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Cureus Jun 2022Human intestinal spirochetosis (HIS) is a condition where spirochetes, a group of spiral-shaped bacteria, attach to the apical membrane of the human colorectal...
Human intestinal spirochetosis (HIS) is a condition where spirochetes, a group of spiral-shaped bacteria, attach to the apical membrane of the human colorectal epithelium. Although most findings of HIS are simply incidental discoveries found during screening colonoscopies, the ability to mimic the presentation of inflammatory bowel diseases should prompt consideration of this condition as part of a working differential diagnosis. Herein, we present the case of a 57-year-old bisexual, African American male with a medical history of Human Immunodeficiency Virus (HIV) on antiretroviral therapy (ART) with an undetectable viral load that presented for an elective, outpatient colonoscopy after experiencing four months of intermittent bloating and hematochezia. Histologic examination of colonic biopsies confirmed a diagnosis of HIS. The nonspecific clinical presentation in the setting of well-controlled HIV makes HIS a formidable diagnostic challenge that requires increased awareness.
PubMed: 35812607
DOI: 10.7759/cureus.25756 -
Anatomical Record (Hoboken, N.J. : 2007) Nov 2018The gastrointestinal tract of the alpaca (Vicugna pacos) is most efficiently adapted to its habitat at high altitudes. Alpacas, just like ruminants, feed on hardly...
The gastrointestinal tract of the alpaca (Vicugna pacos) is most efficiently adapted to its habitat at high altitudes. Alpacas, just like ruminants, feed on hardly digestible forage. However, it has been demonstrated that the anatomy of the camelid digestive tract has developed independently of ruminants and not in homology to them. Despite a long history of domestication and an increasing number of animals worldwide, little research has been done on the intestinal anatomy of alpacas. The purpose of this study was to describe the anatomical features of the alpaca's intestines and to explain anatomical peculiarities in the context of evolutionary function and morphology. Another goal of this study was the demonstration of weaknesses of the intestinal anatomy predisposing alpacas to certain clinical presentations. Six animals were used for dissection. The basic structure of the intestines was comparable to that in ruminants. However, a number of characteristic peculiarities were found in alpacas, like the duodenal ampulla and the proximal and distal loop of the ascending colon. The jejunum and ileum, unlike those of ruminants, had their own mesentery largely separated from the ascending mesocolon. The main blood supply was provided by the cranial and caudal mesenteric artery. The particular lymph nodes were located along the branches of these two arteries. The spiral colon seemed to play a major role in intestinal digestion and water resorption. The size of the distal fermentation chamber allows the presumption that alpacas belong to the group of animals practicing a fractionated fermentation in the proximal and distal fermentation chambers. Anat Rec, 301:1840-1851, 2018. © 2018 Wiley Periodicals, Inc.
Topics: Adaptation, Physiological; Animals; Camelids, New World; Ecosystem; Feeding Behavior; Female; Intestines; Male
PubMed: 30288956
DOI: 10.1002/ar.23863 -
Veterinary Sciences Oct 2018Shiga toxin-producing , like O157:H7, are important human and animal pathogens. Naturally-acquired O157:H7 infections occur in numerous species but, particularly,...
Shiga toxin-producing , like O157:H7, are important human and animal pathogens. Naturally-acquired O157:H7 infections occur in numerous species but, particularly, cattle have been identified as a significant reservoir for human cases. O157:H7 are isolated from a number of domestic and wild animals, including rodents that share a living space with cattle. These Shiga toxin-producing O157:H7 strains can be highly virulent in humans, but little is known about the sequelae of interspecies transfer. In a group of neonatal calves, we determined the differences in colonization patterns and lesions associated with infection using either a wildlife or bovine O157:H7 strain. In calves challenged with the wildlife O157:H7 strain, the large (descending) colon was solely colonized, which differed substantially from the calves inoculated with the bovine O157:H7 strain, where the spiral colon was the principal target of infection. This study also demonstrated that while both interspecies- and intraspecies-derived O157:H7 can infect young calves, the distribution and severity differs.
PubMed: 30326606
DOI: 10.3390/vetsci5040088 -
American Journal of Veterinary Research Jan 2015To analyze the transit time from various locations in the intestines of cows with cecal dilatation-dislocation (CDD), healthy control cows, and cows with left...
Assessment of the excretion time of electronic capsules placed in the intestinal lumen of cows with cecal dilatation-dislocation, healthy control cows, and cows with left displacement of the abomasum.
OBJECTIVE
To analyze the transit time from various locations in the intestines of cows with cecal dilatation-dislocation (CDD), healthy control cows, and cows with left displacement of the abomasum (LDA).
ANIMALS
15 cows with naturally occurring CDD (group 1), 14 healthy control cows (group 2), and 18 cows with LDA (group 3).
PROCEDURES
5 electronic transmitters were encased in capsules and placed in the lumen of the ileum, cecum, proximal portion of the colon, and 2 locations in the spiral colon (colon 1 and colon 2) and used to measure the transit time (ie, time between placement in the lumen and excretion of the capsules from the rectum). Excretion time of the capsules from each intestinal segment was compared among groups.
RESULTS
Cows recovered well from surgery, except for 1 cow with relapse of CDD 4 days after surgery and 2 cows with incisional infection. High variability in capsule excretion times was observed for all examined intestinal segments in all groups. Significant differences were detected for the excretion time from the colon (greater in cows with CDD than in healthy control cows) and cecum (less in cows with LDA than in cows of the other 2 groups).
CONCLUSIONS AND CLINICAL RELEVANCE
The technique developed to measure excretion time of capsules from bovine intestines was safe and reliable; however, the large variability observed for all intestinal segments and all groups would appear to be a limitation for its use in assessment of intestinal transit time of cattle in future studies.
Topics: Abomasum; Animals; Capsules; Case-Control Studies; Cattle; Cattle Diseases; Cecal Diseases; Dairying; Dilatation, Pathologic; Female; Reproducibility of Results
PubMed: 25535662
DOI: 10.2460/ajvr.76.1.60 -
Journal of Postgraduate Medicine 2019
Topics: Cardiac Surgical Procedures; Colonic Pseudo-Obstruction; Erythromycin; Female; Gastrointestinal Agents; Heart Failure; Humans; Intestine, Large; Intubation, Gastrointestinal; Middle Aged; Multidetector Computed Tomography; Neostigmine; Postoperative Complications; Tomography, Spiral Computed; Treatment Outcome
PubMed: 30693875
DOI: 10.4103/jpgm.JPGM_405_18 -
Mutual reinforcement of inflammation and carcinogenesis by the Helicobacter pylori CagA oncoprotein.Scientific Reports May 2015Helicobacter pylori cagA-positive strain delivers the CagA oncoprotein into gastric epithelial cells and at the same time elicits stomach inflammation. To experimentally...
Helicobacter pylori cagA-positive strain delivers the CagA oncoprotein into gastric epithelial cells and at the same time elicits stomach inflammation. To experimentally investigate the pathophysiological interplay between CagA and inflammation, transgenic mice systemically expressing the bacterial cagA gene were treated with a colitis inducer, dextran sulfate sodium (DSS). Compared with control mice, DSS-induced colitis was markedly deteriorated in cagA-transgenic mice. In the colonic epithelia of cagA-transgenic mice, there was a substantial decrease in the level of IκB, which binds and sequesters NF-κB in the cytoplasm. This IκB reduction was due to CagA-mediated inhibition of PAR1, which may stimulate IκB degradation by perturbing microtubule stability. Whereas the CagA-mediated IκB reduction did not automatically activate NF-κB, it lowered the threshold of NF-κB activation by inflammogenic insults, thereby contributing to colitis exacerbation in cagA-transgenic mice. CagA also activates inflammasomes independently of NF-κB signaling, which further potentiates inflammation. The incidence of colonic dysplasia was elevated in DSS-treated cagA-transgenic mice due to a robust increase in the number of pre-cancerous flat-type dysplasias. Thus, CagA deteriorated inflammation, whereas inflammation strengthened the oncogenic potential of CagA. This work revealed that H. pylori CagA and inflammation reinforce each other in creating a downward spiral that instigates neoplastic transformation.
Topics: Animals; Antigens, Bacterial; Bacterial Proteins; Carcinogenesis; Colitis; Dextran Sulfate; Female; Gastrointestinal Neoplasms; Inflammasomes; Male; Mice; Mice, Transgenic
PubMed: 25944120
DOI: 10.1038/srep10024 -
Internal Medicine (Tokyo, Japan) 2019We herein report a case of Brachyspira pilosicoli-caused severe colitis presenting with portal venous gas. A 75-year-old man was admitted because of a fever, severe...
We herein report a case of Brachyspira pilosicoli-caused severe colitis presenting with portal venous gas. A 75-year-old man was admitted because of a fever, severe abdominal pain and bloody diarrhea. He was negative for anti-HIV antibodies. He had been in close contact with a dog earlier. Abdominal computed tomography detected severe wall-thickening and fat-stranding of the entire colon accompanied by portal venous gas. A smear examination of his stool showed many Gram-negative spiral rods, suggesting intestinal spirochetosis. A polymerase chain reaction assay using stool samples detected an amplified band specific for B. pilosicoli. He responded well to antimicrobial agents including metronidazole.
Topics: Abdominal Pain; Aged; Animals; Anti-Bacterial Agents; Brachyspira; Colitis; Diarrhea; Dog Diseases; Dogs; Feces; Gases; Gram-Negative Bacterial Infections; Humans; Male; Metronidazole; Polymerase Chain Reaction; Portal Vein
PubMed: 31787630
DOI: 10.2169/internalmedicine.3254-19 -
Canadian Journal of Gastroenterology &... Dec 2014Sessile or nonpolypoid neoplastic lesions, including sessile serrated adenomas (SSAs), are difficult to detect in patients with inflammatory bowel disease (IBD).
BACKGROUND
Sessile or nonpolypoid neoplastic lesions, including sessile serrated adenomas (SSAs), are difficult to detect in patients with inflammatory bowel disease (IBD).
OBJECTIVES
To assess the prevalence and endoscopic features of SSA in IBD patients undergoing surveillance colonoscopy using novel endoscopic techniques.
METHODS
Histology results of biopsies from a cohort of 87 patients (47 men; median age 51.4 years; median duration of disease 16.9 years; ulcerative colitis [n=40], Crohn disease [n=43], ischemic colitis [n=4]) with longstanding colonic IBD undergoing surveillance colonoscopy were reviewed. Lesions of dysplasia (adenoma-like mass, or dysplasia-associated lesion or mass), SSAs, adenoma-like polyps, hyperplastic polyps and inflammatory polyps were identified. Surveillance colonoscopy using high-definition alone, or with iScan (Pentax, USA) dye-sprayed or virtual chromoendoscopy was performed. Lesion characteristics were described before histological diagnosis.
RESULTS
Fourteen SSAs were detected in 87 (11%) IBD patients. The endoscopic characteristics of SSA lesions were: nonpolypoid appearance (86%), predominant localization in the proximal colon (79%), >6 mm in size (79%), cloudy cover (64%), Kudo pit pattern modified type IIO (86%) and irregular spiral vascular pattern (79%). Among the 44 SSAs and hyperplastic polyps found in the present study, the above characteristics of SSA at colonoscopy had a sensitivity of 92.86% (95% CI 66.06% to 98.8%) and specificity of 93.33% (95% CI 77.89% to 98.99%) in predicting a histological diagnosis of SSA (positive predictive value 86.67%, negative predictive value 96.55%).
CONCLUSION
SSAs are a common finding at surveillance colonoscopy in IBD and have several characteristic features. Further studies are needed to evaluate the natural history of these lesions in IBD patients.
Topics: Adenoma; Adult; Aged; Aged, 80 and over; Colitis, Ulcerative; Colonic Neoplasms; Colonic Polyps; Colonoscopy; Coloring Agents; Crohn Disease; Female; Humans; Male; Middle Aged; Population Surveillance; Predictive Value of Tests; Retrospective Studies; User-Computer Interface; Young Adult
PubMed: 25575106
DOI: 10.1155/2014/386540 -
Case Reports in Hematology 2021The portal vein could be occluded by blood clots partially or completely causing portal vein thrombosis (PVT). The acute episode may be asymptomatic or manifested by...
The portal vein could be occluded by blood clots partially or completely causing portal vein thrombosis (PVT). The acute episode may be asymptomatic or manifested by abdominal pain, increasing body temperature, and unspecific dyspeptic symptoms. The main causes of PVT are categorized into local, acquired, and genetic thrombophilic factors. To our knowledge, this is the 2 recognized case of PVT following colectomy for colonic inertia successfully treated with an effective anticoagulation therapy. The patient received unfractionated heparin as soon the diagnosis was implemented. The patient was a 34-year-old lady with chief complaint of severe abdominal pain, nausea, vomiting, and anorexia 10 days after the first hospital admission for subtotal colectomy due to colonic inertia. Spiral abdominal CT scan with intravenous (IV) contrast showed thrombosis in main portal vein with its extension to right and left intrahepatic branches. Our case showed that we should keep in mind PVT in patients who present with upper gastrointestinal symptoms several days after a major surgery (open colectomy) as a risk factor and oral contraceptive pills (OCP) usage, postpregnancy, and immobility as other risk factors, that the protein C, S, and FVL deficiencies were secondary, and that the PVT can be managed by low molecular weight heparin plus oral warfarin therapy in the continue.
PubMed: 33532102
DOI: 10.1155/2021/8895206