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Introduction: Patients with interstitial lung diseases (ILD) can be suspected to be at risk of experiencing a rapid flare-up due to COVID-19. However, no specific data are currently available for these patients., Methods: We retrospectively analyzed a cohort of 401 patients with ILD and determined the proportion of patients hospitalized for proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and specific symptoms of COVID-19., Results: We found that 1% of patients (n = 4) were hospitalized (1 in ICU) for COVID-19. In total, 310 of the 401 patients answered the phone call. Only 33 patients (0.08%) experienced specific symptoms of SARS-CoV-2 infection., Conclusion: Our study did not demonstrate any increased occurrence of severe COVID-19 in ILD patients compared to the global population. Based on our findings, we could not make any conclusion on the incidence rate of SARS-CoV-2 infection in patients with ILDs, or on the overall outcome of immunocompromised patients affected by COVID-19., Competing Interests: Conflict of Interest None., (Copyright © 2020 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)

Since it was introduced in 2000, capsule endoscopy has become the gold standard for endoscopic examination of the small bowel in several clinical situations such as obscure gastrointestinal bleeding, suspicion of Crohn's disease, and surveillance of polyposis syndromes. In this technique a miniaturised endoscope, embedded in a swallowable capsule, is propelled through the gut by peristalsis and reaches the right colon in 5-8h. Images captured by the capsule are recorded on a hard drive in a belt worn by the patient. In addition to the extensive literature currently available on small bowel CE, new capsule devices are currently under evaluation for the examination of the colon with the purpose of screening for colorectal cancer, and of the oesophagus for screening for oesophageal varices and Barrett's oesophagus. These latter indications currently remain under evaluation. This review considers the technical aspects of capsule endoscopy and discusses the indications. Issues of safety and tolerance are also discussed.

Background: Previous data from the literature reported blunted perception of airway obstruction in severe asthmatics with near fatal asthma. Approximately 25% of patients with asthma are current smokers., Aim: To determine whether there is an alteration in perception of airway obstruction during a non specific provocative challenge with methacholine in mild controlled asthmatics who smoke., Methods: Enrolled in this study were 50 subjects, including 26 mild asthmatics and 24 healthy subjects, all of them current smokers. The first objective was the sensitivity of airway obstruction calculated by the regression slope linking the change in the visual analogic scale (VAS) assessed by the patient and the fall in FEV(1) during a methacholine challenge., Results: Asthmatics who smoke had a blunted perception of airway obstruction during the bronchial challenge significantly different from that seen in healthy smokers (p=0.03). This impaired dyspnea perception was inversely related to baseline VAS (r=-0.29, p<0.05) and positively related to baseline FEV(1) (r=0.35, p<0.05). Perception of airway obstruction was not correlated with age, sex, atopy or with airway inflammation features such as exhaled NO or sputum eosinophils., Conclusion: Mild asthmatics who smoke display reduced dyspnea perception during a non-specific provocative challenge with methacholine. This altered perception of airway obstruction does not relate to airway inflammation.

Capsule endoscopy has recently been introduced to explore endoscopically the whole small intestine, fulfilling a gap between examinations of the upper and lower gastrointestinal tract. The technique consists of a miniaturized endoscope, embedded in a swallowable capsule that is propulsed by peristalsis and achieves the journey to the right colon in five to eight hours. Images captured by the capsule are recorded on a hard drive worn in a belt by the patient. The main indication for capsule examination is the examination of the small bowel to find a bleeding lesion in patients with obscure bleeding. Several studies have shown that the diagnostic yield of capsule endoscopy is superior to that of push enteroscopy in this indication. Other possible indications are patients with suspected intestinal location of Crohn's disease, familial adenomatous polyposis, complicated coeliac disease and lesions due NSAIDs. The review contains information on the technical aspects of capsule endoscopy and discusses the indications. Issues of safety and tolerance are also discussed.

The present study was designed to investigate the clinical efficacy and safety of dioctahedral smectite in Chinese patients with chronic functional diarrhoea and to compare this activity to a probiotic preparation. Patients diagnosed with chronic functional diarrhoea (Rome II criteria), exclusion of blood, ova/parasites in the stool and a normal colonoscopy were included. After a 1-week period of baseline without any medication, they were prescribed three sachets of dioctahedral smectite 3 g, administered 1 h after the meals (Group A), or two capsules of Bifico 210mg (Group B) for 28 consecutive days. Efficacy of the treatments was assessed on frequency of bowel movements and consistency of stool, as compared to baseline. Four hundred and ten patients were included (258 males, 152 females; mean age 43.8+/-13.9 years): 208 in Group A and 202 in Group B. In Group A, the mean number of stool per day decreased from 3.5+/-1.0 at baseline to 2.0+/-0.9 and from 3.3+/-1.0 to 2.2+/-0.9 in Group B (z = 2.699; P = 0.007). Decrease in stool number was significant with both treatments but more important with smectite at week 2 and remained significant throughout the treatment period. Stool consistency, assessed by the Bristol scale, also improved significantly over the treatment period, as compared to baseline (z = 3.310, P = 0.001). Dioctahedral smectite appeared in this study to be an effective and safe treatment of chronic functional diarrhoea, its effect starting during the first week of treatment and consisting in a decrease in the frequency of daily bowel movements and improvement of stool consistency. Moreover, dioctahedral smectite displays a prolonged action after disruption of the treatment that may interfere with the natural course of the disease.

Pathophysiology of irritable bowel syndrome (IBS) is based upon multiple factors that have been organised in a comprehensive model centred around the brain-gut axis. The brain-gut axis encompasses nerve pathways linking the enteric and the central nervous systems and contains a large proportion of afferent fibres. Functionally and anatomically, visceral nerves are divided in to two categories: the parasympathetic pathways distributing to the upper gut through the vagi and to the hindgut, through the pelvic and pudendal nerves, and the sympathetic pathways, arising form the spinal cord and distributing to the midgut via the paravertebral ganglia. Several abnormalities of gut sensori-motor function have been described in patients with IBS. Abnormal motility patterns have been described at the intestinal and colonic levels. Changes in colonic motility are mainly related to bowel disturbances linked to IBS but do not correlate with pain. More recently, visceral hypersensitivity has been recognised as a main characteristic of patients with IBS. It is defined by an exaggerated perception of luminal distension of various segments of the gut and related to peripheral changes in the processing of visceral sensations as well as modulation of perception by centrally acting factors including mood and stress. Viscero-visceral reflexes link the two edges of the brain-gut axis and may account for the origin of symptoms in some pathological conditions. Recent advances in the understanding of the role of myenteric plexus allowed recognition of several neurotransmitters involved at the level of both the afferent and efferent pathways. Targeting the receptors of these neurotransmitters is a promising way for development of new treatments for IBS.

Effect of galanin and CCK8 were studied on isolated smooth muscle cells obtained from pig, guinea-pig, rat, rabbit and dog ileum circular muscle layer. Galanin as well as CCK8 induced a concentration-dependent contraction of pig, rat, rabbit and guinea-pig ileum smooth muscle cells. Maximal contraction ranged between 23.7 +/- 1.9% and 26.1 +/- 3.1% decrease in cell length from control in the presence of both peptides. This maximal contraction was obtained at 1 nM galanin in pig, rat, rabbit, 1 nM CCK8 in rat, rabbit, guinea-pig, at 10 nM galanin in guinea-pig and 10 nM CCK8 in pig. Concentrations of galanin inducing a half maximal contraction (EC50) ranged between 8 pM and 80 pM in these species. In dog, CCK8 induced a concentration-dependent contraction of ileum smooth muscle cells, with a maximal contraction (24.5 +/- 2.3%) at 1nM and an EC50 of 50 pM while galanin inhibited cell contraction induced by CCK8. The CCK-induced contraction was abolished at 10 nM galanin and 10 nM VIP. Concentrations of galanin and VIP inducing a half-maximal relaxation of contracted cells were 2 pM and 3 pM respectively. It is concluded that galanin may induce cell contraction of pig, guinea-pig, rat and rabbit ileum circular muscle layer and cell relaxation of dog ileum by a direct myogenic effect.