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https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#1
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28759484/impact-of-different-ventilation-strategies-on-driving-pressure-mechanical-power-and-biological-markers-during-open-abdominal-surgery-in-rats
#2
Lígia de A Maia, Cynthia S Samary, Milena V Oliveira, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Marcelo M Morales, Marcus J Schulz, Marcelo G Abreu, Paolo Pelosi, Pedro L Silva, Patricia Rieken Macedo Rocco
BACKGROUND: Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28717916/colon-perfusion-patterns-during-colorectal-resection-using-visible-light-spectroscopy
#3
Henry Hoffmann, Tarik Delko, Philipp Kirchhoff, Rachel Rosenthal, Juliane Schäfer, Marko Kraljević, Christoph Kettelhack
BACKGROUND: The impact of blood supply to the anastomosis on development of anastomotic leakage is still a matter of debate. Considering that bowel perfusion may be affected by manipulation during surgery, perfusion assessment of the anastomosis alone may be of limited value. We propose perfusion assessment at different time points during surgery to explore the dynamics of bowel perfusion during colorectal resection and its impact on outcome. METHODS: In this prospective cohort study, patients undergoing elective colorectal resection were eligible...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28666895/the-microbiome-and-disorders-of-the-central-nervous-system
#4
Valeria D Felice, Siobhain M O'Mahony
Alterations of the gut microbiota have been associated with stress-related disorders including depression and anxiety and irritable bowel syndrome (IBS). More recently, researchers have started investigating the implication of perturbation of the microbiota composition in neurodevelopmental disorders including autism spectrum disorders and Attention-Deficit Hypersensitivity Disorder (ADHD). In this review we will discuss how the microbiota is established and its functions in maintaining health. We also summarize both pre and post-natal factors that shape the developing neonatal microbiota and how they may impact on health outcomes with relevance to disorders of the central nervous system...
June 27, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28660179/monitoring-cerebral-and-renal-oxygenation-status-during-neonatal-digestive-surgeries-using-near-infrared-spectroscopy
#5
Jonathan Beck, Gauthier Loron, Claire Masson, Marie-Laurence Poli-Merol, Eliane Guyot, Camille Guillot, Nathalie Bednarek, Caroline François
BACKGROUND: Depending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS) is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause. OBJECTIVE: Evaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28652796/the-microbiota-in-inflammatory-bowel-disease-current-and-therapeutic-insights
#6
REVIEW
Erin R Lane, Timothy L Zisman, David L Suskind
Inflammatory bowel disease is a heterogeneous group of chronic disorders that result from the interaction of the intestinal immune system with the gut microbiome. Until recently, most investigative efforts and therapeutic breakthroughs were centered on understanding and manipulating the altered mucosal immune response that characterizes these diseases. However, more recent studies have highlighted the important role of environmental factors, and in particular the microbiota, in disease onset and disease exacerbation...
2017: Journal of Inflammation Research
https://www.readbyqxmd.com/read/28624575/intestinal-fungal-dysbiosis-associates-with-visceral-hypersensitivity-in-patients-with-irritable-bowel-syndrome-and-rats
#7
Sara Botschuijver, Guus Roeselers, Evgeni Levin, Daisy M Jonkers, Olaf Welting, Sigrid Em Heinsbroek, Heleen H de Weerd, Teun Boekhout, Matteo Fornai, Ad A Masclee, Frank H J Schuren, Wouter J de Jonge, Jurgen Seppen, Rene M van den Wijngaard
BACKGROUND & AIMS: Visceral hypersensitivity is one feature of irritable bowel syndrome (IBS). Bacterial dysbiosis might be involved in activation of nociceptive sensory pathways, but there have been few studies of the role of the mycobiome (the fungal microbiome) in development of IBS. We analyzed intestinal mycobiomes of patients with IBS and a rat model of visceral hypersensitivity. METHODS: We used internal transcribed spacer 1-based metabarcoding to compare fecal mycobiomes of 18 healthy volunteers with those of 39 patients with IBS (with visceral hypersensitivity or normal levels of sensitivity)...
June 14, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28616751/roles-of-amino-acids-in-preventing-and-treating-intestinal-diseases-recent-studies-with-pig-models
#8
REVIEW
Yulan Liu, Xiuying Wang, Yongqing Hou, Yulong Yin, Yinsheng Qiu, Guoyao Wu, Chien-An Andy Hu
Animal models are needed to study and understand a human complex disease. Because of their similarities in anatomy, structure, physiology, and pathophysiology, the pig has proven its usefulness in studying human gastrointestinal diseases, such as inflammatory bowel disease, ischemia/reperfusion injury, diarrhea, and cancer. To understand the pathogenesis of these diseases, a number of experimental models generated in pigs are available, for example, through surgical manipulation, chemical induction, microbial infection, and genetic engineering...
June 14, 2017: Amino Acids
https://www.readbyqxmd.com/read/28609251/intestinal-microbiota-fecal-microbiota-transplantation-and-inflammatory-bowel-disease
#9
Alexa R Weingarden, Byron P Vaughn
Inflammatory bowel disease (IBD) is a complex set of diseases that lead to chronic inflammation in the gastrointestinal tract. Although the etiology of IBD is not fully understood, it is well-known that the intestinal microbiota is associated with the development and maintenance of IBD. Manipulation of the gut microbiota, therefore, may represent a target for IBD therapy. Fecal microbiota transplantation (FMT), where fecal microbiota from a healthy donor is transplanted into a patient's GI tract, is already a successful therapy for Clostridium difficile infection...
May 4, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28601656/prognostic-relevance-of-src-activation-in-stage-ii-iii-colon-cancer
#10
Julia Martinez Perez, Iker Lopez-Calderero, Carmen Saez, Marta Benavent, Maria L Limon, Reyes Gonzalez-Exposito, B Soldevilla, Maria C Riesco-Martinez, Javier Salamanca, Amancio Carnero, Rocio Garcia-Carbonero
Src belongs to a family of cytoplasmic tyrosine kinases that play a key role in tumor initiation and progression. Src activation has been associated with a more aggressive neoplastic phenotype and induces resistance to platinum agents in preclinical models. The aim of our study was to assess the prognostic and/or predictive value of Src activation in stage II-III colon cancer patients. pSrc expression was assessed in paraffin-embedded tumor samples by immunohistochemistry (phospho Y418, ab4816, Abcam). Cases were classified by staining intensity in four categories: no staining (0), weak (1+), moderate (2+) and intense (3+) staining...
June 7, 2017: Human Pathology
https://www.readbyqxmd.com/read/28560286/uncovering-pathogenic-mechanisms-of-inflammatory-bowel-disease-using-mouse-models-of-crohn-s-disease-like-ileitis-what-is-the-right-model
#11
REVIEW
Fabio Cominelli, Kristen O Arseneau, Alexander Rodriguez-Palacios, Theresa T Pizarro
Crohn's disease and ulcerative colitis, together known as inflammatory bowel disease, are debilitating chronic disorders of unknown cause and cure. Our evolving understanding of these pathologies is enhanced greatly by the use of animal models of intestinal inflammation that allow in vivo mechanistic studies, preclinical evaluation of new therapies, and investigation into the causative factors that underlie disease pathogenesis. Several animal models, most commonly generated in mice, exist for the study of colitis...
July 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28554107/manual-laparoscopy-assisted-intraoperative-reduction-for-adult-ileocolic-intussusception-with-ileal-adenoma-a-case-report
#12
Naoki Takahashi, Kiyoshi Narita, Rie Sato, Hideo Suzuki, Hideki Machishi, Yoshikatsu Okada
INTRODUCTION: Adult intussusception is a rare condition with a pathological lead point. Intraoperative reduction of adult intussusception can eliminate the need for extensive or invasive resection. We safely performed a manual laparoscopy-assisted intraoperative reduction that allowed functional preservation of tissue. PRESENTATION OF CASE: A 70-year-old woman with dull right lumbar pain at regular intervals and right lower quadrant abdominal tenderness was admitted to our hospital...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28515561/efficacy-of-myofascial-unwinding-and-myofascial-release-technique-in-a-patient-with-somatic-symptoms-a-case-report
#13
Manu Goyal, Kanu Goyal, Manish Bathla, D Kanimozhi, D Narkeesh
Depression is an aversion to activity disorder which could lead to somatic dysfunctions such as insomnia, excessive sleeping, body aches, listlessness, and irritable bowel syndrome. The World Health Organization has projected the depression to be the second leading cause of disability worldwide by 2020. The physical and mental ill effects of somatic depression can be addressed using the osteopathic manipulative treatment. Therefore, the purpose of the present case report is to explore the effect of myofascial release (MFR) technique and myofascial unwinding (MFU) in the somatic depression...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28491202/just-a-mirage-heterotopic-intrauterine-and-twin-ectopic-pregnancy-mimicked-by-mirror-imaging-on-ultrasound
#14
Rimsha Ahmed, Dejan Samardzic, Michael A Santos, Anna Mesina, Jaimie Maines
Heterotopic pregnancies are rare and are usually diagnosed by transvaginal ultrasound. Despite the routine use of sonography in early pregnancy, artifact created by mirror imaging can drastically and erroneously alter medical decision making by interfering with image interpretation. A heterotopic pregnancy with a single intrauterine gestation and twin left adnexal ectopic gestational sacs was observed on ultrasound in a woman presenting with abdominal pain. During laparoscopy, an ectopic pregnancy was not identified, and subsequent intraoperative ultrasound reproduced the heterotopic pregnancy through manipulation of bowel, confirming mirror image artifact...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489476/benefits-of-thoracic-epidural-analgesia-in-patients-undergoing-an-open-posterior-component-separation-for-abdominal-herniorrhaphy
#15
Daryl S Henshaw, Christopher J Edwards, Austin R Sellers, Gregory B Russell, Robert S Weller
An open posterior component separation (PCS) is a commonly utilized surgical approach for repair of complex abdominal wall defects and hernias. Although this approach may improve surgical outcomes, significant postoperative pain can be expected given the required laparotomy and extensive abdominal wall manipulation. Both systemic opioids and thoracic epidural analgesia (TEA) are viable postoperative analgesic options, and both are commonly utilized. Although the benefits of TEA have been investigated following a variety of surgeries, there is a paucity of literature related to its efficacy for this particular surgery...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28465780/laparoscopic-surgery-for-complex-and-recurrent-crohn-s-disease
#16
EDITORIAL
Yusuf Sevim, Cihangir Akyol, Erman Aytac, Bilgi Baca, Orhan Bulut, Feza H Remzi
Crohn's disease (CD) is a chronic inflammatory disease of digestive tract. Approximately 70% of patients with CD require surgical intervention within 10 years of their initial diagnosis, despite advanced medical treatment alternatives including biologics, immune suppressive drugs and steroids. Refractory to medical treatment in CD patients is the common indication for surgery. Unfortunately, surgery cannot cure the disease. Minimally invasive treatment modalities can be suitable for CD patients due to the benign nature of the disease especially at the time of index surgery...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28433688/vitamin-d-downregulates-the-il-23-receptor-pathway-in-human-mucosal-group-3-innate-lymphoid-cells
#17
Viktoria Konya, Paulo Czarnewski, Marianne Forkel, Anna Rao, Efthymia Kokkinou, Eduardo J Villablanca, Sven Almer, Ulrik Lindforss, Danielle Friberg, Charlotte Höög, Peter Bergman, Jenny Mjösberg
BACKGROUND: Vitamin D deficiency is a risk factor for inflammatory bowel disease (IBD). The IL-23-driven tissue-resident group 3 innate lymphoid cells (ILC3s) play essential roles in intestinal immunity, and targeting IL-23/12 is a promising approach in IBD therapy. OBJECTIVE: We set out to define the role of 1α,25-dihydroxy vitamin D3 (1,25D) in regulating functional responses of human mucosal ILC3s to IL-23 plus IL-1β stimulation. METHODS: Transcriptomes of sorted tonsillar ILC3s were assessed by using microarray analysis...
April 20, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28385296/17%C3%AE-estradiol-prevents-mesenteric-injury-induced-by-occlusion-of-the-proximal-descending-aorta-in-male-rats
#18
Paulo Thales Rocha de Sousa, Ana Cristina Breithaupt-Faloppa, Cristiano de Jesus Correia, Raif Restivo Simão, Sueli Gomes Ferreira, Alfredo Inácio Fiorelli, Luiz Felipe Pinho Moreira, Paulina Sannomiya
OBJECTIVE: In surgical aortic repair or cardiac surgery with aorta occlusion, the occurrence of mesenteric ischemia and bowel injury has been associated with higher short-term mortality. The vascular protection of estrogens has been investigated and is mainly mediated by increasing the availability of nitric oxide (NO). Therefore, this study investigated the role of 17β-estradiol on visceral ischemia-reperfusion (I/R) injury after descending aorta occlusion in male rats. METHODS: Mesenteric ischemia was induced in male Wistar rats by placing a 2F Fogarty arterial embolectomy catheter (Edwards Lifesciences, Irvine, Calif) in the descending aorta, which remained occluded for 15 minutes, followed by reperfusion for up to 2 hours...
April 3, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28370422/clinical-practice-guideline-for-enteroscopy
#19
Hironori Yamamoto, Haruhiko Ogata, Takayuki Matsumoto, Naoki Ohmiya, Kazuo Ohtsuka, Kenji Watanabe, Tomonori Yano, Toshiyuki Matsui, Kazuhide Higuchi, Tetsuya Nakamura, Kazuma Fujimoto
Management of small bowel diseases has evolved since the advent of capsule endoscopy (CE) and balloon-assisted enteroscopy (BAE). One of the most common indications for enteroscopy is obscure gastrointestinal bleeding (OGIB), followed by small bowel stenosis, tumors, and inflammatory bowel disease. Although enteroscopes have been regarded as useful tools, correct guidelines are required to ensure that we manipulate these enteroscopes safely and efficiently in clinical practice. Herein, the Japanese Gastroenterological Endoscopy Society has developed 'Clinical Practice Guidelines for Enteroscopy' in collaboration with the Japanese Society of Gastroenterology, the Japanese Gastroenterological Association, and the Japanese Association for Capsule Endoscopy...
March 31, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28346012/lymphangiogenesis-fuel-smoke-or-extinguisher-of-inflammation-s-fire
#20
REVIEW
Gabriella R Abouelkheir, Bradley D Upchurch, Joseph M Rutkowski
Lymphangiogenesis is a recognized hallmark of inflammatory processes in tissues and organs as diverse as the skin, heart, bowel, and airways. In clinical and animal models wherein the signaling processes of lymphangiogenesis are manipulated, most studies demonstrate that an expanded lymphatic vasculature is necessary for the resolution of inflammation. The fundamental roles that lymphatics play in fluid clearance and immune cell trafficking from the periphery make these results seemingly obvious as a mechanism of alleviating locally inflamed environments: the lymphatics are simply providing a drain...
April 2017: Experimental Biology and Medicine
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