Histopathological Tests Research Articles

Hepatic microgranulomas caused by Mycobacterium marinum (MM) in a Horsfield tortoise (Testudo horsfieldii) presenting with a non‐healing limb granuloma

AbstractA 3‐year‐old, male, entire Horsfield tortoise (Testudo horsfieldii) presented with a non‐healing lesion on the dorsal aspect of the elbow. Fine‐needle aspiration cytology revealed granulomatous inflammation with acid‐fast staining organisms. Due to worsening clinical condition, the animal was euthanased. Postmortem examination included histopathology, Mycobacterium culture and polymerase chain reaction testing. There was gross hepatomegaly and a large, turbid, straw‐coloured, coelomic effusion. Limb granuloma and liver tissue were sent for mycobacterial polymerase chain reaction and culture, and both were positive and confirmed disseminated Mycobacteria marinum. The origin of the infection is not known, but suspected to originate from poor hygiene from the place of purchase and dissemination secondary to the initial limb granuloma. This represents an uncommon presentation and the first reported infection by this mycobacterial agent in the species. It is important to consider mycobacterial disease as a differential in granulomatous infections, given the range of presentations possible in reptile patients.

Current Knowledge on Nail Involvement in Autoimmune Bullous Disorders.

There are few studies, mainly case reports, on the involvement of the nail unit in autoimmune bullous disorders. Nail involvement in autoimmune bullous disorders is a significant clinical phenomenon, marked by a range of manifestations, most often not presenting with blisters like on the skin but rather with alterations of the nail unit such as paronychia, onychomadesis, or onycholysis. This involvement is particularly notable due to the unique immunological features of the nail unit, including the expression of various antigens and the presence of Langerhans cells. Conditions like pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA disease, and bullous systemic lupus erythematosus can lead to nail abnormalities. The prevalence of nail manifestations varies according to the disorder, and diagnosis often relies on histopathological and immunofluorescence testing. Nail involvement correlates with disease severity and duration, sometimes serving as a herald sign. Further research is needed to guide therapeutic approaches for nail involvement in autoimmune bullous diseases. Nail involvement in autoimmune bullous nail disorders may be confusing as there are almost never bullae. One should keep the diagnosis in mind when facing an atypical paronychia.

MST1 selective inhibitor Xmu-mp-1 ameliorates neuropathological changes in a rat model of sporadic Alzheimer's Disease by modulating Hippo-Wnt signaling crosstalk.

Alzheimer's disease (AD), the most prevalent form of dementia, is characterized by progressive cognitive impairment accompanied by aberrant neuronal apoptosis. Reports suggest that the pro-apoptotic mammalian set20-like kinase 1/2 (MST1/2) instigates neuronal apoptosis via activating the Hippo signaling pathway under various stress conditions, including AD. However, whether inhibiting MST1/2 has any therapeutic benefits in AD remains unknown. Thus, we tested the therapeutic effects of intervening MST1/2 activation via the pharmacological inhibitor Xmu-mp-1 in a sporadic AD rat model. Sporadic AD was established in adult rats by intracerebroventricular streptozotocin (ICV-STZ) injection (3mg/kg body weight). Xmu-mp-1 (0.5mg/kg/body weight) was administered once every 48h for two weeks, and Donepezil (5mg/kg body weight) was used as a reference standard drug. The therapeutic effects of Xmu-mp-1 on ICV-STZ rats were determined through various behavioral, biochemical, histopathological, and molecular tests. At the behavioral level, Xmu-mp-1 improved cognitive deficits in sporadic AD rats. Further, Xmu-mp-1 treatment reduced STZ-associated tau phosphorylation, amyloid-beta deposition, oxidative stress, neurotoxicity, neuroinflammation, synaptic dysfunction, neuronal apoptosis, and neurodegeneration. Mechanistically, Xmu-mp-1 exerted these neuroprotective actions by inactivating the Hippo signaling while potentiating the Wnt/β-Catenin signaling in the AD rats. Together, the results of the present study provide compelling support that Xmu-mp-1 negated the neuronal dysregulation in the rat model of sporadic AD. Therefore, inhibiting MST/Hippo signaling and modulating its crosstalk with the Wnt/β-Catenin pathway can be a promising alternative treatment strategy against AD pathology. This is the first study providing novel mechanistic insights into the therapeutic use of Xmu-mp-1 in sporadic AD.

Advances of pathological research and classification in malformations of cortical development associated with refractory epilepsy

With rapid development of genetic testing techniques, neuroimaging and neuroelectrophysiological technologies, our understanding of malformations of cortical development continues to be deepened and updated. In particular, mutations in genes related to the mammalian target of rapamycin (mTOR) signaling pathway have been successively discovered in focal cortical dysplasia (FCD). At the same time, the classification consensus on FCD issued by the International League Against Epilepsy (ILAE) in 2011 has encountered problems and challenges in diagnostic practice. Therefore, in 2022, ILAE proposed an updated version of the FCD classification based on the progress in molecular genetics over the past decade. The main addition to the classification system is "white matter lesions, " and it is also suggested to integrate histopathological, neuroimaging, and molecular testing results for multi-level integrated diagnosis to achieve reliable, clinically relevant, and therapeutic targeted final diagnosis.

Integrated transcriptomics and histopathology approach identifies a subset of rejected donor livers with potential suitability for transplantation

BackgroundLiver transplantation is an effective treatment for liver failure. There is a large unmet demand, even as not all donated livers are transplanted. The clinical selection criteria for donor livers based on histopathological evaluation and liver function tests are variable. We integrated transcriptomics and histopathology to characterize donor liver biopsies obtained at the time of organ recovery. We performed RNA sequencing as well as manual and artificial intelligence-based histopathology (10 accepted and 21 rejected for transplantation).ResultsWe identified two transcriptomically distinct rejected subsets (termed rejected-1 and rejected-2), where rejected-2 exhibited a near-complete transcriptomic overlap with the accepted livers, suggesting acceptability from a molecular standpoint. Liver metabolic functional genes were similarly upregulated, and extracellular matrix genes were similarly downregulated in the accepted and rejected-2 groups compared to rejected-1. The transcriptomic pattern of the rejected-2 subset was enriched for a gene expression signature of graft success post-transplantation. Serum AST, ALT, and total bilirubin levels showed similar overlapping patterns. Additional histopathological filtering identified cases with borderline scores and extensive molecular overlap with accepted donor livers.ConclusionsOur integrated approach identified a subset of rejected donor livers that are likely suitable for transplantation, demonstrating the potential to expand the pool of transplantable livers.

Diagnosis of celiac disease in Poland – what should thelaboratory diagnostician pay special attention?

Celiac disease (CD) is an autoimmune disorder in which the immune system reactsabnormally when exposed to gluten consumption in genetically predisposed individuals. Thedisease affects about 1% of the population, making it one of the most common autoimmunediseases. Due to the heterogeneous presentation of clinical symptoms, celiac disease oftenremains undiagnosed or diagnosed late, even in elderly patients. According to the EuropeanSociety for Paediatric Gastroenterology and Nutrition (ESPGHAN) guidelines in force since2020, the diagnosis of CD in children is based on: serological tests (evaluation of specificantibodies in peripheral blood serum) and histopathological tests (determination of thepresence of lesions in duodenal sections taken during endoscopic examination). Currently,genetic testing of the HLA-DQ2/DQ8 haplotype does not increase the diagnostic accuracy ofserological tests and can only

Videoautopsy-A Minimally Invasive Autopsy Method Using Endoscopic Techniques in Forensic Medicine: Clinical Features.

In light of falling global autopsy rates, one of the causes of which is the resulting body disfigurement, it has become crucial to search for new, minimally invasive post-mortem diagnostic tools. One of these methods is videoautopsy, a minimally invasive autopsy technique using endoscopic methods. In the years 2020-2023, 15 videoautopsies were conducted at the Department of Forensic Medicine of the Poznan University of Medical Sciences in order to determine the usefulness of the method in forensic approaches. Each post-mortem examination included laparoscopy and thoracoscopy, followed by a classic autopsy to assess the effectiveness of the method. In total, the endoscopic examination allowed for determining the cause of death in 53.3% of cases, and when the cause of death was located in the abdominal cavity or chest, the percentage increased to 80%. Traumatic lesions had good recognition efficiency. In addition, it was also possible to collect material for histopathological and toxicological tests. Retroperitoneal organs were difficult to assess. The main limitation of the method is the inability to assess the inside of the skull and the structures of the central nervous system. Videoautopsy may become an important tool in post-mortem diagnostics and in forensic cases, especially when the alternative is to not perform an autopsy. Further research is necessary to standardise the examination protocol, optimise the instrumentation, and assess the potential synergistic effect with other methods of minimally and non-invasive post-mortem examination.

HBeAg-positive patients hepatic tissue inflammatory activity and influencing factors during normal ALT and indeterminate phases

Objective: To analyze the hepatic tissue inflammatory activity and influencing factors in HBeAg-positive patients during normal alanine aminotransferase (ALT) and indeterminate phases so as to provide a basis for evaluating the disease condition. Methods: Patients with HBeAg-positive with normal ALT and HBV DNA levels below 2 × 10(7) IU/ml from January 2017 to December 2021 were selected as the study subjects. A histopathologic liver test was performed on these patients. Age, gender, time of HBV infection, liver function, HBsAg level, HBV DNA load, genotype, portal vein inner diameter, splenic vein inner diameter, splenic thickness, and others of the patients were collected. Significant influencing factors of inflammation were analyzed in patients using logistic regression analysis, and its effectiveness was evaluated using receiver operating characteristic (ROC) curves. Results: Of the 178 cases, there were 0 cases of inflammation in G0, 52 cases in G1, 101 cases in G2, 24 cases in G3, and one case in G4. 126 cases (70.8%) had inflammatory activity ≥ G2. Infection time (Z=-7.138, P<0.001), γ-glutamyltransferase (t =-2.940, P=0.004), aspartate aminotransferase (t =-2.749, P=0.007), ALT (t =-2.153, P=0.033), HBV DNA level (t =-4.771, P=0.010) and portal vein inner diameter (t =-4.771, P<0.001) between the ≥G2 group and < G2 group were statistically significantly different. A logistic regression analysis showed that significant inflammation in liver tissue was independently correlated with infection time [odds ratio (OR)=1.437, 95% confidence interval (CI): 1.267-1.630; P<0.001)] and portal vein inner diameter (OR=2.738, 95% CI: 1.641, 4.570; P<0.001). The area under the curve (AUROC), specificity, and sensitivity for infection time and portal vein inner diameter were 0.84, 0.71, 0.87, 0.72, 0.40, and 0.95, respectively. Conclusion: A considerable proportion of HBeAg-positive patients have inflammation grade ≥G2 during normal ALT and indeterminate phases, pointing to the need for antiviral therapy. Additionally, inflammatory activity has a close association with the time of infection and portal vein inner diameter.

Isolated Breast Sarcoidosis

Background: Sarcoidosis is a rare non-caseating granulomatous disease of unknown origin that affects multiple systems in the body occurring more frequently in young women age 17-24 years. Cases with manifestations that doesn’t affect the common organs can be difficult to identify and delay the patient’s diagnosis, meaning that the finding of an isolated breast mass should include sarcoidosis as one of its differentials, to ensure early detection and a better prognosis. Case presentation: We present the case report of a 21-year-old female patient, who had noticed a palpable breast nodule associated with local pain and fever for 2 months. Physical examination detected palpable bilateral axillary lymph nodes, a nodule occupying the lateral quadrants of the left breast and bullous lesions, along with phlogistic signs in the same topography. The imaging exams of the chest, showed a solid-cystic complex in the lateral quadrants of the left breast, in addition to bilateral axillary lymph node enlargement. Laboratory tests was unremarkable. The histopathological tests detected fibroadipose tissue with noncaseating granulomas, neutrophilic microabscesses and Langerhans-type giant cells, causing chronic granulomatous mastitis, which may represent sarcoidosis. The lesions regresed after the use of corticosteroids. Conclusion: Despite its rarity, the clinical and imaging findings such as those of this patient, should warrant the consideration of breast sarcoidosis as a possible diagnosis given the importance of excluding similar conditions, such as neoplasms, early on.

Application of machine learning in the preoperative radiomic diagnosis of ameloblastoma and odontogenic keratocyst based on cone-beam CT

Abstract Objectives Preoperative diagnosis of oral ameloblastoma (AME) and odontogenic keratocyst (OKC) has been a challenge in dentistry. This study uses radiomics approaches and machine learning (ML) algorithms to characterize cone-beam CT (CBCT) image features for the preoperative differential diagnosis of AME and OKC and compares ML algorithms to expert radiologists to validate performance. Methods We retrospectively collected the data of 326 patients with AME and OKC, where all diagnoses were confirmed by histopathologic tests. A total of 348 features were selected to train six ML models for differential diagnosis by a 5-fold cross-validation. We then compared the performance of ML-based diagnoses to those of radiologists. Results Among the six ML models, XGBoost was effective in distinguishing AME and OKC in CBCT images, with its classification performance outperforming the other models. The mean precision, recall, accuracy, F1-score, and area under the curve (AUC) were 0.900, 0.807, 0.843, 0.841, and 0.872, respectively. Compared to the diagnostics by radiologists, ML-based radiomic diagnostics performed better. Conclusions Radiomic-based ML algorithms allow CBCT images of AME and OKC to be distinguished accurately, facilitating the preoperative differential diagnosis of AME and OKC. Advances in knowledge ML and radiomic approaches with high-resolution CBCT images provide new insights into the differential diagnosis of AME and OKC.

A comparative study on the detection of Mycobacterium leprae DNA in urine samples of leprosy patients using Rlep-PCR with other conventional samples.

Mycobacterium leprae causes leprosy that is highly stigmatized and chronic infectious skin disease. Only some diagnostic tools are being used for the identification M. leprae in clinical samples, such as bacillary detection, and histopathological tests. These methods are invasive and often have low sensitivity. Currently, the PCR technique has been used as an effective tool fordetecting M. leprae DNA across different clinical samples. The current study aims to detect M. leprae DNA in urine samples of untreated and treated leprosy patients using the Rlep gene (129 bp) and compared the detection among Ridley-Jopling Classification. Clinical samples (Blood, Urine, and Slit Skin Smears (SSS)) were collected from leprosy and Non-leprosy patients. DNA extraction was performed using standard laboratory protocol and Conventional PCR was carried out for all samples using Rlep gene target and the amplicons of urine samples were sequenced by Sanger sequencing to confirm the Rlep gene target. The M. leprae DNA was successfully detected in all clinical samples across all types of leprosy among all the study groups using RLEP-PCR. Rlep gene target was able to detect the presence of M. leprae DNA in 79.17% of urine, 58.33% of blood, and 50% of SSS samples of untreated Smear-Negative leprosy patients. The statistical significant difference (p = 0.004) was observed between BI Negative (Slit Skin Smear test) and RLEP PCR positivity in urine samples of untreated leprosy group. The PCR positivity using Rlep gene target (129 bp) was highest in all clinical samples among the study groups, across all types of leprosy. Untreated tuberculoid and PNL leprosy patients showed the highest PCR positivity in urine samples, indicating its potential as a non-invasive diagnostic tool for leprosy and even for contact screening.

Comparing Cervical Cancer Screening Strategies in an Incarcerated Population.

Objective: To describe the prevalence of cervical intraepithelial neoplasia (CIN), high-risk human papillomavirus (hrHPV) infection, and cervical cancer in a high-risk, underscreened incarcerated population and to evaluate the performance of current cervical cancer screening options to detect cervical precancer (CIN 2/3) in this population. Study Design: Deidentified data were obtained from all cytological, hrHPV DNA, and histopathological testing of cervical biopsies performed on people incarcerated at the North Carolina Correctional Institute for Women between January 1, 2013, and December 31, 2020. These were linked to corresponding demographic data. The proportions of histopathological diagnoses of CIN2+ and CIN3+ immediately preceded by abnormal cytology testing or hrHPV testing were determined, and prevalence differences and 95% confidence intervals were calculated. Results: A total of 15,319 individuals incarcerated at the North Carolina Correctional Institute for Women had at least one cytology result during 2013-2020. Of these, 2,829 (18%) had abnormal cervical cytology, and 3,724 (24.3%) had positive hrHPV testing. The detection of CIN2+ was 95.9% by preceding abnormal cervical cytology, 89.9% by preceding positive hrHPV testing (p = 0.03), and 96.5% by preceding positive co-testing. The detection rate of CIN3+ was 96.6% by preceding abnormal cervical cytology, 90.8% by preceding positive hrHPV testing (p = 0.12), and 96.6% by positive co-testing. Conclusion: In our sample, primary cytology and co-testing detected CIN2+ at higher rates when compared with primary hrHPV testing. This reinforces that incarcerated populations do not fall into average-risk populations for which current cervical cancer screening options are designed, which should be considered when performing screening in this population.

Cryptosporidium disease of small ruminants in the region of El Taref and Mostaghanem

In order to identify and quantify Cryptosporidium infection in small ruminants in northern Algeria, specifically in the regions of Tarf and Mostaganem, a three-year survey was conducted between 2019 and 2021. The epidemiological investigation covered several aspects of the prevalence and etiology of Cryptosporidium, including various factors suspected to contribute to the spread of the causative agent of this disease. In addition, a confirmatory study was initiated, with bacteriological and histopathological tests performed on samples collected during the survey period from the various farms examined. The results showed that the epidemic takes several aspects for its spread as well as its persistence, the bacteriological results showed a coincidence of the presence of the pathogen in a significant proportion, and the histopathological interpretation of the slides revealed the diversity of lesions at the intestinal level with the predominance and inversion of enterocytes by sporozoites, resulting in the recurrence of lesions in the different organs collected in all species studied, cattle, sheep and goats.

Mechanistic insights into the hepatoprotective properties of Mallotus phillipensis fruit: Targeting proinflammatory cytokines and free radicals using isolated compound

Ethnopharmacological relevance:Mallotus phillipensis (MP) belongs to the endangered plants of great medicinal value. Widely used in the Ayurvedic healthcare system, parts of the plant which are rich in secondary metabolites are used in the treatment of several diseases like eczema, bronchitis, worm infestation, diabetes, kidney stones, cancer, and malaria. In ethnomedicine, MP has been reported to be traditionally used in the treatment and healing of jaundice and inflammatory conditions in the Ayurveda system. This plant was thus selected to explore its hepatoprotective activity. ObjectiveThis study was undertaken to investigate the protective property of MP and a flavanone i.e. 7,4′-Dihydroxy-3′′,3′′-dimethyl-(5,6-pyrano-2′′-one)-8′′′-(3′′′,3′′′-dimethylallyl)-flavanone (A4) previously identified and obtained from the same plant on CCl4-induced liver injury in animal models to validate the folkloric claims. Traditional medicinal plants have the potential to provide phytoconstituents capable of healing liver cells. In this regard, MP is used in various traditional medicinal systems to treat several diseases. Though it has been studied for its hepatoprotective potential, activity on the isolated compounds is yet to be reported to confirm the active principle. Therefore, the study assessed the hepatoprotective effect of ethyl acetate and methanol extracts and a flavanone isolated from MP fruit extract. MethodsMethanol and ethyl acetate fractions of MP fruits at two different doses (300 mg/kg and 500 mg/kg) and a flavanone (A4-50 mg/kg) isolated from MP were tested for hepatoprotective potential in rats. At 50 mg/kg dosage/ day orally, silymarin was used as a standard drug. The effect on liver enzymes and serum cytokines was also verified in animal models. Histopathology and antioxidant tests were performed on liver tissue. Elemental analysis, 1H- &13C NMR, MS, IR and UV spectral data were used to characterize the structure of isolated flavanone (A4). ResultsThe ethyl acetate and methanol fractions of MP fruit and the isolated compound A4 i.e. flavanone showed strong hepatoprotective effects, as evidenced by their ability to impede the rise in serum transaminases. They also decreased the serum IL-1, IL-6 and TNF-α levels and showed significant antioxidant potential. The effect was found to be in decreasing order as MEA 500 > MPM 500 > MEA 300 > A4 > MPM 300. ConclusionsThe results indicate that MP fruit fractions with methanol, ethyl acetate and A4 can lessen CCL4-induced liver damage. This may be because of their antioxidant and cytokine-inhibitory properties.

First confirmed case of equine pythiosis in Northern Veracruz, Mexico

A clinical case of an adult horse with invasive, ulcerative, proliferative, pyogranulomatous disease of the skin (tumor) in the shoulder region is presented. The mass had a granulomatous and crater-shaped appearance, with serosanguinous discharge and the presence of fistulas with caseous material. The tumor was removed by surgery and sent to the laboratory for diagnosis. Histopathology was performed using Grocott-Gomori methenamine silver stain. The presence of necrotic material, fibrosis, infiltrated cells, and brown-colored hyphae, characteristic of members of the genus Pythium, were observed. To identify the infecting species, conventional PCRs for the amplification of the ITS-1 was carried out. Histopathological and PCR tests confirmed infection by a Pythium insidiosum strain closely associated with previous records from the US and Central America. Our report represents the first molecularly confirmed case of equine pythiosis in Mexico.

Bovine Tuberculosis Testing in Colombia: Comparative Histopathological, Microbiological, and Molecular Biology Findings

Introduction: Bovine tuberculosis (bTB) is a zoonotic infectious disease present in Colombia, caused by Mycobacterium bovis, and causes tuberculosis in water buffalo (Bubalus bubalis). Diagnosis of bovine tuberculosis through the intradermal test is difficult; evaluating and understanding the behavior of other diagnostic tests is necessary.&#x0D; Objective: To describe the behavior and results of different diagnostic methods for bovine tuberculosis in water buffalo positive for the Purifed Proteic Derivate (DPP) intradermal test.&#x0D; Methodology: In water buffaloes positive for comparative cervical tuberculin test, different diagnostic methods were applied, described, and compared: Ziehl-Neelsen staining, microbiological culture, histopathological analysis, and PCR-HRM.&#x0D; Results: Histopathological tests showed that 26 water buffalo positive for DPP (52%) had histological lesions compatible with bovine tuberculosis. 37% of the evaluated samples from tuberculin-positive Buffalo's lungs and secondary lymph nodes showed acid-alcohol-resistant bacillus with Ziehl-Neelsen staining. Four samples of Mycobacterium bovis from tuberculin-positive buffalo were isolated and identified, with two of these isolates confirmed from tissues with PCR-HRM, and three buffalo with microbiological isolates presented granulomatous lesions through histological analysis. Seventeen tuberculin-positive buffalo (34%) tested positive for real-time PCR HRM, and nine of these buffalo did not have histological lesions compatible with bTB and were confirmed with the molecular test.&#x0D; Conclusion: Our results provide positive evidence of histological findings, microbiological isolation, and molecular diagnosis of tuberculin-positive water buffalo in the lowlands of Colombia. None of the complementary tests performed showed 100% concordance with the comparative cervical tuberculin test results for bTB.

The Potential of Purple Sweet Potato-based Food Bar as an Immunomodulator and Hepatoprotector Against Diethylnitrosamine-induced Mice

The food bar’s effect as an immunomodulator and hepatoprotector in vivo was tested on male BALB/c mice induced with diethylnitrosamine (DEN). The experimental animals were treated using the Post-test Control Group Design method. Six groups of 30 mice each made up the sample: The negative control group of healthy mice fed with a normal diet (P0); the group of healthy mice given the food bar (P1); the positive control group of mice induced with DEN and given a normal diet (P2); the group of mice induced with DEN and given a normal diet + food bar at 11,700 mg/kg (P3); the group of mice induced with DEN and given a normal diet + food bar at 23,400 mg/kg (P4); and the group of mice induced with DEN given the food bar (P5). The observations conducted included the spleen, which was used for the analysis of immunomodulators on T CD4+CD25+, CD4+, and CD8+ cells with cytokines TNF-α, IFN-Ɣ, and IL-10, blood serum for the analysis of SGPT and SGOT, and liver organ for the analysis of SOD, MDA, and histopathology. The results of the immunomodulator testing showed that the administration of the food bar (P5) significantly (p &lt; 0.05) resulted in the highest percentage of CD4+ T cells at 2.93 % and CD8+ T cells at 5.30 %, a lower percentage of CD8+ T cells expressing proinflammatory cytokines (TNF-α at 0.27 % and IFN-γ at 0.29 %), a higher percentage of CD4+ T cells expressing CD25+, and CD25+ T cells expressing anti-inflammatory cytokines (IL-10) at 2.83 %. This group also exhibited the lowest levels of SGPT and SGOT, a higher percentage of SOD, and a lower percentage of MDA compared to other groups. The food bar, based on the mix of purple sweet potato, mung beans, moringa leaves, and strawberries, also reduced liver damage, as demonstrated through histopathological testing. HIGHLIGHTS Food bar demonstrated effectiveness as an immunomodulator by increasing CD4+ and CD8+ T-cell populations, enhancing CD4+ T-cells expressing CD25+, elevating CD25+ expressing anti-inflammatory cytokine (IL-10), and reducing CD8+ T-cells suppressing the expression of proinflammatory cytokines (TNF-α and IFN-γ) in the spleens of DEN-induced mice The provision of the food bar as the main diet resulted in reduced levels of SGPT, SGOT, and hepatic MDA in DEN-induced mice and increased SOD activity in mice induced with 50 mg/kg of DEN Food bar based on purple sweet potato, green beans, moringa leaves, and strawberries was able to protect and reduce liver cell damage caused by DEN, as demonstrated by histopathology tests GRAPHICAL ABSTRACT

Cytomegalovirus Diseases of the Gastrointestinal Tract in Immunocompetent Patients: A Narrative Review.

Cytomegalovirus (CMV) is a potential pathogen that causes gastrointestinal (GI) tract diseases regardless of host immunity. In contrast to immunocompromised individuals, immunocompetent patients lack a comprehensive overview of the gastrointestinal manifestations. This study aims to provide a comprehensive summary of the current evidence regarding presentations, diagnostics, management, risk assessment, and outcomes in immunocompetent patients with CMV GI disease. A thorough literature search of English publications up to April 2022 was conducted across electronic databases to identify relevant articles, with eligible case series selected for detailed analysis. The majority of immunocompetent patients affected by CMV GI disease are typically elderly, critically ill, or burdened with comorbidities that compromise immunity. Clinical presentations range from subtle symptoms to severe surgical conditions, including instances of mortality. Specific clinical presentations, blood test results, or endoscopic features are lacking, necessitating reliance on histopathological tests such as immunohistochemistry staining for diagnosis. While antiviral therapy may offer benefits in improving outcomes, careful individual assessment is warranted due to diverse comorbidities and potential side effects. Mortality rates vary considerably based on underlying medical conditions and therapeutic approaches. It is imperative for clinicians to maintain vigilance for CMV GI disease among high-risk groups, despite their baseline immunocompetence, in order to enhance clinical outcomes.

Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection.

A reliable test is essential for diagnosing Helicobacter pylori (H. pylori) infection, and crucial for managing H. pylori-related diseases. Serving as an excellent method for detecting H. pylori infection, histologic examination is a test that clinicians heavily rely on, especially when complemented with immunohistochemistry (IHC). Additionally, other diagnostic tests for H. pylori, such as the rapid urease test (CLO test) and stool antigen test (SA), are also highly sensitive and specific. Typically, the results of histology and other tests align with each other. However, on rare occasions, discrepancy between histopathology and other H. pylori diagnostic tests occurs. To investigate the discordance between histology and other H. pylori tests, the underlying causes, and the impact on clinical management. Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018. Reports were included in the study only if there were other H. pylori tests within seven days of the biopsy. These additional tests include CLO test, SA, and H. pylori culture. Concordance between histopathology and other tests was determined based on the consistency of results. In instances where histology results were negative while other tests were positive, the slides were retrieved for re-assessment, and the clinical chart was reviewed. Of 1396 pathology reports were identified, each accompanied by one additional H. pylori test. The concordance rates in detecting H. pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments. 117 discrepant cases were identified. Only 20 cases (9 with CLO test and 11 with SA) had negative biopsy but positive results in other tests. Four cases initially stained with Warthin-Starry turned out to be positive for H. pylori with subsequent IHC staining. Among the remaining 16 true discrepant cases, 10 patients were on proton pump inhibitors before the biopsy and/or other tests. Most patients underwent treatment, except for two who were untreated, and two patients who were lost to follow-up. There are rare discrepant cases with negative biopsy but positive in SA or CLO test. Various factors may contribute to this inconsistency. Most patients in such cases had undergone treatment.

Autoimmune hepatitis as a rare cause of cirrhosis development

Cirrhosis is a serious condition associated with progressive damage to this organ. Autoimmune hepatitis (AIH) is one of the causes leading to the development of cirrhosis. This disease is characterized by chronic inflammation with damage to hepatocytes and presence of specific immune markers. The diagnosis of AIH is based on biochemical, immunoserological and histopathological tests. There are defined diagnostic criteria, liver biopsy is important in determining the extent of the disease. Symptoms of AIH are nonspecific and include weight loss, fatigue, jaundice, abdominal pain and symptoms associated with the overactivity of an immune system. Advanced cases of AIH can lead to cirrhosis. AIH most often affects middle-aged women, although it can occur in people of any age. Epidemiological data indicate an increase in the incidence of AIH, which may be related to various environmental factors. The rate of progression of AIH to cirrhosis and depends on a number of factors. Effective treatment includes immunosuppression, mainly the use of glucocorticosteroids and azathioprine. Monitoring, healthy lifestyle and patient education are key. In severe cases, liver transplantation may be necessary.