ABSTRACT
Introducción. El dolor abdominal es uno de los principales motivos de admisión a urgencias y una de las causas más frecuentes es la enfermedad diverticular, que aumenta su prevalencia en el adulto mayor. Sin embargo, la diverticulitis del intestino delgado es una enfermedad infrecuente y en la mayoría de casos es asintomática. No obstante, la perforación de un divertículo intestinal es una complicación común de esta patología, por lo que debe ser considerado como un diagnóstico diferencial de abdomen agudo en este grupo poblacional. Caso clínico. Paciente masculino de 71 años, quien consultó por dolor abdominal de inicio súbito, con signos de irritación peritoneal al examen físico. Dado su deterioro hemodinámico fue llevado a cirugía y en la laparotomía exploratoria se halló una diverticulitis aguda perforada de yeyuno e íleon distal. Resultados. El paciente cursó con una adecuada evolución postoperatoria, sin reingresos. Conclusión. La diverticulitis aguda yeyuno-ileal es una causa importante, pero no frecuente de perforación intestinal. Hay muy pocos casos reportados en la literatura, lo que la convierte en un reto diagnóstico para el médico de urgencias y el cirujano general. No obstante, debe ser considerado como un diagnóstico diferencial en adultos mayores con abdomen agudo.
Introduction. Abdominal pain is one of the main reasons for admission to the emergency room and one of the most frequent causes is diverticular disease, which increases its prevalence in the elderly. However, diverticulitis of the small bowel is rare and in most cases asymptomatic. However, perforation of an intestinal diverticulum is a common complication of this pathology and should be considered as a differential diagnosis of acute abdomen in this population group. Clinical case. A71-year-old male patient presented with abdominal pain of sudden onset, with signs of peritoneal irritation. Given his hemodynamic deterioration, he was taken to surgery and in the exploratory laparotomy an acute perforated diverticulitis of the jejunum and distal ileum was found. Results. The patient had an adequate postoperative evolution, without readmissions. Conclusion. Acute jejuno-ileal diverticulitis is an important but uncommon cause of intestinal perforation. There are very few cases reported in the literature, which makes it a diagnostic challenge for the emergency physician and general surgeon. However, it should be considered as a differential diagnosis in older adults with acute abdomen.
Subject(s)
Humans , Abdominal Pain , Diverticulitis , Abdomen, Acute , Ileum , Intestine, Small , JejunumABSTRACT
RESEARCH HIGHLIGHTS: IDS presented pathognomonic dilatation of the jejunum up to Meckel's diverticulum.IDS caused weight loss, decreased egg production, and increased culling and mortality.Chicken parvovirus (ChPV) was consistently detected through PCR assays.Chicken megrivirus (ChMV) was consistently detected through viral metagenomics.
Subject(s)
Chickens , Parvoviridae Infections , Poultry Diseases , Animals , Poultry Diseases/virology , Poultry Diseases/pathology , Chickens/virology , Parvoviridae Infections/veterinary , Parvoviridae Infections/virology , Female , Parvovirus/genetics , Parvovirus/isolation & purification , Polymerase Chain Reaction/veterinary , Dilatation, Pathologic/veterinary , Dilatation, Pathologic/virology , Jejunum/virology , Jejunum/pathology , ParvovirinaeABSTRACT
We evaluated the effects of supplementing yeast mannan-reach-fraction on growth performance, jejunal morphology and lymphoid tissue characteristics in weaned piglets challenged with E. Coli F4. A total of 20 crossbred piglets were used. At weaning, piglets were assigned at random to one of four groups: piglets challenged and fed the basal diet supplemented with yeast mannan-rich fraction (C-MRF, n = 5); piglets challenged and fed the basal diet (C-BD, n = 5); piglets not challenged and fed the basal diet supplemented with yeast mannan-rich fraction (NC-MRF, n = 5), and piglets not challenged and fed the basal diet (NC-BD). Each dietary treatment had five replicates. On days 4, 5 and 10, piglets were orally challenged with 108 CFU/mL of E. Coli F4. C-MRF piglets had higher BW (p = 0.002; interactive effect) than C-BD piglets. C-MRF piglets had higher (p = 0.02; interactive effect) ADG in comparison with C-BD piglets. C-MRF piglets had higher (p = 0.04; interactive effect) ADFI than C-BD piglets. The diameter of lymphoid follicles was larger (p = 0.010; interactive effect) in the tonsils of C-MRF piglets than C-BD piglets. Lymphoid cells proliferation was greater in the mesenteric lymphnodes and ileum (p = 0.04 and p = 0.03, respectively) of C-MRF piglets. A reduction (p > 0.05) in E. Coli adherence in the ileum of piglets fed MRF was observed. In conclusion, the results of the present study demonstrate that dietary yeast mannan-rich fraction supplementation was effective in protecting weaned piglets against E. Coli F4 challenge.
Subject(s)
Dietary Supplements , Enterotoxigenic Escherichia coli , Mannans , Yeasts , Animals , Swine/growth & development , Swine/microbiology , Escherichia coli Infections/veterinary , Swine Diseases/microbiology , Jejunum/growth & development , Weaning , Animal Husbandry , Lymphoid Tissue/physiologyABSTRACT
This work aimed to study the effect of repeated exposure to low doses of ozone on alpha-synuclein and the inflammatory response in the substantia nigra, jejunum, and colon. Seventy-two male Wistar rats were divided into six groups. Each group received one of the following treatments: The control group was exposed to air. The ozone groups were exposed for 7, 15, 30, 60, and 90 days for 0.25 ppm for four hours daily. Afterward, they were anesthetized, and their tissues were extracted and processed using Western blotting, immunohistochemistry, and qPCR. The results indicated a significant increase in alpha-synuclein in the substantia nigra and jejunum from 7 to 60 days of exposure and an increase in NFκB from 7 to 90 days in the substantia nigra, while in the jejunum, a significant increase was observed at 7 and 15 days and a decrease at 60 and 90 days for the colon. Interleukin IL-17 showed an increase at 90 days in the substantia nigra in the jejunum and increases at 30 days and in the colon at 15 and 90 days. Exposure to ozone increases the presence of alpha-synuclein and induces the loss of regulation of the inflammatory response, which contributes significantly to degenerative processes.
Subject(s)
Colon , Jejunum , Ozone , Substantia Nigra , alpha-Synuclein , Animals , Male , Rats , alpha-Synuclein/metabolism , Colon/metabolism , Colon/drug effects , Colon/pathology , Inflammation/metabolism , Inflammation/chemically induced , Inflammation/pathology , Interleukin-17/metabolism , Jejunum/metabolism , Jejunum/drug effects , Jejunum/pathology , NF-kappa B/metabolism , Ozone/toxicity , Rats, Wistar , Substantia Nigra/metabolism , Substantia Nigra/drug effects , Substantia Nigra/pathologyABSTRACT
Studies have reported the occurrence of gastrointestinal (GI) symptoms, primarily diarrhea, in COVID-19. However, the pathobiology regarding COVID-19 in the GI tract remains limited. This work aimed to evaluate SARS-CoV-2 Spike protein interaction with gut lumen in different experimental approaches. Here, we present a novel experimental model with the inoculation of viral protein in the murine jejunal lumen, in vitro approach with human enterocytes, and molecular docking analysis. Spike protein led to increased intestinal fluid accompanied by Cl- secretion, followed by intestinal edema, leukocyte infiltration, reduced glutathione levels, and increased cytokine levels [interleukin (IL)-6, tumor necrosis factor-α, IL-1ß, IL-10], indicating inflammation. Additionally, the viral epitope caused disruption in the mucosal histoarchitecture with impairment in Paneth and goblet cells, including decreased lysozyme and mucin, respectively. Upregulation of toll-like receptor 2 and toll-like receptor 4 gene expression suggested potential activation of local innate immunity. Moreover, this experimental model exhibited reduced contractile responses in jejunal smooth muscle. In barrier function, there was a decrease in transepithelial electrical resistance and alterations in the expression of tight junction proteins in the murine jejunal epithelium. Additionally, paracellular intestinal permeability increased in human enterocytes. Finally, in silico data revealed that the Spike protein interacts with cystic fibrosis transmembrane conductance regulator (CFTR) and calcium-activated chloride conductance (CaCC), inferring its role in the secretory effect. Taken together, all the events observed point to gut impairment, affecting the mucosal barrier to the innermost layers, establishing a successful experimental model for studying COVID-19 in the GI context.
Subject(s)
COVID-19 , Intestinal Mucosa , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , Spike Glycoprotein, Coronavirus/metabolism , Spike Glycoprotein, Coronavirus/immunology , Animals , SARS-CoV-2/physiology , SARS-CoV-2/immunology , Humans , Mice , COVID-19/immunology , COVID-19/metabolism , Intestinal Mucosa/metabolism , Intestinal Mucosa/immunology , Jejunum/immunology , Jejunum/metabolism , Jejunum/pathology , Jejunum/virology , Molecular Docking Simulation , Enterocytes/metabolism , Enterocytes/virology , Immunity, Innate , Cytokines/metabolism , Disease Models, Animal , Male , Clinical RelevanceABSTRACT
BACKGROUND: Isolated perforations of hollow viscus (HV) represent less than 1% of injuries in blunt abdominal trauma (BAT). When they do present, they are generally due to high-impact mechanisms in the segments of the intestine that are fixed. The aim of this study is to determine the incidence of major HV injuries in BAT at the "Dr. Domingo Luciani" General Hospital (HDL), and address the literature gap regarding updated HV perforations following BAT, especially in low-income settings. METHODS: A retrospective review was conducted on the medical records of patients admitted to our trauma center with a diagnosis of complicated BAT with HV perforation over 14 years. RESULTS AND DISCUSSION: Seven hundred sixty-one patients were admitted under the diagnosis of BAT. Of them, 36.79% underwent emergency surgical resolution, and 6.04% had HV perforation as an operative finding. Almost half (44.44%) of these cases presented as a single isolated injury, while the remaining were associated with other intra-abdominal organ injuries. The most common lesions were Grade II-III jejunum and Grade I transverse colon, affecting an equal proportion of patients at 13.33%. In recent years, an increased incidence of HV injuries secondary to BAT has been observed. Despite this, in many cases, the diagnosis is delayed, so even in the presence of negative diagnostic studies, the surgical approach based on the trauma mechanism, hemodynamic status, and systematic reevaluation of the polytraumatized patient should prevail.
Subject(s)
Abdominal Injuries , Intestinal Perforation , Wounds, Nonpenetrating , Humans , Trauma Centers , Wounds, Nonpenetrating/epidemiology , Wounds, Nonpenetrating/surgery , Wounds, Nonpenetrating/complications , Abdominal Injuries/epidemiology , Abdominal Injuries/surgery , Abdominal Injuries/complications , Jejunum , Intestinal Perforation/surgery , Retrospective StudiesABSTRACT
Introduction: Sleeve gastrectomy with jejunal bypass (SGJB) has been used as a bariatric/metabolic procedure since 2003, in the search for a simpler than other standard techniques and as effective as them. The jejunal-ileal anastomosis can deliver food directly to the hindgut where incretins are secreted. This procedure has gained popularity around the globe and has been studied in rat models as in humans, especially in South America and Asia. In this review, we present the details of the original surgical technique SGJB, summarized all the publications of the procedure, discuss possible advantages and disadvantages, and provide scientific information to look for the real place between bariatric/metabolic procedures. Methods: With 20 years of experience performing the original SGJB, the authors present the details of the procedure. Results: The SGJB consists of a traditional sleeve with the addition of a jejunal bypass. The jejunum is transected 20-30 cm distally to the ligament of Treitz. Then, the biliopancreatic limb is anastomosed to restore transit 250-300 cm distal to the jejunum transection. This way, the ileum gets in contact with partially digested food with the subsequent production of incretins. Conclusion: In this article, we describe the original Alamo technique of SGJB. It is important to clarify the technical details since many publications have presented different lengths of the defunctionalized jejunal limb. Also, the SGJB has been categorized in the "sleeve plus" procedures and its promising outcomes should rapidly position it as an alternative metabolic surgery.
Subject(s)
Bariatric Surgery , Gastric Bypass , Obesity, Morbid , Humans , Animals , Rats , Jejunum/surgery , Obesity, Morbid/surgery , Incretins , Bariatric Surgery/methods , Gastrectomy/methods , Gastric Bypass/methodsABSTRACT
Sulfur amino acids are essential for the proper development of broilers and are required throughout the bird's life to perform important physiological functions. Studies that seek to understand the actions of sulfur amino acids in the body of birds are essential. The present study evaluated the influence of sulfur amino acid supplementation using DL-Methionine (DL-Met) and DL-Methionine hydroxy analogue (DL-HMTBA), on the performance and expression of genes related to methionine metabolism, in the jejunum of broilers. Four hundred and fifty male broilers (Cobb-700 slow feathering) were distributed in a completely randomized design, in a factorial scheme (2x3), with two sources of methionine (DL-Met and DL-HMTBA) and three levels of methionine (deficiency, requirement and excess). The mRNA expression of the MAT1, MTR, BHMT, MTRR, CBG and GSS genes, and performance data such as feed intake, weight gain, and feed conversion were evaluated. DL-HMTBA increased the expression of BHMT (p = 0.0072) and MTRR (p = 0.0003) in the jejunum of the birds. Methionine deficiency increased the expression of BHMT (p = 0.0805) and MTRR (p = 0.0018). Higher expression of GSS was observed in birds that were supplemented with DL-HMTBA (p = 0.0672). Analyzing our results, it is preferable to supplement sulfur amino acids with DL-Met at the requirement level. Birds fed with DL-HMTBA showed worse weight gain (p = 0.0117) and higher feed conversion (p = 0.0170); methionine deficiency resulted in higher feed intake (p = 0.0214), lower weight gain (p<0.0001) and consequently higher feed conversion (p<0.0001). Based on the information found in this work, it is recommended to supplement sulfur amino acids with DL-Met at the level of compliance with the requirement.
Subject(s)
Chickens , Homocysteine , Animals , Male , Homocysteine/metabolism , Jejunum/metabolism , Methionine , Diet/veterinary , Racemethionine/metabolism , Dietary Supplements , Weight Gain , Animal Feed/analysis , Animal Nutritional Physiological PhenomenaABSTRACT
AIMS: Our main goals were to investigate the effects of L-glutathione (1%) treatment in Walker-256 tumor-bearing rats by analyzing immunoreactive neurons (IR), responsive to the nNOS enzyme and 3-Nitrotyrosine, in their jejunum myenteric plexus. Moreover, the oxidative state and inflammatory process in these animals were investigated. METHODS: Four experimental groups were utilized: control (C), control treated with L-glutathione (CGT), Walker-256 tumor-bearing rats (TW), and Walker-256 tumor-bearing rats treated with L-glutathione (TWGT). After 14 days of tumor inoculation, the jejunum was collected for immunohistochemical techniques and assessment of oxidative status. Plasma was collected to evaluate oxidative status and measure cytokines. RESULTS: The TW group exhibited a decrease of reduced glutathione in their jejunum, which was prevented in the L-glutathione treated TWGT group. TW animals presented pronounced oxidative stress by increasing levels of lipoperoxidation in their jejunum and malondialdehyde in their plasma; however, the L-glutathione treatment in TWGT group was not able to avoid it. The total antioxidant capacity was altered in groups TW and TWGT, yet the last one had a better index in their plasma. The IL-10, and TNF-α levels increased in TWGT animals. The nNOS-IR neuron density decreased in the jejunum myenteric plexus of the TW group, which was avoided in the TWGT group. The nNOS +3-Nitrotyrosine neurons quantification did not show significative alterations. CONCLUSION: The treatment with L-glutathione (1%) imposed an important defense to some parameters of oxidative stress induced by TW-256, leading to neuroprotection to the loss in the nNOS-IR neuron density.
Subject(s)
Neoplasms , Nitrergic Neurons , Rats , Animals , Jejunum , Rats, Wistar , Neuroprotection , Oxidative Stress , Glutathione/metabolism , Myenteric Plexus/pathology , Neoplasms/metabolism , Neoplasms/pathologyABSTRACT
We present the case of a 32-year-old male patient with a history of Neurofibromatosis type 1, who presented with active small bowel bleeding, initially diagnosed by observing bleeding in ileoscopy, presenting with hemodynamic instability, abdominal angiotomography was performed, identifying a mass with contrast enhancement and active bleeding at the middle jejunum level, for which an angiography with arterial embolization of the branch that supplies said area is performed. With the patient stable, a double-balloon antegrade enteroscopy was performed, observing a subepithelial, ulcerated lesion, endoscopic tattooing was performed and finally surgery was sent for resection by laparoscopy. The pathology study was compatible with a jejunal gastrointestinal stromal tumor (GIST).
Subject(s)
Gastrointestinal Stromal Tumors , Laparoscopy , Neurofibromatosis 1 , Male , Humans , Adult , Neurofibromatosis 1/complications , Neurofibromatosis 1/diagnosis , Neurofibromatosis 1/surgery , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/diagnosis , Jejunum , Endoscopy, Gastrointestinal/methods , Gastrointestinal Stromal Tumors/complications , Gastrointestinal Stromal Tumors/diagnosisABSTRACT
INTRODUCTION: The duodenal-jejunal bypass liner (DJBL) is a less-invasive treatment of obesity and type 2 diabetes mellitus (T2DM). METHODS: This is a systematic review and meta-analysis including randomized clinical trials (RCTs) comparing DJBL versus sham or pharmacotherapies aiming to evaluate the effectiveness and safety of DJBL. RESULTS: Ten RCTs (681 patients) were included. The DJBL group showed superior excess weight loss (+ 11.4% [+ 7.75 to + 15.03%], p < 0.00001) and higher decrease in HbA1c compared to the control group (- 2.73 ± 0.5 vs. - 1.73 ± 0.4, p = 0.0001). Severe adverse events (SAEs) occurred in 19.7%. CONCLUSION: The DJBL did not reach the ASGE/ASMBS thresholds for the treatment of obesity. However, it is important to state that many SAEs were not really severe. Therefore, we believe this therapy plays an important role in the management obesity and T2DM.
Subject(s)
Bariatric Surgery , Diabetes Mellitus, Type 2 , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Duodenum/surgery , Jejunum/surgery , Bariatric Surgery/adverse effects , Treatment Outcome , Randomized Controlled Trials as Topic , Obesity/surgery , Obesity/etiology , Diabetes Mellitus, Type 2/etiologyABSTRACT
This study aimed to assess the effects of light regime and time of slaughter on primal cut and organ weights, peptide transporter 1 (PEPT1) gene expression in the jejunum, arylalkylamine N-acetyltransferase (AANAT) gene expression in the brain, and liver oxidant/antioxidant status in broilers aged 37 days. The experiment was conducted in a factorial completely randomized design, with two light regimes (intermittent light varying according to bird age and continuous light under an 18 h light/6 h dark photoperiod) and four times of slaughter (2:00, 8:00, 14:00 and 20:00 h). There was an interaction effect on PEPT1 and AANAT expression, lipid and protein oxidation and superoxide dismutase (SOD) activity. In both light regimes, PEPT1 expression responded cubically to slaughter time. In the continuous light group, PEPT1 expression was highest in birds slaughtered at 2:00 and 14:00 h, whereas, in the intermittent light treatment, expression was highest at 8:00 h. In the continuous light regime, AANAT expression had a cubic relationship with time of slaughter, with the greatest values recorded at 20:00 h. In the intermittent light regime, slaughter time showed a cubic effect on lipid oxidation, which was highest at 8:00 h. In the continuous light group, there was a cubic effect on nitrite concentration, lipid oxidation, protein oxidation, and SOD activity; nitrite levels, lipid oxidation, and protein oxidation were highest and SOD activity was lowest in birds slaughtered at 14:00 h. Time of slaughter influenced catalase activity, which responded cubically; catalase activity was lowest at 8:00 and 14:00 h. This study is the first to demonstrate that PEPT1 expression in the jejunum of broilers follows a diurnal rhythm and varies according to light regime. The results also suggest that mainly continuous lighting and slaughter at 14:00 h when the animals are possibly more active may be more stressful to broilers.
Subject(s)
Melatonin , Animals , Melatonin/metabolism , Antioxidants , Chickens/metabolism , Jejunum/metabolism , Catalase/metabolism , Nitrites , Circadian Rhythm , Brain/metabolism , Liver/metabolism , Peptides , Lipids , Superoxide Dismutase/metabolismABSTRACT
Degradation of bovine small intestine and respective effects on biomechanics have not been described to date. Biomechanical testing of intestinal tissues is often carried out within a few hours of donor death and tissue deterioration is not accounted for. Freezing is efficient for the preservation of several tissues; however, it may cause cellular damage. This study investigated the morphologic and biomechanical changes of bovine jejunum at different postmortem moments. Effects of freezing and thawing on morphology and biomechanical behavior were also examined. Macroscopic changes were first noted within eight hours of death. At this time, histologic changes also started to set in, and biomechanical tests revealed lower bursting pressure (203.10±46.14mmHg). At 12 hours, tissue rearrangement was noted, and bursting pressure increased (238.43±31.04mmHg). A second drop in pressure was detected at 18 hours (235.20±38.21mmHg), followed by a progressive drop until the end of the experimental period. Histologic changes revealed progressive deterioration. Mechanical resistance did not differ between thawed and fresh specimens. It was concluded that bovine jejunal specimens retain biomechanical resistance up to 6 hours after death. Freezing and thawing did not affect the mechanical resistance of the intestinal wall in this experimental model.
A degradação do intestino delgado de bovinos e seu efeito biomecânico não são descritos na literatura. Trabalhos que envolvem a biomecânica intestinal realizam os ensaios em poucas horas após o óbito dos doadores, sem avaliação de seu estado de deterioração. O congelamento é eficiente na conservação de vários tecidos, porém pode provocar danos em nível celular. Este estudo teve por objetivo avaliar a degradação morfológica e biomecânica do jejuno de bovinos em diferentes tempos post mortem. O efeito do congelamento e do descongelamento sobre essas características também foi avaliado. As primeiras alterações macroscópicas foram observadas oito horas após o óbito. No mesmo momento, se iniciaram as alterações histológicas e a menor pressão suportada ao teste biomecânico (203,10±46,14mmHg). A partir de 12 horas, o tecido sofreu um rearranjo, suportando maior pressão (238,43±31,04mmHg). Uma segunda queda foi detectada após 18 horas (235,20±38,21mmHg), seguida de redução progressiva até o término do experimento. As lesões histológicas foram progressivas e graduais. As amostras testadas após descongelamento não apresentaram diferença estatística quanto à resistência mecânica em comparação com os espécimes frescos. Concluiu-se que as amostras mantêm sua resistência biomecânica até 6 horas após o óbito. Também se mostrou que o congelamento e o descongelamento, nas condições testadas, não alteraram a resistência mecânica da parede intestinal.
Subject(s)
Animals , Cattle , Organ Preservation , Biomechanical Phenomena , Cryopreservation , Freezing , JejunumABSTRACT
Inflammation is an important process for epithelial barrier protection but when uncontrolled, it can also lead to tissue damage. The nuclear factor-kappa light chain enhancer of activated B cells (NF-κB) signaling pathway is particularly relevant in the intestine, as it seems to play a dual role. Whereas NF-κB protects intestinal epithelium against various noxious stimuli, the same pathway mediates intestinal inflammatory diseases by inducing pro-inflammatory gene expression. The availability of appropriate in vitro models of the intestinal epithelium is crucial for further understanding the contribution of NF-κB in physiological and pathological processes and advancing in the development of drugs and therapies against gut diseases. Here we established, characterized, and validated three-dimensional cultures of intestinal organoids obtained from biopsies of NF-κB-RE-Luc mice. The NF-κB-RE-Luc intestinal organoids derived from different intestine regions recreated the cellular composition of the tissue and showed a reporter responsiveness similar to the in vivo murine model. When stimulated with TNF-α, jejunum-derived NF-κB-RE-Luc-reporter organoids, provided a useful model to evaluate the anti-inflammatory effects of natural and synthetic compounds. These reporter organoids are valuable tools to explore the epithelial TNF-α-induced NF-κB contribution in the small intestine, being a reliable alternative method while helping to reduce the use of laboratory animals for experimentation.
Subject(s)
NF-kappa B , Tumor Necrosis Factor-alpha , Animals , Inflammation/metabolism , Jejunum/metabolism , Mice , NF-kappa B/metabolism , Organoids/metabolism , Tumor Necrosis Factor-alpha/metabolismABSTRACT
La diverticulosis puede presentarse en cualquier sector del tubo digestivo. La topografía de intestino delgado es infrecuente, se presenta sobre todo a nivel del yeyuno y en un 35% de los casos se asocia con diverticulosis colónica. Es más frecuente en mayores de 40 años. Los divertículos van disminuyendo de tamaño y número hacia el sector distal. Habitualmente el diagnóstico es incidental, sin embargo, pueden presentar complicaciones de las cuales se destacan por frecuencia el sangrado gastrointestinal y la diverticulitis. Se plantea que la deficiencia de fibra dietética generaría anomalías en el peristaltismo intestinal, lo que junto con fenómenos pseudo-obstructivos y alta presión intraluminal, actuaría en áreas de debilidad focal provocando la lesión. Presentamos el caso de una paciente de 88 años con una oclusión de colon a la cual se le realizó una cirugía de Hartmann, en el intraoperatorio se identificó divertículos de yeyuno sin elementos complicaciones.
Subject(s)
Humans , Female , Aged, 80 and over , Diverticulum/diagnosis , Colon/surgery , Intestinal Obstruction/surgery , Jejunum , Octogenarians , Intraoperative ComplicationsABSTRACT
The present study was conducted to evaluate the effect of dietary zinc (Zn) levels on growth performance, carcass characteristic, nutrient digestibility, jejunum architecture and immune responses in broiler chickens fed wheat-soy diets. In addition the Zn requirement to optimize responses were estimated through regression models. A total, of 250 day-old male Ross-308 broiler chicks were randomly allocated to a completely randomized design experiment with five dietary treatments of five replicates of 10 birds each. Birds were fed diets containing 30, 70, 110, 150, and 190 mg/kg Zn from 1 to 35 days of age. A Zn level of 70 mg/kg diet was adequate to acquire typical growth performance, the nutrient digestibility, and carcass yield. First antibody titres response to sheep red blood cell inoculation, cutaneous basophil hypersensitivity elicited by phytohemagglutinin-P intradermal injection increased linearly by the increase in dietary Zn level. The Zn requirement estimated by the quadratic and linear broken-line models was varied between 63-70 mg/kg to optimize growth performance criteria. It is concluded the basal Zn concentration in wheat-soy diet is inadequate to fulfill the broiler chickens genetic potential in growth and a minimum of 70 mg/kg dietary Zn concentration is suggested to optimize broiler chickens performance.
Subject(s)
Animal Feed , Chickens , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Animals , Diet/veterinary , Dietary Supplements , Immunity , Jejunum , Male , Nutrients , Sheep , Triticum , Zinc/pharmacologyABSTRACT
Background: Multiple small-bowel diverticulosis comprises a rare entity with probable underestimated incidence, and that may be the reason why it is sometimes overlooked when managing cases with peritonitis. Case report: In the present paper, we report the case of a 76-year-old male presenting abdominal pain and fever in an acute setting. Computed tomography (CT) scans revealed jejunal thickening and numerous images of saccular addition that were interpreted as jejunoileal diverticulitis. After an initial period of clinical treatment, surgical management was indicated based on a worsening clinical picture and the presence of an extraluminal focus of gas detected in a subsequent CT scan. Through a laparoscopic approach, multiple small-bowel diverticula and a tamponade perforation were found. A segmental intestinal resection was performed, and the patient was discharged after a ten days. Conclusions: Multiple jejunal diverticulosis is a rare condition that should be remembered in the setting of an acute abdomen. As it prevails among older patients, early diagnosis with radiological aid is crucial to establish the most adequate management, including intestinal resection, if necessary. (AU)
Subject(s)
Humans , Male , Aged , Diverticulum/complications , Jejunum , Tomography, X-Ray Computed , Laparoscopy , Intestinal Perforation/etiologyABSTRACT
PURPOSE: To compare the adaptation processes of the remaining jejunum or ileum after extensive intestinal resection in a growing animal model. MATERIALS AND METHODS: Forty 21-day old rats were divided into four groups: JG: remaining jejunum group - ileal enterectomy; IG: ileum remaining group - jejunum enterectomy; SHAM: sham-operated group - open-and-close laparotomy; and NO: non-operated animals. RESULTS: After 3 weeks, JG and IG animals had decreased weights comparing to SHAM and NO animals (p = 0.017 and p = 0.005, respectively). The histomorphometric analysis showed that in JG animals the villi were higher than in SHAM, NO, and IG animals (p = 0.007, p = 0.008, and p = 0.01), the depth of crypts in JG and IG animals was greater than in NO and SHAM animals (p = 0.03, p = 0.002, and p = 0.003 respectively), and muscle layer thickness of the jejunum of JG animals had values greater than SHAM and NO animals (p = 0.01 and p = 0.02, respectively). The Ki-67 expression in the ileum was higher in comparison with the jejunum (p = 0.014). The pro-apoptotic gene (Bax) expression was decreased in JG animals compared to IG, SHAM, and NO animals (p = 0.013, p = 0.024, and p = 0.021). The anti-apoptotic gene (Bcl-XL) expression was decreased in JG animals in comparison to IG and NO animals (p = 0.002 and p = 0.046) although it was increased in the colon of IG animals in comparison to JG, SHAM, and NO animals (p = 0.002, p = 0.001, and p = 0.001, respectively). The Bax/Bcl-XL ratio was higher in JG than in IG animals (p = 0.011). CONCLUSION: Adaptive responses seemed to be more effective in the ileum than in the jejunum.
Subject(s)
Ileum , Jejunum , Adaptation, Physiological/physiology , Animals , Ileum/metabolism , Ileum/surgery , Intestinal Mucosa , Intestines , Jejunum/surgery , RatsABSTRACT
In vitro tests are performed to evaluate the efficacy of antimycotoxins additives (AMAs); nevertheless, such assays show a low correlation with in vivo trials, which are also required to determine AMAs' efficacy. In search of an alternative method, the current study investigated the use of an ex vivo technique. Six AMAs (AMA1 to AMA6) had their ability to reduce intestinal absorption of aflatoxin B1 (AFB1) evaluated. Jejunal explants were obtained from broilers and subjected to two treatments per AMA in Ussing chambers: T1 (control) - 2.8 mg/L AFB1, and T2 - 2.8 mg/L AFB1 + 0.5% AMA. AMAs were also tested in vitro to assess adsorption of AFB1 in artificial intestinal fluid. In the ex vivo studies, AMA1 to AMA6 decreased intestinal absorption of AFB1 by 67.11%, 73.82%, 80.70%, 85.86%, 86.28% and 82.32%, respectively. As for the in vitro results, AMA1 to AMA6 presented an adsorption of 99.72%, 99.37%, 99.67%, 99.53%, 99.04% and 99.15%, respectively. The evaluated ex vivo model proved useful in the assessment of AMAs. No correlation was reported between ex vivo and in vitro findings. Further studies are needed to elucidate the correlation between ex vivo and in vivo results seeking to reduce animal testing.
Testes in vitro são realizados para avaliar a eficácia de aditivos antimicotoxinas (AAMs); entretanto, tais experimentos apresentam uma baixa correlação com ensaios in vivo, que também são exigidos para determinar a eficácia de AAMs. Em busca de um método alternativo, o presente estudo investigou o uso de uma técnica ex vivo. A capacidade de seis AAMs (AAM1 a AAM6) de reduzir a absorção intestinal de aflatoxina B1 (AFB1) foi avaliada. Explantes jejunais foram coletados de frangos de corte e submetidos a dois tratamentos por AAM em câmaras de Ussing: T1 (controle) - 2,8 mg/L AFB1, e T2 - 2.8 mg/L AFB1 + 0,5% AAM. Os AAMs também foram testados in vitro para verificar a adsorção de AFB1 em fluido intestinal artificial. Nos ensaios ex vivo, AAM1 ao AAM6 diminuíram a absorção intestinal de AFB1 em 67,11%, 73,82%, 80,70%, 85,86%, 86,28% e 82,32%, respectivamente. Quanto aos achados in vitro, AAM1 ao AAM6 apresentaram adsorção de 99,72%, 99,37%, 99,67%, 99,53%, 99,04% e 99,15%, respectivamente. O modelo ex vivo avaliado mostrou-se eficiente na avaliação de AAMs. Não houve correlação entre os resultados ex vivo e in vitro. Estudos adicionais são necessários para definir a correlação entre achados ex vivo e in vivo na tentativa de reduzir os testes em animais.
Subject(s)
Animals , Antitoxins/analysis , Chickens , Aflatoxin B1/toxicity , Jejunum , In Vitro TechniquesABSTRACT
The objective was to evaluate the productivity, microbiology and histopathology of the jejunum, ceca and liver in broilers fed a control or a high non-starch polysaccharide (HNSPs) diet added with an extract of humic substances (EHS). 240 broilers individually allocated, from 21-42 d of age were assigned to a factorial arrangement of 2 types of diets: 1) A corn/soybean meal diet (Control) and 2) As Control plus 7% distillers dried grain with solubles and 12% of wheat bran (HNSPs), and 3 growth promoters: 1) Antibiotic growth promoters (AGP); 2) without AGP (NAGP) and C) with 0.5% of EHS. At the end of the trial, the breast and carcass were weighed and samples of the intestine, ceca and liver were taken for microbial and histopathology analysis. Results were subjected to ANOVA. EHS-fed broilers had lower feed conversion ratio (FCR) and total aerobic bacterial (TAB) counts in the liver and higher ashes digestibility with the Control diet, but negative responses were seen with the HNSPs diet (Type of diet and growth promoter interaction, p≤0.05). The lesion scores in the jejunum were lower in EHS-fed broilers with the Control and HNSPs diet (p≤0.05). The TAB and E. coli were lower in the jejunum and ceca of AGP-fed broilers (p<0.01) compared to NAGP and EHS groups. EHS-fed broilers showed improved FCR and ileal ashes digestibility and lower TAB in the liver with the Control diet and had lower lesion score in the jejunum and similar weight gain compared to the AGP-fed broilers.(AU)