Ruminococcus gnavus bacteremia: Literature review and a case report associated with acute flare of ulcerative colitis in an immunocompromised patient.

We present a case of bacteremia caused by Ruminococcus gnavus in an immunocompromised patient. R. gnavus is a Gram-positive strict anaerobe bacterium that forms chains. The bacteremia has been associated with an acute flare of ulcerative colitis. Anaerobic bacteremia is becoming increasingly frequent in patients with compromised gastrointestinal barrier. The role of the human microbiota and its alterations in the pathogenesis of immune-related diseases is an expanding area of interest. R. gnavus has been identified as a microorganism that may be responsible for the development of these diseases. The contribution of anaerobic bacteria to the pathogenesis of inflammatory bowel disease (IBD) is discussed, and cases reported up until 2023 were reviewed.

Beta Endorphins are not responsible for delayed gastric emptying of digestible solids after exercise in professional cyclists. A preliminary study / Las Beta endorfinas no son responsables del retardo del vaciamiento gástrico de sólidos en ciclistas profesionales tras el ejercicio. Un estudio preliminar

Objective: It has been reported that professional cyclists had an accelerated solid gastric emptying which decreased by increasing the exercise intensity. That could be explained by a predominance of stress-dependent motility inhibitors such gastrointestinal hormones, neurotransmitters and or the predominance of the gastric inhibitory vagal motor circuit. The aim of this preliminary study was to evaluate the role of β-endorphins, inhibitors of gastric motility, in these findings. Methods: Gastric emptying of solids marked with Tc99 while resting and plasmatic levels of β-endorphins were evaluated in 27 healthy controls and 19 professional cyclists (day 1). Besides, gastric emptying of solids was also assessed in cyclists when they reached 50% (day 1) and 75% (day 2) of the maximum oxygen consumption (low and high, respectively), during exercise on the cycle-ergometer. The third day, naloxone was administered in cyclists in order to block the β-endorphins receptors and gastric emptying was measured when they reached 75% of the maximum oxygen consumption. Results: Basal β-endorphin levels were lower in cyclists vs controls (p<0.05) and they increased with the exercise intensity (p<0.001). There were no significant differences in gastric emptying of solids with or without naloxone when 75% of the maximum oxygen consumption was reached. Conclusions: The inhibitory effect of the exercise in the gastric emptying of solids does not seem to be secondary to the action of β-endorphins, that leaves the gastric inhibitory vagal motor circuit a more likely predominant role.(AU)

Objetivo: Se ha informado de que los ciclistas profesionales tienen un vaciado gástrico sólido acelerado que disminuye al aumentar la intensidad del ejercicio. Esto podría explicarse por un predominio de los inhibidores de la motilidad dependientes del estrés, como las hormonas gastrointestinales, los neurotransmisores y o el predominio del circuito motor vagal inhibidor gástrico. El objetivo de este estudio preliminar fue evaluar el papel de las β-endorfinas, inhibidores de la motilidad gástrica, en estos hallazgos. Métodos: Se evaluó el vaciado gástrico de sólidos marcado con Tc99 mientras se evaluaban los niveles en reposo y plasmáticos de β-endorfinas en 27 controles sanos y 19 ciclistas profesionales (día 1). Además, también se evaluó el vaciado gástrico de sólidos en los ciclistas cuando alcanzaron el 50% (día 1) y el 75% (día 2) del consumo máximo de oxígeno (bajo y alto, respectivamente), durante el ejercicio en el cicloergómetro. El tercer día, se administró naloxona en los ciclistas para bloquear los receptores de β-endorfinas y se midió el vaciado gástrico cuando alcanzaron el 75% del consumo máximo de oxígeno. Resultados: Los niveles basales de β-endorfina fueron menores en los ciclistas frente a los controles (p<0,05) y aumentaron con la intensidad del ejercicio (p<0,001). No hubo diferencias significativas en el vaciado gástrico de sólidos con o sin naloxona cuando se alcanzó el 75% del consumo máximo de oxígeno. Conclusiones: El efecto inhibidor del ejercicio en el vaciado gástrico de sólidos no parece ser secundario a la acción de las β-endorfinas, lo que deja al circuito motor vagal inhibitorio gástrico un papel más probablemente predominante.(AU)

ß-Endorphins are not responsible for delayed gastric emptying of digestible solids after exercise in professional cyclists. A preliminary study.

OBJECTIVE: It has been reported that professional cyclists had an accelerated solid gastric emptying which decreased by increasing the exercise intensity. That could be explained by a predominance of stress-dependent motility inhibitors such gastrointestinal hormones, neurotransmitters and or the predominance of the gastric inhibitory vagal motor circuit. The aim of this preliminary study was to evaluate the role of ß-endorphins, inhibitors of gastric motility, in these findings. METHODS: Gastric emptying of solids marked with Tc99 while resting and plasmatic levels of ß-endorphins were evaluated in 27 healthy controls and 19 professional cyclists (day 1). Besides, gastric emptying of solids was also assessed in cyclists when they reached 50% (day 1) and 75% (day 2) of the maximum oxygen consumption (low and high, respectively), during exercise on the cycle-ergometer. The third day, naloxone was administered in cyclists in order to block the ß-endorphins receptors and gastric emptying was measured when they reached 75% of the maximum oxygen consumption. RESULTS: Basal ß-endorphin levels were lower in cyclists vs controls (p<0.05) and they increased with the exercise intensity (p<0.001). There were no significant differences in gastric emptying of solids with or without naloxone when 75% of the maximum oxygen consumption was reached. CONCLUSIONS: The inhibitory effect of the exercise in the gastric emptying of solids does not seem to be secondary to the action of ß-endorphins, that leaves the gastric inhibitory vagal motor circuit a more likely predominant role.

SARS-CoV-2 infection presenting as acute acalculous cholecystitis

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When the routine gets complicated: Gastric and splenic perforation by a nasogastric tube.

Every invasive procedure carries some kind of risk, however rutine it may be. We present a case of a male patient which suffers a gastric and splenic perforation by a nasogastric tube, solved by means of surgery.

Hematochezia secondary to hemosuccus pancreaticus due to a pseudoaneurysm associated with a pancreatic pseudocyst.

The patient had a history of recurrent acute necrotizing pancreatitis, chronic pancreatitis and a pancreatic pseudocyst with an associated pseudoaneurysm in the superior mesenteric artery. He presented mesogastric pain, nausea, 187 U/l amylase and 242 U/l lipase. A hemorrhagic appearance inside the pseudocyst and lumen of the common bile duct was seen on ultrasound.

Enteroscopia como prueba diagnóstica de metástasis de melanoma / No disponible

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Digestive involvement in a patient with Lambert-Eaton syndrome.

We present the case of a 50-year-old male diagnosed with myasthenia gravis, secondary to thymoma or Lambert-Eaton syndrome during the study of repeated vomiting. Gastrointestinal symptoms persisted despite the treatment of the thymoma. He suffered from sigma volvulus that required sigmoidectomy 9 years after diagnosis. Neuromuscular junction disorders are not characterized by gastrointestinal involvement, as in our case. They have previously sporadically been related to intestinal motility dysfunction.

Afectación digestiva en paciente con síndrome de Lambert-Eaton / No disponible

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Protusión mucosa en cápsula endoscópica. ¿En qué podemos pensar? / Mucosal prolapse in capsule endoscopy. What does it make us think of?

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Enteroscopy in the diagnosis of melanoma metastases.

We present abdominal computed tomography and enteroscopy images of a 48-year-old male patient with a previous melanoma who presented with epigastric pain. The pain was not controlled with medical management. Abdominal computed tomography and a histological study of biopsies form enteroscopy confirmed the diagnosis of metastatic melanoma. The gastrointestinal involvement of melanoma is usually metastatic. Symptomatic gastrointestinal involvement occurs in less than 5% of melanomas, although postmortem analyses have reported up to 70%. The clinical presentation is variable and usually presents as abdominal pain. The diagnosis of small intestinal involvement of melanoma is a challenge due to its poor accessibility. The enteroscopy has a fundamental role as it allows a direct visualization and biopsies to be taken for histological study.

Temporomandibular joint dislocation after an upper endoscopy: a complication to consider.

After observing a case of a temporomandibular joint dislocation after an upper endoscopy, we carried out a literature review to find out how frequent it is and suggest the sedation as a possible risk factor to such complication.

Luxación mandibular tras endoscopia: una complicación a tener en cuenta / No disponible

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