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Veterinary World Mar 2024The pathogenesis of staphylococcal infections is mediated by virulence factors, such as enzymes, toxins, and biofilms, which increase the resistance of microorganisms to...
BACKGROUND AND AIM
The pathogenesis of staphylococcal infections is mediated by virulence factors, such as enzymes, toxins, and biofilms, which increase the resistance of microorganisms to host immune system evasion. Testing and searching for standardized multi-level algorithms for the indication and differentiation of biofilms at the early stages of diagnosis will contribute to the development of preventive measures to control the critical points of technology and manage dangerous risk factors for the spread of infectious diseases. This research aimed to study the main stages of s biofilm formation in experiments and to analyze the dynamics of respiratory syndrome development in chickens infected with these bacteria.
MATERIALS AND METHODS
Experimental reproduction of the infectious process was performed using laboratory models: 10-day-old White Leghorn chickens (n = 20). Before the experiments, the birds were divided into two groups according to the principle of analogs: Group I (control, n = 10): the birds were intranasally inoculated with 0.5 cm of 0.9% NaCl solution; Group II (experiment, n = 10): the birds were intranasally inoculated with a suspension of bacteria, 0.5 cm, concentration 1 billion/cm.
RESULTS
Colonization of individual areas of the substrate under study occurred gradually from the sedimentation and adhesion of single motile planktonic cells to the attachment stage of microcolony development. Staining preparations with gentian violet due to the "metachromosia" property of this dye are a quick and fairly simple way to differentiate cells and the intercellular matrix of biofilms. Fixation with vapors of glutaraldehyde and osmium tetroxide preserves the natural architecture of biofilms under optical and scanning electron microscopy. Pure cultures of microorganisms were isolated from the blood, lungs, small intestine, liver, kidneys, and spleen after 5-10 days during experimental infection of chickens. Clinical signs of respiratory syndrome developed within 5-6 days after infection. Acute and subacute serous-fibrinous airsacculitis, characterized by edema and thickening of the membranes of the air sacs and the presence of turbid, watery, foamy contents in the cavity, was the most characteristic pathomorphological sign. The signs of acute congestive hyperemia and one-sided serous-fibrinous pneumonia developed with significant thickening of fibrinous deposits. In Garder's gland, there was an increase in the number of secretory sections, indicating hypersecretion of the glands. In the lymphoid follicles of Meckel's diverticulum, leukocytes, usually lymphocytes, and pseudoeosinophils were detected.
CONCLUSIONS
Hydration and heteromorphism of the internal environment of biofilms determine the localization of differentiated cells in a three-dimensional matrix for protection against adverse factors. The most characteristic pathomorphological sign was the development of acute and subacute serous-fibrinous airsacculitis when reproducing the infectious process in susceptible models. There was a significant thickening of fibrinous deposits and signs of acute congestive hyperemia and one or two serous-fibrinous pneumonia developed.
PubMed: 38680142
DOI: 10.14202/vetworld.2024.612-619 -
ACG Case Reports Journal Apr 2024Meckel diverticulum is the most common congenital variation of the gastrointestinal tract arising from incomplete obliteration of the vitelline duct during gestation. In...
Meckel diverticulum is the most common congenital variation of the gastrointestinal tract arising from incomplete obliteration of the vitelline duct during gestation. In most cases, individuals are asymptomatic. This is a case of a 38-year-old patient with hematochezia in whom Meckel diverticulum was diagnosed. A mass was identified within the diverticulum. Histopathological and immunohistochemical studies revealed a well-differentiated neuroendocrine tumor. The development of tumors in Meckel diverticulum is rare, and when identified, only 0.5%-3.2% of these tumors are found to be malignant. Furthermore, gastrointestinal bleeding is an infrequent clinical feature of neuroendocrine tumors. A unique aspect of this case was that numerous imaging studies and endoscopic procedures were unable to definitively identify the presence of Meckle diverticulum and underlying neuroendocrine tumor. Through a high clinical suspicion and collaboration with surgical colleagues, an exploratory laparotomy was performed, which ultimately led to the identification and diagnosis of the underlying pathology.
PubMed: 38638202
DOI: 10.14309/crj.0000000000001345 -
Cureus Mar 2024Perforated bowel and adhesive intestinal obstruction are common indications for emergency surgical intervention in a preterm neonate. The initial approach to managing...
Perforated bowel and adhesive intestinal obstruction are common indications for emergency surgical intervention in a preterm neonate. The initial approach to managing perforation involves either peritoneal drain insertion or formal laparotomy. Once a neonate presents with complete bowel obstruction, prompt abdominal exploration becomes crucial. One prevalent cause of bowel obstruction in this population is adhesions resulting from previous surgeries. This report details the case of a preterm, extremely low birth weight neonate experiencing pneumoperitoneum, initially managed with an intraperitoneal drain. Despite temporary improvement, the infant developed recurrent pneumoperitoneum, necessitating formal exploratory laparotomy. Approximately one month post-surgery, the baby encountered complete bowel obstruction due to adhesive intestinal obstruction, requiring a second exploratory laparotomy. The child survived both surgical interventions and is thriving at follow-up. Our findings suggest that in select cases, intraperitoneal drain placement may suffice. However, there is a need for further research to improve the suspicion and diagnosis of Meckel's diverticulum perforations in neonates. Additionally, vigilant assessment and timely intervention for adhesive intestinal obstruction can enhance bowel salvage outcomes.
PubMed: 38618400
DOI: 10.7759/cureus.56208 -
Frontiers in Pediatrics 2024Enhanced recovery after surgery (ERAS) has been widely used in adult surgery. However, few studies have reported the efficacy of ERAS in paediatric patients with...
BACKGROUND
Enhanced recovery after surgery (ERAS) has been widely used in adult surgery. However, few studies have reported the efficacy of ERAS in paediatric patients with Meckel's diverticulum (MD), the aim of the study was to prospectively evaluate the safety and efficacy of ERAS in treating MD.
METHODS
A prospective randomised controlled study of children with MD admitted to our hospital from Jan 1, 2021 to Dec 31, 2023 were conducted, we developed and implemented an ERAS program for this patients. All cases were strictly selected according to the inclusion and exclusion criteria. Among these patients, they were randomly assigned to the ERAS group or the traditional (TRAD) group with random number table row randomization. The main observational indicators were operation time, intraoperative hemorrhage, FLACC pain scale results on 2 h, 6 h, 12 h, 24 h after surgery, length of postoperative stay (LOPS), time to first defecation, time to first eating after surgery, time to discontinuation of intravenous infusion, total treatment cost, incidence of postoperative complications, 30-day readmission rate and parental satisfaction rate.
RESULTS
A total of 50 patients underwent Meckel's diverticulectomy during this period, 7 patients were excluded, 23 patients were assigned to the ERAS group and 20 patients were assigned to the TRAD group. There were no significant differences in demographic data and operation time, intraoperative hemorrhage. The FLACC pain scale results on 2 h, 6 h, 12 h, 24 h after surgery were significantly lower in the ERAS group. The LOPS was 6.17 ± 0.89 days in the ERAS group and 8.30 ± 1.26 days in the TRAD group, resulting in a significantly shorter LOPS in ERAS group. ERAS could also reduce the first postoperative defecation time, the time to first eating after surgery and the time to discontinuation of intravenous infusion. The treatment cost was decreased in the ERAS group. The rate of complications and 30-day readmission were not significantly different between the two groups.
CONCLUSIONS
In this single-center study, the ERAS protocol for patients with MD requiring surgery was safe and effective.
PubMed: 38590767
DOI: 10.3389/fped.2024.1378786 -
The American Journal of Case Reports Apr 2024BACKGROUND Meckel's diverticulum is a congenital remnant of the omphalomesenteric duct and is the most common congenital gastrointestinal malformation. Most patients are...
BACKGROUND Meckel's diverticulum is a congenital remnant of the omphalomesenteric duct and is the most common congenital gastrointestinal malformation. Most patients are asymptomatic, but a rare presentation is with subacute small bowel obstruction (SBO) due to herniation of bowel loops through an internal hernia formed by the Meckel's diverticulum and adjacent mesentery that forms an internal hernia. This report is of a 15-year-old girl presenting as an emergency with vomiting and small bowel obstruction due to an internal hernia associated with Meckel's diverticulum. CASE REPORT We present a case of a 15-year-old girl who presented to the Children's Emergency (CE) department with persistent vomiting and abdominal distension and tenderness. X-rays demonstrated dilated small bowel loops, prompting admission under Pediatric Surgery (PAS). A subsequent computed tomography (CT) scan was performed, which demonstrated multiple dilated small bowel loops, confirming SBO, and a blind-ending "C-shaped" bowel loop at the region of the terminal ileum. A diagnostic laparotomy was performed, which confirmed the presence of a Meckel's diverticulum. The tip of the Meckel's diverticulum was adherent to part of the small bowel mesentery, forming an internal hernia defect through which a loop of proximal ileum had herniated, resulting in SBO. She then underwent a laparoscopy-assisted transumbilical Meckel's diverticulectomy (LATUM). The patient recovered uneventfully and was discharged on the 4th postoperative day. CONCLUSIONS In children presenting with SBO, the possibility of Meckel's diverticulum as an etiology should be considered as a differential diagnosis. Early diagnosis and prompt intervention will improve clinical outcomes and avoid complications.
Topics: Adolescent; Female; Humans; Hernia, Abdominal; Internal Hernia; Intestinal Obstruction; Meckel Diverticulum; Vomiting
PubMed: 38576141
DOI: 10.12659/AJCR.943071 -
Journal of Clinical Medicine Mar 2024: The complications associated with Meckel's diverticulum (MD) are well-known. However, blunt injuries regarding MD have not been widely described in the literature....
: The complications associated with Meckel's diverticulum (MD) are well-known. However, blunt injuries regarding MD have not been widely described in the literature. This was the reason for undertaking research on MD lesions. : The materials consisted of 28 cases of damage to MD after blunt trauma published during the years 1921-2022. The collected data were subjected to statistical analysis. : The following MD injuries have been identified, starting with the most common isolated perforation of MD, bleeding from the area of MD, perforation of MD with concomitant tearing of the mesentery intestines and bleeding, intussusception of MD, and intramural hematoma of MD with adjacent mesenteric hematoma. Most injuries were caused by a traffic accident, followed by sports, accidents at work, and then violence. Almost all the cases (27) involved men. Several possible mechanisms may contribute to post-traumatic damage to MD. First of all, they are associated with abdominal compression and a secondary increase in intra-abdominal pressure as well as with the action of shearing forces during deceleration. : Traumatic MD injuries are differentiated and very rare. They can coexist with other serious injuries to the abdominal organs.
PubMed: 38541840
DOI: 10.3390/jcm13061614 -
International Journal of Surgery Case... Apr 2024Cecal volvulus is a rare intestinal pathology that occurs due to abnormal cecum mobility associated with spectrum of complications. It is usually manifested in adults....
INTRODUCTION AND IMPORTANCE
Cecal volvulus is a rare intestinal pathology that occurs due to abnormal cecum mobility associated with spectrum of complications. It is usually manifested in adults. However, on extremely rare occasions, it occurs in pediatrics. We presented a case of cecal volvulus demonstrating the significance of early diagnosis and treatment to reach successful outcomes.
CASE PRESENTATION
A 12 year old boy who presented to the emergency department for clinical evaluation for acute abdomen. History and clinical examination was suggestive of acute bowel obstruction. Abdominal x-ray showed a large, distended gas filled viscus with base pointed towards the right lower quadrant. On the bases of radiological investigations, diagnosis of cecal volvolus made. Accordingly, the patient underwent emergency exploratory laparotomy. The post operative course was uneventful and was discharged in stable condition.
CLINICAL DISCUSSION
Cecal volvulus is an extremely rare manifestation of intestinal obstruction and malrotation. The clinical presentation of cecal volvulus depending on the duration and extent of the involvement of cecal malrotation The exact pathogenesis of cecal volvulus is unclear. However the association of the embryological development of the colon, affects the attachment to the posterior parietal peritoneum after ordinary anatomical rotation of 270°. The core-stone management of cecal volvulus is surgical approach.
CONCLUSION
Cecal volvulus requires a high index of suspicion and delicate care by the pediatric surgeon as it is considered an extremely rare entity in this age group. We highlighted the significance of early diagnosis, surgical treatment and the possibility of developing postoperative complications if left untreated.
PubMed: 38471217
DOI: 10.1016/j.ijscr.2024.109495 -
International Journal of Surgery Case... Apr 2024Bezoars are a known cause of complications in Meckel's diverticulum. We present a case in which a bezoar in a Meckel's diverticulum resulted in intestinal obstruction....
INTRODUCTION
Bezoars are a known cause of complications in Meckel's diverticulum. We present a case in which a bezoar in a Meckel's diverticulum resulted in intestinal obstruction. In addition, we conducted a narrative review to explore the association between Meckel's diverticulum and bezoars.
CASE PRESENTATION
We present the case of a 22-year-old patient admitted for bowel obstruction persisting for three days and periumbilical tenderness. Abdominal CT tomography revealed a hyper dense circular structure with a diameter of 2 cm, small bowel distension of 41 mm, and free fluid. During surgical exploration, a Meckel diverticulum was found between the antimesenteric border of the small bowel and posterior wall of the umbilicus. The Meckel diverticulum was resected, and upon examination, it was found to contain a calcified phytobezoar. The postoperative course was uneventful.
DISCUSSION
The clinical and paraclinical presentation of bezoars in Meckel's diverticulum is nonspecific and diagnosis remains challenging despite improved diagnostic modalities. The association between Meckel's diverticulum and bezoars is often identified during surgery, as it is difficult to diagnose using CT scans. The choice between laparoscopic and open surgery depends on the patient's situation.
CONCLUSION
Diagnosing a bezoar in a Meckel's diverticulum remains challenging. Treatment involves surgery, and the choice of surgical approach depends on the context.
PubMed: 38471214
DOI: 10.1016/j.ijscr.2024.109512 -
Cureus Feb 2024Meckel's diverticulum, a congenital defect that affects about 2% of the population, is a remnant of the embryologic vitelline duct. Perforated Meckel's diverticulum, a...
Meckel's diverticulum, a congenital defect that affects about 2% of the population, is a remnant of the embryologic vitelline duct. Perforated Meckel's diverticulum, a rare consequence of an already rare disease process, frequently presents and is diagnosed as a perforated appendix. We report a case of a 28-year-old male who presented with a two-day history of right-sided lower abdominal pain associated with nausea. The abdominal examination revealed a soft, nondistended abdomen with tenderness in the right iliac fossa. A CT scan of the abdomen showed a normal appendix and inflammation of Meckel's diverticulum without any signs of perforation. Bowel exploration through a small midline incision indicated the presence of a highly inflamed Meckel's diverticulum with localized perforation 75 cm from the ileocecal valve. A resection of 15 cm of the small bowel and an end-to-end primary anastomosis were performed. The patient had an uncomplicated recovery and was discharged after a five-day admission to a surgical ward. This case report illustrates the significance of keeping Meckel's diverticulum as a differential diagnosis in all the patients who present with an acute abdomen.
PubMed: 38449992
DOI: 10.7759/cureus.53598 -
Cureus Feb 2024One of the most frequently encountered congenital anomalies of the gastrointestinal tract is the Meckel's diverticulum. Perforation of the diverticulum, a rare...
One of the most frequently encountered congenital anomalies of the gastrointestinal tract is the Meckel's diverticulum. Perforation of the diverticulum, a rare complication, can significantly hinder accurate diagnosis of the condition. Other common complications associated with Meckel's diverticulum include intestinal obstruction, intussusception, volvulus, inflammation, and hemorrhage. The presentation is similar to the presentation of appendicitis at times. Formation of a phlegmon around a perforated Meckel's diverticulum can mask clinical signs and symptoms. We present a case of a 59-year-old man who presented with pain in the right upper and lower quadrants. After imaging, the patient underwent exploratory laparotomy, which revealed a perforated Meckel's diverticulum. This case highlights the importance of considering Meckel's diverticulum as a possible diagnosis in patients presenting with acute abdominal pain. A thorough approach to history and physical exam combined with imaging can help in the early diagnosis of a perforated Meckel's diverticulum.
PubMed: 38435162
DOI: 10.7759/cureus.53460