Symptoms Of Gastrointestinal Disorders Research Articles

Gastrointestinal Dysmotility, Autonomic Function and Small Intestinal Bacterial Overgrowth Among People with Well-Controlled HIV.

Gastrointestinal dysfunction, including microbiome changes and increased translocation across a compromised gastrointestinal barrier plays a role in the chronic inflammation experienced by people with HIV (PWH). It is unknown whether autonomic neuropathy (AN) may contribute to these mechanisms by altering gastrointestinal motility. This is a cross-sectional study of 100 PWH and 89 controls. All participants underwent assessment of gastrointestinal transit times using a wireless motility capsule (WMC). All PWH and a subset of controls also underwent: a standardized battery of autonomic function tests summarized as the Modified Composite Autonomic Severity Score (MCASS) and its adrenergic, cardiovagal and sudomotor sub-scores, breath testing for small intestinal bacterial overgrowth (SIBO), and the Patient Assessment of Upper Gastrointestinal Disorders Symptoms (PAGI-SYM) and Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaires. PWH displayed shorter gastric emptying times (GET) and longer small bowel and colonic transit times (SBTT, CTT) compared to controls. Among PWH, GET was associated with PAGI-SYM score. The MCASS and its sudomotor sub-score (reflecting peripheral sympathetic function) were associated with SBTT but not GET or CTT. PWH with prolonged SBTT (>6h) were more likely to have SIBO. Gastrointestinal motility is altered in PWH. This study provides preliminary evidence that changes in autonomic function may influence SBTT in PWH and that prolonged SBTT may contribute to the development of SIBO. Future studies are needed to more fully elucidate the pathophysiologic links between HIV-associated AN, altered gastrointestinal motility, the gastrointestinal microbiome, chronic inflammation, and resulting morbidity and mortality among PWH.

Protozoan intestinal invasions in military personnel of the Northern region of Ukraine

Objective — to study the prevalence and spectrum of intestinal parasitic infestations (IPI) agents in groups of military personnel of the Northern region of Ukraine, which differed according to the criteria of having symptoms of gastrointestinal disorders and passing the serving in a combat zone. Materials and methods. From February to November 2023, the study covered 302 servicemen during inpatient medical care at the Military Medical Clinical Center of the Northern Region of Ukraine. Detection and identification of intestinal parasites in samples of feces (SF) was carried out by classical methods of microscopy using the enrichment procedure (formalin‑ethyl acetate sedimentation) and the preparation (from each enriched sediment) of four smears: two thick wet with 50% aqueous solution of glycerol and D’ Anthony iodine solution; two thin, fixed, permanently stained with Whitley’s modified trichrome (mWT) or Heidenhain’s iron hematoxylin (HIH) and the modified Ziehl‑Neelsen acid method (mZN). Smear microscopy results were evaluated according to the criteria of the US Clinical and Laboratory Standards Institute. Results. It was established that the level of prevalence of IPI among the examined servicemen reached 10.6% with variation in the value of this indicator in different groups of soldiers from 2.2% to 12.6%. A specific share of protozoan monoinvasions in soldiers reached 65.6%, and mixed invasions (with two parasites at the same time) — 34.4%. Soldiers with symptoms of gastrointestinal diseases had significantly higher rates of IPI than did asymptomatic. In addition, the infestation rates among soldiers were higher in the cold season (October‑February) with a seasonality index of 1.9. All cases of IPI in servicemen (n=32) were caused by protozoan parasites (n=39), in the etiological spectrum of which the vast majority (84.6%) were pathogenic species (Blastocystis sp., Dientamoeba fragilis, Giardia lamblia), and a smaller proportion (15.4%) were commensal species (Chilomastix mesnili, Iodamoeba butschliі). Among pathogenic protozoa (n=33), Blastocystis sp. (51.5%) and D. fragilis had the highest proportion (42.4%), G. lamblia (6.1%) had significantly less one. Conclusions. Optimizing the management tactics of military medicine to reduce the negative impact of IPI on the health and combat capacity of servicemen requires knowledge about the prevalence and spectrum of pathogens of invasions among specific groups of soldiers. A necessary condition for increasing the efficiency of microscopic detection/identification of protozoan parasites (primarily D. fragilis) in the SF is the production of permanently stained (mWT or HIH) smears. Microscopic examination of such smears at high resolution (100ґ objective, oil immersion) provides an increased incidence of detection/identification of Blastocystis sp. by 47.1% and D. fragilis by 100%.

Abdominal Pain and Chronic Opiate Use in Patients with Gastroparesis

Introduction: Although opiate narcotics may worsen gastroparesis(GP), patients can take these for abdominal pain (AP) or other chronic pain syndromes. This study aims to evaluate medications patients with gastroparesis use for AP and compare patients who use opiate analgesics for AP to those using opiate analgesics for non-abdominal pain. Methods: Patients at a tertiary academic center gastroenterology clinic completed the Patient Assessment of Gastrointestinal Disorders–Symptom Severity Index (PAGI-SYM) and Quality of Life Short-Form 8 (QOL SF-8) surveys between 10/2021 and 03/2023. Patients recorded gastroparesis treatments, pain treatments and indication, and any hospitalizations/emergency department (ED) visits within 3 months of a clinic visit. Results: A total of 53 patients were enrolled: 72% reported having AP. Patients were using the following medications for AP: 25% heating pad, ice or hot showers, 20.8% acetaminophen, 14.6% hyoscyamine, 13% opiate use, 13% marijuana use, 10.4% dicyclomine, 8.3% Nonsteroidal anti-inflammatory drugs (NSAIDs), 4% benzodiazepine, and 2.1% gabapentin. The reported reasons for using opiates were 58% AP, 16.6% chronic back pain, 16.6% Reflex Sympathetic Dystrophy (RSD) and fibromyalgia, and 8.3% osteoarthritis. All opiate users reported daily scheduled use. AP severity scores (4.1 vs. 2.8; p = 0.041), morphine equivalent usage (77 ± 44 vs. 32 ± 28; p = 0.037), and the number of ER visits (1.0 vs. 0 over 3 months) were higher in patients using opiates for AP than those using opiates for non-abdominal pain. Conclusions: In this series, 72% of patients with gastroparesis had abdominal pain, and 13% of patients were taking opiates. Patients who used opiate analgesics for abdominal pain had a higher average abdominal pain severity score and used a higher amount of opiate analgesia than patients using opiates for musculoskeletal pain. Abdominal pain in patients with gastroparesis can be harder to control with opiate analgesia compared to non-abdominal pain, supporting the concept of avoiding chronic opiate usage for abdominal pain in gastroparesis.

The Swedish PedsQL gastrointestinal symptoms scale and symptoms module showed good psychometric performance.

There is no validated symptom scale for Swedish children with gastrointestinal disorders. Our aim was to validate the Swedish version of the Paediatric Quality of Life Inventory (PedsQL) gastrointestinal symptoms scale and symptoms module. Families were recruited from two hospitals in Gothenburg, Sweden, from 1 March 2021 to 31 October 2022. The instruments were completed by 115 children with functional, congenital or organic acquired gastrointestinal disorders and 149 of their parents. These were the gastrointestinal symptoms scales, symptoms module and the 4.0 Generic core scale. Data were analysed for feasibility, construct validity and reliability, including internal consistency, re-test reliability and child-parent agreement. Feasibility was good, with a failure to respond of ≤5%. Construct validity showed strong correlation in the PedsQL gastrointestinal symptoms module. The known-group validity agreed with the expectations associated with the disease characteristics (p < 0.05). Cronbach's alpha was 0.96, which indicated excellent internal reliability. The intraclass correlation coefficient for the child self-report and parent-proxy report was 0.74, which indicated good agreement. The Swedish PedsQL Gastrointestinal Symptoms Scales, the symptoms module provided acceptable measurement properties and can be used to evaluate symptoms of gastrointestinal disorders and quality of life during clinical work or research projects.

Prevalence of Cockroach Density, Gastrointestinal Disorders, and Identification of Parasites in Cockroaches in Helvetia Deli Serdang Village

Background. Cockroaches are known to be vectors of various pathogens that can infect humans, one of which is intestinal parasites. Parasitic infectious diseases can cause symptoms of gastrointestinal disorders in sufferers, which can interfere with the sufferer's quality of life. This research aims to determine cockroach density, and gastrointestinal disorders in the community, and identify parasites in cockroaches. Method. The research method used in this research is observational analytics. The population and sample for this study were the houses of the Helvetia Deli Serdang Village community which met the slum criteria of 100 houses. The caught cockroaches are then examined in the laboratory. Results. The results obtained were that 96 houses (96%) were not infested with cockroaches, 4 houses (4%) had no cockroaches, and no houses were infested with cockroaches. The number of respondents who had experienced gastrointestinal disorders was 41 respondents (41%) and 59 respondents (59%) had never experienced them. Based on laboratory examination, 22 rhabditiform hookworm larvae (21.78%), 5 hookworm eggs (4.95%), and 1 Oxyruris vermicularis egg (0.99%) were found. Toxocara sp. as many as 1 piece (0.99%), and cysts Entamoeba histolytica as much as 1 piece (0.99%). Conclusion. Based on these results, there was no high density of cockroaches found at the research location, the majority of respondents had never experienced gastrointestinal disorders in the past year, and parasites were found in cockroaches.

Different Food Preferences in Patients with Gastrointestinal Disorders.

Objective Gastrointestinal (GI) disorders such as functional dyspepsia (FD), irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and inflammatory bowel disease (IBD) can exhibit overlapping GI symptoms, including abdominal pain and alterations in bowel habits. The symptoms of GI disorders are commonly considered to be triggered and exacerbated by fatty food intake. Therefore, this study aimed to compare the food preferences of patients with GI disorders. Methods Forty food images (including fatty and light foods) and 20 animal images were selected to evaluate food preferences. The preference score was assessed using a visual analog scale ranging from 1 to 100. GI symptoms were evaluated using the GI Symptom Rating Scale (GSRS), and correlations between the GSRS and preference scores were investigated. Results Overall, 22 healthy controls and 23, 29, 27, and 20 patients with FD, IBS, GERD, and IBD, respectively, were enrolled. The preference score for all foods in patients with FD was significantly lower than that in healthy controls and those with IBS, GERD, and IBD (52.9 vs. 66.5 vs. 68.5 vs. 69.1 vs. 70.7, p<0.01). The score of fatty foods was lower in patients with FD than in healthy controls and those with IBS, GERD, and IBD (43.8 vs. 72.3 vs. 77.5 vs. 77.4 vs. 80.7, p<0.01), whereas that of light foods and animal images was not different among the groups. No significant correlation was found between the preference score and symptom severity. Conclusions Patients with FD had a negative preference for foods, particularly fatty foods, independent of the severity of GI symptoms.

Efficacy and safety of itopride SR for upper gastrointestinal symptoms in patients with diabetic gastroparesis: real-world evidence from Pakistan.

Gastroparesis is a serious condition that can be caused by diabetes, surgery or infection, or can be idiopathic. When there is no mechanical obstruction, gastroparesis is characterized by delayed stomach emptying. Itopride, a prokinetic drug, inhibits acetylcholinesterase activity in addition to antagonizing dopamine D2 receptors. This prospective, multicentre study is based on real-world data from 988 patients with a diagnosis of diabetic gastroparesis for index (PAGI-SYM2) evaluation at baseline and week 4 of treatment for upper gastrointestinal disorder symptoms. Upper gastrointestinal symptom severity scores improved significantly after 4 weeks of treatment (p<0.001), with significant improvement across all categories of gastroparesis (very mild (37-58.6%), mild degree (24.6-31.6%), moderate (29.3-7.3%) and severe (8.8-2.6%). Itopride SR (Nogerd SR) in a 150 mg once-daily dose showed promising results in reducing the severity of upper gastrointestinal disorder symptoms associated with diabetic gastroparesis. Both statistical and clinical effectiveness were observed. Moreover, the treatment demonstrated a favourable tolerability profile, with a low incidence of adverse effects.

Development of functional gastrointestinal disorder symptoms following laparoscopic cholecystectomy: a prospective cohort study.

The casual relationship between the role of cholecystectomy and functional gastrointestinal disorders (FGIDs) are a controversial clinical challenge. This study aimed to investigate: (1) the overlap of FGIDs before cholecystectomy and its long-term outcome after surgery in patients with symptomatic cholelithiasis, and (2) the incidence of new-onset FGIDs after cholecystectomy. Patients with symptomatic gallstone disease who underwent elective, laparoscopic cholecystectomy were prospectively enrolled. Healthy populations who underwent medical check-ups were selected as age- and sex-matched controls. Questionnaires regarding sociodemographic characteristics, gastrointestinal symptoms and a somatization symptom checklist (SSC) were completed at baseline and 12 months thereafter. The prevalence of all FGID symptoms before cholecystectomy were significantly higher in the group of patients with symptomatic cholecystolithiasis compared to the control group. In cholecystectomy group, the preoperative FGID symptoms improved after surgery, except for chronic diarrhea. Compared to the controls, the new-onset FGIDs, including functional dyspepsia (14.8% vs. 6.9%; p = 0.040), functional diarrhea (6.6% vs. 0.2%; p < 0.001), and chronic abdominal pain (11.9% vs. 4.4%; p = 0.024), were more common at 1 year after cholecystectomy. Somatization was independent predictors of new-onset dyspepsia and abdominal pain, while newly occurring diarrhea was not realted to somatization. Overlap of FGIDs was common in patients with symptomatic cholelithiasis before surgery and at follow-up 1 year after cholecystectomy. Furthermore, new-onset FGIDs could be occurred after cholecystectomy. Therefore, a delicate diagnostic approaches and appropriate treatments about co-existent FGIDs should be given in patients with cholelithiasis before and after cholecystectomy.

A Comparative Analysis of Optimization Algorithms for Gastrointestinal Abnormalities Recognition and Classification Based on Ensemble XcepNet23 and ResNet18 Features.

Esophagitis, cancerous growths, bleeding, and ulcers are typical symptoms of gastrointestinal disorders, which account for a significant portion of human mortality. For both patients and doctors, traditional diagnostic methods can be exhausting. The major aim of this research is to propose a hybrid method that can accurately diagnose the gastrointestinal tract abnormalities and promote early treatment that will be helpful in reducing the death cases. The major phases of the proposed method are: Dataset Augmentation, Preprocessing, Features Engineering (Features Extraction, Fusion, Optimization), and Classification. Image enhancement is performed using hybrid contrast stretching algorithms. Deep Learning features are extracted through transfer learning from the ResNet18 model and the proposed XcepNet23 model. The obtained deep features are ensembled with the texture features. The ensemble feature vector is optimized using the Binary Dragonfly algorithm (BDA), Moth-Flame Optimization (MFO) algorithm, and Particle Swarm Optimization (PSO) algorithm. In this research, two datasets (Hybrid dataset and Kvasir-V1 dataset) consisting of five and eight classes, respectively, are utilized. Compared to the most recent methods, the accuracy achieved by the proposed method on both datasets was superior. The Q_SVM's accuracies on the Hybrid dataset, which was 100%, and the Kvasir-V1 dataset, which was 99.24%, were both promising.

Gastrointestinal disorders in post-COVID syndrome. Clinical guidelines

Summary Post- COVID syndrome refers to the long-term consequences of a new coronavirus infection COVID-19, which includes a set of symptoms that develop or persist after COVID-19. Symptoms of gastrointestinal disorders in post- COVID syndrome, due to chronic infl ammation, the consequences of organ damage, prolonged hospitalization, social isolation, and other causes, can be persistent and require a multidisciplinary approach. The presented clinical practice guidelines consider the main preventive and therapeutic and diagnostic approaches to the management of patients with gastroenterological manifestations of postCOVID syndrome. The Guidelines were approved by the 17th National Congress of Internal Medicine and the 25th Congress of Gastroenterological Scientifi c Society of Russia.

Depression and risk of gastrointestinal disorders: a comprehensive two-sample Mendelian randomization study of European ancestry.

Major depressive disorder (MDD) is clinically documented to co-occur with multiple gastrointestinal disorders (GID), but the potential causal relationship between them remains unclear. We aimed to evaluate the potential causal relationship of MDD with 4 GID [gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), peptic ulcer disease (PUD), and non-alcoholic fatty liver disease (NAFLD)] using a two-sample Mendelian randomization (MR) design. We obtained genome-wide association data for MDD from a meta-analysis (N = 480 359), and for GID from the UK Biobank (N ranges: 332 601-486 601) and FinnGen (N ranges: 187 028-218 792) among individuals of European ancestry. Our primary method was inverse-variance weighted (IVW) MR, with a series of sensitivity analyses to test the hypothesis of MR. Individual study estimates were pooled using fixed-effect meta-analysis. Meta-analyses IVW MR found evidence that genetically predicted MDD may increase the risk of GERD, IBS, PUD and NAFLD. Additionally, reverse MR found evidence of genetically predicted GERD or IBS may increase the risk of MDD. Genetically predicted MDD may increase the risk of GERD, IBS, PUD and NAFLD. Genetically predicted GERD or IBS may increase the risk of MDD. The findings may help elucidate the mechanisms underlying the co-morbidity of MDD and GID. Focusing on GID symptoms in patients with MDD and emotional problems in patients with GID is important for the clinical management.

Timed Up and Go test and gastrointestinal disorders among hospitalized older adults with fall risk

Purpose of the researchThe study aimed to examine the correlation between underlying medical conditions and gait analysis parameters as well as determine the key determiners of fall risk. Materials and methodsThis was a cross-sectional study. A total of 120 hospitalized older adults, recruited from a medical center in northern Taiwan, completed three instruments: the Timed Up and Go (TUG) test, a demographic questionnaire, and the Morse Fall Scale. The inferential statistics were subjected to the chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation coefficient analysis to determine the correlations among the demographic variables, gait analysis parameters, and fall risk in elderly inpatients. Logistic regression was used to analyze the predictors of elderly inpatients’ fall risk. ResultsThe results showed that longer TUG test times, slower walking speeds, or shorter stride lengths are related to higher fall risk. The new finding was that longer TUG test times and slow gait speeds were correlated with lower gastrointestinal as well as hepatobiliary and pancreatic diseases. ConclusionsThis study confirms that gait analysis parameters are significantly correlated with fall risk among older inpatients and that TUG is an important indicator of frailty, prefrailty, or metabolic state. Early detection of the symptoms of gastrointestinal disorders and the provision of adequate nutrition could potentially improve inpatients’ gait and prevent falls.

An evaluation of the rat intestinal monoamine biogeography days following exposure to acute stress.

Stress-induced abnormalities in gut monoamine levels (e.g., serotonin, dopamine, norepinephrine) have been linked to gastrointestinal (GI) dysfunction, as well as the worsening of symptoms in GI disorders. However, the influence of stress on changes across the entire intestinal monoamine biogeography has not been well-characterized, especially in the days following stress exposure. Therefore, the aim of this study was to comprehensively assess changes to monoamine neurochemical signatures across the entire rat intestinal tract days after exposure to an acute stressor. To the end, adult male F344 rats were subjected to an episode of unpredictable tail shocks (acute stress) or left undisturbed. Forty-eight hours later rats were euthanized either following a 12h period of fasting or 30min of food access to evaluate neurochemical profiles during the peri- and early postprandial periods. Monoamine-related neurochemicals were measured via UHPLC in regions of the small intestine (duodenum, jejunum, ileum), large intestine (cecum, proximal colon, distal colon), cecal contents, fecal contents, and liver. The results suggest a relatively wide-spread increase in measures of serotonin activity across intestinal regions can be observed 48h after exposure to acute stress, however some evidence was found supporting localized differences in serotonin metabolization. Moreover, acute stress exposure reduced catecholamine-related neurochemical concentrations most notably in the ileum, and to a lesser extent in the cecal contents. Next, stress-related fecal serotonin concentrations were consistent with intestinal profiles. However, fecal dopamine was elevated in association with stress, which did not parallel findings in any other intestinal area. Finally, stress exposure and the food access period together only had minor effects on intestinal monoamine profiles. Taken together, these data suggest nuanced differences in monoaminergic profiles exist across intestinal regions the days following exposure to an acute stressor, highlighting the importance of assessments that consider the entire intestinal tract biogeography when investigating stress-related biological outcomes that may be relevant to GI pathophysiology.

Epidemiological Distribution of Risk Factors Contributing to Symptomatic Helicobacter Pylori Infection in Diyala Province, Iraq

Helicobacter pylori is a worldwide spread bacterium, that invades the submucosal membrane of the stomach via feco-oral or feco-fecal transmission, causing several gastric and duodenal diseases. The study aims to assess risk factors for the symptomatic Helicobacter pylori infection and their epidemiological distribution. A cross-sectional study was conducted from October 2020 to May 2021 in Baquba, Iraq. It was conducted on a sample of outpatient patients who complain of various symptoms of gastrointestinal disorders, where the sample size was 194 patients, their ages ranged from 15 to 70 years, the main characteristics taken up in the study included age, sex, and place of residence, smoking status. H. pylori infection was recognized by identifying anti-H. Pylori (IgG) in patient serum using the ELISA technique. Chi-squared and Binomial tests were adopted to assess the difference between study variables. The study shows that the highest rate of infection was among patients aged 15-30 years (45.7%), most patients were females (66.3%), and the majority of them (68.5%) were rural dwellers. In conclusion, younger ages, female gender, rural dwellers, non-smokers, and those who complained of stomach pain were significantly associated with the helicobacter pylori infection.

Is a Non-Caloric Sweetener-Free Diet Good to Treat Functional Gastrointestinal Disorder Symptoms? A Randomized Controlled Trial.

Background: A diet containing non-caloric sweeteners (NCS) could reduce calorie intake; conversely, some animal studies suggest that NCS consumption may increase functional gastrointestinal disorder symptoms (FGDs). This study aimed to compare the effect of consuming a diet containing NCS (c-NCS) versus a non-caloric sweetener-free diet (NCS-f) on FGDs. Methods: We conducted a randomized, controlled, parallel-group study using two different diets for five weeks: the c-NCS diet contained 50–100 mg/day NCS, whereas the NCS-f diet had less than 10 mg/day NCS. At the beginning of the study (PreTx) and at the end (PostTx), we assessed FGDs, dietary intake, and NCS consumption. Results: The percentage of participants with diarrhea (PreTx = 19% vs. PstTx = 56%; p = 0.02), post-prandial discomfort (PreTx = 9% vs. PstTx = 39%; p = 0.02), constipation (PreTx = 30% vs. PostTx = 56%; p < 0.01), and burning (PreTx = 13% vs. PostTx = 33%; p < 0.01) increased in the c-NCS diet group. Conversely, abdominal pain (PreTx = 15% vs. PostTx = 3%; p = 0.04), post-prandial discomfort (PreTx = 26% vs. PostTx = 6%; p = 0.02), burning (PreTx = 15% vs. PostTx = 0%; p = 0.02), early satiety (PreTx = 18% vs. PostTx = 3%; p < 0.01), and epigastric pain (PreTx = 38% vs. PostTx = 3%; p < 0.01) decreased in the NCS-f diet group. Conclusion: A c-NCS diet is associated with increased FGDs, including diarrhea, post-prandial discomfort, constipation, and burning or retrosternal pain. The NCS-f diet also decreased FGDs, as well as abdominal pain, post-prandial discomfort, burning or retrosternal pain, early satiety, and epigastric pain.

Relative bioavailability and pharmacokinetic comparison of a fixed-dose combination tablet of mosapride, pancreatin, and simethicone relative to single-component mosapride tablets in healthy Mexican subjects.

Abbott Laboratories de México S.A. de C.V. developed a new fixed-dose combination of mosapride 5mg, pancreatin 170 mg, and simethicone 125 mg as an alternative to the mosapride monotherapy to improve overall satisfaction and adequate relief of gastrointestinal disorders symptoms and to reduce multiple pill burden. As a part of the fixed-dose combination registration process in Mexico, a pharmacokinetic and relative bioavailability study was carried out to demonstrate nonexistence of pharmacokinetic interaction when mosapride is administered alone or in combination with pancreatin and simethicone using DOSIER® (mosapride) 5-mg tablets as a reference product. Tolerability of the fixed-dose combination tablet was assessed. In this open-label, randomized, oral single-dose, two-way crossover study, 65 healthy male and female subjects received either the fixed-dose combination tablet or the reference product during each study period. The two study periods were separated by a 7-day washout period. Mosapride concentrations in plasma samples were determined using a validated ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) method. Blood samples were collected for up to 16 h post dose. The primary evaluation criteria were Cmax and AUC0-t for mosapride. The 90% confidence intervals for the ratio of geometric means for Cmax (96.12% to 110.90%) and AUC0-t (99.07% to 108.06%) were within the defined acceptance limits of 75% to 133% and 80% to 125% for Cmax and AUC0-t , respectively, indicating bioequivalence between the two products. Both products were safe and well tolerated. Therefore, mosapride in combination with pancreatin and simethicone tablet is bioequivalent to mosapride alone, and no new safety signals emerged.

Manifestation of proliferative enteropathy of pigs (ileitis) in pig farms of Ukraine (diagnostic monitoring)

Proliferative enteropathy of pigs (PPE; ileitis, lawsoniosis) is one of the most common, relatively new and little-studied gastrointestinal diseases of pigs which cause significant economic damage to the pig industry worldwide. The causative agent of ileitis is Lawsonia intracellularis, a gram-negative intracellular bacterium. The incubation period lasts from two to three weeks, the infection has a high degree of infection. The pathogen is transmitted from animal to animal by oral and fecal route. In order to study the manifestations of proliferative enteropathy of pigs on farms in Ukraine, we surveyed 32 farms in 13 regions. The course of PPE was usually observed with symptoms of gastrointestinal disorders, but the disease brought significant economic losses. A characteristic symptom of the chronic course in the studied farms of Ukraine is a slow but progressive weight loss of animals and, as a result, diarrhea and loss of appetite. Clinical signs of ileitis depend on the form of the course. There are three main forms of ileitis: chronic form — intestinal adematosis, acute — hemorrhagic enteropathy and subclinical form. According to our research, the acute form is manifested by pale skin and signs of anemia, hemorrhagic diarrhea and sudden death of the animal. Pigs weighing more than 70 kg suffer the most. The pathological picture characteristic of PPE was observed already at the age of 33 days; 62.5% of the dead piglets aged 33 to 102 days were affected by Lawsonia, which was confirmed by laboratory tests. Pathological examination was observed in the dead pigs of the rearing and fattening group: duodenum — part initially covered with mucus-fibrin; ileum — thickening of the walls, on the serous membrane dark red grooves like a mosaic, dark blood, blood coagulates cylindrical forms; mucous membrane is uneven, thickened, intensely red; colon — stretched through gases, blood dark with coagulates in the lumen; rectum — the contents are thick to semi-liquid, dark red; mesenteric lymph nodes — enlarged and hyperemic. Pathohistological changes in the intestine varied. In some parts of the intestine, there were characteristic of ulcerative necrotic ileitis, and in others — for proliferative enteropathy.

RECOMMENDATIONS FOR VISITING WATER COMPLEXES DURING COVID-19 PANDEMIC

The coronavirus pandemic has changed the usual way of life of almost every one of us, all areas have shifted to work with limited functioning and activities in quarantine. SARS-CoV-2, the causative agent of COVID-19, is mostly transmitted from person to person by close contact through small droplets (released during coughing, sneezing and talking) contaminated with the virus, or virus particles that linger in the air for several minutes to several hours, less often infection occurs through contaminated surfaces and objects. The objective was to analyze the possibility of safe operation of water complexes (water parks, swimming pools, etc.) during a pandemic COVID-19 in our country.&#x0D; Materials and methods. Since November 2019 and so far, we have been taking water samples from one private pool and from the pool of a sports complex in one University in Kyiv, in addition, because of cooperation with the Brovary Regional Department of Laboratory Research of the State Institution «Kyiv Regional Laboratory Center of the Ministry of Health of Ukraine» we have known the results of water control in one under roof water park in Brovary, which is located in Kyiv region. We explored the quality of water by sanitary chemical indices (odor, color, turbidity, pH, water hardness, concentration of ammonia and ammonium ions, chlorides, sulfates, free chlorine, etc.) and microbiological indicators (total microbial count (TMC) and coli bacterial index (index of bacteria of the group of E. coli (CBI)).&#x0D; Results of the research. In our research, we analyzed the guidelines on the possibility and conditions of the functioning of water complexes during quarantine restrictions of various countries. We found that the free chlorine level in water samples complies to those recommendation, which WHO is provided in the context of the coronavirus pandemic in private and public water complexes. Currently, there are no studies that suggest the possibility of survival of SARS-CoV-2 virus in swimming pool water or other water entertainment complexes, although experimental data obtained previously with coronaviruses (on cell cultures) other than SARS CoV-2, indicate that they are usually sensitive to strong oxidants, such as chlorine. Therefore, today, we can assume that purified water in swimming pools and other water complexes is not an environment where the SARS-CoV-2 virus can survive. The WHO states that a residual free chlorine concentration ≥ 0.5 mg / L in pool water at pH &lt; 8,0 is sufficient to kill coronaviruses. The virus that causes COVID-19 has been found in the fecal matter of infected people, not just those with symptoms of gastrointestinal disorders. It's generally believed that the excretion of the virus may persist for several days. However, it should be noted that there are no cases of fecal-oral transmission of SARS-CoV-2 now. Therefore, to date, the risk of SARS-CoV-2 transmission by fecal-oral route is assessed as low.&#x0D; Conclusions. According to the data from lead countries regarding recommendations for visiting water complexes during the COVID-19 pandemic and because of the lack of our own research in our country, we can talk about the possibility of their implementation in Ukraine. We believe that the constant closure of swimming pools and water complexes, and, consequently, constant breaks in the training of not only professional athletes, but also amateurs, run counter to the recommendations regarding the promotion of a healthy lifestyle. It`s worth to remember that prevention is always better than treatment, and training sports is one of the key points in ensuring the effective work of the body and the immune system in particular, which is especially important during a pandemic.

Antitumor Potential of Lippia citriodora Essential Oil in Breast Tumor-Bearing Mice.

Lippia citriodora is a flowering plant cultivated for its lemon-scented leaves and used in folk medicine for the preparation of tea for the alleviation of symptoms of gastrointestinal disorders, cold, and asthma. The oil extracted from the plant leaves was shown to possess antioxidant potential and to exert antiproliferative activity against breast cancer. The aim of this study was to further investigate potential antitumor effects of L. citriodora oil (LCO) on breast cancer. The in vitro antiproliferative activity of LCO was examined against murine DA3 breast cancer cells by the sulforhodamine B assay. We further explored the LCO’s pro-apoptotic potential with the Annexin-PI method. The LCO’s anti-migratory effect was assessed by the wound-healing assay. LCO was found to inhibit the growth of DA3 cells in vitro, attenuate their migration, and induce apoptosis. Finally, oral administration of LCO for 14 days in mice inhibited by 55% the size of developing tumors in the DA3 murine tumor model. Noteworthy, in the tumor tissue of LCO-treated mice the apoptotic marker cleaved caspase-3 was elevated, while a reduced protein expression of survivin was observed. These results indicate that LCO, as a source of bioactive compounds, has a very interesting nutraceutical potential.

Web-Based Educational Intervention for Patients With Uninvestigated Dyspepsia Referred for Upper Gastrointestinal Tract Endoscopy

Diagnostic yield of upper gastrointestinal (GI) tract endoscopy for uninvestigated dyspepsia is low, and its clinical implications are limited. There is an unmet need for better strategies to reduce the volume of upper GI tract endoscopic procedures for dyspepsia. To study the effectiveness of a web-based educational intervention as a tool to reduce upper GI tract endoscopy in uninvestigated dyspepsia. This open-label, multicenter, randomized clinical trial enrolled participants between November 1, 2017, and March 31, 2019, with follow-up 52 weeks after randomization, at 4 teaching hospitals in the Netherlands. Participants included patients with uninvestigated dyspeptic symptoms who were referred for upper GI tract endoscopy by their general health care clinician without prior consultation of a gastroenterologist. A total of 119 patients, aged 18 to 69 years, were included. Patients were excluded if any of the following red flag symptoms were present: (indirect) signs of upper GI tract hemorrhage (hematemesis, melena, hematochezia, or anemia), unintentional weight loss of 5% or higher of normal body weight during a period of 6 to 12 months, persistent vomiting, dysphagia, or jaundice. Patients were randomly assigned (1:1) to education (intervention) or upper GI tract endoscopy (control). Education consisted of a self-managed web-based educational intervention, containing information on gastric function, dyspepsia, and upper GI tract endoscopy. Difference in the proportion of upper GI tract endoscopy procedures between those who received access to the web-based educational intervention and those who did not at 12 weeks and 52 weeks after randomization, analyzed in the intention-to-treat population. Secondary outcomes included quality of life (Nepean Dyspepsia Index) and symptom severity (Patient Assessment of Gastrointestinal Disorders Symptom Severity Index) measured at baseline and 12 weeks. Of 119 patients included (median age, 48 years [interquartile range, 37-56 years]; 48 men [40%]), 62 were randomized to web-based education (intervention) and 57 to upper GI tract endoscopy (control). Significantly fewer patients compared with controls underwent upper GI tract endoscopy after using the web-based educational intervention: 24 (39%) vs 47 (82%) (relative risk, 0.46; 95% CI, 0.33-0.64; P < .001). Symptom severity and quality of life improved equivalently in both groups. One additional patient in the intervention group required upper GI tract endoscopy during follow-up. Findings of this study indicate that web-based patient education is an effective tool to decrease the need for upper GI tract endoscopy in uninvestigated dyspepsia. ClinicalTrials.gov Identifier: NCT03205319.