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Gastrointestinal ischemia

Yaohong Wang, Sudeep P George, Swati Roy, Eric Pham, Amin Esmaeilniakooshkghazi, Seema Khurana
In the small intestine, epithelial cells are derived from stem cells in the crypts, migrate up the villus as they differentiate and are ultimately shed from the villus tips. This process of proliferation and shedding is tightly regulated to maintain the intestinal architecture and tissue homeostasis. Apoptosis regulates both the number of stem cells in the crypts as well as the sloughing of cells from the villus tips. Previously, we have shown that villin, an epithelial cell-specific actin-binding protein functions as an anti-apoptotic protein in the gastrointestinal epithelium...
October 21, 2016: Scientific Reports
A Tassopoulos, A Chalkias, A Papalois, N Iacovidou, T Xanthos
The intestine is highly sensitive to ischemia/reperfusion (I/R) injury. Intestinal I/R may cause local tissue injury and disruption of the intestinal mucosal barrier, allowing the passage of viable bacteria and endotoxins from the gastrointestinal lumen to distant organs. This phenomenon, known as bacterial translocation (BT), may lead to systemic disorders with high morbidity and mortality. Oxidative stress mediators such as reactive oxygen species, polymorphonuclear neutrophils and nitric oxide are believed to contribute to the intestinal I/R injury...
October 13, 2016: Redox Report: Communications in Free Radical Research
Nicola Guglielmo, Brice Malgras, Vinciane Place, Youcef Guerrache, Karine Pautrat, Marc Pocard, Philippe Soyer
Torsion of a uterine leiomyoma is a rare complication that can be life threatening because of ischemia or necrosis. This condition may also lead to gastrointestinal complications such as obstruction or, more rarely, small bowel volvulus. Its diagnosis is difficult and can be facilitated with the use of computed tomography or magnetic resonance imaging. Treatment is based on emergency surgical resection of the twisted uterine leiomyoma and detorsion of the small bowel volvulus.
September 28, 2016: Clinical Imaging
Stefan Schraag
Most patients undergoing major aortic surgery have multiple comorbidities and are at high risk of postoperative complications that affect multiple organ systems. Different aortic pathologies and surgical repair techniques have specific impact on the postoperative course. Ischemia-reperfusion injury is the common denominator in aortic surgery and influences the integrity of end-organ function. Common postoperative problems include hemodynamic instability due to the immediate inflammatory response, renal impairment, spinal cord ischemia, respiratory failure with prolonged mechanical ventilation, and gastrointestinal symptoms such as ileus or mesenteric ischemia...
September 2016: Best Practice & Research. Clinical Anaesthesiology
Wei-Ping Zhang, Qiao-Feng Zong, Qin Gao, Ying Yu, Xiao-Yu Gu, Ya Wang, Zheng-Hong Li, Min Ge
Endomorphins (EMs) have important roles in the body with regards to analgesia, feeding behavior, gastrointestinal movement and inflammatory reaction. Recent studies have reported that EMs may also participate in chronic hypoxia in the protection of rat myocardial ischemia/reperfusion; however, the mediator and underlying mechanisms remain to be elucidated. The aim of the present study was to investigate the effects of EM‑1 postconditioning on myocardial ischemia/reperfusion injury (MIRI) and myocardial cell apoptosis in a rat model, and to assess its likely mechanisms...
October 2016: Molecular Medicine Reports
Wenjuan Zhang, Qin Tao, Zihu Guo, Yingxue Fu, Xuetong Chen, Piar Ali Shar, Mohamed Shahen, Jinglin Zhu, Jun Xue, Yaofei Bai, Ziyin Wu, Zhenzhong Wang, Wei Xiao, Yonghua Wang
Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related...
2016: Scientific Reports
Aristeidis H Katsanos, Dimitris Mavridis, John Parissis, Spyridon Deftereos, Alexandra Frogoudaki, Agathi-Rosa Vrettou, Ignatios Ikonomidis, Maria Chondrogianni, Apostolos Safouris, Angeliki Filippatou, Konstantinos Voumvourakis, Nikos Triantafyllou, John Ellul, Theodore Karapanayiotides, Sotirios Giannopoulos, Anne W Alexandrov, Andrei V Alexandrov, Georgios Tsivgoulis
BACKGROUND: Novel oral anticoagulants (NOACs) have shown to be both safe and effective for ischemic stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). We conducted a network meta-analysis (NMA) using published data from secondary prevention subgroups of different phase III randomized clinical trials (RCTs) comparing individual NOACs with warfarin. METHODS: Eligible studies were identified by searching MEDLINE and SCOPUS and the Cochrane Central Register of Controlled Trials databases...
September 2016: Therapeutic Advances in Neurological Disorders
Gianfranco Donatelli, Fabrizio Cereatti, Parag Dhumane, Bertrand Marie Vergeau, Thierry Tuszynski, Christian Marie, Jean-Loup Dumont, Bruno Meduri
BACKGROUND: The Over-The-Scope Clip (OTSC®, Ovesco Endoscopy GmbH, Tübingen, Germany) is an innovative clipping device that provides a strong tissue grasp and compression without provoking ischemia or laceration. In this retrospective study we evaluated immediate and long-term success rates of OTSC deployment in various pathologies of the gastrointestinal (GI) tract. METHODS: A total of 45 patients (35 female, 10 male) with an average age of 56 years old (range, 24-90 years) were treated with an OTSC for GI defects resulting from a diagnostic or interventional endoscopic procedure (acute setting group) or for fistula following abdominal surgery (chronic setting group)...
September 2016: Therapeutic Advances in Gastroenterology
Viviana Filpa, Elisabetta Moro, Marina Protasoni, Francesca Crema, Gianmario Frigo, Cristina Giaroni
Several studies have been carried out in the last 30 years in the attempt to clarify the possible role of glutamate as a neurotransmitter/neuromodulator in the gastrointestinal tract. Such effort has provided immunohistochemical, biomolecular and functional data suggesting that the entire glutamatergic neurotransmitter machinery is present in the complex circuitries of the enteric nervous system (ENS), which participates to the local coordination of gastrointestinal functions. Glutamate is also involved in the regulation of the brain-gut axis, a bi-directional connection pathway between the central nervous system (CNS) and the gut...
December 2016: Neuropharmacology
Jeong Seok Lee, Hyojin Kim, Eun Bong Lee, Yeong Wook Song, Jin Kyun Park
A 20-year-old man presented with recurrent hemoptysis for seven months. A small subpleural nodule in his right lower lobe was found and excised surgically. Based on the presence of antiphospholipid antibodies (aPL) and vascular wall hypertrophy without vasculitis or an intraluminal thrombus, nonthrombotic proliferative vasculopathy (NTPV) affecting pulmonary arteries was diagnosed. Recently, aPL have been postulated to directly induce the proliferation of vascular cells in the intima and media, leading to NTPV...
August 18, 2016: Modern Rheumatology
Susanna Every-Palmer, Mike Nowitz, James Stanley, Eve Grant, Mark Huthwaite, Helen Dunn, Pete M Ellis
BACKGROUND: Gastrointestinal side effects are particularly common with clozapine and occur with other antipsychotics, ranging from mild constipation to fatal bowel obstruction and/or ischemia. While this adverse-effect spectrum has been attributed to 'gastrointestinal hypomotility', gastrointestinal transit times in antipsychotic-treated patients have not previously been measured, making this mechanism speculative. METHODS: Using standardized radiopaque marker ('Metcalf') methods we established colonic transit times of antipsychotic-treated psychiatric inpatients and compared them with population normative values...
March 2016: EBioMedicine
Yuan Zhao, Gang Li, Xiang Yu, Ping Xie
Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) in treating lower gastrointestinal bleeding caused by angiodysplasia. Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization...
2016: Gastroenterology Research and Practice
Graeme R Polglase, Tracey Ong, Noah H Hillman
The cardiovascular response to asphyxia involves redistribution of cardiac output to maintain oxygen delivery to critical organs such as the adrenal gland, heart, and brain, at the expense of other organs such as the gut, kidneys and skin. This redistribution results in reduced perfusion and localized hypoxia/ischemia in these organs, which, if severe, can result in multiorgan failure. Liver injury, coagulopathy, bleeding, thrombocytopenia, renal dysfunction, and pulmonary and gastrointestinal injury all result from hypoxia, underperfusion, or both...
September 2016: Clinics in Perinatology
Richard Slama, Brit Long, Alex Koyfman
INTRODUCTION: Abdominal aortic aneurysm (AAA) is a deadly condition, particularly with rupture. Emergency physicians provide vital frontline care to the diagnosis and treatment of this disease. Endovascular aortic repair (EVAR) has become the gold standard for treatment of AAA, but the management of EVAR complications is not well discussed in the emergency medicine literature. OBJECTIVE OF THIS REVIEW: The purpose of this article is to provide an emergency medicine-focused review of the complications of EVAR...
October 2016: American Journal of Emergency Medicine
Giovanni Alemanno, Riccardo Somigli, Paolo Prosperi, Carlo Bergamini, Gherardo Maltinti, Alessio Giordano, Andrea Valeri
INTRODUCTION: Acute mesenteric ischemia is the most severe gastrointestinal complication of acute aortic dissection. The timing of diagnosis is of major importance, in fact the recognition of acute mesenteric ischemia often occurs too late due to the presence of unspecific symptoms and lack of reliable exams. Recently, indocyanine green fluorescence angiography has been adopted in order to measure blood perfusion and microcirculation. PRESENTATION OF CASE: We decided to perform a diagnostic laparoscopy with the support of intra-operative near-infrared indocyanine green fluorescence angiography, in order to detect an initial intestinal ischemia in a 68-year-old patient previously treated with a TEVAR procedure for a type-B aortic dissection...
2016: International Journal of Surgery Case Reports
Jihan Harki, Yvonne Vergouwe, Johannes A Spoor, Peter B Mensink, Marco J Bruno, Désirée van Noord, Ernst J Kuipers, Eric T T L Tjwa
BACKGROUND: No golden diagnostic standard is available to diagnose chronic gastrointestinal ischemia (CGI). GOALS: We aimed to establish an accurate prediction model for CGI, based on clinical symptoms and radiologic evaluation of the amount of stenosis in the celiac artery (CA) and superior mesenteric artery (SMA) by means of computed tomography-angiography or magnetic resonance (MR)-angiography. STUDY: We prospectively included 436 consecutive patients with clinical suspicion of CGI in a tertiary referral center...
July 25, 2016: Journal of Clinical Gastroenterology
Joseph E Cruz, Ashley Ward, Shannon Anthony, Susanna Chang, Hyun Billy Bae, Evelyn R Hermes-DeSantis
OBJECTIVE: To review the evidence for using intravenous (IV) epoprostenol to treat Raynaud's phenomenon (RP). DATA SOURCES: The databases MEDLINE (1946 to March 2016), PubMed, and International Pharmaceutical Abstracts were searched using the terms epoprostenol, Flolan, Raynaud's disease, and CREST syndrome. Further literature sources were identified by reviewing article citations. STUDY SELECTION AND DATA EXTRACTION: All English-language, clinical trials and case series evaluating IV epoprostenol for the management or treatment of RP were included...
July 26, 2016: Annals of Pharmacotherapy
Sabine Schindele, Ervice Pouokam, Martin Diener
Ischemia causes severe damage in the gastrointestinal tract. Therefore, it is interesting to study how the barrier and transport functions of intestinal epithelium change under hypoxia and subsequent reoxygenation. For this purpose we simulated hypoxia and reoxygenation on mucosa-submucosa preparations from rat distal colon in Ussing chambers and on isolated crypts. Hypoxia (N2 gassing for 15 min) induced a triphasic change in short-circuit current (Isc): a transient decrease, an increase and finally a long-lasting fall below the initial baseline...
2016: Frontiers in Physiology
Lin Zheng, Ji Hoon Shin, Kichang Han, Jiaywei Tsauo, Hyun-Ki Yoon, Gi-Young Ko, Jong-Soo Shin, Kyu-Bo Sung
PURPOSE: To evaluate the effectiveness of transcatheter arterial embolization (TAE) for gastrointestinal (GI) bleeding caused by GI lymphoma. MATERIALS AND METHODS: The medical records of 11 patients who underwent TAE for GI bleeding caused by GI lymphoma between 2001 and 2015 were reviewed retrospectively. RESULTS: A total of 20 TAE procedures were performed. On angiography, contrast extravasation, and both contrast extravasation and tumor staining were seen in 95 % (19/20) and 5 % (1/20) of the procedures, respectively...
November 2016: Cardiovascular and Interventional Radiology
Bertha Idrogo Regalado, Oscar Frisancho Velarde
The Peutz Jeghers Syndrome (PJS) is characterized by gastrointestinal hamartomatous polyps and mucocutaneous pigmentation, are at high risk of bowel resections because ischemia secondary to intussusception. The risk of gastrointestinal cancer is nine more than the general population. We report five patients diagnosed with SPG, four had intestinal intussusception, one upper gastrointestinal bleeding and one died with pancreatic neoplasia.
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
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