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FP Essentials May 2024Peptic ulcer disease (PUD) involves ulceration of the mucosa in the stomach and/or proximal duodenum. The main causes are Helicobacter pylori infection and nonsteroidal... (Review)
Review
Peptic ulcer disease (PUD) involves ulceration of the mucosa in the stomach and/or proximal duodenum. The main causes are Helicobacter pylori infection and nonsteroidal anti-inflammatory drug (NSAID) use. PUD occurs in 5% to 10% of people worldwide, but rates have decreased by more than half during the past 20 years. This reduction is thought to be because of H pylori management, more conservative use of NSAIDs, and/or widespread use of proton pump inhibitors (PPIs). Common symptoms include postprandial abdominal pain, nausea, vomiting, and weight loss. These symptoms have broad overlap with those of other conditions, making clinical diagnosis difficult. Endoscopy is the gold standard for diagnosis, especially in older patients and those with alarm symptoms, but a test-and-treat strategy (noninvasive test for H pylori and treat if positive) can be used for younger patients with no alarm symptoms. Numerous treatment regimens are available, all of which include PPIs plus antibiotics. As an alternative to PPIs, a new triple therapy with vonoprazan (which blocks acid production) plus antibiotics has been approved and appears to be superior to conventional therapy with PPIs plus antibiotics. At least 4 weeks after treatment, repeat testing for H pylori should be obtained to confirm cure. When possible, NSAIDs should be discontinued; when not possible, antisecretory cotherapy should be considered.
Topics: Humans; Peptic Ulcer; Proton Pump Inhibitors; Anti-Inflammatory Agents, Non-Steroidal; Helicobacter Infections; Helicobacter pylori; Anti-Bacterial Agents; Drug Therapy, Combination; Sulfonamides; Pyrroles
PubMed: 38767885
DOI: No ID Found -
Abdominal Radiology (New York) May 2024Acute pancreatitis is associated with local and systemic complications. Pancreatic fluid collection (PFC) is the most common local complication. Infected or symptomatic... (Review)
Review
Acute pancreatitis is associated with local and systemic complications. Pancreatic fluid collection (PFC) is the most common local complication. Infected or symptomatic PFCs need drainage. Endoscopic drainage (ED) is the first-line procedure for accessible PFCs adjacent to the stomach and duodenum. ED is performed under endoscopic ultrasound (EUS) guidance. The technical and clinical success rates of EUS-guided ED in well-encapsulated PFCs are high. ED of poorly encapsulated PFCs is associated with complications. Bleeding and perforation are the most common complications. Contrast-enhanced computed tomography is critical in planning ED and early detection and management of complications. With the increasing utilization of ED for PFC, the radiologist must be familiar with the ED techniques, types of stents, and the complications related to ED. In this review, we discuss the technical aspects of the ED as well as the imaging findings of ED-related complications.
PubMed: 38763937
DOI: 10.1007/s00261-024-04348-y -
Cureus Apr 2024Horseshoe kidney is the most common renal fusion anomaly and is associated with various complications, ranging from infections to neoplasms. While renal cell carcinoma...
Horseshoe kidney is the most common renal fusion anomaly and is associated with various complications, ranging from infections to neoplasms. While renal cell carcinoma (RCC) is the most frequent renal neoplasm in adults, its occurrence in a horseshoe kidney is rare, and bilateral involvement is rarer. Furthermore, RCC metastasizing to organs is known and rare sites of metastasis are also documented. The report presents a unique case of bilateral RCC in a horseshoe kidney with synchronous metastasis to the gallbladder, pancreas, and duodenum. This presentation, involving metastasis to these specific organs, is exceedingly uncommon, making it a rarest of rare possibilities. The current case report underscores the importance of vigilant monitoring and comprehensive evaluation in patients with horseshoe kidneys, as they may be predisposed to unusual complications like RCC and rare site metastasis.
PubMed: 38756314
DOI: 10.7759/cureus.58363 -
Zhongguo Ying Yong Sheng Li Xue Za Zhi... Dec 2023A peptic ulcer is a lesion (sore) on the stomach lining, or duodenum. Peptic ulcers are probably a twentieth-century condition. The ulcer disease continues to be a... (Review)
Review
A peptic ulcer is a lesion (sore) on the stomach lining, or duodenum. Peptic ulcers are probably a twentieth-century condition. The ulcer disease continues to be a significant source of worldwide morbidity and mortality. The Gastrointestinal ulcers and duodenal ulcers are considered the two most extreme types of peptic ulcers. Peptic ulcers are found to be caused by an excess of violent factors including Hydrochloric acid (HCL) pepsin, refluxed bile leukotrienes (LT), reactive oxygen species (ROS) and protective factors, these include mucus-bicarbonate barrier functions, prostaglandins (PGs), mucosal blood flow, cell regeneration and migration, non-enzymatic and enzymatic and certain growth factors. The primary cause of peptic ulcer disease is pylori infection and the use of NSAIDs. This review article underscores the importance of a multidisciplinary approach in the management of ulcers to improve patient outcomes and quality of life.
Topics: Humans; Peptic Ulcer
PubMed: 38755116
DOI: 10.62958/j.cjap.2023.006 -
Journal of Autoimmunity Jun 2024Many antibody responses induced by infection, vaccination or autoimmunity show signs of convergence across individuals with epitope-dependent selection of particular...
Many antibody responses induced by infection, vaccination or autoimmunity show signs of convergence across individuals with epitope-dependent selection of particular variable region gene segments and complementarity determining region 3 properties. However, not much is known about the relationship between antigen-specific effector cells and antigen-specific precursors present in the naïve B-cell repertoire. Here, we sought to address this relationship in the context of celiac disease, where there is a stereotyped autoantibody response against the enzyme transglutaminase 2 (TG2). By generating TG2-specific monoclonal antibodies from both duodenal plasma cells and circulating naïve B cells, we demonstrate a discord between the naïve TG2-specific repertoire and the cells that are selected for autoantibody production. Hence, the naïve repertoire does not fully reflect the epitope preference and gene usage observed for memory B cells and plasma cells. Instead, distinct naïve B cells that target particular TG2 epitopes appear to be selectively activated at the expense of TG2-binding B cells targeting other epitopes.
Topics: Celiac Disease; Humans; Autoantibodies; Transglutaminases; Protein Glutamine gamma Glutamyltransferase 2; Epitopes, B-Lymphocyte; GTP-Binding Proteins; Lymphocyte Activation; B-Lymphocytes; Plasma Cells; Female; Antibodies, Monoclonal; Epitopes; Male; Adult; Duodenum
PubMed: 38754235
DOI: 10.1016/j.jaut.2024.103241 -
Heliyon May 2024The reasons for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were complex. Here we present an unusual case of...
BACKGROUND
The reasons for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were complex. Here we present an unusual case of life-threatening gastrointestinal bleeding caused by a cytomegalovirus-induced duodenal ulcer in an AIDS patient.
CASE PRESENTATION
A 31-year-old male with AIDS was admitted on July 18, 2023, complaining of abdominal pain for 38 days and intermittent hematochezia for 12 days. During his hospitalization, gastrointestinal endoscopy attributed gastrointestinal bleeding to a giant duodenal ulcer. Furthermore, cytomegalovirus(CMV) infection was confirmed as the reason for the ulcer through metagenomic next-generation sequencing (mNGs), hematoxylin-eosin(HE) staining, and immunohistochemistry (IHC) staining for the biopsy tissue. The patient's gastrointestinal bleeding was stopped by interventional embolization. Following a 4-week course of anti-CMV treatment, the giant duodenal ulcer was cured.
CONCLUSIONS
For AIDS patients with gastrointestinal bleeding, the CMV-induced gastrointestinal ulcer should be considered. Comprehensive mothods (mNGs, HE staining and IHC staining for biopsy tissue) were benefit for confirmed diagnosis. Beside anti-CMV treatment, the interventional embolization is a choice for hemostasis.
PubMed: 38737287
DOI: 10.1016/j.heliyon.2024.e30112 -
Animals : An Open Access Journal From... Apr 2024ser. Enteritidis () is widely found in chickens and eggs, and it can potentially induce human illness. The investigation in this study centers on the impacts of...
ser. Enteritidis () is widely found in chickens and eggs, and it can potentially induce human illness. The investigation in this study centers on the impacts of long-term dietary supplementation with coated sodium butyrate (CSB) on intestinal well-being and the colonization of cecum in laying hens infected with We segregated a total of 120 Lohmann laying hens aged 51 weeks into four treatment categories: 0 (CON), 300 (CSB1), 500 (CSB2), and 800 (CSB3) mg/kg of CSB, supplemented with CSB from the first day of the experiment. A 24-week observation process was carried out for each laying hen. The was orally administered to all chickens on the morning of the first and third days of week 22 of the trial. After the challenge, egg production decreased the most in the CON group. Compared to the CON group, the three doses of CSB significantly improved egg production after the challenge ( < 0.05). challenge increased plasma DAO activity, but CSB supplementation reduced plasma DAO activity ( < 0.05). The challenge disrupted intestinal villi morphology; compared to the CON group, the three dosages of CSB resulted in an increase in villus height (VH) and the ratio of villus height to crypt depth (V/C) in the duodenum, jejunum, and ileum of infected laying hens ( < 0.05), with a significant increase in jejunal villus height ( < 0.05). A decrease in ileal crypt depth was also observed ( < 0.05). CSB2 and CSB3 markedly increased the content of butyric acid in the cecum ( < 0.05). Additionally, in contrast to those in the CON group, the propionic acid content in the CSB supplementation group increased ( < 0.05). Compared with those in the CON group, mRNA relative expression of the and in jejunum ( < 0.05) and mRNA relative expression of the in ileum ( < 0.05) were significantly lower, and mRNA relative expression of the in ileum ( < 0.05) were significantly higher in the CSB group. In addition, in contrast to the CON group, the CSB supplementation group significantly upregulated mRNA relative expression of the and ( < 0.05). Additionally, CSB supplementation reduced the number of and increased the number of Lactobacilli in the cecum ( < 0.05) and tended to increase the total bacteria count ( = 0.069) and reduce the count ( = 0.081). In conclusion, long-term dietary supplementation with coated sodium butyrate can alleviate intestinal injury and the colonization of cecum in laying hens infected with .
PubMed: 38731359
DOI: 10.3390/ani14091356 -
Scientific Reports May 2024Coccidiosis, an intestinal disease caused by Eimeria parasites, is responsible for major losses in the poultry industry by impacting chicken health. The gut microbiota...
Coccidiosis, an intestinal disease caused by Eimeria parasites, is responsible for major losses in the poultry industry by impacting chicken health. The gut microbiota is associated with health factors, such as nutrient exchange and immune system modulation, requiring understanding on the effects of Eimeria infection on the gut microbiota. This study aimed to determine the effects of Eimeria acervulina infection on the luminal and mucosal microbiota of the cecum (CeL and CeM) and ileum (IlL and IlM) at multiple time points (days 3, 5, 7, 10, and 14) post-infection. E. acervulina infection decreased evenness in CeL microbiota at day 10, increased richness in CeM microbiota at day 3 before decreasing richness at day 14, and decreased richness in IlL microbiota from day 3 to 10. CeL, CeM, and IlL microbiota differed between infected and control birds based on beta diversity at varying time points. Infection reduced relative abundance of bacterial taxa and some predicted metabolic pathways known for short-chain fatty acid production in CeL, CeM, and IlL microbiota, but further understanding of metabolic function is required. Despite E. acervulina primarily targeting the duodenum, our findings demonstrate the infection can impact bacterial diversity and abundance in the cecal and ileal microbiota.
Topics: Animals; Chickens; Cecum; Eimeria; Ileum; Coccidiosis; Gastrointestinal Microbiome; Poultry Diseases; Intestinal Mucosa
PubMed: 38729976
DOI: 10.1038/s41598-024-61299-6 -
JGH Open : An Open Access Journal of... May 2024represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa...
Endoscopic mucosal phenotypes and endoscopic Sydney system gastritis assessment in relation to infection and upper digestive clinical signs: A 2-year study among patients with gastroduodenal disorders in Cameroon.
BACKGROUND AND AIM
represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa in relation to infection in Cameroon.
METHODS
This study was conducted in three reference health facilities in Cameroon from October 2020 to October 2022. The study enrolled 494 consecutive volunteer dyspeptic patients attending to the gastroenterology department of the selected health facilities. A description of the aspect of gastric mucosa of all participants was performed during endoscopy examination, and biopsies were collected for detection using rapid urease tests.
RESULTS
Gastritis, ulcerated lesions, duodenitis, esophagitis, normal mucosa aspect, bulbitis, and gastric neoplastic lesions were found in 40.1, 22.3, 10.9, 10.3, 9.7, 6.3, and 0.40% of biopsy samples, respectively. Erythematous/exudative (45.9%) and enterogastric reflux (12.2%) were the main gastritis types recorded. was present in 58.1, 46.3, 87.1, 66.7, and 61.8% in gastritis, duodenitis, bulbitis, esophagitis, and ulcerated lesions, respectively. A positive relationship was noticed between the presence of and gastritis (1.037 [0.720-1.493]; = 0.845), bulbitis (4.237 [1.602-11.235]; = 0.004), esophagitis (1.515 [0.822-2.793]; = 0.183), ulcerated lesions (1.233 [0.798-1.904]; = 0.345), erythematous/exudative gastritis (1.354 [0.768-2.389]; = 0.295), and enterogastric reflux gastritis (1.159 [0.492-2.733]; = 0.736).
CONCLUSION
Gastritis and erythematous/exudative gastritis are the most frequent gastrointestinal pathophysiology conditions in dyspeptic patient in our milieu. infection is responsible for 94.8% of the gastrointestinal pathophysiology conditions with bulbitis as the condition is significantly associated with this bacterium infection.
PubMed: 38725943
DOI: 10.1002/jgh3.13060 -
Turkish Journal of Surgery Dec 2023Secondary peritonitis is caused by infection of the peritoneal cavity due to perforation of the alimentary tract. Mannheim's peritonitis ındex (MPI) is a prognostic...
OBJECTIVES
Secondary peritonitis is caused by infection of the peritoneal cavity due to perforation of the alimentary tract. Mannheim's peritonitis ındex (MPI) is a prognostic scoring system that predicts outcomes in peritonitis. Increasing MPI scores correlate with poor outcomes and mortality. The objective of this study is to evaluate the effectiveness of MPI-based prognosis and its impact on Indian patients with secondary peritonitis.
MATERIAL AND METHODS
For understanding the effectiveness of the MPI scoring system, a cross-sectional data analysis of published studies on secondary peritonitis from 10 geographical locations in India was performed. The 10-site study results were compared with unpublished in-house study data for individual MPI parameters to analyze any variations of MPI score-based predictions across a diverse Indian population. Patients were divided into risk groups on the basis of MPI scores: <21 mild, MPI= 21-29 moderate, MPI> 29 severe risk.
RESULTS
We observed a significant correlation between mortality with age and gender as reported worldwide. Site of perforations were prevalent in the upper alimentary tract with the majority being gastro-duodenal for the Indian population as opposed to distal parts in the western population. Higher lethality in India is often associated with evolution time, organ failure, and sepsis due to delayed presentation and poor management.
CONCLUSION
MPI scoring is effective in predicting risk across geographically diverse Indian populations. The sensitivity and specificity of MPI scores are more reliable and a score >29 specifically recommends aggressive resuscitation & monitoring of patients, initiation of broad-spectrum antibiotics, and intensive care support to reduce mortality and morbidity.
PubMed: 38694533
DOI: 10.47717/turkjsurg.2023.6043