Pathology Of Gastrointestinal Tract Research Articles

CHARACTERISTICS OF DYSPEPTIC SYNDROME IN HEMODIALYSIS PATIENTS

The goal of the paper is to study characteristics of dyspeptic syndrome in hemodialysis patients receiving renal replacement therapy. Materials and Methods. During an open clinical trial, we formed a group of hemodialysis patients (n=50) with end-stage chronic kidney disease (CKD C5). All patients were assessed for the clinical manifestations, dyspeptic syndrome severity, and laboratory data. All patients underwent esophagogastroduodenoscopy (EGDS). Results. All 50 (100 %) patients included in the study had dyspeptic syndromes. The most common symptoms were nausea (46 %), belching (44 %), and heartburn (38 %). At the same time, 56 % of patients had high dyspepsia index. When analyzing the correlation between dyspepsia index and dialysis therapy,a direct connection was established (ρ=0.281, p=0.048). It was revealed that the dialysis therapy duration impacted the dyspepsia index. The most common pathology of the upper gastrointestinal tract was chronic gastritis, diagnosed in 84 % of patients. Chronic duodenitis was found in 50 % of patients, and gastroduodenal ulcer was observed in 6 % of patients. Conclusion. Hemodialysis patients receiving renal replacement therapy are at risk for dyspeptic syndrome accompanying upper gastrointestinal tract organic pathology. Early detection of dyspeptic syndrome in hemodialysis patients is of great importance for the timely diagnostic and corrective therapeutic measures.

RELATIONSHIP BETWEEN PERIODONTAL PATHOLOGY AND GASTROINTESTINAL TRACT DISEASES: A NARRATIVE OVERVIEW

RELATIONSHIP BETWEEN PERIODONTAL PATHOLOGY AND GASTROINTESTINAL TRACT DISEASES: A NARRATIVE OVERVIEW

Oxidative stress induced by the human microbiota yeast component as a micromycetes pathogenicity factor

The introduction of MALDI-ToF mass spectrometry into routine microbiological diagnostics has led to a widely extended list of identified microorganisms. This phenomenon also affected mycological studies. Rare basidiomycetes and ascomycetes began to be detected in various types of pathological material. It is often difficult to assess a role of isolated micromycetes in the pathogenesis of a certain disease. In addition to generally admitted pathogenicity factors, such as aggression enzymes, adhesive activity, and toxin formation, induction or inhibition of reactive oxygen species can play a prominent role in pathogenesis of infectious diseases. In our study, we evaluated the total prooxidant and total antioxidant activity of cultivated ascomycete and basidiomycete yeasts from the human intestinal mycobiome. The strains of micromycetes assessed here were obtained from a fecal culture study from patients with gastrointestinal tract pathology and healthy people undergoing a routine medical examination. Identification was carried out analyzing morphological, cultural, biochemical properties and confirmed by mass spectrometry. The total prooxidant and antioxidant activity was assessed by the induced or inhibited malondialdehyde formation during Tween-80 oxidation. It was found that the level of total prooxidant activity in Rhodotorula mucilaginosa, Geotrichum candidum, Candida albicans, Pichia kudriavzevii significantly exceeds the level of total antioxidant activity, and the Pichia kudriavzevii prooxidase activity was more than twice as high as in other studied micromycetes. The revealed ability of some fungi to induce oxidase stress can be considered as one of significant pathogenicity factors of microorganisms that cause pathomorphological changes in human intestinal tissues.

Features of diagnostics of sialadenosis of parotid salivary glands in patients with gastrointestinal tract pathology associated with Helicobacter pylori

AIM: is improving the diagnostic efficiency of patients with sialadenosis of the parotid salivary glands and acid-dependent diseases associated with Helicobacter pylori.
 MATERIALS AND METHODS. At the clinical base of the Department of Dentistry of the Central State Medical Academy at the Department of Presidential Affairs of the Russian and the Department of Gastroenterology and Hepatology of the Polyclinic № 1 of the Office of the President, 40 people with sialadenosis of the parotid salivary glands and acid-dependent diseases associated with Helicobacter pylori-infection were examined. The mean age of the study patients was 47,03±6,33 years. The control group consisted of 20 practically healthy people aged 35-55 years.
 RESULTS. In the course of the work, data were obtained on a significant increase in IL-1β, 6 and TNFα indicators in patients with sialadenosis and a positive result for Helicobacter pylori, detected using a rapid urease test and PCR diagnostics in parotid saliva.

OBESITY IN CHILDREN AS A PREDICTOR OF THE DEVELOPMENT OF MYOPIA

Despite a suffi cient number of scientifi c studies devoted to the study of myopia risk factors, the infl uence of obesity on the degree of myopia risk in childhood has not been suffi ciently studied, which prompted us to study this issue using children as an example. The aim is to study the frequency and degree of myopia risk in overweight and obese children.Material and Methods. The sample of children for the study was formed step by step in the process of randomization. Thefi rst stage included a one-time epidemiological study of children aged 10-18 years during preventive examinations in schools of Chernivtsi and Chernivtsi region (1,035 persons). The primary screening included anthropometry and assessment of physical development. For detailed examination 205 persons were selected: with overweight (OW, 65 persons), with obesity (75 persons) and with normal body weight (65 persons, comparison group). The ophthalmologic examination included: visometry without and with correction, autorefractokeratometry before and after cycloplegia, biomicroscopy, ophthalmoscopy, optical biometry of the eye. To reveal the statistical diff erence between indicators in normally distributed groups, the Student’s t criterion of reliability was used, the degree of signifi cance – r. Comparison of groups on a qualitative basis was performed using Pearson’s χ2 test. Diff erences were considered statistically signifi cant at p <0.05.The research design and all methods used in this study were reviewed and approved by the Bioethics Committee of theBukovinian State Medical University (Protocol No. 10, dated 18.05.2002). The study was conducted within the research work «Early diagnosis, treatment and prevention of combined pathology of gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results. The frequency of myopia in children with OW and obesity was signifi cantly higher than in children with average body weight (χ2 = 3.2, p < 0.05). Children with obesity and myopia were 2.7 times more likely to have diseases of the musculoskeletal system, 1.8 times more likely to have pathology of the autonomic nervous system, and 3.1 times more likely to have chronic diseases of the oropharynx than children in the control group. In all groups of children, the additional risk was greatest in children whose mother or father was myopic (49.6 and 41.3 %, respectively). Minimal additional risk was associated with a history of childhood infections (<1.6 %), helminthiasis (<3.9 %), nasal polyps (<3.4 %), adenoids (<2.4 %), and spinal cord injury at birth (<9.1 %). The odds ratio for the development of low myopia in the group with OW and obesity compared to the control group (normal weight) were 1.25 [95 % CI 0.56-2.82] and 0.88 [95 % CI 0.49-1. 58], for the development of moderate myopia – 1.22 [95 % CI 0.57-2.59] and 0.82 [95 % CI 0.46-1.49], respectively, and for the development of high myopia–1.37 [95 % CI 0.51-3.66] and 0.80 [95 % CI 0.49-2.09], respectively.Conclusion. The risk of myopia is higher in children with overweight and obesity, which emphasizes the importance andnecessity of taking into account the somatic condition of the child.

HELICOBACTER PYLORI – BIOLOGICAL FEATURES AND METHODS OF LABORATORY DIAGNOSIS

The spring period - in that time the relevance of diagnostics related to Helicobacter pylori infection forces us to pay more attention to the cohort of patients with gastrointestinal tract pathology. Most often, these are patients with exacerbation of chronic gastritis (CH) and peptic ulcer disease (UD) of the stomach and duodenum, the typical course of which involves the seasonality of exacerbations: spring and autumn. Among other criteria of a "typical" course, infection with H. pylori, which is the cause of these diseases and without its destruction in the body, it is impossible to achieve clinical remission of H. pylori-associated diseases and prevent their recurrence. Before prescribing therapy, the causative agent must be identified, and after treatment, its eradication must be confirmed. The severity of chronic diseases of helicobacterial etiology depends on the degree of pathogenicity of the strains, the presence of certain cytotoxic genes. The review analyzes modern information on the biological properties of the causative agent of helicobacteriosis and methods of its diagnosis. They can be divided into invasive (requires taking a biopsy during endoscopic examination) and non-invasive. Bacteriological and morphological research methods are distinguished among the invasive ones. The histological method is recognized as the "gold standard" for the diagnosis of helicobacteriosis. The essence of the method consists in the preparation of preparations of the gastric mucosa and their Giemsa staining in order to detect bacterial cells in the preparation. The method allows you to determine the characteristics of the causative agent and assess the condition of the gastric mucosa. The bacteriological method is considered indispensable for checking strains for resistance to certain antibacterial drugs, which allows predicting the results of treatment. Currently, non-invasive diagnostic methods have become the most widespread. Along with the respiratory urease test, serological methods are used (immunoenzyme analysis, immunoblotting), as well as the immunochromatographic method. The molecular diagnostic method, namely PCR, is used to study the genotypic and phenotypic characteristics of H. pylori strains in gastric biopsy samples, saliva, stools, gastric juice, and dental plaque. PCR provides excellent sensitivity and specificity of over 95% compared to other tests.

Pathogenesis and therapy of anemia in patients with inflammatory bowel diseases

Background. Anemia represents one of the most frequent complications in inflammatory bowel disease and severely impairs the quality of life of affected patients. The etiology of anemia in inflammatory bowel disease patients can be multifactorial, often involving a combination of iron deficiency anemia and anemia of chronic disease. The choice of therapy, focused on the leading cause of anemia, allows for individualized therapy, minimizing the risk of side effects and the cost of therapy.Aim. A comparative analysis of blood parameters before and after treatment was performed.Materials and methods. For 5 years, 47 patients (15 women, 32 men) with inflammatory bowel disease with a median age of 48 years (from 28 to 65 years) were studied. Two groups were formed: patients with iron deficiency anemia and patients with anemia of chronic disease. Patients with combination of iron deficiency anemia and anemia of chronic disease D (n = 21) were not included. A division was also made according to the type of treatment performed.Results. In the iron deficiency anemia group, a statistically significant increase in hemoglobin level was revealed as a result of the use of intravenous iron. During therapy with oral iron and B vitamin therapy, as well as therapy aimed only at correcting gastrointestinal tract pathology, no reliable dynamics of the studied parameters was observed. In the anemia of chronic disease group, there were no significant changes in red blood cell parameters with any of the treatment options (p >0.05).Conclusion. The effectiveness of various therapeutic approaches to correct anemia is controversial. Further follow-up and an increase in the sample size are needed, which will help individualize therapy and improve the patients’ quality of life.

The relationship between gastroesophageal pathogenic reflux and metabolic syndrome

Currently, special attention is drawn to the phenomenon of comorbidity of chronic non-infectious diseases. The emergence of comorbidity is facilitated by the high incidence of coexisting diseases. One such combination is GERD and metabolic syndrome (MS). GERD and MS are multifactorial diseases, the pathogenesis of which is intertwined and mutually aggravates each other. Every year throughout the world and the Russian Federation, there is a clear trend towards an increase in the incidence of pathology of the upper gastrointestinal tract, namely gastroesophageal reflux disease (GERD). The prevalence of obesity in Russia over 40 years of observation has increased 4 times among men and 1.5 times among women. Despite the high incidence, to date there is no diagnosis of “metabolic syndrome” (MS) in ICD-10. MS is coded based on its constituent pathologies (obesity, dyslipidemia, insulin resistance, arterial hypertension). Treatment of this comorbid pathology requires a multidisciplinary approach, thereby placing a high burden on the healthcare system. This article displays the features of the pathogenesis and clinical picture of GERD, as well as the combination of this pathology with the components of MS.

Oral Sulfate Solution Versus Polyethylene Glycol Solution for Bowel Preparation for Colonoscopy: A Randomised Controlled Trial in a Tertiary Care Centre

Colonoscopy is an indispensable procedure in the armamentarium of an endoscopist to diagnose the pathologies of the distal gastrointestinal tract. A well-prepared bowel is mandatory for an ideal colonoscopy which facilitates in clinching the diagnosis. The aim of the study was to compare the palatability, tolerance, volume and side effects of PEG solution as well as OSS for bowel preparation and also to assess the quality of bowel preparation using Boston Bowel Preparation Scale (BBPS) by the colonoscopist in a controlled, randomised, and double- blinded manner.

Diminuição da expressão do microRNA-629 em amostras de câncer gástrico potencializada pelo marcador de virulências do H. pylori, gene cagA

ABSTRACT Background: Helicobacter pylori (H. pylori) is a gram-negative bacterium associated with the etiology of several gastrointestinal tract pathologies, and cagA-positive (cagA+) strains are found in populations with gastric ulcers and precancerous lesions, inducing pro-inflammatory responses. The development of neoplasms is related to microRNA (miRNA) dysregulation, indicating highly expressed miRNA-629. The article aims to correlate the expression level of miRNA-629 with the presence of H. pylori and the pathogenicity marker cagA. Methods: 203 gastric biopsy samples were evaluated from individuals with normal gastric tissue (n=60), gastritis (n=96), and gastric cancer (n=47) of both genders and over 18 years old. The samples were subdivided according to the presence or absence of H. pylori, detected by polymerase chain reaction (PCR). RNA was extracted using a commercial kit and quantified. Complementary DNA (cDNA) was synthesized using commercial kits, and the relative expression was calculated using the 2-ΔΔCt method. Results: Individuals infected with H. pylori are nine times more likely to develop gastric cancer. Cancer patients appeared to have decreased expression of miRNA-629; however, the presence of the bacterium would not influence this reduction. Individuals in the cancer group showed lower miRNA-629 expression when cagA+; however, in the control group, the expression was higher when cagA+. Conclusion: H. pylori is a factor involved in the etiology and progression of gastric diseases. Reduction in miRNA-629 expression in cancer patients occurs independent of the presence of the bacterium, but when the cagA pathogenicity marker is present, it induces changes in the gene expression of the respective miRNA.

The significance of chronic hyperglycemia for the reduced efficacy of eradication therapy in patients with type 2 diabetes mellitus and for Helicobacter pylori survival

Aim: This study aims to determine the significance of chronic hyperglycemia for the reduced efficacy of eradication therapy in patients with type 2 diabetes mellitus (T2DM) and Helicobacter pylori (H. pylori)-associated upper gastrointestinal tract pathology as well as for H. pylori survival. Methods: A prospective randomized study with the participation of 180 patients (87 men and 93 women) with H. pylori-associated upper gastrointestinal pathology was carried out. Ninety of these patients were with T2DM and 90 were without diabetes mellitus (DM). The patients were divided into 4 groups of 45 patients: the group 1 included non-diabetic patients treated with the classical triple eradication scheme; the group 2 included patients with T2DM treated with the classical triple eradication scheme; the group 3 included non-diabetic patients treated with bismuth quadro-therapy; the group 4 included patients with T2DM treated with bismuth quadro-therapy. The presence of H. pylori and evaluation of eradication efficacy was carried out using the Helix breath test. Results: The effectiveness of 1st line anti-Helicobacter therapy was higher (88.2%) in patients without diabetes in comparison with the group of patients with concomitant T2DM (74.7%). The efficacy of classical triple eradication therapy in patients with concomitant T2DM was 69.1%, and quadro-therapy was 80.5%. There was significantly lower effectiveness (P < 0.017) of eradication therapy in patients with T2DM and glycated hemoglobin (HbA1c) level ≥ 7.0% as compared with the group of patients in whom the target (≤ 6.5%) level of HbA1c was achieved. Conclusions: Chronic hyperglycemia has a favorable effect on the viability of H. pylori bacteria in patients with T2DM. A hypothesis explaining the reduced efficacy of eradication therapy in patients with hyperglycemia has been proposed.

COVID-19 and gastroenterological pathology. Review

SARS‑CoV‑2 has led to numerous cases of coronavirus disease (COVID‑19) around the world. In addition to fever and respiratory symptoms, some COVID‑19 patients also have manifestations from digestive system. On the other hand, patients with chronic diseases of the gastrointestinal tract (GIT) also suffer from coronavirus disease.
 Objective — to provide an understanding of the characteristics, possible mechanisms and consequences of gastrointestinal damage caused by SARS‑CoV‑2 infection, in particular in patients with gastrointestinal tract pathology.
 Literature search was carried out using such databases as Scopus, Web of Science. Clinical studies of patients with COVID‑19 have shown that gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, abdominal pain and diarrhea precede or follow respiratory syndromes with a frequency of about 10 to 60%. Literary sources were studied regarding the relationship of COVID‑19 and such gastroenterological pathologies as gastrointestinal bleeding, hepatitis, pancreatitis and inflammatory bowel diseases. Lesions of the digestive system both in patients without chronic pathology and with existing diseases, apparently, are associated with a high concentration of angiotensin converting enzyme 2 (ACE2) throughout the entire GIT, including the intestine, liver, and pancreas. Some studies have shown that the spike (S) SARS‑CoV‑2 protein has a high affinity for human ACE2, while SARS‑CoV‑2 mainly enters cells through the ACE2 receptor. In addition, endothelial injury and thrombus inflammation and dysregulated immune responses may contribute to extrapulmonary manifestations of COVID 19. This requires an appropriate correction of the diagnostic search and therapy.

Analysis of the structure of comorbidity in children with gastrointestinal tract pathologies

Diseases of the gastrointestinal tract take the second place in the structure of somatic pathology in children and adolescents. The number of cases of comorbid pathology also tends to increase. The combination of the most common diseases can be both random and causal relationship, the determination of which is important for improving the health care of the child population.
 Objective — to analyse of comorbidities in children with gastrointestinal diseases based on the results of the city specialized children’s gastroenterological department work.
 Materials and methods. The performance indicators of Kharkiv City Children’s Clinical Hospital No19 for the period from 01.01.2019 to 31.12.2019 were studied. During 2019, 2633 children aged 5 to 18 years (average age: 10.6±2.9 years) with diseases of the digestive system were hospitalized.
 Results. The presence of comorbidity was established in 73.6% of children. The most common among children with diseases of the gastrointestinal tract were manifestations of diseases of the nervous system — 31.8%. Diseases of the endocrine system — 15.4% and cardiovascular system — 15.7% were equally represented. A fairly common pathological condition in patients with gastrointestinal diseases was anemia, which was established in 8.1%. Visual impairment was found in 2.7% children, which coincides with the prevalence of this pathology among the general children’s population.
 Conclusions. The leading place is held by the gastroduodenal pathology, notably chronic gastroduodenitis. The presence of comorbidity from other organs and systems was established in 73.6% of children with gastrointestinal diseases. The most common comorbidity in diseases of the gastroduodenal zone are diseases of the nervous system. The greatest chances of combining pathological conditions with the development of comorbid pathology are diseases of the gastroduodenal zone and nervous system, intestines and autoimmune thyroiditis, gastroesophageal reflux diseases and obesity. The results suggest the necessity of additional examination of children with gastrointestinal pathology in order to early diagnosis of comorbidity and provide the required comprehensive assistance.

The structure of gastrointestinal tract pathology in patients receiving hemodialysis treatment

BACKGROUND. Hemodialysis patients are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, gastrointestinal tract disorders in these patients remains largely unexplored. Patients receiving treatment with programmed hemodialysis are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, the pathology of the gastrointestinal tract in this category of patients remains largely unexplored.AIM: to investigate the structure of digestive diseases in patients receiving hemodialysis treatment.PATIENTS AND METHODS. This study included 180 hemodialysis patients. The median age was 60[47;68] years. Gastrointestinal Symptoms Questionnaire (GSQ) was used to evaluate gastrointestinal symptoms over the last month. The results of abdomen ultrasound, gastroscopy, colonoscopy, and complex laboratory examination were also analyzed.RESULTS. The overall prevalence of gastrointestinal symptoms was 77.2 % (139/180). The most frequent complaints were constipation (46.8 %) and abdominal pain (41 %). The most common stool frequency was one bowel action per day. The third, fourth, fifth type of stool according to the Bristol Stool Form Scale were noted by the majority of participants. Abdominal ultrasound revealed diffuse liver changes in 115 (63.9 %), signs of cirrhosis – in 7(3.9 %) patients. Ultrasound pathology of the gallbladder was represented by anomalies of its shape in 11.1 %, signs of chronic cholecystitis – in 10 %, stones (sludge) – in 7.2 %, polyps – in 2.2 % of patients. Diffuse changes in pancreatic parenchyma, steatosis, pseudocysts and dilatation of the main pancreatic duct were diagnosed respectively in 39(21,7 %), 21(11,7 %), 10(5,6 %) and 3(1.7 %) hemodialysis patients. According to 154 gastroscopies, the most common endoscopic finding in the stomach was chronic gastritis, detected in 86(55.8 %) of the subjects. Erosive gastritis was diagnosed in 22(14.3 %), gastric ulcer – in 3(2.0 %) patients. Endoscopic duodenal pathology was represented by erythematous duodenitis in 53(34.4 %), erosive duodenitis in 15(9.7 %), ulcer in 2(1.3 %), duodenal bulb abnormalities in 23(14.9 %) patients. Combined gastric and duodenal lesions were found in 88(57.1 %) patients. Сolonoscopy was performed in 56 patients, of whom 15 (26.8 %) had signs of colitis (mainly sigmoiditis), 2(3.6 %) – diverticulitis, 10(17.9 %) – diverticulosis, 12(21.4 %) – colon polyps, 8(14.3 %) – angiodysplasia mucosa, in 3(5.4 %) – dolichocolon. Despite the abundance of gastrointestinal symptoms and instrumental findings, no significant deviations in laboratory parameters (including an increase in AST, ALT, total bilirubin, amylase, lipase) were found.CONCLUSION. Hemodialysis patients are characterized by a high prevalence of gastrointestinal symptoms and various pathological changes in the gastrointestinal tract, the diagnosis and treatment of which require an individual multidisciplinary approach.

Application of a diagnostic algorithm for differential diagnosis in a patient with recurrent abdominal pain

Introduction Among the diseases of urgent pathology the leading place belongs to acute pancreatitis, which is second only to acute appendicitis and acute cholecystitis. Moreover, a significant share is occupied by mild forms, which account for 85%. In the Clinical Recommendations for Acute pancreatitis in the section “Prevention and dispensary monitoring”, the authors recommend regular dispensary monitoring by a gastroenterologist and a surgeon. However, this nosology according to the Order of the Ministry of Health of the Russian Federation from 03.15.2022 No 168N is not included in the dispensary observation. In this regard, patients remain without proper attention of doctors when they are discharged from hospitals, or when they refuse hospitalization after examination in the emergency room.The aim of the work – is to present the result of applying the diagnostic algorithm of differential diagnosis of diseases and detection of gastrointestinal tract pathology on the clinical example of a patient with recurrent abdominal pain syndrome.Materials and methods The analysis of medical records of a 59-year-old patient who repeatedly applied to the network of polyclinics and hospitals providing emergency specialized medical care for recurrent abdominal syndrome was carried out.Results and discussion In this clinical observation of recurrent abdominal syndrome in a patient, the biliary mask of acute pancreatitis was revealed. In outpatient conditions using the developed diagnostic algorithm, choledocholithiasis, juxtapapillary diverticulum of the duodenum and hernia of the esophageal aperture of the diaphragm were detected. The diagnosis made it possible to perform the treatment competently and lead to the patient's recovery. Thanks to the dispensary observation and additional methods of investigation according to the developed algorithm, the following were detected: juxtapapillary diverticulum of the duodenum, which may not be visualized at video esophagogastroduodenoscopy with direct optics, as well as ductal stones, which are not always visualized at transabdominal ultrasound and are detected at endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography. Difficulties may arise in the diagnosis of gastrointestinal diseases due to the variability of the clinical course and polymorphism of symptoms in this category of patients. Such a course of diseases causes difficulties at the stage of patients' admission to the emergency room of clinics, can lead to diagnostic errors that lead to incorrect treatment tactics.Conclusion The application of an algorithm based on the assessment of clinical criteria in conjunction with instrumental imaging methods and laboratory tests allowed to optimize the diagnostic process and facilitated the choice of optimal therapy and surgical tactics for the treatment of the patient with recurrent abdominal pain syndrome.

Kinetics of severe dengue virus infection and development of gut pathology in mice.

Dengue virus, an arbovirus, causes an estimated 100 million symptomatic infections annually and is an increasing threat as the mosquito range expands with climate change. Dengue epidemics are a substantial strain on local economies and health infrastructure, and an understanding of what drives severe disease may enable treatments to help reduce hospitalizations. Factors exacerbating dengue disease are debated, but gut-related symptoms are much more frequent in severe than mild cases. Using mouse models of dengue infection, we have shown that inflammation and damage are earlier and more severe in the gut than in other tissues. Additionally, we observed impairment of the gut mucus layer and propose that breakdown of the barrier function exacerbates inflammation and promotes severe dengue disease. This idea is supported by recent data from human patients showing elevated bacteria-derived molecules in dengue patient serum. Therapies aiming to maintain gut integrity may help to abrogate severe dengue disease.

Gastrointestinal tract pathology of the owl monkey (Aotus spp.).

Owl monkeys are small nocturnal new world primates in the genus Aotus that are most used in biomedical research for malaria. Cardiomyopathy and nephropathy are well-described common diseases contributing to their morbidity and mortality; less is known about lesions affecting the gastrointestinal tract. Records from a 14-year period (2008-2022) at the Keeling Center for Comparative Medicine and Research were queried to identify instances of spontaneous gastrointestinal disease that directly contributed to the cause of death from the 235 adult owl monkeys submitted for necropsy. Of the 235, 10.6% (25/235) had gastrointestinal disease listed as a significant factor that contributed to morbidity and mortality. Diagnoses included candidiasis (3/25), gastric bloat (4/25), and intestinal incarceration and ischemia secondary (11/25), which included intussusception (4/25), mesenteric rent (3/25), strangulating lipoma (2/25), intestinal torsion (1/25), and an inguinal hernia (1/25). Intestinal adenocarcinomas affecting the jejunum (4/25) were the most common neoplasia diagnosis. Oral squamous cell carcinoma (1/25) and intestinal lymphoma (2/25) were also diagnosed. This report provides evidence of spontaneous lesions in the species that contribute to morbidity and mortality.

Gynaecological Causes of Acute Pelvic Pain: Common and Not-So-Common Imaging Findings.

In female patients, acute pelvic pain can be caused by gynaecological, gastrointestinal, and urinary tract pathologies. Due to the variety of diagnostic possibilities, the correct assessment of these patients may be challenging. The most frequent gynaecological causes of acute pelvic pain in non-pregnant women are pelvic inflammatory disease, ruptured ovarian cysts, ovarian torsion, and degeneration or torsion of uterine leiomyomas. On the other hand, spontaneous abortion, ectopic pregnancy, and placental disorders are the most frequent gynaecological entities to cause acute pelvic pain in pregnant patients. Ultrasound (US) is usually the first-line diagnostic technique because of its sensitivity across most common aetiologies and its lack of radiation exposure. Computed tomography (CT) may be performed if ultrasound findings are equivocal or if a gynaecologic disease is not initially suspected. Magnetic resonance imaging (MRI) is an extremely useful second-line technique for further characterisation after US or CT. This pictorial review aims to review the spectrum of gynaecological entities that may manifest as acute pelvic pain in the emergency department and to describe the imaging findings of these gynaecological conditions obtained with different imaging techniques.

Bowel preparation in children and adolescents undergoing ileo-colonoscopy: what is new?

Ileo-colonoscopy is a vital diagnostic and therapeutic tool undertaken for evaluating and treating gastrointestinal tract pathologies in children and adolescents as well as adults. Proper visualization of the lower intestinal mucosa, completion of the procedure including terminal ileum/cecal intubation, detection of pathological lesions and therapeutic maneuvers are hinged on how adequate the bowel preparation is. About 25% percent of pediatric patients have inadequate bowel preparations, which can lead to prolonged colonoscopy procedure time, missed pathology, difficult ileal intubation/incomplete examination, and requiring cancellation or repeat procedure with attendant anesthetic risks. An ideal bowel preparation regimen should clear the colon of fecal material with no alteration of the colonic mucosa that could affect the histological findings. There is no acceptable universal regimen for bowel preparation in children; however wide variability of practices exists globally. Hence, the current review is aimed at analyzing recent published literature and personal practical experiences as well as developing a standard bowel preparation guideline that will improve outcome of the ileo- colonoscopy procedure in children particularly in resource limited settings.

Üçüncü Basamak Hastanede Endoskopik Ultrasonografi: Tek Merkez Deneyimi

Introduction : Endoscopic ultrasonography (EUS) is widely used to determine the character of lesions in the hepatobiliary system, pancreas, mediastinum, and rectum, in addition to subepithelial lesions of the upper gastrointestinal tract and for staging in addition to sampling from the lesion.Aim: The aim of this study is to present the endoscopic ultrasonography experience of our clinic over the last year. Material and Methods: EUS indication were performed by two gastroenterologists using a Pentax EPK-i5000 video processor and linear and radial echoendoscopes, under the guidance of an anesthesiologist under sedoanalgesia. Data were analyzed using descriptive statistics. The study results were analyzed using SPSS vn. 22.0 software.Results: Evaluation was made of 155 patients who underwent endoscopic ultrasonography, comprising 88 (56.8%) females and 67 (43.2%) males with a mean age of 56.3±14.2 years (range: 19-91 years). The 41 patients who underwent the EUS procedure for pancreatic lesion comprised 24 (59%) males and 17 (41%) females with a mean age of 54.3±17.1 years.EUS was performed in 74 patients due to subepithelial lesions of the upper gastrointestinal tract. These patients comprised 39 (52.7%) females and 35 (47.3%) males with a mean age of 55.2±13.5 years. Discussion The results of this study show that EUS is a reliable and very useful tool in appropriate indications, especially for the evaluation of subepithelial and malignant lesions of the gastrointestinal tract, pancreas, and ampulla pathologies. Conclusion and suggestions: Endoscopic ultrasonography; It is an effective and guiding method used in the diagnosis of submucosal lesions of the gastrointestinal tract, staging of malignant lesions, and the diagnosis of cystic and solid lesions of the pancreas.