high clinical risk profile and show increasing age over the decades. Staphylococcus aureus is the most frequent microorganism followed by Streptococcus viridans. The identification of independent predictors of in-hospital mortality continues to be a challenge due to the new agents that are identified or risk factors that are added over time; identifying them could help to establish behavioral modification strategies that lead to improved outcomes

Metabolomic analysis to predict the onset and severity of necrotizing enterocolitis

BackgroundNecrotizing enterocolitis (NEC) is the most devastating gastrointestinal (GI) emergency in preterm neonates. Untargeted metabolomics may allow the identification of biomarkers involved in NEC pathophysiology.MethodsWe conducted a prospective study including preterm infants born at < 34 gestational weeks (GWs) whose urine was longitudinally collected at birth (< 48 h, T0) and at 14 (T1) and 28 days (T2). Neonates were followed for their development of NEC, spontaneous intestinal perforation (SIP), or other GI conditions and compared to those of matched healthy controls. Urine samples were investigated by untargeted metabolomic analysis based on mass-spectrometry.ResultsThirty-five patients with NEC, 5 patients with SIP, 14 patients with other GI diseases and 113 controls were enrolled and selected for metabolomic analysis on the basis of their clinical characteristics and available samples. Considering urine samples at T0, the one-class classification approach was able to correctly classify 16/20 subjects (80%) who developed NEC, 3/3 (100%) who developed SIP and 5/7 subjects (71.4%) with other GI pathologies as not belonging to the control group. Neonates with surgical NEC had higher N-acetylaspartic acid, butyrylcarnitine and propionylcarnitine levels than did those with medical NEC. Considering the time evolution of the urinary metabolome, the NEC and control groups showed differences independently of the time point.ConclusionsThe urinary metabolome is closely associated with the underlying GI disease from birth. Urinary metabolic features characterize NEC patients from healthy controls until 28 days of life. The early urinary metabolome has the potential to predict surgical NEC. Future studies are needed to validate our results.

SARS-CoV-2 infection perturbs the gastrointestinal tract and induces modest microbial translocation across the intestinal barrier.

SARS-CoV-2 infects via the respiratory tract, but COVID-19 includes an array of non-respiratory symptoms, among them gastrointestinal (GI) manifestations such as vomiting and diarrhea. Here we investigated the GI pathology of SARS-CoV-2 infections in rhesus macaques and humans. Macaques experienced mild infection with USA-WA1/2020 and shed viral RNA in the respiratory tract and stool, including subgenomic RNA indicative of replication in the GI tract. Intestinal immune cell populations were disturbed, with significantly fewer proliferating (Ki67+) jejunal B cells in SARS-CoV-2-infected macaques than uninfected ones. Modest translocation of bacteria/bacterial antigen was observed across the colonic epithelium, with a corresponding significant increase in plasma soluble CD14 (sCD14) that may be induced by LPS. Human plasma demonstrated significant decreases in interleukin (IL)-6 and sCD14 upon recovery from COVID-19, suggesting resolution of inflammation and response to translocated bacteria. sCD14 significantly positively correlated with zonulin, an indicator of gut barrier integrity, and IL-6. These results demonstrate that GI perturbations such as microbial translocation can occur in even mild SARS-CoV-2 infections and may contribute to the COVID-19 inflammatory state.IMPORTANCEThis study investigates gastrointestinal (GI) barrier disruption in SARS-CoV-2 infections and how it may contribute to disease. We observed bacteria or bacterial products crossing from the colon interior (the lumen) to the lamina propria during SARS-CoV-2 infection in macaques. Bacteria/bacterial products are tolerated in the lumen but may induce immune responses if they translocate to the lamina propria. We also observed a significant increase in soluble CD14, which is associated with an immune response to bacterial products. In addition, we observed that humans recovering from COVID-19 experienced a significant decrease in soluble CD14, as well as the inflammatory marker interleukin (IL)-6. IL-6 and sCD14 correlated significantly across macaque and human samples. These findings suggest that SARS-CoV-2 infection results in GI barrier disruption that permits microbial translocation and a corresponding immune response. These findings could aid in developing interventions to improve COVID-19 patient outcomes.

Probiotics as Potential Tool to Mitigate Nucleotide Metabolism Alterations Induced by DiNP Dietary Exposure in Danio rerio.

Diisononyl phthalate, classified as endocrine disruptor, has been investigate to trigger lipid biosynthesis in both mammalian and teleostean animal models. Despite this, little is known about the effects of DiNP exposure at tolerable daily intake level and the possible mechanisms of its toxicity. Probiotics, on the other hand, were demonstrated to have beneficial effects on the organism's metabolism and recently emerged as a possible tool to mitigate the EDC toxicity. In the present study, using a metabolomic approach, the potential hepatic sex-related toxicity of DiNP was investigated in adult zebrafish together with the mitigating action of the probiotic formulation SLAB51, which has already demonstrated its ability to ameliorate gastrointestinal pathologies in animals including humans. Zebrafish were exposed for 28 days to 50 µg/kg body weight (bw)/day of DiNP (DiNP) through their diet and treated with 109 CFU/g bw of SLAB51 (P) and the combination of DiNP and SLAB51 (DiNP + P), and the results were compared to those of an untreated control group (C). DiNP reduced AMP, IMP, and GMP in the purine metabolism, while such alterations were not observed in the DiNP + P group, for which the phenotype overlapped that of C fish. In addition, in male, DiNP reduced UMP and CMP levels in the pyrimidine metabolism, while the co-administration of probiotic shifted the DiNP + P metabolic phenotype toward that of P male and closed to C male, suggesting the beneficial effects of probiotics also in male fish. Overall, these results provide the first evidence of the disruptive actions of DiNP on hepatic nucleotide metabolism and mitigating action of the probiotic to reduce a DiNP-induced response in a sex-related manner.

Peculiarities of the format of genetic blood systems in patients with oral lichen planus

The number of patients with oral lichen planus (OLP) has increased due to the raise of aggressive forms of the disease (erosive, ulcerative and hyperkeratotic forms) with a possible risk of malignancy. There are isolated researches which indicate a genetic determinism to OLP, but more often these conclusions are based on insufficiently adequate and out of date methods, which make it impossible to correctly interpret the obtained data. The aim was to identify a genetical predisposition with a programmed risk to the oral lichen planus. The main group – 278 patients with the OLP (aged 26-65 years). The control group – 298 people (blood donors) who didn’t have dental diseases, as well as diseases of internal organs and systems. The groups were homogeneous by gender and age. In our research we used such methods: clinical, radiological, immunogenetic, statistical methods were used. The erosive form of OLP was associated with 0(I) group in 54.2±0.4% of cases, while the hyperkeratotic form was associated with group 0(I) only in 28.7±1.8% of cases. B(ІІІ) and AB(ІB) groups were less often associated with the erosive form of OLP and were observed in 17.3±0.1% and 2.0±0.1% of cases, respectively. The integration of A(ІІ) group in the erosive form of OLP was 30.5±0.1%, but the indicator was higher than in individuals with B(III) and AB(IV) groups. Hyperkeratotic form of OLP was more often observed in A(II) carriers than in 0(I) and was 44.1±0.1% versus 28.7±1.8%, respectively. With blood group B (ІІІ), the relationship with OLP is not traced. Correlative relationship with erythrocyte blood antigens of the ABO system in patients with oral lichen planus was established. Risk groups for the development of erosive and hyperkeratotic forms of lichen planus in patients with gastrointestinal tract pathology O(I)&gt;A(II)&gt;B(III) – with erosive form and A(II)&gt;O(I)&gt;B(III)) – with hyperkeratosis.

Pathologist Workload Assessment in Gastrointestinal Subspecialty: A Pilot comparative study in an academic setting

Abstract Introduction/Objective There are no official guidelines regarding the workload to be received by pathologists, and it is challenging to distribute equivalent workloads across subspecialties. This study aims to determine whether slide count is a reliable workload metric in gastrointestinal (GI) pathology. Additionally, we seek to compare the time allocation differences between GI pathologists involved in medical resident teaching and those dedicated only to anatomical pathology duties. Methods/Case Report This is an observational retrospective cohort study. We recorded the first two hours of a workday of three experienced GI pathologists at Stanford Healthcare in 2022, two of whom were engaged in teaching. The authors carefully retrospectively reviewed the recorded videos to extract relevant information: teaching activities, number of histological slides, specimens, types of tissues analyzed, and resultant diagnosis. Results (if a Case Study enter NA) Two attendings (2 and 3) signed out with residents, while only one worked alone (1). The mean time spent on each case was 199 and 486 seconds different between attendings 1 and 2 and 1 and 3, respectively (p&amp;lt;.01). There was a strong positive correlation between the number of slides and time spent analyzing each case, r =.607. The number of slides per case statistically explained 36.8% of the time spent per case, p &amp;lt;.001. Conclusion In conclusion, the slide count metric only explains 36.8% of the time expenditure, suggesting that more sophisticated workload assessment methods must be developed, particularly if used for workload distribution purposes. Also, GI pathologists involved in medical training take longer to sign out cases than GI pathologists who are not, suggesting that this is an essential factor that should be considered when distributing workloads.

The A to Z of Peroral Endoscopic Myotomy

Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible. Since then, the indications for POEM have expanded to a range of benign upper gastrointestinal (GI) pathologies including cricopharyngeal bar (C-POEM), Zenker’s diverticulum (Z-POEM), esophageal diverticula (D-POEM), and gastroparesis (G-POEM). POEM offers the benefit of a minimally invasive alternative to surgical intervention with high clinical success and low rate of adverse events. As the field expands, there is need for more high-quality prospective evidence for the use of POEM within the upper GI tract akin to the ground-breaking work that has been achieved in achalasia. Within this review, we discuss the 5 main indications for POEM, the technical aspects of each corresponding procedure, and analyze the current evidence supporting their use in clinical practice.

Probiotic interventions and quality of life in patients with gastrointestinal diseases: A comprehensive review.

Gastrointestinal disorders manifest through disruptions in gastrointestinal functionality accompanied by dysbiosis within the microbiome. Probiotics are considered biological agents with potential therapeutic efficacy in managing gastrointestinal pathologies by modulating the gut microbiota. Nevertheless, several hurdles, such as safety considerations, resilience to stressors, post-colonization quantifications, and evaluative modalities, may impede the adoption of probiotics for gastrointestinal disorders. Herein, we performed online research using 6 databases: Scopus, ScienceDirect, PubMed, Web of Science, Cochrane Library, and Ovid. Inclusion criteria were mostly articles published in the years 2015-2024, concerning the association between probiotics and gastrointestinal diseases. This review aimed to provide comprehensive data regarding the latest studies in this area. Additionally, this review delineates the various aspects of probiotic use, including both the positive and negative aspects, as well as the role of probiotics in immune system modulation and the prevention of various diseases. Also, we comprehensively discuss the prophylactic and supportive therapeutic role of probiotics in the management of COVID-19. Given the extensive adoption of probiotic formulations as microecological interventions for gastrointestinal disorders, a comprehensive understanding of the challenges inherent in their application and the implementation of contemporary methodologies to enhance probiotic colonization and evaluation systems are paramount for harnessing probiotics as viable biotherapeutic agents. However, there is a need for additional studies to confirm the potential role of probiotics as a suitable target in the treatment of gastrointestinal diseases.

8536 Unusual Finding of Familial Adenomatous Polyposis in a Patient with X Linked Adrenoleukodystrophy

Abstract Disclosure: A. Deswal: None. A. Dwarakanathan: None. Introduction: X Linked Adrenal Leukodystrophy (X-ALD) is a rare hereditary genetic disorder of impaired peroxisomal metabolism due to a defective transmembrane protein, ADLP. Defective ADLP impairs transport of VLCFA-CoA esters across cytosol into peroxisomes leading to build-up of toxic VLCFA in the cells. X-ALD is caused by mutation in ABCD1 gene, located on X chromosome, which codes for ADLP. It has a broad clinical spectrum including Cerebral ALD, Adrenomyeloneuropathy and Adrenocortical insufficiency. X-ALD has a general prevalence of 1 in 17,000 newborns. Approximately 80% of males with X-ALD develop primary adrenal insufficiency in their lifetime. It can be diagnosed by measuring VLCFA levels in plasma , checking for ABCD1 gene mutation or by doing Brain MRI (depending upon phenotypical presentation ). Case presentation: We report a case of a 23 year old man who had primary adrenocortical insufficiency subtype of X-ALD. His mother was a carrier of ABCD1 gene mutation. He himself tested hemizygous for ABCD1 gene. He came to our office for a follow up visit after an episode of adrenal crisis for which he was hospitalized. He was started on replacement therapy with prednisone and fludrocortisone. Over the next couple of years, he was diagnosed with diabetes mellitus with initial HbA1C of 8.8%. GAD antibody test for type I DM came out negative. His diabetes was managed with metformin and pioglitazone( later discontinued) .By the age of 25,he was found to have polyposis of colon. He tested positive for APC gene mutation . He underwent a J pouch surgery . He also developed PICA aneurysm. Discussion: X-ALD is a hereditary progressive disease with no association between genetic and phenotypic presentations. Adrenal insufficiency type is usually the first to present. Cerebral ALD is typically diagnosed between the ages of 3-18 presenting as psychiatric illness. Myelopathy typically starts by middle age and involves the spinal cord, causing the affected individuals to develop gait disturbances , bladder and bowel dysfunction, with severe mobility dysfunction by 5th-6th decade of life. We present a unique case of a young man with adrenal insufficiency type of X-ALD who also developed gastrointestinal pathology. Per our literature review, X-ALD has not been seen associated with APC gene mutations or colon carcinomas . Pathology behind XLD revolves around ABCD1 gene mutaion causing VLCFA accumulation in plasma, fibroblasts, adrenal glands, oligodendrocytes , astrocytes etc. Whereas FAP involves APC gene mutation which affects the intestinal epithelial cells leading to their apoptosis and polyp formation. X-ALD and FAP are disorders of two different gene mutations with varied clinical presentations. But the question arises regarding finding of APC gene mutation in a patient with ABCD1 gene mutation that if it is a mere co-incidence or common mutation pathway linking these two disorders exists. Presentation: 6/2/2024

Adverse Events of the Over The Scope Endoscopic Clips and Cutters: A MAUDE Database Analysis

The OVESCO® clip system, including the Over-The-Scope Clip (OTSC) and Full-Thickness Resection Device (FTRD), has demonstrated efficacy in managing various gastrointestinal pathologies. However, real-world data on device malfunctions and patient complications are limited. This study aimed to analyze adverse events associated with OVESCO® clips and cutters reported to the FDA Manufacturer and User Facility Device Experience (MAUDE) database. The MAUDE database was searched for reports related to OVESCO® clips and cutters from January 1, 2007, to August 30, 2024. Event date, device type and model, manufacturer, event type, device problem, and patient complications were extracted. Descriptive statistics were used to summarize the findings. Forty-two reports were identified, with 41 involving OVESCO® clips and one involving an OVESCO® cutter. The most common device problem for OVESCO® clips was failure to deploy (61.0%), followed by unintended deployment or misfiring (17.1%). Gastrointestinal perforation was the most frequently reported patient complication (60%). The OVESCO® cutter report described device component breakage and foreign body retention. No clear trends in adverse event reporting were observed over the study period. OVESCO® clips and cutters are associated with potential device malfunctions and patient complications, particularly gastrointestinal perforation. The findings highlight the need for careful patient selection, meticulous technique, and close post-procedural monitoring. Collaborative efforts among stakeholders are essential to optimize device safety and efficacy. Continued post-marketing surveillance and real-world data analysis are crucial for monitoring the performance of endoscopic devices and improving patient outcomes.

Clinical outcomes and pathologic results following identification of appendicitis

Aims: Acute appendicitis (AA) is one of the most frequent clinical pathologies for urgent surgery in children We aimed to investigate the occurrence and distribution of pathological findings in appendectomy specimens from patients initially diagnosed with AA. Methods: The demographic information and histopathological findings of patients who underwent appendectomy at our center between 2011 and 2021 were retrospectively analyzed. Results: A total of 259 patients were included in the study. The patients were aged 38-212 months (mean 143±39), with 180 (69.5%) male patients. Based on the histopathological results, 63 (24.3%) patienst had lymphoid hyperplasia (LH), 109 (42.1%) AA, 11 (4.2%) suppurative appendicitis (SA), 46 (17.8%) phlegmonous appendicitis (PA), and 30 (11.6%) gangrenous/necrotizing appendicitis (GA). Twenty (31.7%) patients with LH and 16 patients (53.3%) with GA had an invisible appendix on ultrasound. The leucocyte count and appendix diameter were significantly lower in LH than in the other groups (for all comparisons, p&lt;0.001). CRP level was significantly higher in the complicated groups (GA, PA,SA) than the LH and AA groups. The appendix diameter was significantly higher in the GA group than in the PA group (p=0.049). We found a positive correlation between AD and preopertaive leucocyte count, and the duration of hospitalization in days (r=0.265, p=&lt;0.001;r=0243, p=0.001). On the other hand, there was no correlation between appendix diameter and CRP. The binary logistic regression analyses showed that high appendix diameter was a risk factor fo CA (OR:0.206, CI: 95%, 1.061-1.422, p= 0.006). Conclusion: The high rate of complicated cases (33.5%) we found in our study shows that appendicitis can still be complicated. Additionally, the conclusion has been drawn that even in serious cases such as GA, US may overlook appendicitis at a high rate. Finally new diagnostic methods should be developed for cases that do not require surgical intervention, such as LH and eosinophilic gastrointestinal pathologies (colitis).

QSOX2 Deficiency-induced short stature, gastrointestinal dysmotility and immune dysfunction.

Postnatal growth failure is often attributed to dysregulated somatotropin action, however marked genetic and phenotypic heterogeneity exist. We report five patients from three families who present with short stature, immune dysfunction, atopic eczema and gastrointestinal pathology associated with recessive variants in QSOX2. QSOX2 encodes a nuclear membrane protein linked to disulphide isomerase and oxidoreductase activity. Loss of QSOX2 disrupts Growth hormone-mediated STAT5B nuclear translocation despite enhanced Growth hormone-induced STAT5B phosphorylation. Moreover, patient-derived dermal fibroblasts demonstrate Growth hormone-induced mitochondriopathy and reduced mitochondrial membrane potential. Located at the nuclear membrane, QSOX2 acts as a gatekeeper for regulating stabilisation and import of phosphorylated-STAT5B. Altogether, QSOX2 deficiency modulates human growth by impairing Growth hormone-STAT5B downstream activities and mitochondrial dynamics, which contribute to multi-system dysfunction. Furthermore, our work suggests that therapeutic recombinant insulin-like growth factor-1 may circumvent the Growth hormone-STAT5B dysregulation induced by pathological QSOX2 variants and potentially alleviate organ specific disease.

Quality of life assessment with SIBDQ in children with upper gastrointestinal pathology

Functional and organic diseases of the digestive system today occupy one of the leading places in the structure of somatic pathology of childhood and adolescence and negatively impact young patients’ quality of life. Among the gastrointestinal tract diseases, the first place is occupied by the pathology of the gastroduodenal zone in children. Gastrointestinal diseases rarely occur in isolation in the form of damage to only the upper or lower parts of the digestive system, especially in childhood. Therefore, in the presence of dysfunction symptoms and pathological changes in the upper gastrointestinal tract, it is advisable to use non‑invasive means to diagnose pathological changes in the lower gastrointestinal tract. Objective — to analyze the quality of life using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) in children and adolescents with upper gastrointestinal tract pathologies. Materials and methods. The study involved 174 children who visited the Kharkiv city children’s clinical hospital No 19 with complaints about upper gastrointestinal disorders (7—18 years old). Patients were interviewed using the self‑reported inflammatory bowel disease quality of life questionnaire SIBDQ, which assesses physical, social and emotional well‑being (the result is determined from 10 to 70 points, where 10 is the worst condition). Results. The median SIBDQ score for the entire sample was 51 points [Q1; Q3: 45; 58], with 47.1±3.7% of respondents having up to 50 points. In girls, the median was significantly lower than in boys — 49 [40; 55] versus 55 [49.0; 65.5] (pU=0.05). According to the nature of the endoscopic picture, 55% of children with gastroesophageal and duodenogastric reflux, 38.6% of children with erythematous duodenopathy, 45.9% of children with erosive and ulcerative changes and 61.5% of patients with esophagitis had a low SIBDQ score. Boys with low SIBDQ scores were more prone to gastroesophageal and duodenogastric reflux. All other endoscopic changes were significantly more common (p &lt;0.05) in girls with less than 50 points according to the survey results. Conclusions. In 47% of children with complaints of upper gastrointestinal dysfunction, the quality of life score was low by the SIBDQ (&lt; 50). The median SIBDQ score in girls was significantly lower than in boys: 49 [40; 55] versus 55 [49.0; 65.5] points (pU=0.05), respectively. Girls with instrumentally confirmed esophagitis had significantly lower SIBDQ scores compared to boys with esophagitis and girls with other gastrointestinal disorders — 41.5 [37; 46] (p &lt;0.05). The use of the SIBDQ questionnaires in school‑age children and adolescents is advisable not only for lower gastrointestinal tract diseases but also for gastroduodenal zone diseases.

Domestic researchers who have made important contributions to the study of digestive system diseases: images in art. Nina Fedorivna Deyneko

Nina Fedorivna Deyneko is a Doctor of Medical Sciences, Professor, an honored worker of science and technology of Ukraine, an outstanding health care worker, a labor veteran, and an academician of the International Academy of Sciences in apiphytotherapy and beekeeping. Under Prof. N. F. Deyneko’s supervision, 86 clinical residents, including 34 foreign ones, and postgraduate students were taught during her tenure at the Kharkiv departments of therapy and gastroenterology. Additionally, 25 candidate dissertations and one doctorate thesis were defended. She served as the head of the Kharkiv Medical Institute’s state examination commission for 15 years, founded and presided over the Kharkiv Medical Society of Gastroenterologists for 20 years, was a member of the All‑Union Society of Gastroenterologists’ Presidium of the Board for more than 20 years, and worked as the deputy chairman of the board of the Ukrainian Republican Society of Gastroenterologists. More than 200 research publications, four monographs, textbooks, and copyright certificates have been produced by Nina Fedorivna. Kharkiv Railway Clinical Hospital №1 became the clinical base of the Department of Gastroenterology of the Ukrainian Institute for Advanced Medical Studies, which was headed by Professor Nina Fedorivna Deyneko. Contemporary diagnostic equipment made it possible to perform diagnosis and treatment of patients with pathologies of the gastrointestinal, liver, biliary and pancreatic pathologies. The goal of methodological and pedagogical work was to optimize the educational process by using modern techniques for tracking students’ practical skills and initial, intermediate, and final levels of learning. Four‑ and three‑ month specialty cycles, as well as pre‑certification and theme improvement in the field of gastroenterology, were implemented during the first five years of the department’s existence. In addition to receiving 20 copyright certificates and publishing over 300 research papers, department staff members have also developed 62 rationalization recommendations that have been put into practice in the healthcare industry. The staff of the department participated in many scientific forums, including those conducted abroad.

Correlation between gut microbiota dysbiosis and colorectal cancer: review

Introduction and Purpose: The human gut microbiota, comprising a diverse consortium of approximately 100 trillion microorganisms, is integral to maintaining health and modulating disease processes. Its development begins at birth, influenced by maternal microbiota and environmental factors. Dysbiosis, defined as an imbalance in the gut microbial composition, has been implicated in a range of gastrointestinal pathologies, including colorectal cancer (CRC). This review endeavors to elucidate the relationship between gut microbiota and CRC, examining the impact of specific bacterial taxa on the pathogenesis CRC. Description of the State of Knowledge: Gut microbiota encompasses a multitude of microbial species, with their composition differing along the gastrointestinal tract. Healthy gut microbiota perform essential functions such as pathogen protection, metabolic processes, and immune system modulation. Factors like diet and genetics significantly influence microbial composition. Dysbiosis contributes to CRC through inflammation, genotoxin production, and immune modulation. Specific bacteria, such as Fusobacterium nucleatum and Bacteroides fragilis, are associated with CRC. Mechanisms of carcinogenesis include bacterial adherence, invasion of epithelial cells, and activation of pro-inflammatory pathways. Summary:Understanding the gut microbiota's role in CRC highlights the importance of maintaining a balanced microbiome for cancer prevention. Dietary interventions promoting beneficial bacteria and reducing harmful species could mitigate CRC risk. Further research should prioritize the identification of microbial biomarkers for early CRC detection and the development of therapeutic strategies aimed at modulating the gut microbiota. These efforts will enhance CRC prevention and treatment modalities.

Rate of Diagnostic Change in Surgical Pathology Reports after Mandatory Intradepartmental Peer Review in a Tertiary Hospital in the Philippines: A Retrospective Study.

There is a mandatory intradepartmental peer review algorithm in the University of the Philippines - Philippine General Hospital (UP-PGH) Department of Laboratories wherein specific cases are required to be reviewed by another pathologist before the release of results. The main objective of this study was to determine the rate of diagnostic change in surgical pathology reports after undergoing the said review. All surgical pathology cases which underwent the review from 2015 to 2018 were retrieved from the records of the Section of Surgical Pathology. The cases were classified as concordant or discordant. A case was considered concordant if the reviewing pathologist had agreed with the primary pathologist's diagnosis. A case was considered discordant if the reviewing pathologist had disagreed with the primary pathologist's diagnosis. Out of 5,377 cases included in this study, there were 5,209 concordant cases and 168 discordant cases, with the rate of discordance computed to be 3.1%. Out of the 168 discordant cases, 107 were revised for diagnostic change. Rate of diagnostic change was computed to be 2.0% (107 out of 5,377 cases for review). The most common criterion satisfied for meriting a mandatory review is being under the category of biopsies or cytology cases with malignant or borderline diagnoses (49.4%). The most common category of diagnostic change is change in immunohistochemistry recommendations (24.3%). Most of the discordant cases and cases revised for diagnostic change fall under the categories of gastrointestinal, gynecology, and head & neck pathology. The low rate of diagnostic change in our institution might be attributed to good diagnostic accuracy. However, it is also possible that reviewing pathologists tended to agree with the diagnosis made by their colleagues because of the element of peer pressure. Data from the study may imply that special courses/ lectures or institutional standard practice guidelines on interpreting biopsy and cytology cases as well as on the utility of immunohistochemistry studies, especially those focused on gastrointestinal, gynecology, and head & neck pathology are needed by the pathologists and the doctors training to become pathologists in our institution.

WP4.19 - The Emergency General Surgeon: what is their current operative role?

Abstract Aims Determine the current operative role of dedicated Emergency General Surgery (EGS) surgeons in the United Kingdom (UK) and the Republic of Ireland (ROI). Methods A live interactive online survey, designed and endorsed by ASGBI, was completed by attendees at two ASGBI conferences in 2023. The study was conducted according to CHERRIES and exempt from REC according to HRA. Consent was obtained from study participants, who were asked which surgeons usually perform the most common EGS operations in their hospital. Results The survey was completed by 156/371 eligible participants, of which 132 responses were analysed once duplicate responses (n=16), and non-UK/ROI respondents (n=8), were excluded. Participants included consultants (34%), surgical trainees (42%), and other doctors (23%), 61% were male and 39% were female, aged between 25 and 69. The general surgeon on-call – or a dedicated EGS surgeon, where such service exists – operates on the majority of EGS pathology through an un-selected take. A surgeon with the relevant sub-specialty interest usually operates on emergency non-traumatic complex upper gastrointestinal or colorectal pathology. These include emergency colonic resections for cancer or inflammatory bowel disease, and operations for gastric volvulus, bariatric complications, and Boerhaaves. Acute cholecystectomy forms a major part of a dedicated EGS surgeon’s practice. Conclusions Dedicated EGS surgeons deliver a wide variety of operations, in addition to the peri-operative management of acute surgical patients. Future curriculum design and NHS workforce planning should reflect this service delivery pattern, should EGS become a recognised specialty interest.

Set Up and Utilization of a Three-Dimensional In Vitro Bioreactor System for Human Intestinal Studies and Microbial Co-Cultures.

The study of human intestinal physiology and host-microbe interactions is crucial for understanding gastrointestinal health and disease. Traditional two-dimensional cell culture models lack the complexity of the native intestinal environment, limiting their utility in studying intestinal biology. Here, we present a detailed protocol for the set up and utilization of a three-dimensional (3D) in vitro bioreactor system for human intestinal studies and bacterial co-culture. This article outlines the design and assembly of the bioreactor system, scaffold fabrication, bacterial culture techniques, analysis methods, and troubleshooting tips. By providing step-by-step instructions, the goal is to enable other laboratories to utilize physiologically relevant tissue models of the human intestine, incorporating key features, such as nutrient flow, multiple human cell types, 3D architecture, and microbial communities. The incorporation of commensal bacteria into the bioreactor system allows for the investigation of complex host-microbe interactions, providing insight into gastrointestinal health and pathology. This article serves as a comprehensive resource for scientists seeking to advance their understanding of intestinal biology toward the development of novel therapeutic strategies for gastrointestinal disorders. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Scaffold design Basic Protocol 2: Intestinal cell culture: Caco2 cells Basic Protocol 3: Intestinal cell culture: organoids Basic Protocol 4: Bioreactor design and set up Basic Protocol 5: Bacteria in 3D bioreactor set up Basic Protocol 6: Bacteria and drug dosing.