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1.
Medicine (Baltimore) ; 100(13): e25321, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33787625

RESUMO

ABSTRACT: Factors related to developing postoperative ileus (POI) vary from pharmacologic, inflammatory, hormonal, metabolic, gastrointestinal physiology, neurologic, to psychological factors. Although orthopedic-related incidence of postoperative ileus is about 10%, these studies are limited to spine surgery and pelvic surgery. The purpose of this study was to investigate prevalence of POI and to analyze effect of chewing gum on POI and bowel function in elderly patients after hip fracture surgery.A prospective randomized controlled trial was conducted at the Gyeongsang National University Hospital. Elderly patients with hip fracture who underwent surgery from March 2017 to June 2018 were eligible to participate. Patients were excluded if they had a mastication disability, impaired cognitive function, previous history of gastrointestinal disease, respiratory disease and low oxygen saturation, hip arthroplasty with causes other than hip fractures, acetabular fractures, periprosthetic fractures, or pathological fractures. Patients with consciousness problem by excessive anesthesia were also excluded. Patients were classified into 2 groups by randomization. Group I received sugar-free gum and were encouraged to chew 6 hours following surgery until the first intestinal gas is released. Group II was given the same postoperative procedure and encouraged to consume water after 6 hours.After applying exclusion criteria, 74 patients were finally included. Thirty-one patients were classified to Group I and 43 patients were classified to the Group II. Prevalence of POI in all patients with hip fracture was 63.5% (47/74). Prevalence of POI in Group I was statistically significant lower than that in Group II (Group I: 41%, Group II: 79.1%, P = .01)The prevalence of POI in elderly patients with hip fracture was 63.5%. Chewing gum had a significant effect on reduction of POI in elderly patients with hip fractures.


Assuntos
Goma de Mascar , Fraturas do Quadril/cirurgia , Íleus/epidemiologia , Enteropatias/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Idoso , Feminino , Humanos , Íleus/etiologia , Íleus/prevenção & controle , Enteropatias/etiologia , Enteropatias/prevenção & controle , Masculino , Peristaltismo , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Prevalência , Estudos Prospectivos , Resultado do Tratamento
3.
Eur J Med Res ; 26(1): 12, 2021 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-33485396

RESUMO

INTRODUCTION: Endometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis are associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis. METHODS: Twenty-five patients who underwent laparoscopic colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome. RESULTS: Average follow-up time was 38.68 months (± 19.92). Preoperative VAS-score was 8.32 (± 1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%) and anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (± 2.54). CONCLUSION: Our data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Endometriose/cirurgia , Enteropatias/etiologia , Enteropatias/cirurgia , Adulto , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Enteropatias/patologia , Laparoscopia/métodos , Dor/etiologia , Complicações Pós-Operatórias/epidemiologia , Qualidade de Vida , Resultado do Tratamento
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 24(1): 94-100, 2021 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-33461259

RESUMO

Intestinal failure (IF) is defined as the critical reduction of functional intestines below the minimum needed to absorb nutrients and fluids, so that intravenous supplementation with parenteral nutrition (PN) is required to maintain health and/or growth. Although the benefits are evident, patients receiving PN can suffer from serious cholestasis due to lack of enteral feeding and small intestinal bacterial overgrowth (SIBO). One such complication that may arise is intestinal failure-associated liver disease (IFALD). Evidences from recent studies suggest that alterations in the intestinal microbiota, as well as intraluminal bile acid driven signaling, may play a critical role in both hepatic and intestinal injury. Since Marshall first proposed the concept of the gut-liver axis in 1998, the role of gut-liver axis disorders in the development of IFALD has received considerable attention. The conversation between gut and liver is the key to maintain liver metabolism and intestinal homeostasis, which influences each other and is reciprocal causation. However, as a "forgotten organ" , intestinal microbiota on the pathogenesis of IFALD has not been well reflected. As such, we propose, for the first time, the concept of gut-microbiota-liver axis to emphasize the importance of intestinal microbiota in the interaction of gut-liver axis. Analysis and research on gut-microbiota-liver axis will be of great significance for understanding the pathogenesis of IFALD and improving the prevention and treatment measures.


Assuntos
Microbioma Gastrointestinal , Enteropatias , Hepatopatias , Fígado/fisiopatologia , Nutrição Parenteral/efeitos adversos , Síndrome do Intestino Curto/fisiopatologia , Infecções Bacterianas/etiologia , Infecções Bacterianas/fisiopatologia , Ácidos e Sais Biliares/fisiologia , Colestase/etiologia , Colestase/microbiologia , Colestase/fisiopatologia , Nutrição Enteral , Microbioma Gastrointestinal/fisiologia , Humanos , Enteropatias/etiologia , Enteropatias/microbiologia , Enteropatias/fisiopatologia , Intestinos/microbiologia , Intestinos/fisiologia , Intestinos/fisiopatologia , Fígado/microbiologia , Fígado/fisiologia , Hepatopatias/etiologia , Hepatopatias/microbiologia , Hepatopatias/fisiopatologia , Síndrome do Intestino Curto/complicações , Síndrome do Intestino Curto/dietoterapia , Transdução de Sinais
5.
Int J Mol Sci ; 21(24)2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33348552

RESUMO

Ischemic stroke is a major cause of death among patients with systemic hypertension. The narrowing of the lumen of the brain vasculature contributes to the increased incidence of stroke. While hyalinosis represents the major pathological lesions contributing to vascular lumen narrowing and stroke, the pathogenic mechanism of brain vascular hyalinosis has not been well characterized. Thus, the present study examined the postmortem brain vasculature of human patients who died of ischemic stroke due to systemic hypertension. Hematoxylin and eosin staining and immunohistochemistry showed the occurrence of brain vascular hyalinosis with infiltrated plasma proteins along with the narrowing of the vasa vasorum and oxidative stress. Transmission electron microscopy revealed endothelial cell bulge protrusion into the vasa vasorum lumen and the occurrence of endocytosis in the vasa vasorum endothelium. The treatment of cultured microvascular endothelial cells with adrenaline also promoted the formation of the bulge as well as endocytic vesicles. The siRNA knockdown of sortin nexin-9 (a mediator of clathrin-mediated endocytosis) inhibited adrenaline-induced endothelial cell bulge formation. Adrenaline promoted protein-protein interactions between sortin nexin-9 and neural Wiskott-Aldrich syndrome protein (a regulator of actin polymerization). Spontaneously hypertensive stroke-prone rats also exhibited lesions indicative of brain vascular hyalinosis, the endothelial cell protrusion into the lumen of the vasa vasorum, and endocytosis in vasa vasorum endothelial cells. We propose that endocytosis-dependent endothelial cell bulge protrusion narrows the vasa vasorum, resulting in ischemic oxidative damage to cerebral vessels, the formation of hyalinosis, the occurrence of ischemic stroke, and death in systemic hypertension patients.


Assuntos
Isquemia Encefálica/etiologia , Isquemia Encefálica/mortalidade , Diarreia/etiologia , Diarreia/patologia , Oftalmopatias Hereditárias/etiologia , Oftalmopatias Hereditárias/patologia , Hipertensão/complicações , Enteropatias/etiologia , Enteropatias/patologia , /mortalidade , Anormalidades da Pele/etiologia , Anormalidades da Pele/patologia , Vasa Vasorum/patologia , Doenças Vasculares/etiologia , Doenças Vasculares/patologia , Idoso , Idoso de 80 Anos ou mais , Animais , Autopsia , Encéfalo/patologia , Isquemia Encefálica/patologia , Células Cultivadas , Endocitose/genética , Células Endoteliais/metabolismo , Feminino , Técnicas de Silenciamento de Genes , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/genética , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Nexinas de Classificação/genética , Transfecção
7.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(6): 401-407, jun.-jul. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193365

RESUMO

La obesidad es un problema de salud frecuente en nuestra población. La cirugía bariátrica es el tratamiento de elección en los casos graves, es muy efectiva (junto con una adecuada modificación de los hábitos de vida), pero también se asocia a múltiples efectos secundarios. Uno de los más frecuentes y que puede reducir marcadamente la calidad de vida es la diarrea. La diarrea que aparece posterior a una cirugía bariátrica puede ser de distintas causas y mecanismos fisiopatogénicos que van a depender, en parte, del tipo de cirugía realizada. Las causas más frecuentes son el síndrome de dumping, la diarrea por vagotomía, el síndrome de intestino corto, la malabsorción de hidratos de carbono, la malabsorción proteica, las alteraciones de la microbiota, la infección por Clostridium difficile, el sobrecrecimiento bacteriano, la malabsorción de sales biliares, la insuficiencia pancreática, trastornos endocrinológicos, trastornos adictivos y otros trastornos digestivos no necesariamente relacionados con la cirugía


Obesity is a prevalent health problem in our population. Bariatric surgery is the indicated treatment for severe cases. It is very effective (together with an adequate lifestyle modification) but it is also associated with frequent adverse events. One of the most frequent and disturbing adverse event is diarrhea. Diarrhea after bariatric surgery may be secondary to multiple causes and the physiopathogenic mechanisms may depend on the type of surgery performed. The most frequent diarrhea mechanisms are dumping syndrome, vagotomy, short bowel syndrome, carbohydrate malabsorption, protein malabsorption, alterations of the microbiota, Clostridium difficile infection, bacterial overgrowth, bile salt malabsorption, pancreatic insufficiency, endocrinological disorders, addictive disorders, and other digestive disorders not necessarily related to surgery


Assuntos
Humanos , Diarreia/etiologia , Complicações Pós-Operatórias/etiologia , Cirurgia Bariátrica/efeitos adversos , Enteropatias/etiologia , Síndromes de Malabsorção/etiologia , Microbiota , Diarreia/fisiopatologia , Síndrome de Esvaziamento Rápido/etiologia
11.
Adv Parasitol ; 107: 173-199, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32122529

RESUMO

Giardia is an important cause of diarrhoea, and results in post-infectious and extra-intestinal complications. This chapter presents a state-of-the art of our understanding of how this parasite may cause such abnormalities, which appear to develop at least in part in Assemblage-dependent manner. Findings from prospective longitudinal cohort studies indicate that Giardia is one of the four most prevalent enteropathogens in early life, and represents a risk factor for stunting at 2 years of age. This may occur independently of diarrheal disease, in strong support of the pathophysiological significance of the intestinal abnormalities induced by this parasite. These include epithelial malabsorption and maldigestion, increased transit, mucus depletion, and disruptions of the commensal microbiota. Giardia increases epithelial permeability and facilitates the invasion of gut bacteria. Loss of intestinal barrier function is at the core of the acute and post-infectious complications associated with this infection. Recent findings demonstrate that the majority of the pathophysiological responses triggered by this parasite can be recapitulated by the effects of its membrane-bound and secreted cysteine proteases.


Assuntos
Giardíase/complicações , Giardíase/parasitologia , Enteropatias/etiologia , Giardia lamblia/fisiologia , Giardíase/patologia , Humanos , Enteropatias/parasitologia
12.
Chirurgia (Bucur) ; 115(1): 112-119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155406

RESUMO

Postoperative ileus (POI) is a complex phenomenon with important morbidity and mortality, well known in many surgical fields. POI occurs commonly after abdominal and pelvic surgery, especially in cancer patients. We report the case of a 63-year-old patient without known risk factors for POI, who underwent total hysterectomy with bilateral adnexectomy for ovarian tumor with suspicion of malignancy, invalidated by the extemporaneous pathology examination. The postoperative evolution is marked by reduced bowel movements, lack of intestinal transit for flatus and stool for 6 days. In cooperation with the general surgeon conservative treatment for POI was administered, without effect. The abdomen remained distended, with no nausea or vomiting. On the 6th postoperative day a wound dehiscence with incomplete evisceration occurred, after a CT scan of the abdomen and pelvic region was requested to make a differential diagnosis between an intestinal mass and other pathology involving the bowell. In conjunction with the General Surgery team the surgical reintervention was decided and performed. After the procedure, the patient successfully regained transit, with flatus and stool emission, but another 2 complications occurred, which were successfully treated: sepsis and deep vein thrombosis. Understanding the pathophysiology could help to prevent, diagnose, and implement protocols in order to avoid POI and its complications, to reduce hospital stay and cost burden.


Assuntos
Hérnia Ventral/cirurgia , Histerectomia/efeitos adversos , Íleus/etiologia , Hérnia Incisional/cirurgia , Neoplasias Ovarianas/cirurgia , Feminino , Hérnia Ventral/diagnóstico por imagem , Hérnia Ventral/etiologia , Humanos , Hérnia Incisional/diagnóstico por imagem , Hérnia Incisional/etiologia , Enteropatias/diagnóstico por imagem , Enteropatias/etiologia , Enteropatias/cirurgia , Pessoa de Meia-Idade , Reoperação , Deiscência da Ferida Operatória/diagnóstico por imagem , Deiscência da Ferida Operatória/etiologia , Deiscência da Ferida Operatória/cirurgia
13.
Proc Natl Acad Sci U S A ; 117(15): 8431-8436, 2020 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-32220957

RESUMO

Intestinal barrier dysfunction, which leads to translocation of bacteria or toxic bacterial products from the gut into bloodstream and results in systemic inflammation, is a key pathogenic factor in many human diseases. However, the molecular mechanisms leading to intestinal barrier defects are not well understood, and there are currently no available therapeutic approaches to target intestinal barrier function. Here we show that soluble epoxide hydrolase (sEH) is an endogenous regulator of obesity-induced intestinal barrier dysfunction. We find that sEH is overexpressed in the colons of obese mice. In addition, pharmacologic inhibition or genetic ablation of sEH abolishes obesity-induced gut leakage, translocation of endotoxin lipopolysaccharide or bacteria, and bacterial invasion-induced adipose inflammation. Furthermore, systematic treatment with sEH-produced lipid metabolites, dihydroxyeicosatrienoic acids, induces bacterial translocation and colonic inflammation in mice. The actions of sEH are mediated by gut bacteria-dependent mechanisms, since inhibition or genetic ablation of sEH fails to attenuate obesity-induced gut leakage and adipose inflammation in mice lacking gut bacteria. Overall, these results support that sEH is a potential therapeutic target for obesity-induced intestinal barrier dysfunction, and that sEH inhibitors, which have been evaluated in human clinical trials targeting other human disorders, could be promising agents for prevention and/or treatment.


Assuntos
Translocação Bacteriana , Epóxido Hidrolases/imunologia , Enteropatias/enzimologia , Intestinos/enzimologia , Obesidade/complicações , Tecido Adiposo/imunologia , Animais , Bactérias/genética , Bactérias/isolamento & purificação , Fenômenos Fisiológicos Bacterianos , Epóxido Hidrolases/genética , Microbioma Gastrointestinal , Humanos , Enteropatias/etiologia , Enteropatias/imunologia , Enteropatias/microbiologia , Intestinos/imunologia , Intestinos/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Obesidade/enzimologia , Obesidade/genética
14.
J Pharmacol Sci ; 143(1): 30-38, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32151540

RESUMO

The role of nitric oxide (NO) on intestinal mucosal injury induced by single or consecutive administration of methotrexate was investigated in a rodent model. Rats received methotrexate intraperitoneally either as a single administration (50 mg/kg) or as a consecutive administration (12.5 mg/kg/day) for 4 days. NG-nitro-l-arginine methyl ester (L-NAME) was given subcutaneously to inhibit NO synthase (NOS). Ninety-six hours after the first administration of methotrexate, ileal tissues were collected for analysis. Consecutive administration of methotrexate led to decreased body weight and reduced intake of food and water, which were further worsened by L-NAME. Although a slight mucosal injury resulted from single administration of methotrexate, L-NAME had almost no effect. Consecutive administration of methotrexate caused a significant mucosal injury, which was further worsened by L-NAME. Consecutive, but not single, administration of methotrexate induced mRNA expression of inflammatory cytokines in ileal tissue. Consecutive administration of methotrexate significantly induced constitutive NOS expression in ileal tissue. These results suggest that consecutive administration, rather than single administration, of methotrexate aggravates mucosal injury. Potentiation of constitutive NOS expression by consecutive administration might be one of the main reason to antagonize the intestinal mucosal injury as well as lead to a reduction in rat quality of life.


Assuntos
Expressão Gênica , Enteropatias/etiologia , Intestino Delgado/metabolismo , Intestino Delgado/patologia , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Óxido Nítrico/efeitos adversos , Óxido Nítrico/metabolismo , Animais , Citocinas/genética , Citocinas/metabolismo , Mediadores da Inflamação/metabolismo , Masculino , Modelos Animais , Óxido Nítrico/genética , RNA Mensageiro/metabolismo , Ratos Wistar
15.
Clin Immunol ; 212: 108362, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32058070

RESUMO

A number of gastrointestinal complications occur in common variable immunodeficiency (CVID). Infections are one cause, but various forms of severe non-infectious enteropathy also lead to substantial morbidity. The presence of T cell lymphocytic infiltrates in the mucosa have suggested that vedolizumab, a humanized monoclonal antibody which binds to alpha4 beta7 integrin and inhibits the migration of effector T-lymphocytes into gastrointestinal tissues, would be an effective treatment. A previous report of 3 CVID cases suggested benefit in 2 subjects. In this study 7 CVID patients with severe enteropathy were treated with vedolizumab. Four of the 7 completed vedolizumab induction therapy but 3 subjects had acute decompensation during induction and treatment was stopped. While one subject showed improvement, 6 of the 7 patients were withdrawn from therapy. While vedolizumab may be of use in some CVID subjects, it was not ultimately found helpful in most of these patients.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Imunodeficiência de Variável Comum/imunologia , Fármacos Gastrointestinais/uso terapêutico , Enteropatias/tratamento farmacológico , Adulto , Idoso , Imunodeficiência de Variável Comum/complicações , Feminino , Humanos , Inflamação , Enteropatias/etiologia , Enteropatias/imunologia , Enteropatias/patologia , Síndromes de Malabsorção/etiologia , Síndromes de Malabsorção/terapia , Masculino , Desnutrição/etiologia , Desnutrição/terapia , Pessoa de Meia-Idade , Nutrição Parenteral , Falha de Tratamento
16.
J Therm Biol ; 87: 102481, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32001015

RESUMO

Rapid cooling after acute hyperthermia may cause a sustained increase in body temperature and exacerbate intestinal damage in pigs. Therefore, the study objective was to evaluate the temporal effects of rapid and gradual cooling on body temperature response and intestinal integrity after acute hyperthermia in pigs. In three repetitions, 54 pigs [83.3 ± 6.7 kg initial body weight (BW)], balanced by sex were exposed to thermoneutral conditions for 6 h (TN; n = 6 pigs/repetition; 21.1 ± 2.0°C), or heat stress conditions (HS; 39.3 ± 1.6°C) for 3 h, followed by a 3 h recovery period of gradual cooling [HSGC; n = 6 pigs/repetition; gradual decrease from HS to TN conditions] or rapid cooling [HSRC; n = 6 pigs/repetition; rapid TN exposure and cold water (4.0°C) dousing every 30 min for 1.5 h]. Feed was withheld throughout the entire 6 h period, but water was provided ad libitum. Gastrointestinal (TGI) and rectal (TR) temperatures were recorded every 15 min during the HS and recovery periods. Six pigs per repetition (n = 2/treatment) were euthanized and jejunal and ileal samples were collected for histology immediately after (d 0), 2 d after, and 4 d after the recovery period. Data were analyzed using PROC MIXED in SAS 9.4. Overall, rapid cooling reduced TR and TGI (P < 0.01; 0.95°C and 0.74°C, respectively) compared to gradual cooling. Jejunal villus height was reduced overall (P = 0.02; 14.01%) in HSGC compared to HSRC and TN pigs. Jejunal villus height-to-crypt depth ratio was reduced overall (P = 0.05; 16.76%) in HSGC compared to TN pigs. Ileal villus height was reduced overall (P < 0.01; 16.95%) in HSGC compared to HSRC and TN pigs. No other intestinal morphology differences were detected. In summary, HSRC did not cause a sustained increase in body temperature and did not negatively impact biomarkers of intestinal integrity in pigs.


Assuntos
Temperatura Corporal , Febre/veterinária , Hipotermia Induzida/efeitos adversos , Enteropatias/etiologia , Intestinos/patologia , Doenças dos Suínos/etiologia , Suínos/fisiologia , Animais , Jejum/efeitos adversos , Febre/terapia , Hipotermia Induzida/métodos , Absorção Intestinal , Enteropatias/fisiopatologia , Enteropatias/veterinária , Intestinos/fisiopatologia , Doenças dos Suínos/fisiopatologia , Doenças dos Suínos/terapia
17.
Int J Mol Sci ; 21(2)2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31963519

RESUMO

Nerve injury-induced protein 1 (Ninjurin1, Ninj1) is a cell-surface adhesion molecule that regulates cell migration and attachment. This study demonstrates the increase in Ninj1 protein expression during development of intestinal inflammation. Ninj1-deficient mice exhibited significantly attenuated bodyweight loss, shortening of colon length, intestinal inflammation, and lesser pathological lesions than wild-type mice. Although more severe inflammation and serious lesions are observed in wild-type mice than Ninj1-deficient mice, there were no changes in the numbers of infiltrating macrophages in the inflamed tissues obtained from WT and Ninj1-deficient mice. Ninj1 expression results in activation of macrophages, and these activated macrophages secrete more cytokines and chemokines than Ninj1-deficient macrophages. Moreover, mice with conditional deletion of Ninj1 in myeloid cells (Ninj1fl/fl; Lyz-Cre+) alleviated experimental colitis compared with wild-type mice. In summary, we propose that the Ninj1 in myeloid cells play a pivotal function in intestinal inflammatory conditions.


Assuntos
Moléculas de Adesão Celular Neuronais/fisiologia , Adesão Celular , Movimento Celular , Colite/prevenção & controle , Inflamação/prevenção & controle , Enteropatias/prevenção & controle , Células Mieloides/metabolismo , Fatores de Crescimento Neural/fisiologia , Animais , Células Cultivadas , Colite/etiologia , Colite/metabolismo , Colite/patologia , Feminino , Inflamação/etiologia , Inflamação/metabolismo , Inflamação/patologia , Enteropatias/etiologia , Enteropatias/metabolismo , Enteropatias/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Transdução de Sinais
18.
J Gastroenterol Hepatol ; 35(8): 1340-1346, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31999379

RESUMO

BACKGROUND AND AIMS: Small intestinal lesions in patients with Behçet disease (BD) have a risk of perforation and hemorrhage requiring surgery. However, no screening strategy for such lesions has been established. We investigated small intestinal lesions in BD patients with video capsule endoscopy (VCE) and analyzed clinical characteristics to identify noninvasive biomarkers of such lesions. METHODS: This study included 33 BD patients who underwent VCE (PillCam® SB3) at our institution from June 2016 to January 2019. Clinical characteristics, including age, sex, disease duration, body mass index, gastrointestinal symptoms, eye involvement, and blood examinations, were obtained from the medical records of 27 of the 33 patients. Fecal immunochemical tests for hemoglobin, fecal calprotectin (FC), and fecal lactoferrin (FL) were measured. VCE findings of 145 healthy Japanese individuals from a previous report were used as controls. RESULTS: Two intestinal BD patients were included in the 27 patients. We observed that BD patients exhibit more small intestinal lesions compared with healthy individuals, including erosions, ulcers, and total lesions (erosions or ulcers). FC and FL levels were significantly higher in patients with versus without small intestinal lesions (P = 0.034 and P = 0.046, respectively). Receiver operating characteristic analyses demonstrated that FC (cutoff value = 119 µg/g) and FL (cutoff value = 17 µg/g) were biomarkers for small intestinal lesions in patients with BD. CONCLUSION: The present study using VCE showed that patients with BD had more small intestinal lesions than healthy individuals. FC and FL could be useful for screening BD patients who may have small intestinal lesions.


Assuntos
Síndrome de Behçet/complicações , Endoscopia por Cápsula , Fezes/química , Enteropatias/diagnóstico , Enteropatias/etiologia , Intestino Delgado , Lactoferrina/análise , Complexo Antígeno L1 Leucocitário/análise , Adolescente , Adulto , Biomarcadores/análise , Feminino , Humanos , Enteropatias/diagnóstico por imagem , Enteropatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Adulto Jovem
19.
Curr Gastroenterol Rep ; 22(1): 4, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31940112

RESUMO

PURPOSE OF REVIEW: Small bowel diverticulosis is a well-known clinical entity whose diagnosis and management has evolved in recent years. This review covers pathophysiology, incidence, and prevalence, and it also provides an update on modern diagnosis and management. Meckel's diverticula are covered elsewhere in this volume. RECENT FINDINGS: CT scan and MRI have largely supplanted barium follow-through for diagnosis. No intervention is needed in asymptomatic individuals. Endoscopic management is playing an increasing role for both bleeding and resection of intraduodenal diverticula, but surgical intervention remains the only definitive intervention for other complications like diverticulitis and small bowel obstruction. Small bowel diverticulosis is an uncommon condition which is associated with numerous possible complications. While endoscopy is playing an increasingly large role in management, surgical resection remains the treatment of choice for most complications. A high index of suspicion is needed in order to diagnose this entity.


Assuntos
Divertículo/diagnóstico , Enteropatias/diagnóstico , Divertículo/epidemiologia , Divertículo/etiologia , Divertículo/terapia , Humanos , Enteropatias/epidemiologia , Enteropatias/etiologia , Enteropatias/terapia , Intestino Delgado/fisiopatologia
20.
Biomed Pharmacother ; 124: 109855, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31986410

RESUMO

MGN-3 is an arabinoxylan from rice bran that has been shown to be an excellent antioxidant and radioprotector. This study examined the protective effects of MGN-3 on radiation-induced intestinal injury. Mice were treated with MGN-3 prior to irradiation, then continued to receive MGN-3 for 4 weeks thereafter. MGN-3 increased the activity of mitochondrial respiratory chain complexes Ⅰ, Ⅲ, Ⅳ and Ⅴ, the intercellular ATP content, the mitochondria-encoded gene expression and mitochondrial copy numbers in the jejunal and colonic mucosa. MGN-3 reduced the oxidative stress levels and inflammatory response indicators in the serum and jejunal and colonic mucosa. Antioxidant indicators such as superoxide dismutase, glutathione peroxidase, catalase and total antioxidant capacity were significantly increased in the serum and jejunal and colonic mucosa in the MGN-3 group. Moreover, MGN-3 decreased the gene abundances and enzymatic activities of caspase-3, 8, 9 and 10 in the jejunal and colonic mucosa. The endotoxin, diamine peroxidase, d-lactate and zonulin levels were significantly reduced in the serum and jejunal and colonic mucosa in the MGN-3 group. MGN-3 also markedly upregulated the gene abundances of ZO-1, occludin, claudin-1 and mucin 2. MGN-3 effectively attenuated radiation-induced changes in the intestinal epithelial mitochondrial function, oxidative stress, inflammatory response, apoptosis, intestinal permeability and barrier function in mice. These findings add to our understanding of the potential mechanisms by which MGN-3 alleviates radioactive intestinal injury.


Assuntos
Antioxidantes/farmacologia , Lesões Experimentais por Radiação/prevenção & controle , Protetores contra Radiação/farmacologia , Xilanos/farmacologia , Animais , Inflamação/etiologia , Inflamação/prevenção & controle , Enteropatias/etiologia , Enteropatias/prevenção & controle , Mucosa Intestinal/patologia , Mucosa Intestinal/efeitos da radiação , Intestinos/patologia , Intestinos/efeitos da radiação , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Permeabilidade/efeitos da radiação
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