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3.
Int J Nanomedicine ; 14: 7191-7213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564873

RESUMO

Background: Diosmin showed poor water solubility and low bioavailability. Poly(d,l-lactide-co-glycolide) (PLGA) nanoparticles were successfully used to improve the drugs solubility and bioavailability. Coating of PLGA nanoparticles with chitosan can ameliorate their gastric retention and cellular uptake. Methodology: PLGA nanoparticles of diosmin were prepared using different drug and polymer amounts. Nanoparticles were selected based on entrapment efficiency% (EE%) and particle size measurements to be coated with chitosan. The selected nanoparticles either uncoated or coated were evaluated regarding morphology, ζ-potential, solid-state characterization, in vitro release, storage stability, and mucoadhesion. The anti-ulcer activity (AA) against ethanol-induced ulcer in rats was assessed through macroscopical evaluation, histopathological examination, immunohistochemical localization of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and transmission electron microscopic examination of gastric tissues compared to free diosmin (100 mg/kg) and positive control. Results: Based on EE% and particle size measurements, the selected nanoparticles, either uncoated or coated with 0.1% w/v chitosan, were based on 1:15 drug-PLGA weight ratio and 20 mg diosmin employing methylene chloride as an organic phase. Examination by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed nanoscopic spherical particles. Drug encapsulation within the selected nanoparticles was suggested by Fourier transform-infrared, differential scanning calorimetry (DSC) and X-ray diffractometry results. Chitosan-coated nanoparticles were more stable against size enlargement probably due to the higher ζ-potential. Only coated nanoparticles showed gastric retention as revealed by SEM examination of stomach and duodenum. The superior AA of coated nanoparticles was confirmed by significant reduction in average mucosal damage, the majority of histopathological changes and NF-κB expression in gastric tissue when compared to positive control, diosmin and uncoated nanoparticles as well as insignificant difference relative to normal control. Coated nanoparticles preserved the normal ultrastructure of the gastric mucosa as revealed by TEM examination. Conclusion: The optimized chitosan-coated PLGA nanoparticles can be represented as a potential oral drug delivery system of diosmin.


Assuntos
Antiulcerosos/uso terapêutico , Quitosana/química , Diosmina/uso terapêutico , Nanopartículas/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Estômago/patologia , Úlcera/tratamento farmacológico , Adesividade , Animais , Antiulcerosos/farmacologia , Varredura Diferencial de Calorimetria , Diosmina/farmacologia , Portadores de Fármacos/química , Liberação Controlada de Fármacos , Duodeno/efeitos dos fármacos , Duodeno/patologia , Duodeno/ultraestrutura , Mucosa Gástrica/patologia , Mucosa Gástrica/ultraestrutura , Cinética , Masculino , Muco/química , NF-kappa B/metabolismo , Nanopartículas/ultraestrutura , Tamanho da Partícula , Ratos Sprague-Dawley , Espectroscopia de Infravermelho com Transformada de Fourier , Estômago/efeitos dos fármacos , Estômago/ultraestrutura , Úlcera/patologia , Difração de Raios X
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(9): 856-860, 2019 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-31550825

RESUMO

Objective: To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra-gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods: A retrospective case - control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra - gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann-Whitney U-test. Survival curves were drawn by the Kaplan-Meier method and compared with the Log-rank test. Results: Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ(2)=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow-up of whole group was 43 (14 to 76) months. The 3-year recurrence/metastasis-free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3-year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions: As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.


Assuntos
Tumores do Estroma Gastrointestinal , Neoplasias de Tecido Conjuntivo , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/mortalidade , Neoplasias Duodenais/patologia , Duodeno/patologia , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/mortalidade , Tumores do Estroma Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias de Tecido Conjuntivo/diagnóstico , Neoplasias de Tecido Conjuntivo/patologia , Prognóstico , Estudos Retrospectivos , Estatísticas não Paramétricas
7.
Khirurgiia (Mosk) ; (5): 77-81, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31169824

RESUMO

Treatment of complicated giant duodenal ulcers is one of the most difficult problems in abdominal surgery. Simultaneous course of diabetes mellitus and giant duodenal ulcer has clinical features and requires correction of the treatment. It is presented case report that may be useful regarding accumulation of knowledge about comorbid course of these pathologies. The patient 58-year old was urgently delivered with signs of gastrointestinal bleeding, ulcerative anamnesis for 15 years, diabetes mellitus type 2 for 8 years. Gastroduodenoscopy revealed chronic giant (2.5×3.5 cm) duodenal ulcer complicated by bleeding and subcompensated pyloric stenosis. Endoscopic hemostasis included drug injection and argon-plasma coagulation. Recurrent bleeding occurred after 22 hours. It was performed Billroth II procedure with resection of 2/3 of the stomach and manual formation of 'difficult' duodenal stump. Cicatricial ring was used as a frame for the stump. Postoperative period was uneventful, patient was discharged after 14 days. This clinical case demonstrates the need for more active surgical strategy in patients with diabetes mellitus and reliability of the proposed method of 'difficult' stump forming.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Úlcera Duodenal/cirurgia , Úlcera Péptica Hemorrágica/cirurgia , Estenose Pilórica/cirurgia , Cicatriz/etiologia , Cicatriz/cirurgia , Úlcera Duodenal/complicações , Úlcera Duodenal/diagnóstico , Duodeno/patologia , Duodeno/cirurgia , Gastroenterostomia , Humanos , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/etiologia , Estenose Pilórica/diagnóstico , Estenose Pilórica/etiologia , Reprodutibilidade dos Testes
8.
PLoS Negl Trop Dis ; 13(6): e0007415, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170141

RESUMO

BACKGROUND: Strongyloides stercoralis is an intestinal nematode unique in its ability to replicate in the human host, allowing ongoing cycles of autoinfection, persisting for decades within the same host. Although usually asymptomatic, overwhelming infections can occur in Strongyloides and HTLV-1 co-infected individuals (SS/HTLV-1). Regulatory T cells (Tregs) are able to blunt specific Th2 responses necessary to control the parasite. We previously reported that peripheral blood Tregs are increased in SS/HTLV-1 and correlate with low Th2 responses. We hypothesized that Tregs are also increased at the site of infection in duodenal mucosa. METHODS: Paraffin embedded duodenal biopsies were obtained from 10 SS/HTLV-1 patients, 3 controls with non-parasitic chronic duodenitis, and 2 healthy controls. Immunohistochemistry was performed using monoclonal antibodies against human CD3, CD8, IgE and FoxP3. The number of cells were counted using a conventional light microscope. The number of CD3+, CD8+, FoxP3+ and IgE positive cells per 0.35 mm2 was measured using ImagePro Plus software comparing areas adjacent or distant from parasite material. RESULTS: In patients with SS/HTLV-1, T lymphocyte counts and CD8+ cells were lower in areas adjacent to the parasite compared to non-adjacent areas (CD3+: adjacent: 6.5 [Interquartile range (IQR: 2.8-12.3)]; non-adjacent: 24.5 [IQR: 20.9-34.4]; Mann-Whitney p = 0.0003; CD8+: adjacent: 4.5 [IQR: 2.3-11.8]; non-adjacent: 21 [IQR: 15.3-42.9]; Mann-Whitney p = 0.0011). Tregs cells in the intestines (FoxP3+ expressing cells) were increased in patients with SS/HTLV-1 compared with patients with chronic duodenitis (SS/HTLV-1: 1.5 [IQR: 0.7-2.3]; duodenitis controls: 0 [range 0-0.7]; healthy controls: 0; Mann-Whitney p = 0.034). There was also a trend towards fewer eosinophils adjacent to the parasites. Among SS/HTLV-1 patients the number of IgE expressing cells was increased for in areas not adjacent to the parasite compared to non-adjacent areas (ANOVA, p = 0.001). CONCLUSIONS: Our data shows increased Treg cell numbers localized adjacent to the parasites in the duodenum SS/HTLV-1 patients. In addition, other T lymphocytes and IgE expressing cells were decreased adjacent to the parasites, suggesting an important role for Tregs in down-regulating local parasite effector responses.


Assuntos
Coinfecção/patologia , Duodeno/patologia , Infecções por HTLV-I/patologia , Imunoglobulina E/análise , Fatores Imunológicos/análise , Estrongiloidíase/patologia , Linfócitos T Reguladores/imunologia , Adolescente , Adulto , Biópsia , Coinfecção/complicações , Feminino , Expressão Gênica , Infecções por HTLV-I/complicações , Humanos , Imuno-Histoquímica , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estrongiloidíase/complicações , Adulto Jovem
9.
Gastroenterology ; 157(1): 109-118.e5, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31100380

RESUMO

BACKGROUND & AIMS: Confocal laser endomicroscopy (CLE) is a technique that permits real-time detection and quantification of changes in intestinal tissues and cells, including increases in intraepithelial lymphocytes and fluid extravasation through epithelial leaks. Using CLE analysis of patients with irritable bowel syndrome (IBS), we found that more than half have responses to specific food components. Exclusion of the defined food led to long-term symptom relief. We used the results of CLE to detect reactions to food in a larger patient population and analyzed duodenal biopsy samples and fluid from patients to investigate mechanisms of these reactions. METHODS: In a prospective study, 155 patients with IBS received 4 challenges with each of 4 common food components via the endoscope, followed by CLE, at a tertiary medical center. Classical food allergies were excluded by negative results from immunoglobulin E serology analysis and skin tests for common food antigens. Duodenal biopsy samples and fluid were collected 2 weeks before and immediately after CLE and were analyzed by histology, immunohistochemistry, reverse transcription polymerase chain reaction, and immunoblots. Results from patients who had a response to food during CLE (CLE+) were compared with results from patients who did not have a reaction during CLE (CLE-) or healthy individuals (controls). RESULTS: Of the 108 patients who completed the study, 76 were CLE+ (70%), and 46 of these (61%) reacted to wheat. CLE+ patients had a 4-fold increase in prevalence of atopic disorders compared with controls (P = .001). Numbers of intraepithelial lymphocytes were significantly higher in duodenal biopsy samples from CLE+ vs CLE- patients or controls (P = .001). Expression of claudin-2 increased from crypt to villus tip (P < .001) and was up-regulated in CLE+ patients compared with CLE- patients or controls (P = .023). Levels of occludin were lower in duodenal biopsy samples from CLE+ patients vs controls (P = .022) and were lowest in villus tips (P < .001). Levels of messenger RNAs encoding inflammatory cytokines were unchanged in duodenal tissues after CLE challenge, but eosinophil degranulation increased, and levels of eosinophilic cationic protein were higher in duodenal fluid from CLE+ patients than controls (P = .03). CONCLUSIONS: In a CLE analysis of patients with IBS, we found that more than 50% of patients could have nonclassical food allergy, with immediate disruption of the intestinal barrier upon exposure to food antigens. Duodenal tissues from patients with responses to food components during CLE had immediate increases in expression of claudin-2 and decreases in occludin. CLE+ patients also had increased eosinophil degranulation, indicating an atypical food allergy characterized by eosinophil activation.


Assuntos
Alérgenos , Claudina-2/metabolismo , Citocinas/metabolismo , Duodeno/patologia , Proteína Catiônica de Eosinófilo/metabolismo , Hipersensibilidade Alimentar/patologia , Linfócitos Intraepiteliais/patologia , Síndrome do Intestino Irritável/patologia , Ocludina/metabolismo , Adolescente , Adulto , Idoso , Animais , Biópsia , Degranulação Celular , Duodeno/metabolismo , Hipersensibilidade a Ovo/metabolismo , Hipersensibilidade a Ovo/patologia , Clara de Ovo , Endoscopia do Sistema Digestório , Eosinófilos/metabolismo , Feminino , Hipersensibilidade Alimentar/metabolismo , Humanos , Imunoglobulina E , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Síndrome do Intestino Irritável/metabolismo , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Leite , Hipersensibilidade a Leite/metabolismo , Hipersensibilidade a Leite/patologia , Permeabilidade , Estudos Prospectivos , RNA Mensageiro/metabolismo , Soja , Junções Íntimas/metabolismo , Junções Íntimas/patologia , Triticum , Hipersensibilidade a Trigo/metabolismo , Hipersensibilidade a Trigo/patologia , Leveduras , Adulto Jovem
11.
Vet Immunol Immunopathol ; 210: 15-22, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30947975

RESUMO

Toll-like receptor 4 (TLR4), nucleotide-binding oligomerization domain 2 (NOD2), and TNF-α play important roles in human inflammatory bowel diseases. The aim of this study was to elucidate the relationship between Toll-like receptor 4, NOD2, and TNF-α and the severity of chronic gastrointestinal diseases in dogs. We examined the expression levels of TLR4, NOD2, and TNF-α in the stomach, duodenum, ileum, colon, and rectum obtained from 21 dogs with chronic gastrointestinal disease, including inflammatory bowel disease, high-grade lymphoma, food responsive enteropathy, chronic pancreatitis, low-grade lymphoma, inflammatory colorectal polyp, and chronic colitis. Next, we demonstrated whether there is good correlation between the expression levels of TLR4, NOD2, and TNF-α and the histopathological analysis of each sample. We found that the level of TLR4 expression in the ileum of dogs with chronic gastrointestinal disease was positively associated with the histopathological severity. We also found that the level of NOD2 expression in the duodenum, stomach, and rectum was positively associated with the histopathological severity. However, there was no correlation between TNF-α expression in the 5 regions tested in this study and the histopathological severity. These findings indicate that TLR4 and NOD2 are remarkably associated with the severity of chronic gastrointestinal disease in dogs.


Assuntos
Gastroenteropatias/imunologia , Gastroenteropatias/patologia , Proteína Adaptadora de Sinalização NOD2/genética , Receptor 4 Toll-Like/genética , Animais , Biópsia , Doença Crônica , Colo/imunologia , Colo/patologia , Cães , Duodeno/imunologia , Duodeno/patologia , Feminino , Masculino , Índice de Gravidade de Doença , Transdução de Sinais , Estômago/imunologia , Estômago/patologia , Fator de Necrose Tumoral alfa/genética
12.
Medicine (Baltimore) ; 98(14): e15035, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946342

RESUMO

RATIONALE: Ulcerative colitis (UC) is a chronic, nonspecific, inflammatory disease of the colon. Colorectal is the main target organ of UC, while other digestive tract involvement is rare. This report describes 2 rare cases of duodenal mucosa lesions in patients with UC after total colectomy. PATIENT CONCERNS: In case 1, a patient of 45-year-old with intermittent diarrhea and bloody mucosanguineous feces who was diagnosed as UC, revealed diffuse erosive ulcers in the descending duodenum through gastroscopy after total colectomy. In case 2, a 55-year-old Chinese female with UC, aggravated to colon cancer and received total colectomy. Eighteen months after surgery, the patient was admitted to hospital following upper abdominal pain and acid regurgitation. A gastroscopy found inflammation in the descending part of the duodenum. DIAGNOSIS: UC, duodenal mucosa lesions INTERVENTIONS:: In case 1, the patient was treated with oral mesalazine (1 g/tid) and hydrocortisone (0.3 g/d) but symptoms did not improve, and the treatment was changed to oral methylprednisolone (0.6 g/d) and a hydrocortisone enema (0.1 g/late). Finally, the patient underwent a total colectomy and ileostomy. In case 2, the patient was treated with sulfasalazine, mesalazine, and intermittent hormone enemas. A total colectomy and ileostomy were performed with the patient after diagnosed as colon cancer. After surgery, the patient received N1-(2 tetrahydrofuryl)-5-fluorouracil (FT-207), 8 g, 300 mg, and 100 mg oxaliplatin chemotherapy, and biologic therapy. OUTCOMES: In case 1, the patient presented with duodenal necrosis and died of septic shock. In case 2, the patient recovered well without recurrence by taking proton pump inhibitor. LESSONS: The occurrence of UC related ulcerative gastroduodenal mucosal lesions may be associated with progressing UC or total colitis that does not respond to hormone therapy, leading to requirement of total colectomy.


Assuntos
Colite Ulcerativa/complicações , Neoplasias Duodenais/etiologia , Colectomia/métodos , Colite Ulcerativa/patologia , Colite Ulcerativa/cirurgia , Neoplasias do Colo/etiologia , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Duodeno/patologia , Duodeno/cirurgia , Feminino , Humanos , Mucosa Intestinal/patologia , Mucosa Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade
13.
BMJ Case Rep ; 12(4)2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30948400

RESUMO

Intramural small bowel haematoma is a rare cause of intestinal obstruction in children. Coagulation disorders or anticoagulant therapy are the most common cause followed by blunt trauma. A one and half-year-old boy, with known case of gastro-oesophageal reflux disease had undergone upper gastrointestinal endoscopy and biopsy. Four days later, he presented to us with clinical features of small bowel obstruction. CT of the abdomen showed features suggestive of haemorrhagic duplication cyst. Explorative laparotomy revealed 15-20 cm of bowel from the third part of the duodenum to proximal jejunum filled with clotted blood and thinned out serosa. There was no evidence of intraluminal blood in the distal bowel loops. Resection of the involved bowel with primary anastomoses was done. Histopathological examination of bowel revealed intramural haematoma associated with prolapse of the mucosa. There was no evidence of duplication cyst or vascular malformations. Postoperative period was uneventful.


Assuntos
Duodenopatias/complicações , Hemorragia Gastrointestinal/complicações , Hematoma/complicações , Mucosa Intestinal/patologia , Obstrução Intestinal/etiologia , Duodenopatias/patologia , Duodeno/patologia , Hemorragia Gastrointestinal/patologia , Hematoma/patologia , Humanos , Lactente , Masculino , Prolapso
14.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936343

RESUMO

Common variable immunodeficiency syndrome (CVID) is a heterogeneous disorder characterised by diminished levels of IgG, IgA and/or IgM, and recurrent bacterial infections. Sinopulmonary infections are most commonly reported followed by gastrointestinal (GI) infections. GI tract represents the largest immune organ with abundance of lymphoid cells, its involvement can manifest variably ranging from asymptomatic involvement to florid symptoms and signs. Diffuse nodular lymphoid hyperplasia (DNLH) of the GI tract is characterised by numerous small polypoid nodules of variable size in the small intestine, large intestine or both. It is commonly seen in association to immunodeficiency states such as CVID, IgA deficiency and chronic infections due to Giardia lamblia and Helicobacter pylori and cryptosporidiosis. Repetitive antigenic stimulation leads to lymphoid hyperplasia. We herein describe a case of DNLH of the intestine and another case of duodenal cytomegalovirus (CMV) infection associated with CVID.


Assuntos
Imunodeficiência de Variável Comum/virologia , Infecções por Citomegalovirus/complicações , Diarreia/virologia , Duodeno/patologia , Hiperplasia/virologia , Intestino Delgado/patologia , Transtornos Linfoproliferativos/virologia , Adulto , Antivirais/uso terapêutico , Imunodeficiência de Variável Comum/tratamento farmacológico , Imunodeficiência de Variável Comum/fisiopatologia , Infecções por Citomegalovirus/fisiopatologia , Duodeno/virologia , Endoscopia do Sistema Digestório , Ganciclovir/uso terapêutico , Humanos , Hiperplasia/tratamento farmacológico , Hiperplasia/fisiopatologia , Imunoglobulinas Intravenosas/uso terapêutico , Intestino Delgado/virologia , Transtornos Linfoproliferativos/tratamento farmacológico , Transtornos Linfoproliferativos/fisiopatologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
15.
Indian J Pathol Microbiol ; 62(2): 290-292, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971558

RESUMO

Brunner's gland hamartomas (BGHs) are uncommon lesions of duodenum which show hyperplasia of these glands along with smooth muscle bundles, adipose tissue and lymphoid aggregates. These are usually benign, solitary, pedunculated, polypoidal lesions. Dysplastic changes in BGH are extremely rare and even rarer is the multiplicity of this lesion. We hereby report an index case of BGH showing features of high-grade dysplasia, presenting as multiple duodenal polyps.


Assuntos
Glândulas Duodenais/patologia , Duodenopatias/diagnóstico , Hamartoma/diagnóstico , Pólipos/patologia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Mucosa Gástrica/patologia , Hamartoma/patologia , Humanos , Hiperplasia , Masculino , Pancreaticoduodenectomia , Tomografia Computadorizada por Raios X , Adulto Jovem
16.
Microb Pathog ; 132: 1-9, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30999021

RESUMO

Enteroinvasive Escherichia coli (EIEC) are well-known food-borne pathogens that cause animal intestinal diseases. Lactobacillus is believed to inhibit intestinal pathogens and maintain a healthy gut microbiota. This study aimed to investigate the effects of pre-supplementation of Lactobacillus from yaks (4500m) to prevent the clinical symptoms and the improvement of the disordered flora caused by E. coli infection. Forty healthy mice were randomized to four study groups (n = 10); Leuconostoc pseudomesenteroides (LP1), Lactobacillus johnsonii (LJ1), blank control, and control groups. Mice in the LP1, LJ1, and control groups were intraperitoneally challenged with EIEC O124 (1 × 109 CFU) on day 23. After two days, the mice in control group were recorded for high mortality. The diarrhea in LP1 and LJ1 groups was much lower than that in the control group, and no death was recorded. In histopathology, pre-supplementation of LJ1 and LP1 relieved the damage to the liver, spleen and duodenum caused by E. coli. In addition, the normal intestinal microecology was also affected by infection of EIEC, including an increase in relative abundance of Proteobacteria. At the same time, the beneficial bacteria were increased and harmful bacteria were decreased in different intestinal segments of the LJ1 and LP1 groups compared to the control group. In conclusion, pre-supplementation of LP1 and LJ1 can mitigate EIEC-induced intestinal flora dysbiosis and can also reduce EIEC-associated diarrhea.


Assuntos
Diarreia/prevenção & controle , Infecções por Escherichia coli/prevenção & controle , Microbioma Gastrointestinal , Lactobacillus/fisiologia , Animais , Bovinos , DNA Bacteriano , Diarreia/microbiologia , Suplementos Nutricionais , Modelos Animais de Doenças , Duodeno/patologia , Disbiose , Escherichia coli , Infecções por Escherichia coli/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Intestinos/microbiologia , Intestinos/patologia , Lactobacillus/isolamento & purificação , Fígado/patologia , Camundongos , RNA Ribossômico 16S/genética , Baço/patologia , Tibet
18.
J Gastrointestin Liver Dis ; 28(1): 15-22, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30851167

RESUMO

BACKGROUND AND AIMS: There is no literature on the role of repeat small bowel capsule endoscopy (SBCE) in patients with refractory coeliac disease (RCD) following treatment with steroids +/- immunosuppressants. METHODS: The findings on SBCEs from a group of patients with histologically proven RCD (n=23) were compared to the findings from patients with uncomplicated coeliac disease (n=48). All patients had concurrent duodenal histology and serology taken at the time of SBCE. RESULTS: Patients with RCD had a greater extent of mucosal involvement on SBCE than patients with uncomplicated CD (42.4+/-34.1% vs 9.7+/-21.7%, p=0.0001). Following treatment with steroids and / or immunosuppressants, patients with RCD had an improvement in the extent of affected small bowel mucosa (42.4+/-34.1% vs 26.4+/-28.9% p=0.012). There was no statistical difference in histology and serology taken at the time of the first and second SBCE in patients with RCD. CONCLUSIONS: Our study suggests that SBCE is valuable in documenting the extent of mucosal involvement in patients with RCD. This is the first study that delineates the value of a second look SBCE to assess improvement in the extent of disease in the small bowel following treatment.


Assuntos
Endoscopia por Cápsula , Doença Celíaca/tratamento farmacológico , Doença Celíaca/patologia , Duodeno/efeitos dos fármacos , Duodeno/patologia , Imunossupressores/uso terapêutico , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/patologia , Esteroides/uso terapêutico , Adulto , Idoso , Doença Celíaca/complicações , Resistência a Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Cicatrização/efeitos dos fármacos
19.
Intern Med ; 58(13): 1865-1870, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30918185

RESUMO

An unconscious 55-year-old man with a history of neurofibromatosis type 1 (NF1) was transported to the emergency department and was diagnosed with acute renal failure owing to a large bladder tumor. A submucosal tumor was also identified in the duodenum. The patient was diagnosed with a primary gastrointestinal stromal tumor (GIST) of the bladder and duodenum. After six cycles of regorafenib therapy, 18F-fluorodeoxyglucose accumulation in the duodenal GIST on positron emission tomography-computed tomography (PET-CT) showed a partial metabolic response. Currently, no standard drug therapy for unresectable or relapsed NF1-associated GIST has been established. Regorafenib may thus be considered as and appropriate initial therapy.


Assuntos
Duodeno/patologia , Inibidores Enzimáticos/uso terapêutico , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/patologia , Neurofibromatose 1/patologia , Compostos de Fenilureia/uso terapêutico , Piridinas/uso terapêutico , Neoplasias da Bexiga Urinária/patologia , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Neurofibromatose 1/diagnóstico por imagem , Neurofibromatose 1/etiologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Resultado do Tratamento
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