Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytica...Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytical study involving 96 patients collected at the radiology and medical imaging department of CIMED, from January 2022 to January 2023. Result: The age of our patients varied between 11 and 86 years with an average age of 36 years. There was a male predominance of 64.6% compared to 35.4% for women, i.e. a sex ratio of 1.82. The notion of previous surgery was found in 61.5% of our patients. Pain was present in all patients. Radiography of the ASP was performed in 89.6% of patients. It showed hydro-aerial levels in 96.5% of patients. Abdominopelvic CT was performed in 12 patients and made it possible to make the diagnosis of occlusion in all patients. The results of the positive diagnosis were concordant with those intraoperatively in 92% of cases. 8% of our patients, compared to the treatment, spontaneously resumed their transit, 91% benefited from surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients or 83.3%, poor with death in 16 patients or 16.7% of cases. Conclusion: Acute intestinal obstruction remains a serious pathology for which ASP radiography often remains the only radiological examination performed urgently. However, abdominopelvic CT seems widely indicated thanks to its contribution both for the positive diagnosis and for the serious and etiological diagnoses. However, this imaging technique is largely underused in our practice due to its high cost and lack of availability.展开更多
Magnesium(Mg^(2+))has an important role in numerous biological functions,and Mg^(2+)deficiency is associated with several diseases.Therefore,adequate intestinal absorption of Mg^(2+)is vital for health.The small intes...Magnesium(Mg^(2+))has an important role in numerous biological functions,and Mg^(2+)deficiency is associated with several diseases.Therefore,adequate intestinal absorption of Mg^(2+)is vital for health.The small intestine was previously thought to absorb digested Mg^(2+)exclusively through an unregulated paracellular mechanism,which is responsible for approximately 90%of total Mg^(2+)absorption.Recent studies,however,have revealed that the duodenum,jejunum,and ileum absorb Mg^(2+)through both transcellular and paracellular routes.Several regulatory factors of small intestinal Mg^(2+)uptake also have been explored,e.g.,parathyroid hormone,fibroblast growth factor-23,apical acidity,proton pump inhibitor,and pH-sensing channel and receptors.The mechanistic factors underlying proton pump inhibitor suppression of small intestinal Mg^(2+),such as magnesiotropic protein dysfunction,higher mucosal bicarbonate secretion,Paneth cell dysfunction,and intestinal inflammation,are currently being explored.The potential role of small intestinal microbiomes in Mg^(2+)absorption has also been proposed.In this article,we reviewed the current knowledge on the mechanisms and regulatory factors of small intestinal Mg^(2+)absorption.展开更多
OBJECTIVES To investigate the value of CCKBR^(fl/fl)villin-Cre mice as a mouse model of salt-sensitive hypertension(SSH).METHODS In the first part,2-month-old CCKBR^(fl/fl)villin-Cre mice(CKO)and control CCKBR^(fl/fl)...OBJECTIVES To investigate the value of CCKBR^(fl/fl)villin-Cre mice as a mouse model of salt-sensitive hypertension(SSH).METHODS In the first part,2-month-old CCKBR^(fl/fl)villin-Cre mice(CKO)and control CCKBR^(fl/fl)mice(WT)were fed with normal diet(0.4%NaCl)or high salt diet(4%NaCl),separately for 6 weeks.In the rescue study,one week of hydrochlorothiazide or saline injection were treated with the CKO mice fed high salt diet.The blood pressure,biochemical indexes,and the expression of small intestinal sodium transporters(NHE3,NKCC1,eNaC)was detected.The organ injury markers(MMP2/MMP9)and the histopathological changes of kidneys were observed,whereas the changes of duodenal sodium absorption were detected by small intestinal perfusion in vivo.RESULTS The CCKBR^(fl/fl)villin-Cre mice with high salt intake exhibited high blood pressure,increased duodenal sodium absorption and urinary sodium excretion,and with renal injury.The protein expression of NHE3,NKCC1 and eNaC were also significant increase in the intestine of CKO-HS mice.Treatment with hydrochlorothiazide remarkably attenuated the elevated blood pressure by high salt absorption in the CCKBR^(fl/fl)villin-Cre mice,but no significant histopathological changes were observed.CONCLUSIONS These results support a crucial role of intestinal Cckbr deficiency on SSH development and the diuretic antihypertension effect in CCKBR^(fl/fl)villin-Cre mice.The CCKBR^(fl/fl)villin-Cre mice with the high salt intake may serve as a stable model of salt-sensitive hypertensive induced by sodium overloading.展开更多
BACKGROUND The incidence of intestinal malrotation in adults has been reported to only be about 0.2%.Duodenal web as a cause of intestinal obstruction is rare,with an incidence of about 1:20000-1:40000.Furthermore,whe...BACKGROUND The incidence of intestinal malrotation in adults has been reported to only be about 0.2%.Duodenal web as a cause of intestinal obstruction is rare,with an incidence of about 1:20000-1:40000.Furthermore,when described,these conditions are usually seen in early life and very infrequently in adulthood.CASE SUMMARY We report a case of a middle-aged woman with intestinal malrotation who presented with a three-month history of right-sided abdominal pain,early satiety,and a 22-pound weight loss.Patient underwent an esophagogastroduodenoscopy,which demonstrated numerous retained pills in a deformed first portion of the duodenum,concerning for a partial gastric outlet obstruction.An upper gastrointestinal series showed marked distention of the proximal duodenum with retained debris and the presence of a windsock sign,increasing the suspicion of a duodenal web.The patient subsequently underwent surgical intervention where a duodenal web with two lumens was noted and resected,opening the duodenum.There were over 150 pill capsules that were removed.The patient is doing well after this intervention.CONCLUSION Both intestinal malrotation and duodenal webs are infrequently encountered in the adult population.These pathologies can also present with nonspecific abdominal symptoms such as chronic abdominal pain and nausea.Hence,providers might not consider these pathologies in the differential for patients who present with vague symptoms which can lead to delay in management and increased mortality and morbidity.展开更多
BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in adults.Nevertheless,the absence of clear guidance from diagnosis to treatment and progn...BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in adults.Nevertheless,the absence of clear guidance from diagnosis to treatment and prognosis poses challenges for both physicians and patients.AIM To enhance understanding by investigating clinical presentation,diagnosis,treatment,complications,and prognoses in adult PIL cases.METHODS We enrolled adult patients diagnosed with PIL between March 2016 and September 2021.The primary outcome involved examining the diagnosis and treatment process of these patients.The secondary outcomes included identifying complications(infections,thromboembolism)and assessing prognoses(frequency of hospitalization and mortality)during the follow-up period.RESULTS Among the 12 included patients,peripheral edema(100%)and diarrhea(75%)were the main presenting complaints.Laboratory tests showed that all the pati-ents exhibited symptoms of hypoalbuminemia and hypogammaglobulinemia.Radiologically,the predominant findings were edema of the small intestine(67%)and ascites(58%).The typical endoscopic finding with a snowflake appearance was observed in 75%of patients.Among the 12 patients,two responded positive-ly to octreotide and sirolimus,and eight who could undergo maintenance therapy discontinued subsequently.Complications due to PIL led to infection in half of the patients,thromboembolism in three patients,and one death.CONCLUSION PIL can be diagnosed in adults across various age groups,with different severity and treatment responses among patients,leading to diverse complications and prognoses.Consequently,tailored treatments will be necessary.We anticipate that our findings will contribute to the management of PIL,an etiology of protein-losing enteropathy.展开更多
Iron deficiency is one of the leading risk factors for disability and death worldwide. Targeted iron supplementation with pharmaceuticals is widely used, but oral iron salt ingestion often causes side effects—nausea,...Iron deficiency is one of the leading risk factors for disability and death worldwide. Targeted iron supplementation with pharmaceuticals is widely used, but oral iron salt ingestion often causes side effects—nausea, vomiting, abdominal pain. The present study demonstrated that red beetroot juice (RBRJ) contains a compound or compound complex with the ability to specifically stimulate duodenal iron absorption, shown in experiments in vitro, in situ and in vivo. The effect does not depend on juice sugar and ascorbic acid concentration. Fractionated RBRJ impact on iron absorption is dose dependent. This phenomenon is described for the first time.展开更多
Crohn’s disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The reported case...Crohn’s disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The reported case presents a patient with intestinal subocclusion associated with a pharmacobezoar who had a good evolution with clinical treatment. This case report aims to demonstrate the complexity of diagnostic search, even with the classic version of the disease. And it also comes to show the need for a thorough medical history and differential diagnosis investigation.展开更多
Background:This study aimed to develop a combined model to quantify the net absorption of volatile fatty acids(VFA)in the large intestine(LI)of pigs.Methods:Fifteen female growing pigs(Duroc×Large White×Land...Background:This study aimed to develop a combined model to quantify the net absorption of volatile fatty acids(VFA)in the large intestine(LI)of pigs.Methods:Fifteen female growing pigs(Duroc×Large White×Landrace)were ranked by body weight(30±2.1 kg)on day 0 and assigned to one of three treatments,namely the basal diet containing different crude fiber(CF)levels(LCF:3.0%CF,MCF:4.5%CF,and HCF:6.0%CF).The pigs were implanted with the terminal ileum fistula and the cannulation of the ileal mesenteric vein(IMV),portal vein(PV),and left femoral artery(LFA)from days 6 to 7.[13 C]-Labeled VFA and P-aminohippuric acid were constantly perfused into the terminal ileum fistula and the cannulation of the IMV(day 15),respectively.Blood samples were collected from the PV and the LFA during perfusion(5 h),and LI samples were collected.Results:The net flux of[12 C]-acetic acid in the PV was greater for LCF versus MCF(p=0.045),but no difference was observed in the net flux of[12 C]-propionic acid(p=0.505)and[12 C]-butyric acid(p=0.35)in the PV among treatments.The deposition of[12 C]-acetic acid in the LI was greater for LCF versus MCF(p=0.014),whereas the deposition of[12 C]-propionic acid(p=0.007)and[12 C]-butyric acid(p=0.037)in the LI was greater for LCF versus HCF.Conclusions:In conclusion,this pig model was found conducive to study the net absorption of VFAs in the LI,and LCF had more net absorption of VFAs in the LI than MCF and HCF.展开更多
The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop o...The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop of materials without stopping gases appeared gradually and evolving for 4 months. The patient was chronically constipated. She administered daily enemas with homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea—constipation. Mother of 3 children alive and apparently healthy. On clinical examination the abdomen was enlarged in size, painless but of firm consistency. The hernial orifices were free. Hard and abundant stools were noted on digital rectal examination. The abdominal CT scan revealed a large endorectal fecal impaction going up into the left colon, an absence of abdominal mass. We retained the diagnosis of giant fecal impaction. The patient was hospitalized and we instituted paraffin oil therapy combined with an evacuator enema with glycerin. The evolution was marked by a resumption of transit in the form of stool and gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had decreased in volume the transit was regular and the patient was discharged on Day 10. Reviewed 3 months later, she maintained a regular transit made of one bowel movement a day. After a setback of 3 years the transit is still preserved. The authors discuss the etiologies of fecal impaction and their respective treatments.展开更多
BACKGROUND Congenital hepatic cysts are relatively rare but are now diagnosed earlier and more frequently with a routine prenatal ultrasound.Solitary liver cysts are divided into simple and solitary intrahepatic bilia...BACKGROUND Congenital hepatic cysts are relatively rare but are now diagnosed earlier and more frequently with a routine prenatal ultrasound.Solitary liver cysts are divided into simple and solitary intrahepatic biliary cysts,depending on the biliary connection.While some solitary liver cysts are symptomatic in childhood,even in newborns,they are often found incidentally in adults.CASE SUMMARY A 3-mo-old female infant was admitted to Mogadishu Somali Training and Research Hospital with recurrent vomiting,respiratory problems,and abdominal bloating complaints.On examination,the abdomen was greatly distended and extremely tight.She had repeated vomiting for 3 d,no stool output,and decreased urine.The abdominal ultrasonography detected a solitary cystic lesion measuring 10 cm×10 cm×14 cm,extending from the liver or right kidney to the pelvis.In the magnetic resonance imaging examination of the patient,a solitary cystic structure of 10 cm×10 cm×14 cm in the right abdomen was observed,extending to the pelvis and possibly originating from the liver.The patient was operated via fenestration after her fluid and electrolytes improved.Oral nutrition was initiated on the 2nd postoperative day,and the drain was removed on the 5th postoperative day.The patient visited the outpatient clinic control 1 mo later with no clinical complaints.CONCLUSION Congenital liver cysts are usually followed without complications.They rarely reach gigantic dimensions and may cause respiratory distress,intestinal obstruction and recurrent vomiting.Surgery can provide quite successful outcomes in the treatment of giant sized simple liver cysts.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the in...Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the intestinal lining. The presence of these lesions reduces the animal’s ability to digest and absorb nutrients, significantly impacting their overall performance. The current study aimed to explore the potential correlation between seasonal variations and the incidence of Eimeria spp-induced lesions in broiler chickens’ gastrointestinal tracts in Brazil from 2012 to 2018. A total of 8,607 broiler chickens, aged 14 to 42 days, were sampled from 103 poultry integrated companies in Brazil to conduct intestinal health examinations. The sampling process involved selecting 3 to 6 chickens from each poultry house for examination. The assessment included various abnormalities such as shedding of intestinal cells and excessive fluid and mucus presence, thickening and tension of the intestines, food movement, roughened mucosal surface resembling a Turkish towel in the small intestine, tissue death, duodenal inflammation, intestinal inflammation, gizzard erosion, presence of worms and bedding material, and ingestion of mealworms. During the seasons, winter exhibited the highest average occurrence of Eimeria maxima microorganisms at 52.83%, with E. acervulina following closely at 26.42% in second place. In spring, E. maxima had an occurrence of 11.31%, while in fall, E. tenella had the lowest occurrence at 6.74%. When analyzing the seasonal occurrence of Eimeria, it was observed that E. maxima micro was more common during winter compared to summer (P = 0.0491). However, no discernible variation was observed in the occurrence of the remaining species across different seasons. Research findings suggest that subclinical coccidiosis is most prevalent during the winter season in Brazil. Likewise, clinical disease caused by E. acervulina is also prevalent during this time. In contrast, E. maxima is more likely to cause clinical disease in the spring, whereas E. tenella is more commonly associated with clinical disease in the fall. Lesions induced by Eimeria spp. are associated with factors influencing the overall health of broiler intestines. These findings allow for the utilization of seasonal metrics in disease management, thereby reducing economic losses associated with the condition.展开更多
Background To improve our understanding of host and intestinal microbiome interaction,this research investigated the effects of a high-level zinc oxide in the diet as model intervention on the intestinal microbiome an...Background To improve our understanding of host and intestinal microbiome interaction,this research investigated the effects of a high-level zinc oxide in the diet as model intervention on the intestinal microbiome and small intestinal functionality in clinically healthy post-weaning piglets.In study 1,piglets received either a high concentration of zinc(Zn)as zinc oxide(Zn O,Zn,2,690 mg/kg)or a low Zn concentration(100 mg/kg)in the diet during the post weaning period(d 14–23).The effects on the piglet's small intestinal microbiome and functionality of intestinal tissue were investigated.In study 2,the impact of timing of the dietary zinc intervention was investigated,i.e.,between d 0–14 and/or d 14–23 post weaning,and the consecutive effects on the piglet's intestinal functionality,here referring to microbiota composition and diversity and gene expression profiles.Results Differences in the small intestinal functionality were observed during the post weaning period between piglets receiving a diet with a low or high concentration Zn O content.A shift in the microbiota composition in the small intestine was observed that could be characterized as a non-pathological change,where mainly the commensals inter-changed.In the immediate post weaning period,i.e.,d 0–14,the highest number of differentially expressed genes(DEGs)in intestinal tissue were observed between animals receiving a diet with a low or high concentration Zn O content,i.e.,23 DEGs in jejunal tissue and 11 DEGs in ileal tissue.These genes are involved in biological processes related to immunity and inflammatory responses.For example,genes CD59 and REG3G were downregulated in the animals receiving a diet with a high concentration Zn O content compared to low Zn O content in both jejunum and ileum tissue.In the second study,a similar result was obtained regarding the expression of genes in intestinal tissue related to immune pathways when comparing piglets receiving a diet with a high concentration Zn O content compared to low Zn O content.Conclusions Supplementing a diet with a pharmaceutical level of Zn as Zn O for clinically healthy post weaning piglets influences various aspects intestinal functionality,in particular in the first two weeks post-weaning.The model intervention increased both the alpha diversity of the intestinal microbiome and the expression of a limited number of genes linked to the local immune system in intestinal tissue.The effects do not seem related to a direct antimicrobial effect of Zn O.展开更多
Background Optimal gut health is important to maximize growth performance and feed efficiency in broiler chickens.A total of 1,365 one-day-old male Ross 308 broiler chickens were randomly divided into 5 treatments gro...Background Optimal gut health is important to maximize growth performance and feed efficiency in broiler chickens.A total of 1,365 one-day-old male Ross 308 broiler chickens were randomly divided into 5 treatments groups with 21 replicates,13 birds per replicate.The present research investigated effects of microbial muramidase or a precision glycan alone or in combination on growth performance,apparent total tract digestibility,total blood carotenoid content,intestinal villus length,meat quality and gut microbiota in broiler chickens.Treatments included:NC:negative control(basal diet group);PC:positive control(basal diet+0.02%probiotics);MR:basal diet+0.035%microbial muramidase;PG:basal diet+0.1%precision glycan;and MRPG:basal diet+0.025%MR+0.1%PG,respectively.Results MRPG group increased the body weight gain and feed intake(P<0.05)compared with NC group.Moreover,it significantly increased total serum carotenoid(P<0.05)and MRPG altered the microbial diversity in ileum contents.The MRPG treatment group increased the abundance of the phylum Firmicutes,and family Lachnospiraceae,Ruminococcaceae,Oscillospiraceae,Lactobacillaceae,Peptostreptococcaceae and decreased the abundance of the phylum Campilobacterota,Bacteroidota and family Bacteroidaceae.Compared with the NC group,the chickens fed MRPG showed significantly increased in duodenum villus length at end the trial.Conclusion In this study,overall results showed that the synergetic effects of MR and PG showed enhancing growth performance,total serum carotenoid level and altering gut microbiota composition of broilers.The current research indicates that co-supplementation of MR and PG in broiler diets enhances intestinal health,consequently leading to an increased broiler production.展开更多
Background The benefits of combining benzoic acid and essential oils(BAO)to mitigate intestinal impairment during the weaning process have been well established,while the detailed underlying mechanism has not been ful...Background The benefits of combining benzoic acid and essential oils(BAO)to mitigate intestinal impairment during the weaning process have been well established,while the detailed underlying mechanism has not been fully elucidated.Previous research has primarily focused on the reparative effects of BAO on intestinal injury,while neglecting its potential in enhancing intestinal stress resistance.Methods In this study,we investigated the pre-protective effect of BAO against LPS-induced stress using a modified experimental procedure.Piglets were pre-supplemented with BAO for 14 d,followed by a challenge with LPS or saline to collect blood and intestinal samples.Results Our findings demonstrated that BAO supplementation led to significant improvements in piglets’final weight,average daily gain,and feed intake/body gain ratio.Additionally,BAO supplementation positively influenced the composition of intestinal microbiota,increasing beneficial Actinobacteriota and Alloprevotella while reducing harmful Desulfobacterota,Prevotella and Oscillospira.Furthermore,BAO supplementation effectively mitigated oxidative disturbances and inflammatory responses induced by acute LPS challenge.This was evidenced by elevated levels of T-AOC,SOD,and GSH,as well as decreased levels of MDA,TNF-α,and IL-6 in the plasma.Moreover,piglets subjected to LPS challenge and pre-supplemented with BAO exhibited significant improvements in intestinal morphological structure and enhanced integrity,as indicated by restored expression levels of Occludin and Claudin-1 compared to the non-supplemented counterparts.Further analysis revealed that BAO supplementation enhanced the jejunal antioxidative capacity by increasing GSH-Px levels and decreasing MDA levels under the LPS challenge and stimulated the activation of the Nrf2 signaling pathway.Additionally,the reduction of TLR4/NF-κB/MAPK signaling pathways activation and proinflammatory factor were also observed in the jejunal of those piglets fed with BAO.Conclusions In summary,our study demonstrates that pre-supplementation of BAO enhances the anti-stress capacity of weaned piglets by improving intestinal microbiota composition,reinforcing the intestinal barrier,and enhancing antioxidative and anti-inflammatory capabilities.These effects are closely associated with the activation of Nrf2 and TLR4/NF-κB/MAPK signaling pathways.展开更多
文摘Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytical study involving 96 patients collected at the radiology and medical imaging department of CIMED, from January 2022 to January 2023. Result: The age of our patients varied between 11 and 86 years with an average age of 36 years. There was a male predominance of 64.6% compared to 35.4% for women, i.e. a sex ratio of 1.82. The notion of previous surgery was found in 61.5% of our patients. Pain was present in all patients. Radiography of the ASP was performed in 89.6% of patients. It showed hydro-aerial levels in 96.5% of patients. Abdominopelvic CT was performed in 12 patients and made it possible to make the diagnosis of occlusion in all patients. The results of the positive diagnosis were concordant with those intraoperatively in 92% of cases. 8% of our patients, compared to the treatment, spontaneously resumed their transit, 91% benefited from surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients or 83.3%, poor with death in 16 patients or 16.7% of cases. Conclusion: Acute intestinal obstruction remains a serious pathology for which ASP radiography often remains the only radiological examination performed urgently. However, abdominopelvic CT seems widely indicated thanks to its contribution both for the positive diagnosis and for the serious and etiological diagnoses. However, this imaging technique is largely underused in our practice due to its high cost and lack of availability.
文摘Magnesium(Mg^(2+))has an important role in numerous biological functions,and Mg^(2+)deficiency is associated with several diseases.Therefore,adequate intestinal absorption of Mg^(2+)is vital for health.The small intestine was previously thought to absorb digested Mg^(2+)exclusively through an unregulated paracellular mechanism,which is responsible for approximately 90%of total Mg^(2+)absorption.Recent studies,however,have revealed that the duodenum,jejunum,and ileum absorb Mg^(2+)through both transcellular and paracellular routes.Several regulatory factors of small intestinal Mg^(2+)uptake also have been explored,e.g.,parathyroid hormone,fibroblast growth factor-23,apical acidity,proton pump inhibitor,and pH-sensing channel and receptors.The mechanistic factors underlying proton pump inhibitor suppression of small intestinal Mg^(2+),such as magnesiotropic protein dysfunction,higher mucosal bicarbonate secretion,Paneth cell dysfunction,and intestinal inflammation,are currently being explored.The potential role of small intestinal microbiomes in Mg^(2+)absorption has also been proposed.In this article,we reviewed the current knowledge on the mechanisms and regulatory factors of small intestinal Mg^(2+)absorption.
基金This study is funded by the CAMS Innovation Fund for Medical Sciences(CIFMS,2022-I2M-C&T-A-010)the National Natural Science Foundation(China)(81970358).
文摘OBJECTIVES To investigate the value of CCKBR^(fl/fl)villin-Cre mice as a mouse model of salt-sensitive hypertension(SSH).METHODS In the first part,2-month-old CCKBR^(fl/fl)villin-Cre mice(CKO)and control CCKBR^(fl/fl)mice(WT)were fed with normal diet(0.4%NaCl)or high salt diet(4%NaCl),separately for 6 weeks.In the rescue study,one week of hydrochlorothiazide or saline injection were treated with the CKO mice fed high salt diet.The blood pressure,biochemical indexes,and the expression of small intestinal sodium transporters(NHE3,NKCC1,eNaC)was detected.The organ injury markers(MMP2/MMP9)and the histopathological changes of kidneys were observed,whereas the changes of duodenal sodium absorption were detected by small intestinal perfusion in vivo.RESULTS The CCKBR^(fl/fl)villin-Cre mice with high salt intake exhibited high blood pressure,increased duodenal sodium absorption and urinary sodium excretion,and with renal injury.The protein expression of NHE3,NKCC1 and eNaC were also significant increase in the intestine of CKO-HS mice.Treatment with hydrochlorothiazide remarkably attenuated the elevated blood pressure by high salt absorption in the CCKBR^(fl/fl)villin-Cre mice,but no significant histopathological changes were observed.CONCLUSIONS These results support a crucial role of intestinal Cckbr deficiency on SSH development and the diuretic antihypertension effect in CCKBR^(fl/fl)villin-Cre mice.The CCKBR^(fl/fl)villin-Cre mice with the high salt intake may serve as a stable model of salt-sensitive hypertensive induced by sodium overloading.
文摘BACKGROUND The incidence of intestinal malrotation in adults has been reported to only be about 0.2%.Duodenal web as a cause of intestinal obstruction is rare,with an incidence of about 1:20000-1:40000.Furthermore,when described,these conditions are usually seen in early life and very infrequently in adulthood.CASE SUMMARY We report a case of a middle-aged woman with intestinal malrotation who presented with a three-month history of right-sided abdominal pain,early satiety,and a 22-pound weight loss.Patient underwent an esophagogastroduodenoscopy,which demonstrated numerous retained pills in a deformed first portion of the duodenum,concerning for a partial gastric outlet obstruction.An upper gastrointestinal series showed marked distention of the proximal duodenum with retained debris and the presence of a windsock sign,increasing the suspicion of a duodenal web.The patient subsequently underwent surgical intervention where a duodenal web with two lumens was noted and resected,opening the duodenum.There were over 150 pill capsules that were removed.The patient is doing well after this intervention.CONCLUSION Both intestinal malrotation and duodenal webs are infrequently encountered in the adult population.These pathologies can also present with nonspecific abdominal symptoms such as chronic abdominal pain and nausea.Hence,providers might not consider these pathologies in the differential for patients who present with vague symptoms which can lead to delay in management and increased mortality and morbidity.
文摘BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in adults.Nevertheless,the absence of clear guidance from diagnosis to treatment and prognosis poses challenges for both physicians and patients.AIM To enhance understanding by investigating clinical presentation,diagnosis,treatment,complications,and prognoses in adult PIL cases.METHODS We enrolled adult patients diagnosed with PIL between March 2016 and September 2021.The primary outcome involved examining the diagnosis and treatment process of these patients.The secondary outcomes included identifying complications(infections,thromboembolism)and assessing prognoses(frequency of hospitalization and mortality)during the follow-up period.RESULTS Among the 12 included patients,peripheral edema(100%)and diarrhea(75%)were the main presenting complaints.Laboratory tests showed that all the pati-ents exhibited symptoms of hypoalbuminemia and hypogammaglobulinemia.Radiologically,the predominant findings were edema of the small intestine(67%)and ascites(58%).The typical endoscopic finding with a snowflake appearance was observed in 75%of patients.Among the 12 patients,two responded positive-ly to octreotide and sirolimus,and eight who could undergo maintenance therapy discontinued subsequently.Complications due to PIL led to infection in half of the patients,thromboembolism in three patients,and one death.CONCLUSION PIL can be diagnosed in adults across various age groups,with different severity and treatment responses among patients,leading to diverse complications and prognoses.Consequently,tailored treatments will be necessary.We anticipate that our findings will contribute to the management of PIL,an etiology of protein-losing enteropathy.
文摘Iron deficiency is one of the leading risk factors for disability and death worldwide. Targeted iron supplementation with pharmaceuticals is widely used, but oral iron salt ingestion often causes side effects—nausea, vomiting, abdominal pain. The present study demonstrated that red beetroot juice (RBRJ) contains a compound or compound complex with the ability to specifically stimulate duodenal iron absorption, shown in experiments in vitro, in situ and in vivo. The effect does not depend on juice sugar and ascorbic acid concentration. Fractionated RBRJ impact on iron absorption is dose dependent. This phenomenon is described for the first time.
文摘Crohn’s disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The reported case presents a patient with intestinal subocclusion associated with a pharmacobezoar who had a good evolution with clinical treatment. This case report aims to demonstrate the complexity of diagnostic search, even with the classic version of the disease. And it also comes to show the need for a thorough medical history and differential diagnosis investigation.
基金National Natural Science Foundation of China,Grant/Award Number:31201833 and 31872373Open Project of Hubei Key Laboratory of Animal Nutrition and Feed Science,Grant/Award Number:202306Scientific Research Plan Guiding Project of Hubei Provincial Education Department,Grant/Award Number:B2018082。
文摘Background:This study aimed to develop a combined model to quantify the net absorption of volatile fatty acids(VFA)in the large intestine(LI)of pigs.Methods:Fifteen female growing pigs(Duroc×Large White×Landrace)were ranked by body weight(30±2.1 kg)on day 0 and assigned to one of three treatments,namely the basal diet containing different crude fiber(CF)levels(LCF:3.0%CF,MCF:4.5%CF,and HCF:6.0%CF).The pigs were implanted with the terminal ileum fistula and the cannulation of the ileal mesenteric vein(IMV),portal vein(PV),and left femoral artery(LFA)from days 6 to 7.[13 C]-Labeled VFA and P-aminohippuric acid were constantly perfused into the terminal ileum fistula and the cannulation of the IMV(day 15),respectively.Blood samples were collected from the PV and the LFA during perfusion(5 h),and LI samples were collected.Results:The net flux of[12 C]-acetic acid in the PV was greater for LCF versus MCF(p=0.045),but no difference was observed in the net flux of[12 C]-propionic acid(p=0.505)and[12 C]-butyric acid(p=0.35)in the PV among treatments.The deposition of[12 C]-acetic acid in the LI was greater for LCF versus MCF(p=0.014),whereas the deposition of[12 C]-propionic acid(p=0.007)and[12 C]-butyric acid(p=0.037)in the LI was greater for LCF versus HCF.Conclusions:In conclusion,this pig model was found conducive to study the net absorption of VFAs in the LI,and LCF had more net absorption of VFAs in the LI than MCF and HCF.
文摘The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop of materials without stopping gases appeared gradually and evolving for 4 months. The patient was chronically constipated. She administered daily enemas with homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea—constipation. Mother of 3 children alive and apparently healthy. On clinical examination the abdomen was enlarged in size, painless but of firm consistency. The hernial orifices were free. Hard and abundant stools were noted on digital rectal examination. The abdominal CT scan revealed a large endorectal fecal impaction going up into the left colon, an absence of abdominal mass. We retained the diagnosis of giant fecal impaction. The patient was hospitalized and we instituted paraffin oil therapy combined with an evacuator enema with glycerin. The evolution was marked by a resumption of transit in the form of stool and gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had decreased in volume the transit was regular and the patient was discharged on Day 10. Reviewed 3 months later, she maintained a regular transit made of one bowel movement a day. After a setback of 3 years the transit is still preserved. The authors discuss the etiologies of fecal impaction and their respective treatments.
文摘BACKGROUND Congenital hepatic cysts are relatively rare but are now diagnosed earlier and more frequently with a routine prenatal ultrasound.Solitary liver cysts are divided into simple and solitary intrahepatic biliary cysts,depending on the biliary connection.While some solitary liver cysts are symptomatic in childhood,even in newborns,they are often found incidentally in adults.CASE SUMMARY A 3-mo-old female infant was admitted to Mogadishu Somali Training and Research Hospital with recurrent vomiting,respiratory problems,and abdominal bloating complaints.On examination,the abdomen was greatly distended and extremely tight.She had repeated vomiting for 3 d,no stool output,and decreased urine.The abdominal ultrasonography detected a solitary cystic lesion measuring 10 cm×10 cm×14 cm,extending from the liver or right kidney to the pelvis.In the magnetic resonance imaging examination of the patient,a solitary cystic structure of 10 cm×10 cm×14 cm in the right abdomen was observed,extending to the pelvis and possibly originating from the liver.The patient was operated via fenestration after her fluid and electrolytes improved.Oral nutrition was initiated on the 2nd postoperative day,and the drain was removed on the 5th postoperative day.The patient visited the outpatient clinic control 1 mo later with no clinical complaints.CONCLUSION Congenital liver cysts are usually followed without complications.They rarely reach gigantic dimensions and may cause respiratory distress,intestinal obstruction and recurrent vomiting.Surgery can provide quite successful outcomes in the treatment of giant sized simple liver cysts.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
文摘Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the intestinal lining. The presence of these lesions reduces the animal’s ability to digest and absorb nutrients, significantly impacting their overall performance. The current study aimed to explore the potential correlation between seasonal variations and the incidence of Eimeria spp-induced lesions in broiler chickens’ gastrointestinal tracts in Brazil from 2012 to 2018. A total of 8,607 broiler chickens, aged 14 to 42 days, were sampled from 103 poultry integrated companies in Brazil to conduct intestinal health examinations. The sampling process involved selecting 3 to 6 chickens from each poultry house for examination. The assessment included various abnormalities such as shedding of intestinal cells and excessive fluid and mucus presence, thickening and tension of the intestines, food movement, roughened mucosal surface resembling a Turkish towel in the small intestine, tissue death, duodenal inflammation, intestinal inflammation, gizzard erosion, presence of worms and bedding material, and ingestion of mealworms. During the seasons, winter exhibited the highest average occurrence of Eimeria maxima microorganisms at 52.83%, with E. acervulina following closely at 26.42% in second place. In spring, E. maxima had an occurrence of 11.31%, while in fall, E. tenella had the lowest occurrence at 6.74%. When analyzing the seasonal occurrence of Eimeria, it was observed that E. maxima micro was more common during winter compared to summer (P = 0.0491). However, no discernible variation was observed in the occurrence of the remaining species across different seasons. Research findings suggest that subclinical coccidiosis is most prevalent during the winter season in Brazil. Likewise, clinical disease caused by E. acervulina is also prevalent during this time. In contrast, E. maxima is more likely to cause clinical disease in the spring, whereas E. tenella is more commonly associated with clinical disease in the fall. Lesions induced by Eimeria spp. are associated with factors influencing the overall health of broiler intestines. These findings allow for the utilization of seasonal metrics in disease management, thereby reducing economic losses associated with the condition.
基金partially funded by the Ministry of AgricultureNature and Food Quality(project number BO-55-001-015)partly by“Vereniging Diervoederonderzoek Nederland”。
文摘Background To improve our understanding of host and intestinal microbiome interaction,this research investigated the effects of a high-level zinc oxide in the diet as model intervention on the intestinal microbiome and small intestinal functionality in clinically healthy post-weaning piglets.In study 1,piglets received either a high concentration of zinc(Zn)as zinc oxide(Zn O,Zn,2,690 mg/kg)or a low Zn concentration(100 mg/kg)in the diet during the post weaning period(d 14–23).The effects on the piglet's small intestinal microbiome and functionality of intestinal tissue were investigated.In study 2,the impact of timing of the dietary zinc intervention was investigated,i.e.,between d 0–14 and/or d 14–23 post weaning,and the consecutive effects on the piglet's intestinal functionality,here referring to microbiota composition and diversity and gene expression profiles.Results Differences in the small intestinal functionality were observed during the post weaning period between piglets receiving a diet with a low or high concentration Zn O content.A shift in the microbiota composition in the small intestine was observed that could be characterized as a non-pathological change,where mainly the commensals inter-changed.In the immediate post weaning period,i.e.,d 0–14,the highest number of differentially expressed genes(DEGs)in intestinal tissue were observed between animals receiving a diet with a low or high concentration Zn O content,i.e.,23 DEGs in jejunal tissue and 11 DEGs in ileal tissue.These genes are involved in biological processes related to immunity and inflammatory responses.For example,genes CD59 and REG3G were downregulated in the animals receiving a diet with a high concentration Zn O content compared to low Zn O content in both jejunum and ileum tissue.In the second study,a similar result was obtained regarding the expression of genes in intestinal tissue related to immune pathways when comparing piglets receiving a diet with a high concentration Zn O content compared to low Zn O content.Conclusions Supplementing a diet with a pharmaceutical level of Zn as Zn O for clinically healthy post weaning piglets influences various aspects intestinal functionality,in particular in the first two weeks post-weaning.The model intervention increased both the alpha diversity of the intestinal microbiome and the expression of a limited number of genes linked to the local immune system in intestinal tissue.The effects do not seem related to a direct antimicrobial effect of Zn O.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(NRF-RS-2023-00275307)。
文摘Background Optimal gut health is important to maximize growth performance and feed efficiency in broiler chickens.A total of 1,365 one-day-old male Ross 308 broiler chickens were randomly divided into 5 treatments groups with 21 replicates,13 birds per replicate.The present research investigated effects of microbial muramidase or a precision glycan alone or in combination on growth performance,apparent total tract digestibility,total blood carotenoid content,intestinal villus length,meat quality and gut microbiota in broiler chickens.Treatments included:NC:negative control(basal diet group);PC:positive control(basal diet+0.02%probiotics);MR:basal diet+0.035%microbial muramidase;PG:basal diet+0.1%precision glycan;and MRPG:basal diet+0.025%MR+0.1%PG,respectively.Results MRPG group increased the body weight gain and feed intake(P<0.05)compared with NC group.Moreover,it significantly increased total serum carotenoid(P<0.05)and MRPG altered the microbial diversity in ileum contents.The MRPG treatment group increased the abundance of the phylum Firmicutes,and family Lachnospiraceae,Ruminococcaceae,Oscillospiraceae,Lactobacillaceae,Peptostreptococcaceae and decreased the abundance of the phylum Campilobacterota,Bacteroidota and family Bacteroidaceae.Compared with the NC group,the chickens fed MRPG showed significantly increased in duodenum villus length at end the trial.Conclusion In this study,overall results showed that the synergetic effects of MR and PG showed enhancing growth performance,total serum carotenoid level and altering gut microbiota composition of broilers.The current research indicates that co-supplementation of MR and PG in broiler diets enhances intestinal health,consequently leading to an increased broiler production.
基金supported by the National Key Research and Development Program(2021YFD1300400)Natural Science Foundation of Guangdong Province(2021A1515010944)Science and Technology Projects in Guangzhou(202201011730).
文摘Background The benefits of combining benzoic acid and essential oils(BAO)to mitigate intestinal impairment during the weaning process have been well established,while the detailed underlying mechanism has not been fully elucidated.Previous research has primarily focused on the reparative effects of BAO on intestinal injury,while neglecting its potential in enhancing intestinal stress resistance.Methods In this study,we investigated the pre-protective effect of BAO against LPS-induced stress using a modified experimental procedure.Piglets were pre-supplemented with BAO for 14 d,followed by a challenge with LPS or saline to collect blood and intestinal samples.Results Our findings demonstrated that BAO supplementation led to significant improvements in piglets’final weight,average daily gain,and feed intake/body gain ratio.Additionally,BAO supplementation positively influenced the composition of intestinal microbiota,increasing beneficial Actinobacteriota and Alloprevotella while reducing harmful Desulfobacterota,Prevotella and Oscillospira.Furthermore,BAO supplementation effectively mitigated oxidative disturbances and inflammatory responses induced by acute LPS challenge.This was evidenced by elevated levels of T-AOC,SOD,and GSH,as well as decreased levels of MDA,TNF-α,and IL-6 in the plasma.Moreover,piglets subjected to LPS challenge and pre-supplemented with BAO exhibited significant improvements in intestinal morphological structure and enhanced integrity,as indicated by restored expression levels of Occludin and Claudin-1 compared to the non-supplemented counterparts.Further analysis revealed that BAO supplementation enhanced the jejunal antioxidative capacity by increasing GSH-Px levels and decreasing MDA levels under the LPS challenge and stimulated the activation of the Nrf2 signaling pathway.Additionally,the reduction of TLR4/NF-κB/MAPK signaling pathways activation and proinflammatory factor were also observed in the jejunal of those piglets fed with BAO.Conclusions In summary,our study demonstrates that pre-supplementation of BAO enhances the anti-stress capacity of weaned piglets by improving intestinal microbiota composition,reinforcing the intestinal barrier,and enhancing antioxidative and anti-inflammatory capabilities.These effects are closely associated with the activation of Nrf2 and TLR4/NF-κB/MAPK signaling pathways.
