Pathology Of Gastrointestinal Tract Research Articles

Особливості перебігу поєднаної патології верхніх відділів шлунково-кишкового тракту та алергодерматозів у дітей

Актуальність. Дослідження останніх років свідчать про те, що однією з причин виникнення алергодерматозів (АД) у дітей і дорослих є захворювання шлунково-кишкового тракту. Однак чимало проблем виникнення даних поєднань досі не вирішені. Мета. Встановити частоту та характер ураження верхніх відділів травного тракту у дітей з АД. Матеріали та методи. На базі Чернівецької обласної дитячої клінічної лікарні обстежено 40 дітей із АД у поєднанні з патологією верхніх відділів шлунково-кишкового тракту (ВВШКТ) та 20 пацієнтів із АД без патології ВВШКТ віком 3–18 років. Проведено дворазове клініко-лабораторне обстеження (загальноклінічні аналізи, скарифікаційні проби з неінфекційними алергенами в період ремісії АД), фіброгастродуоденоскопію, ультразвукове дослідження, рН-метрію, біохімічне дослідження крові (аланінамінотрансфераза, аспартатамінотрансфераза, гамма-глутамілтранспептидаза, лужна фосфатаза, холестерин), ідентифікація Helicobacter pylori. Результати. Серед 40 обстежених дітей із АД у 30 (75 %) було діагностовано різні ураження стравоходу, шлунка й дванадцятипалої кишки. У 10 (25 %) дітей — функціональні зміни у вигляді дуоденогастрального рефлюксу (70 %) та недостатності кардії (30 %). Множинний характер рефлюксу відзначався у 85,7 % дітей із хронічним гастродуоденітом, у 100 % дітей із езофагітом і виразковою хворобою дванадцятипалої кишки. Інфікованість Helicobacter pylori становила 72,5 %. Встановлено підвищення активності аланінамінотрансферази, аспартатамінотрансферази, гамма-глутамілтранспептидази, лужної фосфатази та холестерину в сироватці крові. Висновки. У дітей із АД у 75 % випадків діагностується органічна патологія верхніх відділів травного тракту, в зв’язку з чим усім пацієнтам рекомендується здійснити гастроентерологічне обстеження.

Prevalence of Dental Diseases in Children with Digestive Tract Diseases

To study the prevalence of stomatitis among children with the background of chronic gastroduodenitis (CG). 74 children aged from 3 to 17 years old, who were in inpatient treatment during the 1st half of 2020. The patients' aged 5 to 16 years. Boys - 41.8%, girls - 58.2%. The duration of the disease in 45% from 1 to 5 years, in 55% it was 5 or more years. Symptoms of CG were characterized by pain (82.6%), dyspeptic (76%) and asthenovegetative (in 2/3) syndromes. In 65.6%, signs of poly hypovitaminosis and micronutrient deficiencies were found. According to the endoscopic examination, superficial (42.2%), erosive (31.8%), atrophic forms of gastritis (18.8%) were more common, other forms of CG were less common. Among the oral cavity pathologies, caries (20.2%), aphthous stomatitis and angular cheilitis (39.1%) were common. Chronic stomatitis prevailed (62.1%) compared with acute (37.9%). Mild was 14.8%, medium - 51.7%, severe - 10.3%. In the structure of stomatitis, the fibrous form was often (62%), less often necrotic (17.2%) and granulation and lichenoid form 10 3%. The etiological factor: herpes virus (24.1%), Candida (17.2%), bacterial (27.5%, often staphylococci, streptococci, Klebsiela, etc.), combined flora was in angular cheilitis (31,2%) Stomatitis in children with gastrointestinal tract pathology has more severe course. Success in the treatment and maintenance of health in different ages children. The work of a multidisciplinary team is required.

Bowel Preparation for Pediatric Colonoscopy.

Colonoscopy is an important diagnostic and therapeutic tool in evaluating and treating gastrointestinal tract pathologies. Adequate visualization of the intestinal lumen is necessary for detection of lesions, and thus bowel preparation is a key component of the process. It is estimated that over 25% percent of pediatric patients have sub-optimal bowel preparations, which can lead to longer procedure times, missed pathology, unsuccessful ileal intubation, and possibly repeat procedure/anesthesia. There is no universal protocol for bowel preparation in pediatrics and there is a wide variability of practices around the world. The purpose of this paper is to review the recent published literature regarding bowel preparations for pediatric colonoscopy with focus on published work in the last decade exploring a number of factors involved in bowel preparation including the role of patient education, types of bowel preparation, and their efficacy and safety.

Upper gastrointestinal tract condition in patients with morbid obesity before and after bariatric surgery

Obesity is the 21st century pandemic. By 2025 6 % of men and 9 % of women will suffer from morbid obesity. For morbid obesity bariatric surgery is the main treatment option. The presence of pathology of the upper gastrointestinal tract (GERD) determines the choice of surgical intervention. The study involved 68 patients 47.1 ± 10.2 years with morbid obesity. Patients had the following gastroenterological pathologies: erosive esophagitis – 6 (8.8 %), hiatal hernia – 9 (13 %), erosive and ulcerative lesions of the stomach and duodenum – 13 (19 %). Heartburn disturbed 38 (55 %), regurgitation – 17 (25 %), severity and feeling of fullness in the epigastrium – 29 (42 %), pain or burning in the epigastrium – 8 (11 %) patients. Fifty (73.5 %) patients underwent laparoscopic sleeve gastrectomy, 18 (26.5 %) patients – laparoscopic Roux-en-Y gastric bypass. Comprehensive preoperative examination (x-ray of the upper gastrointestinal tract with barium, daily pH impedance measurement, esophageal manometry) and phenotyping of GERD lead to reduction of GERD symptoms in patients with morbid obesity after sleeve gastrectomy.

Plasma cells are essentially absent in the luminal gastrointestinal tract of patients with “complete” 22q11.2 deletion syndrome (DiGeorge syndrome)

Gastrointestinal symptoms are commonly reported in patients with 22q11.2 deletion syndrome or DiGeorge syndrome (DGS) in addition to the dominant cardiac manifestations and immunodeficiency. But literature providing specific morphologic details of the gastrointestinal tract pathology is very limited. Here, we provide the first comprehensive morphologic description of the luminal gastrointestinal tract changes in patients with DGS. Cytogenetically confirmed DGS patients were identified, clinical and laboratory data were reviewed to determine the severity of immunodeficiency, and patients were stratified into mildly immunocompromised, that is, partial DiGeorge anomaly or severely immunosuppressed, that is, complete DiGeorge anomaly groups. Gastrointestinal tract biopsies from these patients were retrospectively reviewed and compared with those from controls without the history of DGS. Patients with immunosuppressed DGS showed a near complete absence of plasma cells in the stomach, duodenum, and colon lamina propria by hematoxylin and eosin evaluation. Immunohistochemistry for CD138 used to highlight plasma cells confirmed this finding. The notable absence of plasma cells adds to the existing knowledge of the pathophysiology underlying DGSand expands the differential diagnostic considerations for this finding, which has been previously described in common variable immunodeficiency. It also provides a useful morphologic marker observable by the readily accessible light microscopy. Second, patients with DGS showed a mild increase in epithelial cell apoptosis in their colon. This finding is significant because of its overlap with morphologic features of gastrointestinal graft versus host disease as thymus transplantation is being used as a treatment option for patients with complete DGS.

Rise of Lower GI Complaints in Young Population: 5 Year Detailed Analysis of Colonoscopic Findings Using ASGE Guidelines in Public Center Hospital of Pakistan

Introduction: Colonoscopy gives detail account of lower gastro intestinal tract pathologies. As the procedure is invasive, operator dependent and associated with few complications, clear indication has to be established.Current study was conducted to evaluate detailed account of clinicopathological findings on colonoscopy that will give idea about the prevalent lower gastrointestinal tract disorders, common complaints, correlation between findings and symptoms, age and gender wise distribution of these pathologies among our population. The study will serve as baseline to construct nationwide guidelines for the procedure. Materials & Methods: This retrospective study was carried out at Gastroenterology Department, Pakistan Institute of Medical Sciences from January 2014 to June 2019. All the patients fulfilling the ASGE criterion or having complaints of lower GI tract for more than 2 months underwent colonoscopy. Patients with inadequate preparation or other undergoing therapeutic procedures were excluded from the study. Total 850 patients fulfilling the criterion were included in the study. Data was recorded and analyzed by SPSSv20. Results: Mean age of the patients was 43.02 ± 18.22. Majority (63.9%) of the patients were males. Majority (n=543, 63.9%) of the patients had some finding on colonoscopy. Most common finding on colonoscopy was hemorrhoid followed by ulceration, mass, inflammation and polyps.Most common complaint was per rectum bleed followed by diarrhea, suspected growth on other modalities andsuspected inflammatory bowel disease.Total 540 patients i.e. 63.52% were below age of 50 years.. Trend of pathologies showed ulceration to be most common finding in patients below 50 years followed by hemorrhoids and mass. Conclusion: The results of our finding shows rise of lower GI pathologies in young male population of Pakistan with ulcerative colitis, hemorrhoids and colorectal cancer being top three diseases. This is an alarming situation and we need to take urgent big steps to control it. Keywords: Colonoscopy, Hemorrhoids, Colorectal Cancer, Per Rectal Bleed, Ulceration

Giardiasis and post-infectious bowel syndrome

Post-infectious irritable bowel syndrome — one of the most frequent conditions diagnosed in pediatric gastroenterological practice. According to numerous research parisitosis contributes to the chronology of gastrointestinal tract pathology. it is known that the infection Lamblia intestinalis can increase the risk of developing post-infectious IBS, changing species composition and diversity of the intestinal microbiota, modulating metabolism of the host, the nature of the immune response and adversely affecting the mucosal barrier and the motility of the digestive tract. Importantly, the prevalence of giardiasis in patients with symptoms of IBS and dyspepsia at the moment, it remains at a high level. Further research into the pathogenesis of Lamblia intestinalis infection in patients with IBS will be of great importance in medicine.

Exacerbating of chronic disease as risk factor for surgical delay in patients with spinal metastases

Object. Determining the degree of influence of exacerbation of somatic pathology on the shift of the terms of surgical treatment in patients with spinal metastases. Methods. A retrospective analysis of the data of 210 patients with spinal neoplasms undergoing treatment in the period from 2013 to 2017 was performed. In this cohort, the average terms from the moment of determining the indications for surgical treatment to surgery, as well as the frequency of somatic pathology, which was a contraindication to surgical treatment, were analyzed Results. The average time from the moment of determining the indications for surgical treatment to surgery in the main cohort of patients was 46.4 days (12 - 86). An aggravation of the gastrointestinal tract pathology with the formation of ulcers or erosion of the stomach and duodenum was the most common cause of delayed surgical treatment (41%). At the same time, 86% of cases of this complication led to a shift in the timing of surgery to 1 month. The presence of foci of chronic infection statistically significantly determined the greatest duration of the preoperative period (> 1 month) in 52.6% of cases. Conclusion. An aggravation of the gastrointestinal tract pathology and the presence of foci of chronic infection in patients with metastatic spinal lesions are the most frequent contraindications to surgical treatment and the reasons for the increase in the duration of the preoperative period.

Расширение арсенала диагностического мониторинга пациентов с увеитами

Goal. To evaluate the structure of somatic and ophthalmological polymorbidity, etiology, and course of the disease in patients with uveitis on the basis of clinical, laboratory, and instrumental research methods based on the data of a 24-hour ophthalmological hospital. Materials and methods. We examined 655 patients diagnosed with uveitis who were treated in the adult ophthalmology department of the GBUZ TO OKB No. 2 for the period from 2017 to 2019. All patients underwent standard laboratory, clinical, and instrumental examinations. In addition, the leukocyte index, a marker of viral infections (MVI), was determined. Results. The average age of patients with uveitis was 51 years, with a significant (p < 0.05) prevalence of cases of anterior uveitis over posterior and panuveitis. Pathology of the cardiovascular system occupies a leading position in the structure of somatic polymorbidity, mainly in women. Gender dependence in patients with rheumatic diseases, pathology of the gastrointestinal tract and endocrine system, bronchopulmonary pathology, cancer, and HIV infection was not detected. A method of early diagnosis of the nature of the course of the inflammatory process of the vascular membrane (acute or chronic) by determining the age of the patient and the indicator of MVI is proposed. Conclusions. Modern monitoring of the diagnosis of this disease and adequate empirical treatment with antiviral drugs with an extended spectrum of activity until the results of ELISA are obtained, followed by treatment correction, will prevent early disability of the population and improve the quality of life.

Dental mask of gastroesophageal reflux disease

In clinical practice, there are patients for whom traditional methods of treatment do not allow getting rid of a dental disease. Dental mask of underlying pathology may be a potential cause of this. The aim of the study was to study the features of the clinical course of dental manifestations of gastroesophageal reflux disease. Methods. The study group included 45 patients aged 20 to 50 years with complaints of pathological changes in the oral cavity that did not stop during the last month. The survey included a survey and clinical examination. The GerdQ questionnaire was used to verify gastrointestinal disorders. Results. It was found that 85% of the surveyed complained of a burning sensation behind the breastbone, the ingress of acidic contents into the oral cavity. 100% of the surveyed presented dental complaints. At the same time, the frequency of dental complaints was significantly higher compared to the frequency of complaints of esophageal symptoms. According to the results of the GerdQ questionnaire, the average score among the subjects was 11.0, which corresponds to the presence of gastroesophageal reflux disease. According to the results of the dental examination, 87% of the examined patients had pathological elements on the oral mucosa, and the pathological elements of aphthous and herpetic stomatitis were found significantly more often in patients with an exacerbation of gastroesophageal reflux disease (p<0.05). Desquamative glossitis was detected in 33% of the examined patients, benign migratory glossitis (“geographical” tongue) in 59% of patients, exfoliative cheilitis (dry form) in 70% of patients, angular cheilitis in 23% of patients. The pathology of hard dental tissues was represented by multiple carious lesions in 75% of patients and non-carious lesions in 53% of patients. Conclusions. Diseases of the oral mucosa and non-carious lesions accompany patients with gastrointestinal tract pathology in the form of gastroesophageal reflux disease.

Modern aspects of hepatology: liver steatosis and fibrosis through the prism of comorbidity in pediatric practice

The relevance of the topic is dictated by the growing prevalence of hepatic steatosis and fibrosis in the pediatric population, which is due to an increase in the number of pathologies of various organs and systems, which may be accompanied by the development of these liver lesions.
 The aim of the study: to analyze the data of modern sources of scientific literature regarding the prevalence and features of the course of pathology of various organs and systems, which is associated with the development of steatosis and liver fibrosis in the pediatric population.
 Materials and methods. A systematic search of scientific was carried out using Web of Science, Scopus, PubMed, scientific bases with key words: «hepatic steatosis», «hepatic fibrosis», «non-alcoholic fatty liver disease», «comorbid pathology», «children and adolescents».
 Conclusions. Currently, the number of children and adolescents who are diagnosed with steatosis and/or fibrosis of the liver is increasing in the world. In particular, the formation of this pathology is associated with the presence of metabolic syndrome and is associated with its main components, such as obesity, hypertension, disorders of carbohydrate and lipid metabolism. More and more studies indicate the role of non-alcoholic fatty liver disease, which is based on steatosis, as a comorbid pathology in systemic, cardiovascular, endocrine diseases, gastrointestinal tract pathology, and genetic disorders. Also, a number of drugs with steatogenic and fibrogenic effects on liver tissue have been established, which are widely used in pediatric practice. It is necessary to monitor the structural and functional state of the liver already in childhood and adolescence for adequate treatment of the underlying disease and prevention of the formation of comorbid pathology

A case of ganglioneuroma in a patient with the pathology of the upper gastrointestinal tract

In view of the rare occurrence, the small spectrum of clinical manifestations and the non-specificity of changes in instrumental and laboratory data, the diagnosis of ganglioneuroma at the moment is a very difficult task for the routine of a doctor. Ganglioneuromas have a slow growth, which leads to a long asymptomatic course and, as a result, complicates its early diagnosis. In most cases, ganglioneuroma is random. Complaints in these patients are non-specific and are directly dependent on localization.One of the available methods for imaging retroperitoneal tumors is ultrasound (ultrasound)., which makes preventive and regular ultrasound an indispensable method for early detection of extraorgan formations. This article describes the clinical case of ganglioneroma in a young man with the pathology of the upper gastrointestinal tract.

СИНДРОМ ГЕЙНЕРА – РЕДКАЯ ФОРМА АЛЛЕРГИИ К БЕЛКАМ КОРОВЬЕГО МОЛОКА У РЕБЕНКА ПЕРВОГО ГОДА ЖИЗНИ

The problem of food allergy is now receiving considerable attention in paediatrics, due not only to its increasing prevalence but also to the difficulties of differential diagnosis of the disease. Cow's milk protein (CMP) is a leading food allergen in young children. The skin and gastrointestinal tract (GIT) most often become shock organs in case of CMP allergy, and the lungs are much less likely to be affected. One of the variants of lung tissue damage is Heiner syndrome – an extremely rare pathology caused by non-IgE-dependent hypersensitivity to CMP, which occurs mainly in infants and toddlers. This clinical case described 8-month-old baby suffering from recurrent broncho-obstructive syndrome resistant to standard therapy, and repeated pneumonia. Differential diagnosis was run with congenital pulmonary airway malformation, cystic fibrosis, primary immunodeficiencies, volume rendering of tracheobronchial tree, organic pathology of GIT, gastroesophageal reflux disease. All of the above mentioned conditions are excluded during laboratory and instrumental examination. Taking into account the burdened allergic anamnesis, familial predisposition to allergies, the presence of CMP in the child's diet, a rare form of CMP allergy with damage to lung tissue – Heiner syndrome was supposed. After correcting the child's nutrition and transferring him to feeding with an adapted milk formula based on highly hydrolyzed CMP, a positive dynamics of a pronounced degree was noted. Elimination diet is the main therapeutic approach for Heiner syndrome. The description of this clinical observation will help to increase the level of knowledge about rare forms of allergic pathology in children, timely diagnosis and improve the quality of medical care for such patients.

Automated bleeding detection in wireless capsule endoscopy images based on color feature extraction from Gaussian mixture model superpixels.

Wireless capsule endoscopy is the commonly employed modality in the treatment of gastrointestinal tract pathologies. However, the time taken for interpretation of these images is very high due to the large volume of images generated. Automated detection of disorders with these images can facilitate faster clinical interventions. In this paper, we propose an automated system based on Gaussian mixture model superpixels for bleeding detection and segmentation of candidate regions. The proposed system is realized with a classic binary support vector machine classifier trained with seven features including color and texture attributes extracted from the Gaussian mixture model superpixels of the WCE images. On detection of bleeding images, bleeding regions are segmented from them, by incrementally grouping the superpixels based on deltaE color differences. Tested with standard datasets, this system exhibits best performance compared to the state-of-the-art approaches with respect to classification accuracy, feature selection, computational time, and segmentation accuracy. The proposed system achieves 99.88% accuracy, 99.83% sensitivity, and 100% specificity signifying the effectiveness of the proposed system in bleeding detection with very few classification errors.

Mixed invasion of H. pylory and Protozoa as a pathogenetic factor of diseases of the upper digestive tract

Modern research indicates a possible synergistic effect of bacterial-protozoal infestations in the pathology of the upper gastrointestinal tract, among which special attention is paid to the problem of giardiasis. Other parasitic agents, in particular Blastocystis spp, are also gaining some significance. The aim is to study the prevalence of H. pylori and protozoal infestations in chronic gastroduodenal diseases and the influence on the indicators of enzymatic digestion. Materials and methods. We examined 244 patients (130 adults and 114 children) with clinical manifestations with abdominal pain and dyspeptic syndromes. All patients were examined by immunochromatographic test for the qualitative detection of H. pylori in the feces, coprological and protozoological methods. Results. In the group of patients with chronic gastroduodenal diseases, the H. pylori antigen in the feces was detected in 116 (47.5%) patients. During protozoooscopic examination of feces, the detection rate of Lamblia intestinalis was 22.9%, in Blastocystis spp. - 13.1%, Entamoeba coli 10.2%, Entamoeba spp. 9.4%. Protozoan invasion was detected in the groups of H. pylori + and H. pylori - patients: infection of Lamblia intestinalis was diagnosed in 27.6% and 18.8% of cases respectively (p<0.05), in Blastocystis spp. - in 16.4% and 10.2% cases (p<0.05). There were no significant differences in the frequency of detection of non-pathogenic amoebas in these groups of patients. Mixed infection with H. pylori and pathogenic protozoa, along with increased manifestations of gastrogenic, ileocecal, enteral and acholian syndrome, signs of pancreatogenic and distal-colitic syndromes were detected. Monoinfection Lamblia intestinalis, signs of enteral, ileocecal, and acholia with signs of ileocecal syndromes were detected, and when monoinfection Blastocystis spp. signs of enteral and ileocecal syndromes were revealed. Conclusions. It is shown that intestinal protozoan and bacterial-protozoan mixed infection (H. pylori + L. intestinalis; H. pylori + Blastocystis spp.) can have a negative effect on enzyme digestion and are important etiopathogenetic factors of diseases of the upper gastrointestinal tract.

Особенности офтальмологических заболеваний при инфекции COVID-19

Before ophthalmic science and practice, the COVID-19 pandemic has identified a number of challenges. Aim. Сlinical and statistical analysis of eye pathology in patients admitted to the ophthalmology department during the incubation period of a new coronovirus infection for routine and emergency care, as well as in persons who have undergone COVID-19, with a demonstration of clinical observation. Materials and methods. 24 medical records of patients of the specialized ophthalmology department in the State Medical Institution of the “OKB No. 2” were retrospectively analyzed. The study period is from April 2020 to February 2021. A total of 24 patients received treatment, of which two-thirds were men Results. The structure of nosologies is presented as follows: inflammatory diseases 33.4%; injuries of the eyeball and their consequences 25%; retinal detachment 12.5%; glaucoma 12.5%; vascular pathology 8.3%; cataract 8.3%. Eye injuries – severe contusions and their consequences 16.7%. Nosologies that occurred in patients for the first time: neuritis of the optic nerve of both eyes, partial thrombosis of the upper-temporal branch of the central retinal vein of the left eye, hemophthalmos of the right eye, phlegmon of the orbit of the right eye, purulent ulcer of the cornea of the left eye, uncompensated, first detected, glaucoma of both eyes. Clinical manifestations of coronavirus infection occurred in 37.5% of patients who received specialized surgical treatment, including high-tech treatment for cataracts, glaucoma and retinal detachment in the early postoperative period. Somatic pathology was represented by: arterial hypertension in 37.5% of patients; type 2 diabetes mellitus and atherosclerosis with the same frequency-29.2% of patients. Anemia, diseases of the gastrointestinal tract, hepatitis and chronic lung pathology also occurred with the same frequency – 8.3% of patients. Conclusions. Patients may be admitted to the ophthalmology department during the incubation period of coronovirus infection. Acute conditions of the eyeball (retinal vein thrombosis, hemophthalmos, changes in the optic nerve, retinovasculitis) from our point of view belong to the initial manifestations of a new coronovirus infection.

Differentiated approach to the examining children with chest pain

The aim of this work is to determine the causes of chest pain in children with combined pathology and to develop an examination algorithm for chest pain. Materials and methods. Examined 20 children aged 7-18 years who consulted a pediatrician with pain complaints in the chest. To exclude the cardiac genesis of pain, all patients underwent electrocardiography and echocardiography; the rest of the examinations were prescribed, taking into account the anamnesis and clinical examination data. Results. According to the examination results, most patients were found to have gastrointestinal tract pathology: gastroesophageal reflux disease, chronic gastritis, biliary tract dysfunction. Against the background of adherence to a diet and taking medications prescribed by a gastroenterologist, their pain syndrome subsided, which confirmed the noncardial genesis of thoracalgia. A clinical analysis of cases of combined (cardiac and non-cardiac) pathology was carried out, an algorithm for examining children with chest pain was presented. Discussion. The causes of chest pain in children and the tactics of managing these patients are discussed, the clinical significance of the history and clinical examination data in drawing up a plan for the examination of such patients is determined.

Impact of working conditions on the health of pharmacy workers

The analysis revealed factors that have an adverse effect on human health: artificial lighting (I =0.72); standing activity (I=0.63); monotonous movements (I =0.56); prolonged work at the computer (I =0.55). It was found that many pharmacy workers have chronic diseases: vascular pathology (29.4%), musculoskeletal pathology (28.4%), gastrointestinal tract pathology (27.5%); visual impairment (27.5%). It was found that 20.6% of pharmacy employees do not have breaks for rest and meal; 13.7% do not have the opportunity to take warm food at work; 35.3% have the biggest meal of the day in the evening. In the workplace, a set of factors that have an adverse effect on the health of pharmaceutical professionals has been identified; many workers have work-related chronic diseases; most pharmacists experience discomfort after work; some employers violate labour legislation by not providing specialists with breaks for rest and meal.

Growth and Puberty in Children with Inflammatory Bowel Diseases.

Inflammatory bowel diseases (IBD) are gastrointestinal tract pathologies of unknown etiology; they have an alternating trend, with active and silent phases. IBD are classified in two main forms: ulcerative colitis (UC) and Crohn’s disease (CD). Both have chronic and recurrent course, gastrointestinal symptoms, and extraintestinal manifestations. The altered immune response role seems to be important both in UC and CD. In the majority of cases, CD begins with abdominal pain, diarrhea, decrease in appetite, and weight loss; there can be also perianal fistulas, rhagades, and perianal recurrent abscesses. In addition, retarded growth and delayed puberty can precede the development of the disease or can even be predominant at onset. Growth retardation is found in 40% of IBD patients, but the underlying mechanism of this and other extra-intestinal manifestations are partially known: the main hypotheses are represented by malnutrition and inflammatory response during the active phase of the disease. The increased level of pro-inflammatory cytokines can influence growth, but also the onset of puberty and its progression. In addition, it could be essential to clarify the role and the possible effects of all the currently used treatments concerning growth failure and delayed puberty.

Unique Running Pattern and Mucosal Morphology Found in the Colon of Cotton Rats.

Cotton rats are one of the experimental rodents used for testing different infectious and non-infectious diseases, including gastrointestinal tract pathology. However, their intestinal morphological characteristics are still poorly understood. Here, we clarified the anatomical and histological characteristics of the cecum and ascending colon (AC) of young (1–3-month old), adult (4–6-month old), and old (10–12-month old) cotton rats. The large intestine (LI) in cotton rats is composed of the cecum, AC, transverse and descending colons, and rectum, and is similar to that of other mammals. The AC begins with a double or triple spiral loop-like flexure (SLLF) and ends with a coupled horseshoe-like flexure (HSLF). A single longitudinal mucosal fold (SLMF) was found at the beginning of the AC along the mesentery line and developed with age. Furthermore, the SLMF contained several lymphatic nodules (LNs), indicating their role in digestive and immunological functions. Small and large protuberant LNs were found in the cecum and SLLF, respectively, whereas thin and flat LNs were observed in the HSLF and transverse colon, respectively. Regarding sex-related differences, adult females had a significantly longer AC with a higher number of SLLFs compared to males. The SLMF length and LN number were also longer and higher, respectively, in adult females compared to adult males. These are crucial findings, indicating the presence of sex-related differences in the morphology of the LI in cotton rats, and ours is the first study to discover a sex difference in the mammalian LI lining. Our study clarified the unique morphology of the LI in cotton rats, which could serve as the principal model for elucidating species-specific digestive tract functions and gastrointestinal disorders.