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Revista Espanola de Enfermedades... Mar 2024A 69-year-old male, three years post-endovascular exclusion for an abdominal aortic aneurysm, presented with asthenia and fever. An abdominal CT scan showed no...
A 69-year-old male, three years post-endovascular exclusion for an abdominal aortic aneurysm, presented with asthenia and fever. An abdominal CT scan showed no gastrointestinal tract communications, abscess, or contrast extravasation. Tc-99m-HMPAO-labeled leukocytes scintigraphy with SPECT/CT revealed increased uptake on the posterior surface of the aortic graft, along with air bubbles in its right iliac limb. Upper gastrointestinal endoscopy was performed, revealing a duodenal ulcer in the transition between the second and third portions. The ulcer exhibited yellow graft tissue at its center. The patient underwent in situ reconstruction, involving the replacement of the infected prosthetic graft, and the duodenal defect was addressed through segmental resection and duodenojejunal anastomosis. Secondary aorto-duodenal fistula (SADF), a rare complication of vascular surgery, may arise from factors such as local infection or graft-bowel contact. SADF, often located in the duodenum, poses a high mortality risk, necessitating early diagnosis. Clinical presentation varies from significant upper gastrointestinal bleeding to obscured bleeding.
PubMed: 38469815
DOI: 10.17235/reed.2024.10358/2024 -
Poultry Science Aug 2023The poultry industry has not been spared from the prevalent incidence of diseases caused by invasive pathogens, especially Salmonella. Due to the pressing need to...
Red osier dogwood extract versus Trimethoprim-sulfadiazine (Part 1). Effects on the growth performance, blood parameters, gut histomorphometry, and Salmonella excretion of broiler chickens orally challenged with Salmonella Enteritidis.
The poultry industry has not been spared from the prevalent incidence of diseases caused by invasive pathogens, especially Salmonella. Due to the pressing need to identify a suitable antibiotic alternative for use in poultry production, this study investigated the efficacy of red osier dogwood (ROD) extract on the growth, blood parameters, gut morphology, and Salmonella excretion in broiler chickens orally challenged with Salmonella Enteritidis (SE). A 4 × 2 factorial experiment was conducted based on 2 main factors, namely dietary treatments, and SE challenge. A total of 404, one-day-old male Ross broiler chicks were randomly assigned to 4 dietary treatments; 1) Negative control (NC), 2) NC + 0.075 ppm of Trimethoprim-sulfadiazine (TMP/SDZ)/kg of diet, 3) NC + 0.3% ROD extract, and 4) NC + 0.5% ROD extract. The absence of SE in the fecal samples obtained from chick delivery boxes was confirmed on d 0. On d 1, half of the birds were orally gavaged with 0.5 mL of phosphate-buffered saline each (noninfected group) and the remaining with 0.5 mL of 3.1 × 10 CFU/mL SE (infected group) in all treatment groups. Dietary treatments were randomly assigned to 8 replicate cages at 6 birds/cage. On 1-, 5-, 12-, and 18-day postinfection (DPI), cloacal fecal samples were collected on the 6 birds/cage to assess SE excretion. Average weight gain (AWG), average feed intake (AFI), feed conversion ratio (FCR), and mortality were determined weekly. On d 21, 10 chickens/treatment were euthanized to perform hematology, gut histomorphometry, serum immunoglobulins G and M (IgG and IgM), and superoxide dismutase measurements. Both ROD extract levels did not affect (P > 0.05) growth performance; however, the SE-infected birds showed increased (P < 0.05) AFI and FCR throughout the experimental period. Regardless of the SE-infection, both ROD extract levels improved (P < 0.05) duodenal villus height: crypt depth compared to other treatments. 0.5% ROD extract improved (P < 0.05) ileal villus width (VW) of noninfected birds and ileal crypt depth of infected birds, but it decreased (P < 0.05) the ileal VW of infected birds, compared to other treatments. The SE-infected birds showed lower (P < 0.05) lymphocytes (L) but increased (P < 0.05) heterophils (H), H:L, and monocytes (MON). Both ROD extract levels did not affect (P > 0.05) white blood cell differential, while dietary 0.3% ROD extract increased (P < 0.05) MON of the birds, regardless of infection model. Regardless of infection model, both TMP/SDZ and 0.5% ROD extract reduced the concentration of IgM in the serum, compared to the control and 0.3% ROD (P = 0.006). Conclusively, both ROD extract levels improved duodenal histomorphology and body defense against SE infection in broiler chickens; however, the 0.3% ROD extract was better.
Topics: Animals; Male; Chickens; Salmonella enteritidis; Cornus; Trimethoprim; Sulfadiazine; Diet; Immunoglobulin M; Animal Feed; Poultry Diseases; Dietary Supplements; Salmonella Infections, Animal
PubMed: 37406598
DOI: 10.1016/j.psj.2023.102723 -
Veterinary Microbiology Mar 2024Swine enteric coronaviruses, such as porcine epidemic diarrhea virus (PEDV) or transmissible gastroenteritis virus (TGEV), have risen concern for the porcine industry...
Swine enteric coronaviruses, such as porcine epidemic diarrhea virus (PEDV) or transmissible gastroenteritis virus (TGEV), have risen concern for the porcine industry and research community due to the increase in their virulence, their potential recombination capacity and the emergence of new variants. This in vivo study aims to compare the impact of three different strains of swine enteric coronaviruses [(two G1b (S-INDEL) PEDV strains and a recombinant TGEV-PEDV or Swine enteric coronavirus (SeCoV)] in the intestine of 3-weeks-old infected piglets, focusing on the pathology and main components of the intestinal barrier, including the number of goblet cells, and the expression of IgA as well as FoxP3, a regulatory T cell marker. Severity of lesions was evidenced in the three infected groups and was highly correlated with the viral load in feces and the frequency of viral antigen-positive cells. Furthermore, higher cellular death together with an increase in the expression of the FoxP3 marker was detected in the duodenum and jejunum of infected animals at 3 days post-infection. Our results highlight a recruitment of FoxP3 cells in the small intestine of infected animals which may represent a response to the tissue damage caused by viral replication and cell death. Further studies should be addressed to determine the potential role of these cells during swine enteric coronavirus infections.
Topics: Swine; Animals; Coronavirus; Swine Diseases; Coronavirus Infections; Intestine, Small; Porcine epidemic diarrhea virus; Transmissible gastroenteritis virus; Forkhead Transcription Factors
PubMed: 38217919
DOI: 10.1016/j.vetmic.2023.109956 -
BioRxiv : the Preprint Server For... May 2024Human noroviruses (HuNoVs) are the leading cause of acute gastroenteritis worldwide. Currently, there are no targeted antivirals for the treatment of HuNoV infection....
Human noroviruses (HuNoVs) are the leading cause of acute gastroenteritis worldwide. Currently, there are no targeted antivirals for the treatment of HuNoV infection. Histo-blood group antigens (HBGAs) on the intestinal epithelium are cellular attachment factors for HuNoVs; molecules that block the binding of HuNoVs to HBGAs thus have the potential to be developed as antivirals. Human milk oligosaccharides (HMOs) are glycans in human milk with structures analogous to HBGAs. HMOs have been shown to act as decoy receptors to prevent the attachment of multiple enteric pathogens to host cells. Previous X-ray crystallography studies have demonstrated the binding of HMO 2'-fucosyllactose (2'FL) in the same pocket as HBGAs for some HuNoV strains. We evaluated the effect of 2'FL on the replication of a globally dominant GII.4 Sydney [P16] HuNoV strain using human intestinal enteroids (HIEs) from adults and children. A significant reduction in GII.4 Sydney [P16] replication was seen in duodenal and jejunal HIEs from multiple adult donors, all segments of the small intestine from an adult organ donor and in two pediatric duodenal HIEs. However, 2'FL did not inhibit HuNoV replication in two infant jejunal HIEs that had significantly lower expression of α1-2-fucosylated glycans. 2'FL can be synthesized in large scale, and safety and tolerance have been assessed previously. Our data suggest that 2'FL has the potential to be developed as a therapeutic for HuNoV gastroenteritis.
PubMed: 38853945
DOI: 10.1101/2024.05.30.596597 -
Frontiers in Medicine 2024Purse-string suture with nylon cords and metal clips under the endoscope is a novel therapeutic technique which is minimally invasive and it is particularly indicated...
Purse-string suture with nylon cords and metal clips under the endoscope is a novel therapeutic technique which is minimally invasive and it is particularly indicated for the closure and repair of gastrointestinal fistula or perforations such as duodenal fistulae. Duodenal fistulae are often caused by medical manipulation, disease progression or trauma. Once this occurs, it leads to a series of pathophysiologic changes and a variety of complications. In most cases, these complications will exacerbate the damage to the organism, and the complications are difficult to treat and can lead to infections, nutrient loss, multi-organ dysfunction and many other adverse effects. In this case report, the use of endoscopic nylon cords combined with purse-string suture and metal clips in the treatment of duodenal fistula is presented and discussed. The patient was treated with endoscopic purse-string suture and the duodenal fistula was significantly improved. The results indicate that endoscopic purse-string suture is an effective strategy for the treatment of duodenal fistulae.
PubMed: 38947235
DOI: 10.3389/fmed.2024.1403218 -
Journal of Pharmacy & Bioallied Sciences Feb 2024This study aimed to study the awareness and practice of patients with () toward their disease in the Riyadh region, Saudi Arabia.
OBJECTIVE
This study aimed to study the awareness and practice of patients with () toward their disease in the Riyadh region, Saudi Arabia.
MATERIAL AND METHODS
This is a descriptive cross-sectional community-based study, in the central region of the kingdom. The target population of this study was adult patients with infection, and a sample of 808 Saudi and non-Saudi male and female individuals were randomly selected using an online questionnaire. A consent form was obtained from all participants. Ethical approval was obtained from the university ethics committee.
RESULTS
There were a total of 808 responses. Most participants were female (89.4%) (n = 722) and between the ages of 35 and 60 years (60.8%), and most participants had a bachelor's degree (62.4%). 53.47% of the participants have good knowledge regarding their disease. Most of the participants knew it could cause gastric and duodenal ulcers (82.5%), but they did not know the infection might cause gastric cancer (48.6%).
CONCLUSION
The study concluded that the majority of patients with infection (53.47%) have good knowledge regarding their disease. Additionally, many participants were aware of the symptoms associated with . Furthermore, many participants complained about their treatment.
PubMed: 38595531
DOI: 10.4103/jpbs.jpbs_755_23 -
Revista Espanola de Enfermedades... Oct 2023A 35-year old male from Brazil presented with intermittent abdominal pain. Abdominal computed tomography revealed a nodule adjacent to splenic hilum and multiple...
A 35-year old male from Brazil presented with intermittent abdominal pain. Abdominal computed tomography revealed a nodule adjacent to splenic hilum and multiple abdominal nodules, suspicious of carcinomatosis. The patient underwent gastroscopy and endoscopic ultrasound (EUS), that revealed an ill-defined hypoechogenic lesion adjacent to the spleen and two hypoechogenic subepithelial lesions located in the 4th layer of the stomach and duodenal bulb. Biopsies revealed non-necrotizing granulomatous inflammation with multinucleated giant cells. Soon after, a 18cm palpable mass within the rectus abdominis muscle was identified, and the biopsy was positive for Mycobacterium tuberculosis DNA, confirming the diagnosis of disseminated abdominal tuberculosis.
Topics: Male; Humans; Adult; Tuberculosis; Abdomen; Spleen; Stomach; Gastroscopy
PubMed: 37539521
DOI: 10.17235/reed.2023.9855/2023 -
Cureus Jul 2023Brunner's gland hyperplasia is an uncommon pathology from the duodenum and is believed to be associated with infection with . Patients commonly present with...
Brunner's gland hyperplasia is an uncommon pathology from the duodenum and is believed to be associated with infection with . Patients commonly present with gastrointestinal bleeding, nausea, or abdominal pain. However, obstruction is an unusual clinical finding. A 47-year-old male presented to the emergency department with complaints of recurrent emesis, epigastric pain, and cramping for three days. Medical history was significant for duodenitis and diverticulitis, but there had been no prior abdominal surgeries. Epigastric tenderness to palpation without rebound tenderness was present on physical examination, stool antigen was positive on admission, and treatment with triple therapy was initiated. Progressively the patient developed increasing emesis, with an associated cessation in flatus and bowel movements. On endoscopy, it was reported that the endoscope could not advance past the second portion of the duodenum. A nasogastric tube was placed for gastric decompression. Small bowel follow-through showed obstruction at the distal second duodenal segment. Bismuth quadruple therapy was initiated on day three. Push enteroscopy showed luminal narrowing and a transition point at the second duodenal segment with no identifiable mass or significant ulceration. Biopsy reports indicated Brunner's gland hyperplasia. By day seven, the patient reported increased bowel movements and flatus, with a resolution of his nausea and emesis, and the nasogastric tube was removed. The patient was discharged on day eight with outpatient prescriptions for quadruple therapy for six days. He was also instructed to follow up with the general surgery and gastroenterology teams for outpatient colonoscopy six weeks post-discharge and with his primary care physician (PCP) four weeks after completing quadruple therapy to ensure eradication. Studies have shown that were detected in most patients with Brunner's gland hyperplasia and may induce proliferation in Brunner's glands. Brunner's gland hyperplasia has a low incidence, with minimal cases reported. There is malignant potential but a low risk of progression into adenocarcinoma. Our case reinforces the idea that Brunner's gland hyperplasia should be included in the work-up, alongside testing for infection with in assessing patients with gastric obstruction.
PubMed: 37408935
DOI: 10.7759/cureus.41351 -
BMC Gastroenterology Apr 2024Endoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic...
BACKGROUND
Endoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic characteristics of patients diagnosed with iTAM.
METHODS
This retrospective analysis included 14 patients pathologically diagnosed with iTAM after stem cell transplantation for hematolymphoid neoplasms (n = 13) or thalassemia (n = 1). The sex, age at diagnosis, endoscopic features, and prognosis of each patient were assessed. Serological markers for diagnosing transplant-associated thrombotic microangiopathy were also evaluated.
RESULTS
The mean age at the time of iTAM diagnosis was 40.2 years. Patients diagnosed based on the pathognomonic pathological changes of iTAM presented with diverse symptoms at the times of endoscopic examinations, including diarrhea (n = 10), abdominal pain (n = 5), nausea (n = 4), appetite loss (n = 2), bloody stools (n = 2), abdominal discomfort (n = 1), and vomiting (n = 1). At the final follow-up, six patients survived, while eight patients succumbed, with a median time of 100.5 days (range: 52-247) post-diagnosis. Endoscopic manifestations included erythematous mucosa (n = 14), erosions (n = 13), ulcers (n = 9), mucosal edema (n = 9), granular mucosa (n = 9), and villous atrophy (n = 4). Erosions and/or ulcers were primarily observed in the colon (10/14, 71%), followed by the ileum (9/13, 69%), stomach (4/10, 40%), cecum (5/14, 36%), duodenum (3/10, 30%), rectum (4/14, 29%), and esophagus (1/10, 10%). Cytomegalovirus infection (n = 4) and graft-versus-host disease (n = 2) coexisted within the gastrointestinal tract. Patients had de novo prolonged or progressive thrombocytopenia (6/14, 43%), decreased hemoglobin concentration (4/14, 29%), reduced serum haptoglobin level (3/14, 21%), and a sudden and persistent increase in lactate dehydrogenase level (2/14, 14%). Peripheral blood samples from 12 patients were evaluated for schistocytes, with none exceeding 4%.
CONCLUSIONS
This study provides a comprehensive exploration of the endoscopic characteristics of iTAM. Notably, all patients exhibited erythematous mucosa throughout the gastrointestinal tract, accompanied by prevalent manifestations, such as erosions (93%), ulcers (64%), mucosal edema (64%), granular mucosa (64%), and villous atrophy (29%). Because of the low positivity for serological markers of transplant-associated thrombotic microangiopathy in patients with iTAM, endoscopic evaluation and biopsy of these lesions are crucial, even in the absence of these serological features.
Topics: Humans; Male; Female; Adult; Retrospective Studies; Middle Aged; Thrombotic Microangiopathies; Young Adult; Intestinal Mucosa; Endoscopy, Gastrointestinal; Adolescent; Hematologic Neoplasms; Stem Cell Transplantation; Intestinal Diseases; Diarrhea; Hematopoietic Stem Cell Transplantation; Aged
PubMed: 38649868
DOI: 10.1186/s12876-024-03221-y -
Frontiers in Cellular and Infection... 2023Enterotoxigenic (ETEC), an important intestinal pathogen, poses a significant threat to the intestinal health of piglets. (BC), a potential feed additive, can improve...
BACKGROUND
Enterotoxigenic (ETEC), an important intestinal pathogen, poses a significant threat to the intestinal health of piglets. (BC), a potential feed additive, can improve the intestinal function of piglets. However, the effects of BC on growth performance and intestinal function in ETEC-infected piglets are still unclear. In this study, 24 7-day-old piglets were randomly assigned to three treatment groups: control group (fed a basal diet), ETEC group (fed a basal diet and challenged with ETEC K88) and BC+ETEC group (fed a basal diet, orally administered BC, challenged with ETEC K88). During Days 1-6 of the trial, piglets in the BC+ETEC group were orally administered BC (1×10CFU/kg). On Day 5 of the trial, piglets in the ETEC and BC+ETEC groups were orally administered ETEC K88 (5×10CFU/piglet). Blood, intestinal tissue, and content samples were collected from the piglets on Day 7 of the trial.
RESULTS
The average daily feed intake in the ETEC group was significantly reduced compared to that of the control group. Further research revealed that ETEC infection significantly damaged the structure of the small intestine. Compared to the control group, the villus height and surface area of the jejunum, the ratio of villus height to crypt depth in the duodenum and jejunum, and the activities of catalase and total superoxide dismutase in the jejunum were significantly reduced. Additionally, the levels of myeloperoxidase in the jejunum, malondialdehyde in the plasma and jejunum, and intestinal epithelial apoptosis were significantly increased in the ETEC group. However, BC supplementation had significantly mitigated these negative effects in the BC+ETEC group by Day 7 of the trial. Moreover, BC supplementation improved the gut microbiota imbalance by reversing the decreased numbers of , and in jejunum and , and in the colon, as well as the increased number of in the jejunum induced by ETEC K88.
CONCLUSIONS
Overall, BC supplementation reduced the decline in average daily feed intake in ETEC K88-infected piglets by attenuating intestinal epithelial apoptosis and oxidative stress and regulating the gut microbiota. This suggests that BC may be used to prevent intestinal infections caused by ETEC in piglets.
Topics: Animals; Bacillus coagulans; Eating; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Gastrointestinal Microbiome; Intestines; Swine; Swine Diseases
PubMed: 38035331
DOI: 10.3389/fcimb.2023.1284166