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1.
Radiología (Madr., Ed. impr.) ; 66(2): 155-165, Mar.- Abr. 2024. ilus
Artigo em Espanhol | IBECS | ID: ibc-231517

RESUMO

A los pacientes que acuden a urgencias con síntomas inflamatorio/infecciosos a nivel cervical o con masas que pueden comprometer el tracto aerodigestivo o las estructuras vasculares, es necesario hacerles una tomografía computarizada (TC) de cuello con contraste. Su interpretación radiológica se ve dificultada por la complejidad anatómica y la interrelación fisiopatológica entre los diferentes sistemas que lo componen, en un área de estudio relativamente pequeña. Estudios recientes proponen realizar una evaluación sistemática de las estructuras cervicales, utilizando para ello un listado de verificación de 7 elementos, para identificar correctamente la patología, y detectar los hallazgos incidentales que pueden interferir en el manejo del paciente. El objetivo de este trabajo es revisar los hallazgos de la TC en la patología no traumática del cuello en urgencias siguiendo una lectura sistemática, tras la cual se pueda realizar un informe radiológico estructurado, completo y conciso.(AU)


Patients attending the emergency department (ED) with cervical inflammatory/infectious symptoms or presenting masses that may involve the aerodigestive tract or vascular structures require a contrast-enhanced computed tomography (CT) scan of the neck. Its radiological interpretation is hampered by the anatomical complexity and pathophysiological interrelationship between the different component systems in a relatively small area. Recent studies propose a systematic evaluation of the cervical structures, using a 7-item checklist, to correctly identify the pathology and detect incidental findings that may interfere with patient management. As a conclusion, the aim of this paper is to review CT findings in non-traumatic pathology of the neck in the ED, highlighting the importance of a systematic approach in its interpretation and synthesis of a structured, complete, and concise radiological report.(AU)


Assuntos
Humanos , Masculino , Feminino , Serviços Médicos de Emergência , Trato Gastrointestinal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Pescoço/diagnóstico por imagem
2.
BMC Pediatr ; 24(1): 203, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38519924

RESUMO

Langerhans cell histiocytosis (LCH) involving the gastrointestinal tract is a rare condition for which clinical experience is limited. We describe the cases of two patients who initially presented with chronic diarrhoea, hypoproteinaemia, and intermittent fever. These findings suggest that in cases of refractory diarrhoea accompanied by recurrent hypoalbuminaemia, especially with abdominal rash, LCH should be considered. Gastrointestinal endoscopy, biopsy, and imaging studies are essential for obtaining a definitive diagnosis. This approach might be helpful for the early recognition of gastrointestinal tract involvement in LCH.


Assuntos
Histiocitose de Células de Langerhans , Hipoalbuminemia , Criança , Humanos , Hipoalbuminemia/complicações , Hipoalbuminemia/patologia , Histiocitose de Células de Langerhans/complicações , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/patologia , Trato Gastrointestinal/patologia , Biópsia , Diarreia/complicações
3.
J Gastrointest Surg ; 28(2): 158-163, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38445937

RESUMO

Given the exponentially aging population and rising life expectancy in the United States, surgeons are facing a challenging frail population who may require surgery but may not qualify based on their general fitness. There is an urgent need for greater awareness of the importance of frailty measurement and the implementation of universal assessment of frail patients into clinical practice. Pairing risk stratification with stringent protocols for prehabilitation and minimally invasive surgery and appropriate enhanced recovery protocols could optimize and condition frail patients before, during, and immediately after surgery to mitigate postoperative complications and consequences on patient function and quality of life. In this paper, highlights from the 2022 Society for Surgery of the Alimentary Tract State-of-the-Art Session on frailty in surgery are presented. This work aims to improve the understanding of the impact of frailty on patients and the methods used to augment the outcomes for frail patients during their surgical experience.


Assuntos
Fragilidade , Cirurgiões , Humanos , Idoso , Fragilidade/complicações , Qualidade de Vida , Trato Gastrointestinal , Complicações Pós-Operatórias/etiologia
4.
Cell ; 187(5): 1206-1222.e16, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38428395

RESUMO

Plasmids are extrachromosomal genetic elements that often encode fitness-enhancing features. However, many bacteria carry "cryptic" plasmids that do not confer clear beneficial functions. We identified one such cryptic plasmid, pBI143, which is ubiquitous across industrialized gut microbiomes and is 14 times as numerous as crAssphage, currently established as the most abundant extrachromosomal genetic element in the human gut. The majority of mutations in pBI143 accumulate in specific positions across thousands of metagenomes, indicating strong purifying selection. pBI143 is monoclonal in most individuals, likely due to the priority effect of the version first acquired, often from one's mother. pBI143 can transfer between Bacteroidales, and although it does not appear to impact bacterial host fitness in vivo, it can transiently acquire additional genetic content. We identified important practical applications of pBI143, including its use in identifying human fecal contamination and its potential as an alternative approach to track human colonic inflammatory states.


Assuntos
Bactérias , Trato Gastrointestinal , Metagenoma , Plasmídeos , Humanos , Bactérias/genética , Bacteroidetes/genética , Fezes/microbiologia , Plasmídeos/genética
5.
Science ; 383(6687): 1096-1103, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38452063

RESUMO

Monitoring homeostasis is an essential aspect of obtaining pathophysiological insights for treating patients. Accurate, timely assessments of homeostatic dysregulation in deep tissues typically require expensive imaging techniques or invasive biopsies. We introduce a bioresorbable shape-adaptive materials structure that enables real-time monitoring of deep-tissue homeostasis using conventional ultrasound instruments. Collections of small bioresorbable metal disks distributed within thin, pH-responsive hydrogels, deployed by surgical implantation or syringe injection, allow ultrasound-based measurements of spatiotemporal changes in pH for early assessments of anastomotic leaks after gastrointestinal surgeries, and their bioresorption after a recovery period eliminates the need for surgical extraction. Demonstrations in small and large animal models illustrate capabilities in monitoring leakage from the small intestine, the stomach, and the pancreas.


Assuntos
Implantes Absorvíveis , Fístula Anastomótica , Trato Gastrointestinal , Ultrassom , Animais , Humanos , Homeostase , Estômago , Trato Gastrointestinal/cirurgia , Fístula Anastomótica/diagnóstico por imagem , Modelos Animais
6.
A A Pract ; 18(3): e01762, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38498670

RESUMO

Semaglutide, a glucagon-like peptide-1 (GLP-1) analog, has various effects on the gastrointestinal tract. In patients undergoing anesthesia delayed gastric emptying time can have sequelae if not identified preoperatively. Modalities include thorough history regarding the last dose administration of a GLP-1 analog and ultrasound of gastric contents before induction of anesthesia. We present a case in which gastric ultrasound identified a patient at increased risk for aspiration on induction and allowed for appropriate alterations in the anesthetic plan.


Assuntos
Peptídeo 1 Semelhante ao Glucagon , Peptídeos Semelhantes ao Glucagon , Sistemas Automatizados de Assistência Junto ao Leito , Humanos , Trato Gastrointestinal , Testes Imediatos
7.
Food Res Int ; 182: 114182, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38519194

RESUMO

Lactoferrin (LF) is a thermally sensitive iron-binding globular glycoprotein. Heat treatment can induce its denaturation and aggregation and thus affect its functional activity. In this study, carrageenan (CG), xanthan gum (XG) and locust bean gum (LBG), allowed to apply in infant food, were used to form protein-polysaccharide complexes to improve the thermal stability of LF. Meanwhile, in vitro simulated infant digestion and absorption properties of LF were also estimated. The results showed that the complexes formed by CG and XG with LF (LF-CG and LF-XG) could significantly inhibit the loss of α-helix structure of LF against heating. LF-CG and LF-LBG could protect LF from digestion in simulated infant gastric fluid and slow down the degradation of LF under the simulated intestinal conditions. Besides, LF, LF-CG and LF-XG showed no adverse effects on the growth of Caco-2 cells in the LF concentration range of 10-300 µg/mL, and LF-XG exhibited better beneficial to improve the cell uptake of the digestive product than the other protein-polysaccharides at the LF concentration of 100 µg/mL. This study may provide a reference for the enhancement of thermal processing stability of LF and development infant food ingredient with high nutrients absorption efficiency in the gastrointestinal environment in the future.


Assuntos
Trato Gastrointestinal , Lactoferrina , Lactente , Humanos , Lactoferrina/química , Células CACO-2 , Fenômenos Químicos , Trato Gastrointestinal/metabolismo
8.
Sci Rep ; 14(1): 6468, 2024 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-38499629

RESUMO

Linear endoscopic ultrasonography (EUS) has been extensively utilized as a novel diagnostic and therapeutic modality across various fields. However, there have been relatively few studies focusing on lower gastrointestinal lesions. The aim of our study was to investigate the feasibility, safety and clinical value of linear EUS in the lower gastrointestinal subepithelial lesions. This was a retrospective study involving patients with lower gastrointestinal subepithelial lesions diagnosed by linear EUS from August 2019 to April 2023 at the Second Affiliated Hospital of Anhui Medical University. The data, including basic clinical information, linear EUS features, technical success rate, complications, and follow-up, were retrospectively collected and analyzed. A total of 69 patients with lower gastrointestinal subepithelial lesions underwent examination by linear EUS. Excluding the rectum, the technical success rate of linear EUS was 90.6% (29/32). Apart from the 7 patients whose diagnosis remained unknown, 3 patients with no abnormal EUS findings, and 3 patients failed the procedure, 56 patients were included in the final diagnostic performance analysis. The most common locations of the lesions were the rectum (37/56, 66.1%) and sigmoid colon (7/56, 12.5%). Based on endoscopy findings and pathological results, the most prevalent types of subepithelial lesions in the lower gastrointestinal tract were neuroendocrine tumor (NET) (12/56, 20.3%), lipoma (8/56, 13.6%) and extraluminal compression (8/56, 13.6%). The majority of lesions ranged in diameter from 1 to 3 cm (χ2 = 18.750, p < 0.001). After undergoing linear EUS examination, 36 patients received EUS-FNA (3/36), biopsy (5/36), endoscopic resection (25/36), or surgical excision (3/36) respectively. The pathological results of 29 patients were entirely consistent with the diagnosis made using linear EUS, with an 80.6% (29/36) diagnostic accuracy rate. Follow-up indicated that the lesions remained unchanged within 6-36 months. All patients tolerated the procedure well without any complications. In conclusion, linear EUS demonstrates technical feasibility, safety, and a high diagnostic accuracy for subepithelial lesions in the lower gastrointestinal tract.


Assuntos
Endossonografia , Trato Gastrointestinal , Humanos , Endossonografia/métodos , Estudos Retrospectivos , Estudos de Viabilidade , Trato Gastrointestinal/diagnóstico por imagem , Trato Gastrointestinal/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico
9.
Animal ; 18(3): 101102, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38430665

RESUMO

Microbial composition of the gastrointestinal tracts is an important factor affecting the variation in feed efficiency in ruminants. Several studies have investigated the composition of the ruminal and fecal microbiotas, as well as their impacts on feed efficiency and digestion. In addition, next-generation DNA sequencing techniques have allowed us to gain a better understanding of such microbiomes. In this study, the beef cattle microbiome data were analyzed using both a multivariate and a univariate approach and the results were compared. Moreover, a statistical procedure to classify calves in two groups with extreme Residual Feed Intake (RFI) values, using their microbiota profile, was developed. Both fecal and ruminal samples were collected from 63 Angus steers at two different time points for evaluation of their microbiomes: at the beginning and at the end of the feedlot. An additional fecal sample was collected at weaning. A total of 149 and 119 bacterial families (BFs) were retrieved from the ruminal and fecal samples, respectively. A Canonical Discriminant Analysis (CDA) was used to investigate whether BFs were able to distinguish between rumen and fecal samples. A sub-sample of 28 steers was divided in two groups based on their feed efficiency status: positive or negative for RFI. Fecal samples collected at weaning were used to assign the positive and negative RFI animals to their corresponding groups using both Stepwise Discriminant Analysis and CDA. Results revealed that CDA was able to distinguish between rumen and fecal samples. Peptostreptococcaceae was the family most associated with the fecal samples, whereas Prevotellaceae the most associated with the ruminal samples. The CDA using 19 BFs selected from the stepwise was able to correctly assign all animals to the proper RFI groups (negative or positive). Rhizobiaceae was the family most associated with negative RFI, whereas Comamonadacea was the family most linked with positive RFI. The results from this study showed that the multivariate approach can be used to improve microbiome data analysis, as well as to predict feed efficiency in beef cattle using information derived from the fecal microbiome.


Assuntos
Microbioma Gastrointestinal , Humanos , Bovinos , Animais , Ingestão de Alimentos , Fezes/microbiologia , Desmame , Trato Gastrointestinal , Bactérias/genética , Ração Animal/análise , Rúmen/microbiologia
12.
Meat Sci ; 212: 109468, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38428150

RESUMO

This study investigated whether the freezing-then-aging treatment of beef affects protein digestibility and release of potentially bioactive peptides using an in vitro infant digestion model. After 28 days of storage, aged-only (AO) and frozen-then-aged (FA) beef exhibited higher α-amino group contents in the 10% trichloroacetic acid-soluble fraction compared to day 0 (P < 0.05). Following in vitro digestion in the infant model, FA showed higher contents of α-amino groups and smaller proteins (<3 and 1 kDa) than day 0 and AO (P < 0.05). Relative contributions of myofibrillar, sarcoplasmic, and stromal proteins to the bioactive peptides released from AO and FA differed from those of day 0. In addition, FA exhibited a higher proportion of potential bioactive peptide sequences. Overall, freezing-then-aging treatment can enhance the potential health benefits of beef to be used as a protein source for complementary foods.


Assuntos
Peptídeos , Proteínas , Lactente , Animais , Bovinos , Humanos , Congelamento , Peptídeos/química , Trato Gastrointestinal , Digestão
13.
J Smooth Muscle Res ; 60: 1-9, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38462479

RESUMO

Macrophages are the originators of inflammatory compounds, phagocytic purifiers in their local environment, and wound healing protectors in oxidative environments. They are molded by the tissue milieu they inhabit, with gastrointestinal (GI) muscularis macrophages (MMs) being a prime example. MMs are located in the muscular layer of the GI tract and contribute to muscle repair and maintenance of GI motility. MMs are often in close proximity to the enteric nervous system, specifically near the enteric neurons and interstitial cells of Cajal (ICCs). Consequently, the anti-inflammatory function of MMs corresponds to the development and maintenance of neural networks in the GI tract. The capacity of MMs to shift from anti-inflammatory to proinflammatory states may contribute to the inflammatory aspects of various GI diseases and disorders such as diabetic gastroparesis or postoperative ileus, functional disorders such as irritable bowel syndrome, and organic diseases such as inflammatory bowel disease. We reviewed the current knowledge of MMs and their influence on neighboring cells due to their important role in the GI tract.


Assuntos
Sistema Nervoso Entérico , Anti-Inflamatórios , Motilidade Gastrointestinal , Trato Gastrointestinal , Macrófagos , Músculos , Humanos
14.
Trop Anim Health Prod ; 56(2): 100, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38472670

RESUMO

Gastrointestinal nematodes (GIN) exacerbate the impact of droughts on the survival of cattle. The inadequacies of the conventional system make it increasingly important to explore indigenous knowledge (IK) to create drought-tolerant and GIN resilient herds. The objective of the study was to assess the indigenous strategies for controlling GIN during droughts. Face-to-face interviews with experts on IK were conducted to give insight into the importance, methods and ranking of GIN control. The experts identified 86 cattle that were used to test their assertions. The control methods used were identifying cattle that were susceptible to high GIN loads using predisposing factors, diagnosis of GIN burdens using faecal appearance, and treatment using phytotherapy. Experts ranked predisposing factors as the most critical control strategy and identified body condition, class, sex, coat colour, pregnancy status and lactation status as predisposing factors to high GIN burdens. Thin, older, dark-coloured cattle, as well as pregnant and lactating cows, were considered susceptible to GIN. However, pregnancy status, coat colour and sex were significantly associated with high GIN burdens. Cows were 2.6 times more likely to have high GIN burdens than bulls. Dark-coloured cattle were 3.5 times more likely to have high GIN burdens than light-coloured ones, and the likelihood of pregnant cows was 4.9 times higher than non-pregnant cows. A dark-coloured pregnant cow was extremely susceptible to high GIN burdens. In conclusion, knowledge of predisposing factors informs selection decisions when purchasing foundation stock. Cattle that are susceptible to high GIN loads are prioritised during droughts or culled where resources are scarce.


Assuntos
Doenças dos Bovinos , Nematoides , Feminino , Animais , Bovinos , Masculino , Gravidez , Lactação , Trato Gastrointestinal , África Austral
16.
Sci Rep ; 14(1): 6100, 2024 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-38480815

RESUMO

Endoscopy, a widely used medical procedure for examining the gastrointestinal (GI) tract to detect potential disorders, poses challenges in manual diagnosis due to non-specific symptoms and difficulties in accessing affected areas. While supervised machine learning models have proven effective in assisting clinical diagnosis of GI disorders, the scarcity of image-label pairs created by medical experts limits their availability. To address these limitations, we propose a curriculum self-supervised learning framework inspired by human curriculum learning. Our approach leverages the HyperKvasir dataset, which comprises 100k unlabeled GI images for pre-training and 10k labeled GI images for fine-tuning. By adopting our proposed method, we achieved an impressive top-1 accuracy of 88.92% and an F1 score of 73.39%. This represents a 2.1% increase over vanilla SimSiam for the top-1 accuracy and a 1.9% increase for the F1 score. The combination of self-supervised learning and a curriculum-based approach demonstrates the efficacy of our framework in advancing the diagnosis of GI disorders. Our study highlights the potential of curriculum self-supervised learning in utilizing unlabeled GI tract images to improve the diagnosis of GI disorders, paving the way for more accurate and efficient diagnosis in GI endoscopy.


Assuntos
Currículo , Autogestão , Humanos , Endoscopia Gastrointestinal , Trato Gastrointestinal , Aprendizado de Máquina Supervisionado
17.
Drug Des Devel Ther ; 18: 613-630, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476206

RESUMO

Oral administration of dosage forms is convenient and beneficial in several respects. Lipid nanoparticulate dosage forms have emerged as a useful carrier system in deploying low solubility drugs systemically, particularly class II, III, and IV drugs of the Biopharmaceutics Classification System. Like other nanoparticulate delivery systems, their low size-to-volume ratio facilitates uptake by phagocytosis. Lipid nanoparticles also provide scope for high drug loading and extended-release capability, ensuring diminished systemic side effects and improved pharmacokinetics. However, rapid gastrointestinal (GI) clearance of particulate delivery systems impedes efficient uptake across the mucosa. Mucoadhesion of dosage forms to the GI mucosa results in longer transit times due to interactions between the former and mucus. Delayed transit times facilitate transfer of the dosage form across the mucosa. In this regard, a balance between mucoadhesion and mucopenetration guarantees optimal systemic transfer. Furthermore, the interplay between GI anatomy and physiology is key to ensuring efficient systemic uptake. This review captures salient anatomical and physiological features of the GI tract and how these can be exploited for maximal systemic delivery of lipid nanoparticles. Materials used to impart mucoadhesion and examples of successful mucoadhesive lipid nanoformulations are highlighted in this review.


Assuntos
Nanopartículas , Lipossomos , Trato Gastrointestinal , Administração Oral , Lipídeos , Sistemas de Liberação de Medicamentos
18.
Khirurgiia (Mosk) ; (3): 29-37, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38477241

RESUMO

OBJECTIVE: To analyze the pediatric patients with multiple magnetic foreign bodies of the gastrointestinal tract undergoing surgical intervention; to present the treatment and diagnostic algorithm in pediatric practice; to compare surgical interventions for these lesions and determine the most optimal one. MATERIAL AND METHODS: A retrospective single-center study included 9 patients diagnosed with multiple magnetic foreign bodies of the gastrointestinal tract. Exclusion criteria: outpatient cases and endoscopic removal of magnetic foreign bodies. All patients underwent laparoscopy and/or laparotomy. We analyzed postoperative data and determined the preferable approach. RESULTS: All patients were discharged without complications. Length of hospital-stay was shorter after laparoscopy (7 vs. 12 days). Patients after laparoscopy didn't need for intensive care while laparotomy required ICU stay for 4.5±2.2 days. Enteral feeding started after 1 and 3 days, respectively. CONCLUSION: Laparoscopy is preferable for multiple magnetic foreign bodies of the gastrointestinal tract due to shorter hospital-stay, no need for ICU-stay, lower surgical trauma and earlier enteral feeding.


Assuntos
Corpos Estranhos , Laparoscopia , Criança , Humanos , Estudos Retrospectivos , Corpos Estranhos/complicações , Trato Gastrointestinal , Fenômenos Magnéticos
19.
Methods Mol Biol ; 2777: 123-133, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38478340

RESUMO

Patient-derived organoids (PDOs) generated from adult stem cells present in tissues are invaluable tools for translational cancer research (Drost, Clevers, Nat Rev Cancer 18(7):407-418, 2018). The generation of this 3D cultures is not trivial and requires dedicated procedures. Despite the rapid increase in the use of organoids in cancer research, it is noteworthy that published procedures regarding their generation often lack critical information and standardized protocols remain elusive. Addressing these limitations, the protocol described in this chapter offers an in-depth and comprehensive guide to establishing, expanding, and freezing gastrointestinal PDOs obtained from normal and tumor tissue biopsies. Notably, it also provides valuable insights in the form of tips and tricks to guide and overcome potential challenges that may arise during the procedure.


Assuntos
Bancos de Espécimes Biológicos , Neoplasias , Adulto , Humanos , Neoplasias/patologia , Trato Gastrointestinal , Biópsia , Organoides
20.
Molecules ; 29(5)2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38474665

RESUMO

Vitamin D3 deficiency is a global phenomenon, which can be managed with supplementation and food fortification. However, vitamin D3 bioaccessibility may depend on factors such as matrix composition and interactions throughout the gastrointestinal (GI) tract. This research focused on the effect of different matrices on vitamin D3 content during digestion, as well as the effect of pH on its bioaccessibility. The INFOGEST protocol was employed to simulate digestion. Three different types of commercial supplements, two foods naturally rich in vitamin D3, and three fortified foods were investigated. High-Performance Liquid Chromatography was used to determine the initial vitamin D3 content in the supplements and foods, as well as after each digestion stage. The results indicate that the foods exhibited higher bioaccessibility indices compared to the supplements and a higher percentage retention at the end of the gastric phase. The pH study revealed a positive correlation between an increased gastric pH and the corresponding content of vitamin D3. Interestingly, exposing the matrix to a low pH during the gastric phase resulted in an increased intestinal content of D3. Vitamin D3 is more bioaccessible from foods than supplements, and its bioaccessibility is susceptible to changes in gastric pH. Fasting conditions (i.e., gastric pH = 1) enhance the vitamin's bioaccessibility.


Assuntos
Colecalciferol , Suplementos Nutricionais , Colecalciferol/química , Suplementos Nutricionais/análise , Alimentos Fortificados/análise , Trato Gastrointestinal/metabolismo , Concentração de Íons de Hidrogênio , Digestão , Disponibilidade Biológica
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