Gastrointestinal Diseases Research Articles

In vitro validation of colon delivery of vitamin B2 through a food grade multi-unit particle system.

Colon target delivery of active ingredients is frequently applied in pharmaceutical products. However, in functional food and beverage applications, dietary supplements, and medical nutrition, formats targeting colonic delivery to improve human health are rare. Nevertheless, there is emerging evidence for beneficial effects of colonic delivered nutrients on gut microbiota and host health which increases the demand for sustainable food grade materials that are regulatory approved for application. In this paper, we describe a double layer coated multi-unit particle system (MUPS) with a diameter of approximately 730 microns consisting of food grade materials: shellac as outer layer, alginate as inner layer, cellulose as a core and riboflavin as active ingredient. The suitability of the MUPS for colonic delivery was tested in three well-established in vitro digestion and fermentation models: the USP Apparatus 3 and the TNO Intestinal Models 1 and 2 (TIM-1 and TIM-2). All systems confirmed the integrity of the MUPS under simulated upper gastrointestinal tract conditions with approximately 90% of the active ingredient being released under simulated ileal-colonic conditions. The TIM-2 model also showed the effects of riboflavin loaded MUPS on the microbiome composition with an increase in the production of short-chain fatty acids, acetate and butyrate. The results of these experiments provide a reliable basis for validation of this vitamin-loaded food grade MUPS in future human clinical trials. In addition, following the recent announcement of the European Commission to restrict intentionally added microplastics to products, the materials used in the described formulation offer an environmentally friendly alternative to often applied methyl acrylate based coatings.

Patterns of overeating in middle-aged Chinese from Hong Kong

Abstract Background Obesity is one of the most important risk factors for non-communicable diseases worldwide. Overweightness may be attributable to a wide spectrum of overeating behaviours. However, the various types of overeating behaviors are under-studied in Asia, particularly in non-adolescent age groups. This study aims to estimate the prevalence and factors associated with various overeating patterns among middle-aged Chinese adults. Methods A random telephone survey was conducted in 2023 on Hong Kong Chinese adults between 35 and 59 years or age (n = 785). An instrument composed of modified Positive-Negative Emotional Eating (EE) Scale, Night Eating Questionnaire-Chinese (NEQ), Binge Eating Disorder Screener (BED-7), Depression Anxiety and Stress Scales (DASS-21), demographic factors, BMI and number of reported gastrointestinal (GI) conditions was used. Multiple regression analyses were conducted to test the association of demographic factors, BMI, GI conditions as well as dysphoric mood with overeating behaviors. Results Hong Kong Chinese middle-aged adults reported the following past-month prevalence of overeating behaviors: positive EE (26.1%), general overeating (12.4%), negative EE (9.2%), binge eating (6.0%) and night eating behavior (1.8%). Nightshift work, mental stress, being single and younger age were common risk factors for the various overeating patterns among middle-aged men. Anxiety, high/low educational levels and younger age were common risk factors among middle-aged women. Obesity was associated with binge eating and positive EE in men (OR: 1.7-4.0) and associated with negative EE and general overeating (OR:2.3-2.7) in women. Conclusions This study noted that binge eating, night eating, positive/negative EE, and GOB were distinct eating patterns requiring different clinical approaches. The significant association between various overeating behaviors with BMI, indicates that these individuals should be prioritized to receive healthy eating interventions. Key messages • Adult overeating is not a singular behavior but represents an array of different eating patterns with different risk factors. • Like their Western counterparts, overeating behaviors in Chinese adults are often linked to dysphoric mood, therefore treatment of obesity may require psychological counseling.

Diets, ergogenic supplements, and microbiota in professional and non-professional athletes

Abstract Background Regular physical activity has significant health benefits and can help prevent and manage non-communicable diseases. Intense exercise during training requires diet modulation to support health and performance. Anaerobic sports require high-protein diets, while aerobic sports prefer high-carbohydrate diets. Two-thirds of adult athletes take dietary supplements, and non-professional athletes also use supplements to enhance their appearance. However, dietary stress and imbalanced use of supplements leads the body to different diseases like gastrointestinal diseases and even multifactorial diseases e.g. cancer, cardiovascular diseases, and neurodegenerative diseases. Depending on the specific nutritional intake, supplementations, types of exercises the microbiota can be influenced positively or negatively. A systematic review meta-analysis and a pilot study were conducted to investigate the role of diet and supplementation about the microbial composition of the gut, under different types and intensities of physical activities. Methods The systematic review and meta-analysis were conducted according to the PRISMA guidelines, and the protocol was registered in PROSPERO (Number CRD42024500826). In a pilot study gut microbiota (16S amplicon sequencing), anthropometric data, and information on diet and supplementation, physical activity and sport habits were collected in a sample including professional and non-professional athletes. Results Out of 1318 studies, only 9 met the criteria for inclusion in the meta-analysis. The pilot study’s meta-regression analysis and microbiota analysis highlight the role of physical activity type in changing the Bacillota/Bacteroidota ratio (p = 0.001). Conclusions As gut training becomes more popular among athletes, it is necessary to map interactions between microbiota and different personalized diets, physical activities, and the most popular ergogenic supplements to enhance performance and athletic wellness Key messages • The microbiome can be influenced positively or negatively by the specific dietary intake, types of physical activities and ergogenic supplementations. • To map interactions between microbiota and different diets, physical activities, and popular ergogenic supplements is needed to design new strategies to enhance performance and athletic wellness.

Post-operative Mortality Trends for Complicated Appendicitis: Adults with and without Disabilities

Abstract Background Even for the same complicated appendicitis, the prognosis may vary if appropriate post-operative care and follow-up are not provided. We aimed to investigate the 10-year trend of complicated appendicitis mortality among disabilities and non-disabilities peoples in Korea, recognizing potential disparities in post-surgical outcomes and the importance of adequate post-operative care. Methods Patients with complicated appendicitis were classified by severity using DRG codes. Causes of death were categorized into infectious, respiratory, cardiovascular, and digestive diseases using ICD-10 data. Age-adjusted mortality rates were calculated annually from 2008 to 2017 based on disability presence, severity, and type. Factors associated complicated appendicitis mortality were analyzed using multivariate logistic regression models. Results The mortality of complicated appendicitis was 10.2 times (40.8% vs. 413.9%) higher in people with disabilities, especially those with severe disabilities. This difference was more evident in patients with a severe disability (aOR=2.12, 95% CI:1.58-2.86), intellectual or psychological disability (aOR=2.95, 95% CI:1.49-5.85) and internal organ problems (aOR=2.05, 95% CI:1.28-3.28). Conclusions Our findings suggest that insufficient post-operative care among disabled peoples, especially those with severe disabilities, internal organ problems, and intellectual or psychological disabilities, may impact outcomes. This is exacerbated by poor healthcare facilities and limited disability awareness among healthcare workers. Additionally, further research is required to uncover unexplained mortality causes. Funding: This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Ministry of Education (No. 2022R1I1A3070074) and by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC23C0165). Key messages • Complicated appendicitis mortality rates show a stark 10.2-fold disparity between people with and without disabilities. • Severe disabilities, intellectual or psychological disabilities, and internal organ problems heighten the risk, emphasizing the importance of disability-inclusive healthcare practices.

How can interventions of building renovation and household energy conversion effectively improve the physical and mental health outcomes? A systematic review and meta-analysis

Household energy efficiency measures can effectively reduce indoor air pollution and positively impact the health of residents, but there is no conclusive evidence on the effectiveness of different energy efficiency measures for various diseases. This study used systematic review and meta-analysis to research the effects of two interventions on residents’ physical and mental health: building renovation (heating, insulation, double-glazed windows and ventilation) and household energy conversion (stove upgrading and clean energy use). A total of 79 papers published between 1977 and 2023 were reviewed in this study, providing comprehensive meta-analytic evidence on the effectiveness of energy efficiency measures. The results show that household energy-saving measures have a minor but significant positive influence on residents’ physical and mental health, with the effect on mental health being larger than the impact on physical health. Stove upgrading is advantageous in respiratory and cardiovascular diseases; insulation can greatly reduce the risk of skin diseases; heating is beneficial in sensory and digestive diseases; and clean energy use can successfully mitigate integrative diseases. Furthermore, a combination of heating and insulation measures has the most favourable influence on mental health conditions such as depression, anxiety and social isolation. The study findings can help residents, policymakers and relevant organizations take appropriate interventions to promote residents’ physical and mental health.

Circadian rhythm disruption modulates enteric neural precursor cells differentiation leading to gastrointestinal motility dysfunction via the NR1D1/NF-κB axis

ObjectivesCircadian rhythm disruption (CRD) is implicated with numerous gastrointestinal motility diseases, with the enteric nervous system (ENS) taking main responsibility for the coordination of gastrointestinal motility. The purpose of this study is to explore the role of circadian rhythms in ENS remodeling and to further elucidate the underlying mechanisms.MethodsFirst, we established a jet-lagged mice model by advancing the light/dark phase shift by six hours every three days for eight weeks. Subsequent changes in gastrointestinal motility and the ENS were then assessed. Additionally, a triple-transgenic mouse strain (Nestin-creERT2 × Ngfr-DreERT2: DTRGFP) was utilized to track the effects of CRD on the differentiation of enteric neural precursor cells (ENPCs). RNA sequencing was also performed to elucidate the underlying mechanism.ResultsCompared to the control group, CRD significantly accelerated gastrointestinal motility, evidenced by faster intestinal peristalsis (P < 0.01), increased fecal output (P < 0.01), and elevated fecal water content (P < 0.05), as well as enhanced electrical field stimulation induced contractions (P < 0.05). These effects were associated with an increase in the number of glial cells and nitrergic neurons in the colonic myenteric plexus. Additionally, ENPCs in the colon showed a heightened differentiation into glial cells and nitrergic neurons. Notably, the NR1D1/nuclear factor-kappaB (NF-κB) axis played a crucial role in the CRD-mediated changes in ENPCs differentiation. Supplementation with NR1D1 agonist or NF-κB antagonist was able to restore gastrointestinal motility and normalize the ENS in jet-lagged mice.ConclusionsCRD regulates the differentiation of ENPCs through the NR1D1/NF-κB axis, resulting in dysfunction of the ENS and impaired gastrointestinal motility in mice.

The health profile of Lithuanian beekeepers and use of bee products for health purposes

Abstract Background There is little research about the health profile and attitude of beekeepers themselves who are the main suppliers of apitherapy products to the general public. The study aims to describe the health profile of Lithuanian bee keepers and identify their attitudes towards use of bee products for health purposes. Methods A cross-sectional survey was carried out from November 2023 to February 2024 among beekeepers in Lithuania. A representative sample of N = 369 (5% margin of error) has been enrolled in the study. A mixed-model approach was used for data collection. Research instrument consisted of a two-part questionnaire covering socio-demographic variables and questions on the use of bee products. Results 369 respondents participated in the study: 73% (n = 270) males and 27% (n = 99) of females. The mean age was 57.8 years (SD = 14.4). Beekeepers assessed their health as good and only 2% assessed it as bad, while the Lithuanian rate is 12%. 95% of the respondents used bee products for health purposes, 5% did not use at all. Large beekeepers (&amp;gt;100 beehives) were more likely not to choose bee products (p &amp;lt; 0.001). No correlation was found between chronic diseases and consumption of bee products, except for diabetes mellitus (p = 0.001). The most common reasons for choosing apitherapy products included respiratory (62%), digestive (31%) diseases, immunity boosting (77%), dermatological conditions (53%). Propolis was pointed out in the survey as being used by 74%. Elder beekeepers (&amp;gt;65 years) were found to be more likely to use propolis (p &amp;lt; 0.001). They were also more likely to use it for prevention (p &amp;lt; 0.001) and in case of toothache (p = 0.001). Conclusions The majority of beekeepers use bee products for health purposes. The most common reasons for consuming honey and other bee products are immunity boosting and colds. It was found that beekeepers over 65 years of age are more likely to use propolis for prevention and toothache treatment. Key messages • Although the consumption of bee products is high among beekeepers, elder generation and owners of smaller apiaries are more likely to use bee products for health purposes. • Chronic diseases are not associated with consumption of bee products, except for beekeepers with diabetes mellitus who do not consume it.

Validating Simple Modifications to the Rome IV Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care.

The Rome IV criteria for irritable bowel syndrome (IBS) may be too restrictive for clinical practice and research. To validate the Rome IV criteria and study the diagnostic performance of simple modifications to them. We collected symptom data from consecutive adults with suspected IBS seen in a single clinic. We used a reference standard to confirm IBS (presence of lower abdominal pain associated with altered stool form or frequency; no evidence of organic gastrointestinal disease after limited investigation). We applied Rome IV criteria, but also two modifications. First, we re-incorporated abdominal discomfort but kept symptom frequency required for both abdominal pain and discomfort to at least 1 day per week. Second, we included only abdominal pain but relaxed symptom frequency back to 3 days per month. We calculated sensitivity, specificity and positive and negative likelihood ratios (LRs), with 95% confidence intervals (CIs), for each diagnostic criterion. We recruited 170 patients (76.5% female, mean age 37.9 years). Sensitivity and specificity of the Rome IV criteria were 82.1% and 85.1%, respectively; positive and negative LRs were 5.51 (95% CI 2.95-11.3) and 0.21 (95% CI 0.14-0.31), respectively. Modifying the criteria by relaxing the frequency of abdominal pain to 3 days per month led to the best performance [sensitivity 90.2%, specificity 85.1%, positive LR 6.06 (95% CI 3.25-12.2), and negative LR 0.11 (95% CI 0.07-0.19)]. The Rome IV criteria performed well in diagnosing IBS. A simple modification relaxing the required frequency of abdominal pain improved their performance.

Collaborative development of open-source outbreak detection tools: Needs, concept and implementation

Abstract Issue The early detection of infectious disease outbreaks through surveillance is critical to initiate targeted public health interventions. Automated outbreak detection helps to identify trends and unusual events. Yet, there is no overview of how many EU countries use outbreak detection systems and what factors hindered their implementation. Description of the problem One aim of the Joint Action UNITED4Surveillance (U4S) is to identify EU countries’ requirements for outbreak detection, and based on these, develop and deploy a tool for the timely and accurate detection of outbreaks. Through surveys, interviews and an in-person workshop involving public health experts, we identified uses cases, collected functional and technical requirements for a tool. Subsequently the tool development started in August 2023 as an open-source software process on GitHub. Results Despite high interest, only three of the 21 countries that took part in the survey have implemented outbreak detection tools, even though national surveillance systems offer the potential for their use. Reasons for this are limited resources and low prioritization. Experts identified gastrointestinal diseases as one major potential use case and emphasised the necessity of flexible outputs. Tailored to these requirements, data scientists from five European public health institutes developed an open-source R package for signal detection. The tool generates signals based on national surveillance data and enables the user to analyses these results using a dashboard with flexible exploration and generation of a report. The tool is now being piloted locally by ten European public health authorities and its use will be evaluated. Lessons There is a need to use automated outbreak detection tools for routine surveillance of infectious diseases in EU countries but often lack resources. Projects like U4S can bring together expertise to build sustainable tools and supporting material that can address the identified needs. Key messages • Collaborative and open-source development leads to tools that are well tailored to the needs of the community and foster a high uptake in the usage of these tools. • The tool enhances surveillance and outbreak detection in countries without the capacities to develop and implement outbreak detection methods for their surveillance systems.

Inter-regional Hospital Patients’ mobility: Is co-operation better than competition?

Abstract Background According to Italian law, citizens are free to choose their preferred place of care across the national territory. This study aims to analyze the associations between patients’ mobility between Tuscany (Italy) and other Italian regions and the complexity of Diagnosis Related Groups (DRGs) provided for these hospitalizations. Methods A retrospective study was conducted using 2019 Hospital Discharge Cards data of Tuscany provided by the Italian Ministry of Health. The surgical DRGs of each Major Diagnostic Categories (MDCs) were considered according to high specialty (HS) and non-high specialty (N-HS). For each MDCs, patients’ attractions, and escapes to bordering and non-bordering regions with Tuscany were associated with HS and N-HS surgical discharge DRGs by using the Odds Ratio. The analysis was performed using STATA software, and the significance level was set at 95%. Results For Digestive Diseases, patients from non-border regions were more likely to be attracted to Tuscan hospitals for HS DRGs (OR: 1.37 95%CI: 1.08-1.74; p &amp;lt; 0,05), while for Musculoskeletal Diseases those from non-border regions were less likely to be attracted for HS DRGs (OR: 0.51 95%CI: 0.47-0.56; p &amp;lt; 0,05). For Nervous Diseases (OR: 3.08 95%CI: 2.18-4.37; p &amp;lt; 0,05), for Ear, Nose, Mouth And Throat Diseases (OR: 2.41 95%CI: 1.52-5.03; p &amp;lt; 0,05) and for Hepatobiliary And Pancreas Diseases (OR: 4.55 95%CI: 2.71-7.68; p &amp;lt; 0,05), Tuscan patients were more likely to escape to non-border regions for HS DRGs, while for Musculoskeletal Diseases (OR: 0.76 95%CI: 0.68-0.84; p &amp;lt; 0,05) they were less likely to be admitted to non-border regions for HS DRGs. Conclusions The results suggest the necessity of establishing mobility agreements between regions, particularly for high-specialty DRGs. In fact, the provision of mobility care economically benefits the receiving (creditor) region, which provides the medical service, but is not advantageous to the patient’s region of residence (debtor). Key messages • Monitoring mobility flows is critical to improve identify possible lack of supply of resources. • There is a need to develop interregional mobility agreements to ensure better cooperation between different regional health systems.

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.

IL-1 receptor antagonist: etiological and drug delivery systems overview.

This article is aims to provide an overview of studies reported in the literature to investigate the etiological role of IL-1/IL-1ra in various disease conditions and the different drug delivery systems developed to achieve IL-1ra as a possible therapeutic option. Studies reported in PubMed, Google scholar, and other open-source literature related to etiological involvement of IL-1ra in pathophysiological conditions and various drug delivery schemes developed for IL-1ra for its efficacy evaluation as a possible treatment for different disease conditions were surveyed. The pathophysiological conditions involving IL-1/IL-1 ra spanned CNS-related disorders, Diabetes, Cardiac disorders, Ocular disease conditions, Gastrointestinal conditions, Tumor growth & metastasis, and miscellaneous conditions. The drug delivery systems developed for IL-1ra included a commercial drug product, Gene therapy, Antibody fusions, Extended-release delivery systems, and Pegylated-IL-1ra systems.

Prevalence of an empty colon in patients with acute and chronic small intestinal mechanical obstruction: A retrospective radiographic study in 100 dogs and cats

Small intestinal mechanical obstruction (SIMO) is a common clinical condition, with radiographic studies typically focusing on the small intestine. However, the colon's appearance in SIMO has not been extensively studied. This retrospective study aimed to determine the prevalence of an empty colon on radiographs of dogs and cats with confirmed SIMO. Pre-surgical abdominal radiographs of 100 patients (68 dogs and 32 cats) with surgically confirmed mechanical ileus and a control group of 30 dogs and 20 cats with non-obstructive gastrointestinal (GI) disease and one without GI disease, respectively, were evaluated. The colon was assessed for content (none/collapsed, gas, faeces) and segmental distribution (ascending, transverse, descending colon) and correlated to the duration of clinical signs (acute, chronic). A colon was classified as empty when ≥2/3 was collapsed and/or gas-filled. The overall prevalence of an empty colon in cases of mechanical ileus was 61% (p=0.028), with 49/68 in dogs (72.1%) and 12/32 in cats (37.5%), p=0.001 between dogs and cats. Clinical signs duration did not influence the prevalence 28/61 (45.9%) acute, 33/61 (54.1%) chronic, p=0.522. However, acute cases had more empty colon segments (2/3 segments: 6/28, 21.4%; 3/3 segments: 22/28, 78.6%) than chronic cases (2/3 segments: 23/33, 69.7%; 3/3 segments: 10/33, 30.3%; p≤0.001). In the control groups, the prevalence of an empty colon was 64% (p=0.048) with and 38%, p=0.048) without GI disease, with no statistical difference between dogs and cats. An empty colon can be a supporting radiographic finding in diagnosing patients with GI disease, including SIMO, in addition to other established characteristic features. Dogs are more likely to have an empty colon in the presence of mechanical ileus.

Daikenchuto, a Japanese herbal medicine, ameliorates experimental colitis in a murine model by inducing secretory leukocyte protease inhibitor and modulating the gut microbiota

BackgroundInflammatory bowel disease (IBD) is a refractory inflammatory disorder of the intestine, which is probably triggered by dysfunction of the intestinal epithelial barrier. Secretory leukocyte protease inhibitor (SLPI) secreted by colon epithelial cells protects against intestinal inflammation by exerting anti-protease and anti-microbial activities. Daikenchuto (DKT) is one of the most commonly prescribed Japanese traditional herbal medicines for various digestive diseases. Although several animal studies have revealed that DKT exerts anti-inflammatory effects, its detailed molecular mechanism is unclear. This study aimed to clarify the anti-inflammatory mechanism of DKT using a murine colitis model, and to evaluate its potential as a therapeutic agent for IBD.MethodsExperimental colitis was induced in wild-type (WT) mice and SLPI-deficient (KO) mice by dextran sulfate sodium (DSS) after oral administration of DKT. The resultant clinical symptoms, histological changes, and pro-inflammatory cytokine levels in the colon were assessed. Expression of SLPI in the colon was detected by Western blotting and immunohistochemistry. Composition of the gut microbiota was analyzed by 16S rRNA metagenome sequencing and intestinal metabolites were measured by gas chromatography-mass spectrometry analysis. Intestinal epithelial barrier function was assessed by oral administration of FITC-dextran and immunostaining of tight junction proteins (TJPs).ResultsOral administration of DKT increased the number of butyrate-producing bacteria, such as Parabacteroides, Allobaculum, and Akkermansia, enhanced the levels of short-chain fatty acids, including butyrate, in the colon, induced SLPI expression, and ameliorated DSS-induced colitis in WT mice. We found that mouse colon carcinoma cell line treatment with either DKT or butyrate significantly enhanced the expression of SLPI. Moreover, supplementation of DKT protected the intestinal epithelial barrier with augmented expression of TJPs in WT mice, but not in KO mice. Finally, the composition of the gut microbiota was changed by DKT in WT mice, but not in KO mice, suggesting that DKT alters the colonic bacterial community in an SLPI-dependent manner.ConclusionThese results indicate that DKT exerts anti-inflammatory effects on the intestinal epithelial barrier by SLPI induction, due, at least in part, to increased butyrate-producing bacteria and enhanced butyrate levels in the colon. These results provide insight into the mechanism of the therapeutic effects of DKT on IBD.

Lobular panniculitis of the lower legs in a patient with eosinophilic gastrointestinal disease: A case report of scurvy.

Eosinophilic gastrointestinal disease (EGID) is a chronic condition that is commonly treated with restrictive food elimination diets, and may be complicated by food aversion. Here, we present a patient with recalcitrant EGID with lobular panniculitis of the lower legs secondary to scurvy. Cutaneous eruptions are the first manifestations of scurvy, and thus a high suspicion for panniculitis in the context of food restriction is critical to prevent further complications and mortality.

Sex Differences in Colonoscopy Indications and Findings: Results from a Large Multicenter Database.

Background: Sex-based differences are common among diseases. We aimed to investigate the differences in colonoscopy indications and its findings between males and females. Methods: A large, multi-center, cross-sectional, retrospective study included all colonoscopies performed between 2016 and 2021 in seven endoscopy departments. The indications and findings of the procedures were compared between males and females. Results: A total of 151,411 (52.6%) women and 136,519 (47.4%) men were included, aged 56.54 ± 12.9 years and 56.59 ± 12.7. Cecal intubation was similar (95.6% vs 95.5%, p = 0.251). More females had excellent or good bowel preparation compared to males (71.4% vs 65.6%). Colonoscopy due to abdominal pain, constipation, diarrhea, and anemia was higher in females compared to males (15% vs 9.9%, 3.9% vs 2.2%, and 7.6% vs 4.9%, p < 0.001, respectively), while positive FOBT, rectal bleeding and post-polypectomy surveillance and screening were more common indications among males (9.5% vs 7.8%, 10.7% vs 7.8%, and 10.8% vs 7.1%, respectively). On colonoscopy, males were found to have significantly higher colorectal cancer and polyps (0.5% vs 0.4% and 35.1% vs 24.6%). Polyp detection rates were lower in females across all indications, whereas diverticulosis rates were higher in males. However, a clinically significant difference regarding diverticulosis was observed only in patients with anemia as the indication. Conclusions: Notable differences exist between males and females in terms of the indications and findings on colonoscopy. This highlights the need for identifying the factors contributing to these differences and the developing sex-specific approaches for the diagnosis and management of gastrointestinal diseases.

A scoping review of the epidemiology of systemic sclerosis and its organ manifestations: 2018-2024.

Updates from large, observational cohorts and new statistical techniques have resulted in new data on the epidemiology of systemic sclerosis (SSc). This scoping review uses data from 2018 to 2024 to describe the current understanding of the epidemiology of SSc and several of its organ- manifestations. Our review identified new estimates for the global incidence and prevalence of SSc (1.4-8.6 per 100 000 person-years and 17.6-18.9 per 100 000 individuals, respectively). Mortality rates remain high, though mortality at younger ages has decreased. interstitial lung disease and pulmonary arterial hypertension remain the most common causes of death for patients with SSc. Literature on gastrointestinal (GI) manifestations of SSc was scarce, and we identified significant heterogeneity in results. Furthermore, data on the epidemiology of racial, ethnic and sex-based disparities was lacking. New techniques for the evaluation of the epidemiology of SSc highlight the high morbidity and mortality of SSc, and a growing prevalence rate compared with prior eras. Further research is needed to address notable heterogeneity in the reporting of epidemiological data and understudied disease manifestations, including GI disease and health disparities in disease outcomes.

Diversity of Campylobacter spp. circulating in a rhesus macaque (Macaca mulatta) breeding colony using culture and molecular methods.

Gastrointestinal disease is one of the most common reasons for hospitalization in non-human primate colonies and accounts for over one-third of non-research related euthanasia. In rhesus macaques, this manifests as both acute diarrhea and chronic enterocolitis (CE), a syndrome of chronic diarrhea resulting in poor weight gain or weight loss which is minimally responsive to treatment. Campylobacter spp. are major causes of acute enterocolitis in rhesus macaques and may predispose individuals to the development of CE, similar to post-infectious irritable bowel syndrome in humans. Despite these concerns, there are few studies characterizing Campylobacter in rhesus macaque colonies, in particular utilizing whole genome sequencing and assessing findings with respect to the health status of the host. Our findings provide insight into Campylobacter strains circulating in rhesus macaque colonies, which can improve clinical monitoring, assist in treatment decisions, and provide new avenues of investigation into campylobacteriosis as a catalyst for CE.

Design of a duplex Loop-mediated isothermal amplification assay suitable for real-time, and end-point, colorimetric detection of Vibrio parahaemolyticus, and a universal Internal Amplification Control, in mussel samples

Vibrio parahaemolyticus remains as one of the most important foodborne pathogens worldwide, causing gastrointestinal disease in humans due to the consumption of raw, or undercooked, seafood. Even though molecular techniques, like PCR and qPCR, have allowed to overcome most of the limitations associated to culture-based methods, some persist such as the need for highly trained personnel, or the need to acquire expensive equipment. Loop-mediated isothermal amplification, LAMP, has emerged as a promising tool to solve these issues. The present study reports the development of a novel LAMP-based method for the detection of V. parahaemolyticus in mussels. This assay targets the gene toxR, and implements a novel, universal, freely available Internal Amplification Control (IAC) which was detected in a multiplex real-time LAMP format, where it is differentiated by melt curve analysis (86.70 ± 0.32 °C and 90.24 ± 0.34 °C for toxR and IAC respectively) and did not impact the analytical sensitivity of the target. Alternatively, the IAC was also applied in a parallel reaction and the assays performed by end-point, colorimetric LAMP. This novel IAC allowed to identify reaction inhibition due to matrix effect, and rule out false negative results. This new assay was combined with the ISO 21872 enrichment protocol, and the evaluation of spiked mussel samples indicated that an LOD95 of 14.5 and 10.8 CFU/25g could be reached after the primary 6h and secondary 24h enrichment steps by real-time LAMP, and 27.9 and 10.9 CFU/25g by naked-eye, color LAMP. It was important to note that in addition to these differences in terms of LOD95, a higher number of samples presenting reaction inhibition was observed after the primary enrichment, compared to the secondary, all successfully identified thanks to the new IAC; and also that statistically longer amplification times were required (Cq values of 19.47 ± 7.87 and 7.90 ± 1.20 respectively). The overall evaluation of the method returned values of diagnostic sensitivity, specificity and accuracy of 100 % along with an index of concordance of 1.00. These results were consistent regardless if the real-time, or the colorimetric, LAMP strategy was followed.

The impact of specific health warning messages on Chinese young people's perception of smoking risks and quitting intentions.

Although a substantial body of research has analyzed the effectiveness of cigarette package warning labels in tobacco control, the very general health warnings messages (HWMs) on cigarette packaging in China have shown limited effectiveness in deterring youth from smoking. Therefore, this study investigates the impact of specific and more detailed warning text messages on Chinese young people's risk perception of smoking and their intention to quit. We employed a randomized survey experiment to examine the impact of specific text-based warning labels on Chinese young people's risk perception of smoking and intention to quit. The total effective sample size was 1064 participants. The subjects were divided into three groups: the first group served as the control group, which was shown the existing cigarette package warning labels; the second group was shown cigarette package warning labels related to cardiovascular, digestive, and respiratory diseases; and the third group was shown cigarette package warning labels related to sexual dysfunction. The respiratory disease-related warnings significantly increased young people's awareness of smoking-related respiratory risks (p<0.01). The impact of warning labels for the three common diseases on enhancing young people's overall risk perception of smoking (p<0.05) and their intention to quit exhibited only weak statistical significance (p<0.05). In contrast, warning labels related to sexual dysfunction significantly increased young people's risk perception of smoking (p<0.001) and their intention to quit (p<0.001), with a much higher level of statistical significance compared to those related to the other three common diseases. Detailed descriptions of the risks associated with all four diseases were positively correlated with awareness of smoking-related harm and the intention to quit. However, warnings related to sexual dysfunction had a greater level of statistical significance compared to those related to the other three common diseases. This stronger significance may be attributed to young people's heightened concern about sexual dysfunction.