Treatment Of Gastrointestinal Tract Research Articles

Jak mohou ledviny ovlivnit léčbu pacientů s gastroenterologickými chorobami

Summary: The treatment of gastrointestinal tract (GIT) diseases may, under specific conditions, be significantly influenced by the kidneys or by kidney disorders. One of the potential scenarios of such interaction is the concurrent involvement of the kidneys and the GIT organs within one disorder, another option being the negative impact of impaired renal function on the prognosis of the GIT disease and, finally, the need for an adequate choice and dose adjustment of renally eliminated medication to avoid nephrotoxicity. Renal impairment may occur as an adverse effect of the treatment of the GIT condition and may limit further therapy. In this context we have recently focused on the following clinical situations: the development of acute kidney injury during treatment with proton pump inhibitors, renal complications of inflammatory bowel disease management and the development of acute phosphate nephropathy due to the use phosphate containing laxatives. An early identification of the mechanisms leading to renal injury can prevent the development of irreversible renal lesions and facilitate an efficient treatment of the GIT. Key words: treatment of gastrointestinal tract disorders – acute kidney injury – proton pump inhibitors – renal complications of inflammatory bowel disease – acute phosphate nephropathy

Probiotics: Role in immunomodulation and consequent effects

Microbiologically gastrointestinal tract (GIT) is one of the most active ecosystems with rich diversity of microflora and this gut microbial ecosystem is very crucial for the development and maturation of the of GIT associated immune system. The probiotics mediate their effects by regulating various immune cells, such as T regulatory cells, effector lymphocytes, natural killer T cells, B cells, dendritic cells, and epithelial cells. The gut microbiota is very instrumental in the development and immunomodulation of mucosal immune system and any sort of impairment might result in development of microbiota-related diseases. There are two major mechanisms underlying the immunomodulatory actions of probiotics – regulation of gene expression and signaling pathways in the host cells. The immunomodulatory effect is achieved by: a) direct stimulation of residing immune cells in the GIT, which results in macrophage activation and enhanced phagocytosis, b) modulation of enzyme activity by changing the microbial metabolism. On exposure to any foreign antigen an immune response is initiated by host gut mucosal immune system to maintain the homeostasis partly by adaptive immune response and partly by inducing inflammation. The advancement in the knowledge of intestinal microbiota as a result of metagenomics strategies has provided us a greater understanding of underlying mechanisms of how gut microorganisms affect the body functions. Significant amount of encouraging data pertaining to studies on humans and animal models show that supplementation of probiotics are promising approaches for prevention and treatment of GIT and immune disorders. The effects of probiotics have been observed beyond GIT and the interaction between GIT and central nervous system have revealed the role of neurochemical signalling in gut homeostasis and mental health. However, there is uncertainty in reproducibility of the effects of probiotic supplementation in animal or human nutrition and also there is no information whether the probiotics used in animal nutrition enter the human food chain or not.

Computer‐aided diagnosis system for ulcer detection in wireless capsule endoscopy images

Wireless capsule endoscopy (WCE) has revolutionised the diagnosis and treatment of gastrointestinal tract, especially the small intestine which is unreachable by traditional endoscopies. The drawback of the WCE is that it produces a large number of images to be inspected by the clinicians. Hence, the design of a computer-aided diagnosis (CAD) system will have a great potential to help reduce the diagnosis time and improve the detection accuracy. To address this problem, the authors propose a CAD system for automatic detection of ulcer in WCE images. Firstly, they enhance the input images to be better exploited in the main steps of the proposed method. Afterward, segmentation using saliency map-based texture and colour is applied to the WCE images in order to highlight ulcerous regions. Then, inspired by the existing feature extraction approaches, a new one has been proposed for the recognition of the segmented regions. Finally, a new recognition scheme is proposed based on hidden Markov model using the classification scores of the conventional methods (support vector machine, multilayer perceptron and random forest) as observations. Experimental results with two different datasets show that the proposed method gives promising results.

Modern diagnostics and treatment of combined congenital cardiovascular system and gastrointestinal tract malformations

Purpose – to share the experience of qualified medical care providing to newborn children born with combined abnormal development.Materials and methods. Diagnostics, treatment of a newborn child and further monitoring was performed according to the protocols of the Ministry of Health ofUkraine for the diagnosis and treatment of cardiovascular system and gastrointestinal tract diseases in children.Results. The article describes a case of girl clinical observation, born with combined cardiovascular and gastrointestinal tract anomalies. The main data of anamnesis, objective, laboratory and instrumental examination, the results of child with combined congenital malformations of cardiovascular system and gastrointestinal tract treatment are presented: double outlet right ventricle, atrial septal defect, ventricular septal defect and esophageal atresia, tracheoesophageal fistula, duodenal atresia.Conclusions. All pregnant women should undergo ultrasound and screening genetic examinations to exclude or diagnose congenital malformations in the fetus. The success of therapy and surgical correction, the quality of child life depend on timely diagnosis, continuity and good teamwork of neonatologists, pediatric surgeons, cardiologists, pediatricians, diagnosticians.

Pharmacodynamic and cytotoxicity effects of <i>Syzygium cordatum</i> {S Ncik, 48 (UZ)} fruit-pulp extract in gastrointestinal tract infections

Purpose: To evaluate the pharmacodynamic effect and cytotoxicity of S. cordatum pulp extract in the treatment of gastrointestinal tract infections.Methods: The air-dried fruit pulps were ground, extracted with 100 % methanol and screened for phytochemicals. Serial microdilution method was used to determine the antibacterial activity of the extract against Bacillus cereus (ATCC 10102), Staphylococcus aureus (ATCC 25925), Enterococcus hirae (ATCC 8043), Escherichia coli (ATCC 25922), Salmonella typhimurium (ATCC 700030), Klebsiella pneumonia (ATCC 4352), Pseudomonas aeruginosa (ATCC 7700), Vibrio fluvialis (AL 019) and Vibrio vulnificus (AL 042). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to assess the cytotoxicity of the extract. Antidiarrheal and antimotility activities were evaluated using castor oil-induced diarrhoea model in rats.Results: The extract revealed the presence of alkaloids, cardiac glycosides, flavonoids, saponins and terpenoids. Total phenolic content was 16.4 ± 1.8 μg/mg. The extract exhibited antibacterial activity with minimum inhibitory concentration (MIC) of as low as 3.13 mg/ml against B. cereus (ATCC 10102), S. aureus (ATCC 25925), E. hirae (ATCC 8043), P. aeruginosa (ATCC 7700) and K. pneumonia (ATCC 4352). Median inhibitory concentration (IC50) of 92 μg/ml and therapeutic index of 0.1 - 0.3 were exerted by the extract. In vivo antidiarrheal activity was 49 % at extract dose of 400 mg/kg, which was much higher than that of the control (0 %).Conclusion: The fruit-pulp extract of Syzyhium cordatum has both antibacterial, antimotility and antidiarrheal activities, and may therefore be clinically safe for use at low concentrations as an antidiarrheal agent.Keywords: Syzyhium cordatum, Antibacterial, Antidiarrheal, Antimotility, Cytotoxicity

Computer-assisted bleeding detection in wireless capsule endoscopy images

Wireless capsule endoscopy (WCE) has revolutionised the diagnosis and treatment of gastrointestinal tract, especially the small intestine where traditional endoscopies cannot reach. However, this new technology leads to the inspection of a large number of images, which is a time-consuming process and also too hard by naked eyes for doctors. In this paper, we propose a new computerised method for bleeding detection in WCE images. We use the second component of CIE Lab colour space together with appropriate segmentation and enhancement techniques, involving an adaptive anisotropic diffusion (alike Perona–Malik diffusion). As a result of this procedure, it is possible to devise four functions to discriminate between bleeding and normal regions in WCE images. These four bleeding detectors rely on the eigenvalues of the Hessian and on the Laplacian of the modified enhanced image. Multiscale image analysis approach is also involved in the definition of these detectors for handling the maximum and minimum sizes at which the bleeding regions are expected to be found. Experimental results on several medical data-sets show that the new algorithm achieves a very good rate of success and promising performance for bleeding detection.