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(1) Background: The main goal of this study was to analyze the morphology of the rat's jejunum after long-term treatment with calcineurin inhibitor-based immunosuppressive drugs and to investigate their impact on the location of MMP-2 and its inhibitor TIMP-2, as well as the balance between them. (2) Methods: Twenty-four rats were divided into four groups receiving different immunosuppressive regiments. After six months of treatment, the jejunums were collected and analyzed. (3) Results: immunosuppressive drug panels containing calcineurin inhibitors (CNIs) have a negative impact on the morphology and morphometry of the small intestinal wall. These drugs disrupt the MMP-2/TIMP-2 balance. Both CsA and TAC interfere with the synthesis of intercellular matrix components in the connective tissue of the small intestine. Furthermore, tacrolimus appears to disrupt the MMP-2/TIMP-2 balance in the small intestine the most, as the results show the highest difference between MMP-2 and TIMP-2 expression. The results were also confirmed by digital analysis of tissue segmentation. (4) Conclusions: The research conducted in this study is unique because there is limited information available on the direct effects of immunosuppressive drugs on the expression of MMP-2 and their inhibitors in the jejunum. Additionally, this study involves three drugs instead of one, which accurately reflects the panel of drugs used in organ recipients. Our results suggest that immunosuppressive drugs affect morphology and MMP2/TIMP2 immunoexpression; however, further studies are required. AI-based tools provide a reliable analysis of tissue samples, which represents an exciting approach for future histopathological studies. However, the results of the analyses generated by these tools need to be verified by specialists. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Exhaled breath tests (BTs) are the main diagnostic method for fructose and lactose malabsorption/intolerance (FI and LI, respectively) and for detecting small intestine bacterial or methanogen overgrowth (SIBO/IMO). Although FI/LI-BTs may provide evidence of the presence of SIBO/IMO, there is limited literature evaluating their reliability for this purpose. The objective of this study was to assess the sensitivity and specificity of FI/LI-BTs in detecting SIBO and their concordance with SIBO-BTs in the identification of IMO. In this retrospective observational study, FI/LI-BTs and SIBO-BTs performed in the same patients within a period of 6 weeks were selected from 652 gas chromatography-based BTs. A total of 146 BTs from 67 eligible adult patients were identified. LI-BTs had higher specificity than FI-BT in detecting SIBO (93.8 % vs. 72.7 %). In contrast, FI-BTs showed higher sensitivity (60.0 % vs. 28.6 %) as FI was more frequently established in SIBO-positive patients (70 % vs. 29 %). With regard to IMO, concordance with LI-BT was 100 %, with a 27 % of false negatives on FI-BTs. Findings suggestive of SIBO or IMO on LI-BTs were highly consistent with those of SIBO-BTs. In contrast, the rate of false positives for SIBO and the rate of false negative for IMO on FI-BTs was 27 % in both cases. [ABSTRACT FROM AUTHOR]

Vaginal evisceration is an exceedingly rare and poorly documented complication following vaginal hysterectomy. Prompt detection and surgical intervention are critical to prevent severe complications such as bowel ischemia, perforation, and secondary sepsis. We present the case of an 84-year-old woman with a history of vaginal hysterectomy two years prior, who presented with acute abdominal pain and a significant portion of her small bowel protruding through a defect in the vaginal vault. The patient was urgently transferred to the operating room, where the loops of the small bowel were manually reduced through the vaginal defect. As the bowel appeared viable, no resection was required. The etiology of this condition is unclear and likely multifactorial. Various surgical approaches, including laparoscopic, abdominal, transvaginal, and combined techniques, have been described, all offering comparable outcomes. Therefore, the choice of surgical procedure should be tailored to the patient's clinical presentation. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Small intestinal obstruction (SIO) is a blockage of the intestinal lumen by blunt foreign bodies, neoplasms originating from the intestinal wall or thick chyme. This study analysed the medical records (only data) of 110 cattle with SIO and described the clinical findings, treatment and outcome. These findings were compared between surviving and non-surviving cattle, and among the affected regions such as the duodenum, jejunum and ileum. Results Colic occurred in 42.7% (47/110) of the cattle. Rumen motility was absent in all cattle and intestinal motility was reduced or absent in 82.6% (90/109). Ballottement and/or percussion and simultaneous auscultation were positive on the right side in 63.3% (69/109). Little or no faeces in the rectum occurred in 93.6% (102/109) of the cattle. Dilated loops of small intestines could be palpated transrectally in 46.8% (51/109) and the actual obstruction (palpated as a firm mass in the small intestine) in 5.5% (6/109) of the cattle. The main laboratory changes were hypokalaemia (80.9%, 89/110), hypermagnesaemia (75.3% 58/77), hypocalcaemia (71.8%, 56/78), haemoconcentration (66.4%, 73/110), azotaemia (66.4%, 73/110) and positive base excess (63.3%, 62/98). Abnormal ultrasonographic findings included dilated loops of small intestines (94.3%, 83/88) and subjectively reduced or absent small intestinal motility (85.4%, 70/82). The actual obstruction could be visualised in 3.4% (3/89) of the cattle by ultrasonography. In the 14 non-surviving and the 96 surviving cattle the frequencies of abdominal dilatation (57.1%, 8/14 vs. 22.1%, 21/95) and the presence of blood, mucus and/or fibrin in the rectum (92.9%, 13/14 vs. 63.2%, 60/95) were significantly different. Abomasal reflux syndrome was significantly worse in the cattle with duodenal obstruction (26/110) than in those with jejunal (51/110) or ileal obstruction (33/110). A total of 107 cattle underwent right flank laparotomy, and the obstruction was resolved by massaging the affected area or it was removed via enterotomy. Of the 110 cattle, 14 (12.7%) were euthanized and 96 (87.3%) were discharged 3 to 10 days after surgery. Conclusions Transrectal and/or ultrasonographic diagnosis is the exception, and in almost all cases laparotomy, was required. The prognosis is good provided that surgical treatment is carried out promptly.

Congenital segmental absence of bowel muscle layer which is also known as Segmental absence of intestinal musculature (SAIM) is rare cause of obstruction in neonates and exceedingly rare in adults. We present 35 years old male with right iliac fossa (RIF) pain since 7 daysandnot passing stool since 3 days, was operated with suspicion of intestinal tuberculosis (TB). Our case shows two rare anomalies, SAIM and duplication in single patient which makes itunique. Histopathologically it was diagnosed as Congenital segmental absence of bowel muscle layer with duplication of bowel wall.

Abstract Background Sodium butyrate is a potential antibiotic growth promoter and has had advantageous effects on the poultry industry. Methods Evaluating the effect of sodium butyrate on the intestinal villi and the humoral part of innate immunity of the male Cobb 500 broiler using scanning electron microscopy and quantitative real-time PCR analysis, the control group and treated group of Cobb 500 with SB supplemented received water containing 0.98 mg sodium butyrate. Results The administration of sodium butyrate changed the villi characters, as the shape changed from tongue to long tongue. They were mainly parallel to each other and long finger-like at the duodenum. The tips of the villi in the control group appeared thin-slight curved with a prominent center in the duodenum, thin rectangular in the jejunum, and ileum in the control group. In contrast, in the treatment group, they changed to thick rectangular in the duodenum and ileum zigzag shape in the jejunum. The epithelium lining of the duodenal villi showed a dome shape, the jejunal villi showed a polygonal shape, and the ileal villi appeared scales-like. The epithelium lining showed irregular microfolds and many different-sized pores, and the treatment group showed islands of long microvilli in the duodenum and solitary long microvilli in the ileum. Real-time PCR of AvBD 1, 2, 10, and 12 significantly (P

Abstract Background Video capsule endoscopy is a noninvasive technique for evaluation of the gastrointestinal tract. Objective To investigate the safety of using the video capsule ALICAM in dogs with chronic enteropathy (CE) >10 kg, and to compare macroscopic gastrointestinal morphology between CE dogs and healthy controls (HC). Animals Fifteen CE dogs and 15 similarly breed, age and body weight matched HC. Methods All dogs underwent a clinical work up including blood analyses, fecal samples, abdominal ultrasonographic examination, and blood pressure measurement. The dogs were withheld from food for 16 hours before and 8 hours after they PO received an ALICAM. All recordings were quality assessed, and blindly evaluated by 2 trained observers. Results The median age of CE dogs and HC was 3.3 (interquartile range [IQR] 2.5‐5.9) years and 4.7 (IQR 3.3‐5.6) years, respectively. The median body weight in the CE dogs and HC was 25.9 (IQR 20.6‐30.9) kg, and 29 (IQR 16.2‐30.5) kg, respectively. Complete recordings of the gastrointestinal tract were obtained from all dogs without complications. No significant differences were found between groups regarding number of abnormalities such as irregular mucosa, erythema, nonbleeding erosions, bleeding erosions, and dilated lacteals, as well as severity and extent of the abnormalities. Conclusions and Clinical Importance The use of ALICAM for evaluation of the gastrointestinal tract in CE dogs and HC seems safe and feasible regarding gastrointestinal transit and macroscopic morphology assessment in dogs >10 kg. Abnormalities were found in similar proportions in CE dogs and HC.

Intestinal obstruction is a surgical emergency frequently encountered in routine practice, usually caused by abdominal adhesions. Although extra nodal lymphoma is most often localized in the gastrointestinal tract and may be responsible for intestinal obstruction, Burkitt's lymphoma is a very rare cause in adults.We report a case of Burkitt's lymphoma mimicking an intestinal obstruction in a 48-year-old adult who presented with an obstructive syndrome and altered general condition.Imaging and anatomopathological examination after immunohistochemical analysis concluded to a multi-systemic Burkitt's lymphoma.Chemotherapy was immediately started with complete remission.

ABSTRACTGlucose transporter 5 (GLUT5), the main fructose transporter in mammals, is primarily responsible for absorbing dietary fructose in the small intestine. The expression of this intestinal gene significantly increases in response to developmental and dietary cues that reach the glucocorticoid receptor and carbohydrate response element-binding protein (ChREBP), respectively. Our study demonstrates that ChREBP is involved in the dexamethasone (Dex)-induced expression of GLUT5 in Caco-2BBE cells and the small intestine of both wild-type and ChREBP-knockout mice. Dex, a glucocorticoid, demonstrated an increase in GLUT5 mRNA levels in a dose- and time-dependent manner. While the overexpression of ChREBP moderately increased GLUT5 expression, its synergistic increase in the presence of Dex was noteworthy, whereas the suppression of ChREBP significantly reduced Dex-induced GLUT5 expression. Dex did not increase ChREBP protein levels but facilitated its nuclear translocation, thereby increasing the activity of the GLUT5 promoter. In vivo experiments conducted on 14-day-old mice pups treated with Dex for three days revealed that only wild-type mice (not ChREBP-knockout mice) exhibited Dex-mediated Glut5 gene induction, which further supports the role of ChREBP in regulating GLUT5 expression. Collectively, our results provide insights into the molecular mechanisms involved in the regulation of GLUT5 expression in response to developmental and dietary signals mediated by glucocorticoids and ChREBP.General significance: The transcription factor ChREBP is important for Dex-mediated Glut5 gene expression in the small intestine.

Flavonoid compounds exhibit a wide range of health benefits as plant-derived dietary components. Typically, co-consumed with the food matrix,they must be released from the matrix and converted into an absorbable form (bioaccessibility) before reaching the small intestine, where they are eventually absorbed and transferred into the bloodstream (bioavailability) to exert their biological activity. However, a large number of studies have revealed the biological functions of individual flavonoid compounds in different experimental models, ignoring the more complex but common relationships established in the diet. Besides, it has been appreciated that the gut microbiome plays a crucial role in the metabolism of flavonoids and food substrates, thereby having a significant impact on their interactions, but much progress still needs to be made in this area. Therefore, this review intends to comprehensively investigate the interactions between flavonoids and food matrices, including lipids, proteins, carbohydrates and minerals, and their effects on the nutritional properties of food matrices and the bioaccessibility and bioavailability of flavonoid compounds. Furthermore, the health effects of the interaction of flavonoid compounds with the gut microbiome have also been discussed. HIGHLIGHTS: Flavonoids are able to bind to nutrients in the food matrix through covalent or non-covalent bonds. Flavonoids affect the digestion and absorption of lipids, proteins, carbohydrates and minerals in the food matrix (bioaccessibility). Lipids, proteins and carbohydrates may favorably affect the bioavailability of flavonoids. Improved intestinal flora may improve flavonoid bioavailability. [ABSTRACT FROM AUTHOR]

An age-dependent increase in interferon (IFN)-γ expression by intestinal intraepithelial lymphocytes (IELs) contributes to the acquisition of resistance to infection by pathogens. However, how IELs acquire the ability to produce IFN-γ remains to be elucidated. Here, we report that IELs in the small intestine acquire the ability to rapidly produce IFN-γ at two distinct life stages. TCRαβ+ IELs (αβIELs) started producing IFN-γ at 4 weeks of age, within 1 week after weaning. In contrast, TCRγδ+ IELs (γδIELs) started producing IFN-γ at 7 weeks of age. In mice lacking Eγ4, an enhancer of the TCRγ locus (Eγ4−/− mice), Thy-1+ Vγ5+ γδIELs, a major subpopulation of γδIELs, were specifically reduced and their ability to produce IFN-γ was severely impaired, whereas Vγ2+ γδIELs normally produced IFN-γ. In Eγ4−/− mice, TCR expression levels were reduced in Vγ5+ γδIEL precursors in the thymus but unchanged in the Vγ5+ IELs. Nevertheless, TCR responsiveness in Vγ5+ γδIELs was impaired in Eγ4−/− mice, suggesting that the TCR signal received in the thymus may determine TCR responsiveness and the ability to produce IFN-γ in the gut. These results suggest that αβIELs and γδIELs start producing IFN-γ at different life stages and that the ability of Vγ5+ γδIELs to produce IFN-γ in the gut may be predetermined by TCR signalling in IEL precursors in the thymus. [ABSTRACT FROM AUTHOR]

Background: Opioids inhibit motility and secretion of the gut and have been used for antidiarrheal treatment for centuries. However, the underlying mechanisms of opium tincture are not evident. Aim: To investigate the effects of opium tincture on gastrointestinal motility, intestinal volumes, and water content of different gut segments assessed by magnetic resonance imaging (MRI). Methods: Twenty healthy volunteers were included in a randomized, placebo‐controlled, crossover study of 9 days of treatment with 30 drops of opium tincture per day. MRI was performed on day 1 (before treatment) and day 9 (during treatment). Measurements included assessments of gastric volume, gastric emptying, gastric motility, small bowel volume, small bowel water content, small bowel motility, colon volume, colon water content, and whole gut transit. Key Results: Opium tincture delayed gastric emptying by a mean difference of 5.6 min [95% CI: 1.8–9.4], p = 0.004, and increased postprandial gastric meal volume (17–21%, p = 0.02). Small bowel endpoints did not change. Opium tincture delayed whole gut transit time (p = 0.027) and increased ascending colon volume by 59 mL [95% CI: 15–103], p = 0.004, and transverse colon volume by 48 mL [95% CI: 4–92], p = 0.027. T1‐relaxation time of the descending colon chyme was decreased during opium treatment, indicating dryer feces (difference: −173 ms [95% CI: −336 ‐11], p = 0.03). Conclusion and Inferences: Opium tincture induced changes in the stomach and colon in healthy volunteers. An improved understanding of how opioids affect gut functions may lead to a better understanding and optimized management of diarrhea. [ABSTRACT FROM AUTHOR]

The objective of this study was to study the effect of probiotic supplementation in diet on egg production, egg quality, intestinal morphology, and bacterial population in caecum of laying hens. A total of 768 Lohmann Brown-Classic laying hens, aged 42 - 54 weeks, were used. The laying hens were divided into 3 groups, each with 8 subgroups of 32 birds each. The experiment was planned to use a completely randomized design method. The 3 experimental groups were classified based on their dietary treatment as follows: 1) Basal diet (without probiotic supplementation), 2) Basal diet with probiotic 0.01 and 0.02 % in 3, respectively. Data was collected for 12 weeks. Adding probiotic in the diet was no significant difference on egg production, egg quality, and bacterial population in caecum. However, probiotic supplementation in the diet increased villi height of the duodenum significantly improved (p < 0.02), villi height per depth crypt of the duodenum significantly improved (p < 0.05), villi height per depth crypt of the jejunum significantly improved (p < 0.01), and villi height per depth crypt of the ileum significantly improved (p < 0.02). Therefore, studies have shown that dietary probiotic supplementation can improved small intestinal morphology are the most important indexes for measuring the digestive and absorption function of the small intestine are more efficient. [ABSTRACT FROM AUTHOR]

Carriage of HLA‐DQA1*05 is thought to increase the formation of anti‐tumour necrosis factor alpha (TNF‐α) antibodies, reducing the drug efficacy in Crohn's disease (CD) patients. However, little data are currently available for small‐bowel Crohn's disease (SB‐CD). A specific assessment of the impact of HLA‐DQA1*05 on the clinical response to treatment with infliximab (IFX), a TNF‐α antagonists, in SB‐CD patients is necessary. We conducted a single‐center retrospective study that included 106 SB‐CD patients treated with IFX. The serum samples were collected for antibodies to infliximab (ATI) testing and HLA‐DQA1*05 genotyping. Double‐balloon enteroscopy (DBE) was performed following the IFX treatment, with endoscopic outcomes evaluated using the partial simple endoscopic score for CD (pSES‐CD), whereas the clinical response was assessed with the Crohn's disease activity index (CDAI). Multivariate logistic regression and multivariate COX regression analyses were employed to analyze the correlation of the HLA‐DQA1*05 genotypes with other clinical variables. In this study, 30.2% of SB‐CD patients carried the HLA‐DQA1*05 allele, which significantly increased their risk of ATI generation (odds ratio [OR] = 2.337, p =.043), but it was not associated with the clinical response to IFX and drug persistence (OR = 2.356, p =.145; OR = 0.457, p =.249). The endoscopic remission rates were 40.6% (13/32) and 55.4% (41/74) in HLA‐DQA1*05 carriers and non‐carriers, respectively. HLA‐DQA1*05 was not associated with endoscopic remission (OR = 0.684, p =.414). The HLA‐DQA1*05 variant is identified as a significant risk factor of ATI formation in Chinese patients with SB‐CD, but is not associated with the clinical response of IFX treatment and endoscopic remission of SB lesions. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the protein oxidation of soybean meal (SBM) stored in a warehouse and the effects of SBM on growth performance, antioxidant status, digestive performance, intestinal morphology, and breast muscle quality of broilers. Methods: In total, 160 one-day-old Arbor Acres Plus broilers (half male and half female) were randomly divided into two groups with ten replicates of eight birds each: The control group was served with a basal diet including SBM stored at –20°C (FSBM), and the experimental group was served with a basal diet including SBM stored in a warehouse at room temperature for 45 days (RSBM). Results: Compared with FSBM, the protein carbonyl level in RSBM was increased, the free and total thiol levels and in vitro digestibility of protein were decreased. The RSBM decreased the serum glutathione (GSH) level and the hepatic total superoxide dismutase (T-SOD) activity at days 21 and 42 when compared with FSBM. Further, RSBM reduced the duodenal T-SOD activity, jejunal catalase (CAT), and T-SOD activities at day 21, and decreased the duodenal CAT and T-SOD activities, jejunal T-SOD activity, and ileal GSH level and T-SOD activity at days 21 and 42 when compared with FSBM. Besides, the trypsin activity and the ratio of villus height to crypt depth in small intestines of broilers at days 21 and 42 were reduced when fed with a RSBM-contained diet. Compared with FSBM, the 24-h drip loss, shear force, and 24- and 48-h cooking loss of breast muscle were increased of RSBM group, the opposite result was observed for muscle lightness at 48 h. Conclusion: Room temperature storage for 45 days led a protein oxidation and decreased in vitro digestibility in SBM, and fed RSBM impaired growth performance, antioxidant status, and meat quality, reduced trypsin activity, and affected the small intestine morphology in broilers. [ABSTRACT FROM AUTHOR]

Background: Small bowel obstruction (SBO) is a known complication following congenital diaphragmatic hernia (CDH) repair, resulting in significant morbidity and potential mortality. Our study aims to evaluate the incidence and risk factors for SBO following CDH repair. Methods: A single-institution retrospective review evaluated all CDH births between January 2010 and September 2022 (n = 120). Risk factors for SBO were analyzed, including operative approach, type of repair, need for extracorporeal membrane oxygenation (ECMO), and additional abdominal surgeries (gastrostomy tube and fundoplication). Results: 120 patients were included. 16 (13%) patients developed an SBO, of which 94% were due to adhesive bands. The median time to SBO was 7.5 months. 15/16 (94%) patients required operative intervention. Need for ECMO (P < 0.01), prior gastrostomy tube (P < 0.01), and prior fundoplication (P < 0.01) were associated with an increased risk of SBO, as were longer time to initial CDH repair (6 days vs 3 days; P < 0.01) and longer length of initial hospitalization (63 days vs 29 days; P = 0.01). Discussion: Neonates with increased acuity of illness (ie, those requiring ECMO, additional abdominal operations, longer time to repair, and longer initial hospitalizations) appear to have an increased risk of developing adhesive SBO after CDH repair. More than 90% of patients who developed SBO required surgery. [ABSTRACT FROM AUTHOR]

The oral biguanide metformin is used to treat type 2 diabetic mellitus (T2DM). Anti-cancer effects have been proven by metformin in different hormone-sensitive tumors, including breast, pancreatic, colon, and prostate cancer. Therefore, we investigated whether metformin could defend against small intestine damage in Dunning's prostate cancer. The study divided the six groups of male Copenhagen rats into the following categories: control, diabetic (D), cancer (C), diabetic + cancer (DC), cancer + metformin (CM), and diabetic + cancer + metformin (DCM). After sacrifice, the small intestines were removed to assess biochemical markers and histopathological evaluation. Biochemical evaluations showed that glutathione (reduced) levels and other enzyme activities related antioxidant systems, paraoxonase, sodium potassium ATPase, acetylcholinesterase activities were decreased. In contrast, lipid peroxidation, total oxidant status, reactive oxygen species, interleukin-1β, interleukin-6, tumor necrosis factor-α, sucrase, maltase, trypsin, myeloperoxidase, xanthine oxidase activities, protein carbonyl contents and sialic acid levels were raised in the damaged groups. Treatment with metformin restored all of this. The histological assessment revealed moderate to severe damage in the small intestine following processes D and C. According to the study's findings, metformin treatment led to a notable decline in histopathological damage in the C and DC. A slight lowering in inflammatory cells and an improvement in the damaged gland integrity in the small intestine were noted with metformin treatment.​ Metformin use protected the small intestinal tissue damage and decreased oxidative stress. [ABSTRACT FROM AUTHOR]

This study aimed to confirm the applicability of the new nitrogen (N2) gas stunning method in the broiler slaughtering process by comparing the meat and small intestine quality following different stunning methods (electrical, carbon dioxide (CO2), N2, and halal). Four treatments were compared: (i) electrical stunning (Elec), (ii) 80% CO2 gas stunning (CO2-gas), (iii) 98% N2 gas stunning (N2-gas), and (iv) the non-stunning method (halal). N2 gas stunning (98%) and the halal method were conducted at the pilot plant abattoir of the national institute of animal science, Korea, and electrical and 80% CO2 stunning were performed on the nearest commercial slaughter house. Meat pH24h, color (lightness, redness and yellowness), proximate composition, water holding capacity (WHC), cooking loss, and Warner-Bratzler shear force (WBSF) were measured, and in the small intestine, pH24h, color, thickness, and WBSF were measured. The Elec treatment showed high lightness, yellowness, and low redness in both meat and the small intestine, indicated by a pale color; the CO2-gas treatment showed high redness, low lightness, and low yellowness, and the coloration of meat from the N2-gas treatment was intermediate between Elec and CO2-gas. For other quality traits, the N2-gas showed good results and was between Elec and CO2-gas. Additionally, severe stress (low pH in both meats), low WHC in meat, and cracked small intestine with numerous apertures were observed in the CO2-gas, and pale colored hemorrhagic breast meat was found in the Elec. Therefore, in view of animal welfare and quality traits of meat and the small intestine, 98% N2 gas can be considered in broiler stunning.

ABSTRACT: The intestinal microbiota plays a pivotal role in digestive processes and maintains gut health and intestinal homeostasis. These functions may be compromised by increased environmental heat, which in turn reduces feed intake and gut integrity and activates the intestinal immune system. It remains unknown whether high ambient temperatures, which cause heat stress (HS) in dairy cows, disturb the eubiosis of the microbial community, and if so, to which extent the reduction in feed intake and the impairment of circulating and intestinal metabolites account for the alterations of the jejunal microbiota. To address these questions, jejunal digesta, mucosa, and plasma samples were collected from cows exposed to heat stress (HS; 28°C, temperature-humidity index [THI] = 76, n = 10), control conditions (CON; 16°C, THI = 60, n = 10), or pair-fed (PF; 16°C, THI = 60, n = 10) for 7 d. Digesta fluids were examined for pH, acetate, nonesterified fatty acids (NEFA), glucose, and lactate, and plasma samples were analyzed for glucose, lactate, BHB, triglycerides, NEFA, creatinine, and urea. The microbiota of the digesta and mucosa samples were analyzed by 16S rRNA sequencing. The α-diversity was higher in mucosa than digesta but was not affected by high ambient temperatures. However, the mucosa-associated microbiota appeared more responsive to ambient heat than the digesta microbiome. The adaptive responses under HS conditions comprised an increased mucosal abundance of Bifidobacteriaceae, Succinivibrionaceae UCG-001, Clostridia and Lactobacillus. In the digesta, HS has exerted effects on microbial abundance of Colidextribacter, and Lachnospiraceae UCG-008. Several correlations between plasma or intestinal metabolites and microbiota were elucidated, including Methanobacteriaceae correlating positively with plasma BHB and digesta glucose concentrations. Moreover, the reduction in feed intake during HS had non-negligible effects on microbial diversity and the abundance of certain taxa, underpinning the importance of nutrient supply on maintaining intestinal homeostasis.

Introduction: Due to genetic selection, today's strains exhibit higher metabolic activity, resulting in increased heat production and reduced heat resistance. This can negatively impact their immune system and production performance (Havenstein et al. 1994).Thaxton et al. (1968) showed that high ambient temperature can have a negative effect on the immune responses of broiler chickens. In recent years, in order to improve the health of chicken meat consumers, the production of broiler chickens without the use of antibiotics has been proposed, and the ban on the use of antibiotics has been issued by the European Union in 1999 (Youssef et al., 2016). For this reason, today there is a tendency to use alternative sources. Algae and microalgae are of the natural substances whose beneficial effects have received much attention in recent years. Spirulina platensis (SP) is a filamentous blue-green microalgae (cyanobacteria) generally regarded as prebiotic and source of high quality protein, minerals, essential fatty acids, essential amino acids, pigments and phenolic acids. Many studies have shown that Spirulina has antioxidant, immunomodulatory, anti-inflammatory, antiviral, and antimicrobial activity in various experimental animals (Hajati and Zaghari 2019).Materials and Methods: A total of 360 one-day old male broiler chickens (Ross 308 strain) were allocated to 6 treatments, 6 replicates and 10 birds each replicate in a completely randomized design. The experimental treatments included different levels of Spirulina platensis microalgae powder: 0 (Control), 0.25, 0.50, 0.75, and 1.0 percent Spirulina platensis powder, and one treatment included Vitamin E at the level of 150 g/ton feed. The basal diet was based on corn0soybean meal and all the diets were isocaloric and isonitrogenous and used for 42 days in diets. During the experiment, the feed consumption and weight gain of the chickens were measured weekly and the feed conversion ratio was calculated for each week and period.On 42 d of experiment, 2 birds from each replicate were randomly selected, humoral immune response was evaluated and then killed after weighing, carcass components and internal organs were weighed and their weight was calculated as a percentage of live weight. In order to evaluate the humoral immune system, the antibody titer produced against SRBC was measured using the hemagglutination method. In the end of experiment, the microbial population of the cecum was counted. All the data were analyzed in the form of a completely random design by SAS software and with the GLM procedure, and the comparison of means was done with Tukey's test.Results and Discussion: Results showed that the use of different levels of SP had no significant effect on the amount of feed intake during the whole period (P0.05). The response of humoral immune system was higher in all four levels of SP and also vitamin E compared to control treatment. Chickens which consumed Spirulina at the level of 1 percent had the highest level of antibody titer. Mustafa et al. (2021) by achieving a growth performance similar to the present research, stated that the effect of SP on the intestinal microbial population, such as the increase of Lactobacillus and the decrease of Escherichia coli, has improved the performance of the birds under heat stress conditions. According to the reports on the effects of heat stress on digestive enzymes (Sahin et al., 2002) and the efforts of previous researchers to overcome the adverse effects of heat stress on digestive enzymes by using phytogenic compounds (Khosravinia et al., 2016), the researchers of the present study believe that the improvement of the mucous tissue and intestinal immune system and perhaps the increase in the secretion of digestive enzymes are the most important factors for improving the performance of birds in heat stress conditions.Conclusion: Under heat stress condition, using 1 percent Spirulina platensis microalgae in broiler chickens’ diet could improve both humoral immune system and growth performance.

A great interest is placed on the influence of probiotic, prebiotic and synbiotic preparations on animals in accordance with the principle of One health. The small intestine mucosa represents a complex ecosystem ensuring the homeostasis of the animal organism. The effect of Lacto-Immuno-Vital synbiotic preparation on the quantity of mucin produced in the broiler chicken small intestine was studied. The chickens (7 days old Hybrid ROSS 308) were divided into 3 equal size (n = 16) groups, housed in separate halls: control group (CG), and two experimental groups that received syn-biotic preparation Lacto-Immuno-Vital, – one with continuous synbiotic administration (EGC), and another with pulsed synbiotic administration (EGP). The preparation was administered to EGC group from the experimental day 1 to day 7 continuously every day (500 g per 1000 l of drinking water.day−1), and to EGP group from experimental day 8 to day 22 in a pulsed manner (every third day) at a dose of 300 g per 1000 l of drinking water. The experiment lasted 22 days. A significant effect on mucus production quantity was found in the duodenum (P < 0.001), in EG after both types of synbiotic supplementation compared to CG. The comparison of continuous and pulsed supplementation was as follows: a significant effect (P < 0.001) was observed after continuous supplementation of the synbiotic preparation, compared to pulsed supplementation in EG.

Abstract Intestinal preservation for transplantation is accompanied by hypoperfusion with long periods of ischemia with total blood cessation and absolute withdrawal of oxygen leading to structural damage. The application of intraluminal oxygen has been successfully tested in small-animal series during storage and transport of the organ but have been so far clinically unrelatable. In this study, we tested whether a simple and clinically approachable method of intraluminal oxygen application could prevent ischemic damage in a large animal model, during warm ischemia time. We utilised a local no-flow ischemia model of the small intestine in pigs. A low-flow and high-pressure intraluminal oxygen deliverance system was applied in 6 pigs and 6 pigs served as a control group. Mucosal histopathology, hypoxia and barrier markers were evaluated after two hours of no-flow conditions, in both treatment and sham groups, and in healthy tissue. Macro- and microscopically, the luminal oxygen delivered treatment group showed preserved small bowel’s appearance, viability, and mucosal integrity. A gradual deterioration of histopathology and barrier markers and increase in hypoxia-inducible factor 1-α expression towards the sites most distant from the oxygen application was observed. Intraluminal low-flow, high oxygen delivery can preserve the intestinal mucosa during total ischemia of the small intestine. This finding can be incorporated in methods to overcome small bowel ischemia and improve intestinal preservation for transplantation.

BACKGROUND: The general assumption that prebiotics reach the colon without any alterations has been challenged. Some in vitro and in vivo studies have demonstrated that 'non‐digestible' oligosaccharides are digested to different degrees depending on their structural composition. In the present study, we compared different methods aiming to assess the digestibility of oligosaccharides synthesized by β‐galactosidase (β‐gal) of Lactobacillus delbruecki subsp. bulgaricus CRL450 (CRL450‐β‐gal) from lactose, lactulose and lactitol. RESULTS: In the simulated gastrointestinal fluid method, no changes were observed. However, the oligosaccharides synthesized by CRL450‐β‐gal were partially hydrolyzed in vitro, depending on their structure and composition, with rat small intestinal extract (RSIE) and small intestinal brush‐border membrane vesicles (BBMV) from pig. Digestion of some oligosaccharides increased when mixtures were fed to C57BL/6 mice used as in vivo model; however, lactulose‐oligosaccharides were the most resistant to the physiological conditions of mice. In general β (1→6) linked products showed higher resistance compared to β (1→3) oligosaccharides. CONCLUSION: In vitro digestion methods, without disaccharidases, may underestimate the importance of carbohydrates hydrolysis in the small intestine. Although BVMM and RSIE digestion assays are appropriate in vitro methods for these studies, in vivo studies remain the most reliable for understanding what actually happens in the digestion of oligosaccharides. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Aim Methods and Results Conclusion Gastrointestinal medullary carcinoma is a rare histologic subtype of adenocarcinoma. As nonampullary small bowel medullary carcinomas (SB‐MCs) are poorly characterized, we aimed to analyse their clinicopathologic and immunohistochemical features and to compare them with nonmedullary small bowel adenocarcinomas (NM‐SBAs).Surgically resected SBAs collected through the Small Bowel Cancer Italian Consortium were classified as SB‐MCs (carcinomas with ≥50% of tumour fulfilling the typical histologic criteria of MC) or NM‐SBAs. Immunohistochemistry for cytokeratin (CK)7, CK20, CDX2, programmed death‐ligand 1 (PD‐L1) and mismatch repair proteins was performed in both SB‐MCs and NM‐SBAs. SB‐MCs were also tested for CK8/18, synaptophysin, SMARCB1, SMARCA2, SMARCA4, and ARID1A and for Epstein–Barr virus (EBV)‐encoded RNAs by in‐situ hybridization. MLH1 promoter methylation status was evaluated in MLH1‐deficient cases. Eleven SB‐MCs and 149 NM‐SBAs were identified. One (9%) SB‐MC was EBV‐positive, while 10 (91%) harboured mismatch repair deficiency (dMMR). MLH1 promoter hypermethylation was found in all eight dMMR SB‐MCs tested. Switch/sucrose nonfermentable deficiency was seen in two (18%) SB‐MCs, both with isolated loss of ARID1A. Compared with NM‐SBAs, SB‐MCs exhibited an association with coeliac disease (P < 0.001), higher rates of dMMR (P < 0.001), and PD‐L1 positivity by both tumour proportion score and combined positive score (P < 0.001 for both), and a lower rate of CK20 expression (P = 0.024). Survival analysis revealed a better prognosis of SB‐MC patients compared to NM‐SBA cases (P = 0.02).SB‐MCs represent a distinct histologic subtype, with peculiar features compared to NM‐SBAs, including association with coeliac disease, dMMR, PD‐L1 expression, and better prognosis. [ABSTRACT FROM AUTHOR]

Anticoccidial vaccines comprising living oocysts of Eimeria tenella, Eimeria necatrix, Eimeria maxima, and Eimeria acervulina are used to control coccidiosis. This study explored the potential of IL-1β to act as a molecular adjuvant for enhancing the immunogenicity of Eimeria necatrix and mucosal immunity. We engineered E. necatrix to express a functional chIL-1β (EnIL-1b) and immunized chickens with oocysts of the wild type (EnWT) and tranegenic (EnIL-1b) strains, respectively. The chickens were then challenged with EnWT oocysts to examine the immunogenicity-enhancing potential of chIL-1b. As expected, the oocyst output of EnIL-1β-immunized chickens was significantly reduced compared to those immunized using EnWT. No difference in body weight gain and lesion scores of EnIL-1β and EnWT groups was observed. The parasite load in the small intestine and caeca showed that the invasion and replication of EnIL-1β was not affected. However, the markers of immunogenicity and mucosal barrier, Claudin-1 and avian β-defensin-1, were elevated in EnIL-1binfected chickens. Ectopic expression of chIL-1β in E. necatrix thus appears to improve its immunogenicity and mucosal immunity, without increasing pathogenicity. Our findings support chIL-1β as a candidate for development of effective live-oocyst-based anticoccidial vaccines. [ABSTRACT FROM AUTHOR]

Intestinal obstruction, a rare manifestation of immunotherapy-related gastrointestinal adverse events, can be severe and even life-threatening with intestinal perforation. We present a 64-year-old man with HCC and currently under the therapy with Pembrolizumab, who was admitted in our hospital with abdominal distension. Radiologic findings were consistent with small bowel ileus. After conservative treatment, the patient underwent colonoscopy where no cause of ileus was discovered. The patient received high-dose prednisone due to the side effects of immune checkpoint inhibitor therapy. This resulted in a gradual improvement of symptoms. [ABSTRACT FROM AUTHOR]

Background: The previously underestimated effects of commensal gut microbiota on the human body are increasingly being investigated using omics. The discovery of active molecules of interaction between the microbiota and the host may be an important step towards elucidating the mechanisms of symbiosis. Results: Here, we show that in the bloodstream of healthy people, there are over 900 peptides that are fragments of proteins from microorganisms which naturally inhabit human biotopes, including the intestinal microbiota. Absolute quantitation by multiple reaction monitoring has confirmed the presence of bacterial peptides in the blood plasma and serum in the range of approximately 0.1 nM to 1 μM. The abundance of microbiota peptides reaches its maximum about 5 h after a meal. Most of the peptides correlate with the bacterial composition of the small intestine and are likely obtained by hydrolysis of membrane proteins with trypsin, chymotrypsin and pepsin – the main proteases of the gastrointestinal tract. The peptides have physicochemical properties that likely allow them to selectively pass the intestinal mucosal barrier and resist fibrinolysis. Conclusions: The proposed approach to the identification of microbiota peptides in the blood, after additional validation, may be useful for determining the microbiota composition of hard-to-reach intestinal areas and monitoring the permeability of the intestinal mucosal barrier. [ABSTRACT FROM AUTHOR]

Urine amylase levels are usually used to diagnose acute pancreatitis. However, there are reported cases where urine amylase levels are slightly increased in individuals without pancreatitis. Herein, we report the case of a young lady who presented with acute abdominal pain for 3 days. Her urine amylase level was 1717 U/L upon admission, and her condition was initially treated as acute pancreatitis. Unfortunately, the patient demonstrated abdominal guarding after 24 h; thus, urgent computed tomography (CT) was performed. CT revealed the presence of a dilated small bowel. She underwent emergency laparotomy, wherein a gangrenous small bowel with no evidence of saponification at the lesser sac was noted. Due to the non-specific nature of hyperamylasaemia, an alternative diagnosis other than acute pancreatitis should be considered if the clinical symptoms are not suggestive of pancreatitis or the condition worsens despite conservative management. [ABSTRACT FROM AUTHOR]

Abdominal adhesions manifests following abdominal infections triggered by intestinal fistulas. The severity of such adhesions depends on the extent of fiber deposition and peritoneal fibrinolysis following peritoneal injury, which may be influenced by sustained inflammation within the abdominal cavity. In this regard, the visceral-to-subcutaneous fat area (VFA/SFA) ratio has been implicated as a potential marker of inflammation. This study aimed to explore the relationship between VFA/SFA and abdominal adhesions. This multicenter study was conducted across four tertiary institutions and involved patients who had undergone definitive surgery (DS) for intestinal fistula from January 2009 and October 2023. The presence of abdominal adhesions was determined intraoperatively. VFA/SFA was investigated as a potential risk factor for severe adhesions. The study comprised 414 patients with a median age of 50 [interquartile range (IQR) 35–66] years and a median body mass index of 20.0 (IQR 19.2–22.4) kg/m2, including 231 males with a median VFA/SFA of 1.0 (IQR 0.7–1.2) and 183 females a median VFA/SFA of 0.8 (0.6–1.1). VFA/SFA was associated with severe abdominal adhesions in males [odds ratio (OR) = 3.34, 95% CI 1.14–9.80, p = 0.03] and females (OR = 2.99, 95% CI 1.05–8.53, p = 0.04). J-shaped association between VFA/SFA ratio and severe adhesions was revealed in both sex. The increasing trend can be revealed when OR more than 0.8, and 0.6 in males and females respectively. Preoperative VFA/SFA demonstrates predictive value for statues of severe abdominal adhesions in DS for anastomotic fistula after small intestine resection. [ABSTRACT FROM AUTHOR]

Background: Abdominal tuberculosis comprises all forms of tuberculosis that involve the gastrointestinal tract. Controversies exist regarding the surgical approach and timing and type of intervention for complicated forms of abdominal tuberculosis. The aim of this systematic review is to define the rate of surgical treatment, the type of surgical procedures performed and the role of minimally invasive surgery in the management of abdominal tuberculosis. Methods: The literature in MEDLINE, Scopus and Google Scholar and forward and backward citations for studies published between database inception and July 2022 were searched without language restrictions. All prospective and retrospective studies were included. The electronic database search yielded 2440 records. Additionally, eight records were identified through snowball searching. Following duplicate removal (45 duplicates found), 2403 records were screened for titles and abstracts. After screening for titles and abstracts and exclusion criteria, 38 reports were included for systematic review, 27 retrospective studies and 11 prospective studies. Data extracted included the general and demographic characteristics of the studies, diagnostic methods used, clinical presentation, site of involvement and details on surgical treatment. Results: In total, 2870 patients with a diagnosis of abdominal tuberculosis were included, and 1803 (63%) underwent a surgical procedure. The majority of patients underwent an open surgical procedure (95%). The most commonly performed procedures were adhesiolysis (21%) and small bowel resection with primary anastomosis (21%). Conclusions: The results of this review suggest that whenever surgery is required, there is a tendency to perform open surgical procedures in patients with complicated abdominal tuberculosis, both in emergency and elective settings, despite advances in minimally invasive surgery. The study protocol was registered on PROSPERO (CRD42022354322). [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Reversed intestinal malrotation is an extremely rare disease, with an incidence of 1 in 250 000. In Japan, application of robotic-assisted colorectal cancer surgery is expected to increase. There are no reports of robot-assisted surgery for cecal cancer with reversed intestinal malrotation. Case Report: An 84-year-old Japanese man with epigastric pain and abdominal distention was referred to our hospital’s Department of Gastroenterology for thorough examination. Colonoscopy revealed a semicircumferential type 2 tumor in the cecum and ascending colon. Gastrografin contrast study showed that the large intestine was entirely on the patient’s right side and the small intestine was shifted to the left side. Contrast-enhanced computed tomography revealed enlarged lymph nodes near the tumor, and masses were observed at the liver, which were believed to be metastases. Following examination, reversed intestinal malrotation and concurrent cecal cancer was diagnosed. The patient was referred to our department for surgery and underwent robot-assisted ileocecal resection with D3 lymphadenectomy. The postoperative course was favorable, and patient was discharged on the sixth postoperative day, without complications. According to the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma 9th edition, the pathological diagnosis was pT4b (ileum), pN1b, cM1a (H1 [grade A]), and pStage IVa cancer. After considering tumor stage and patient’s overall condition in consultation with his family, we decided against palliative systemic therapy. The patient was provided with best supportive care. Conclusions: Robot-assisted surgery might be useful in manipulation of the dissection of adhesions, owing to its capacity for high-resolution 3-dimensional imaging and forceps manipulation, using articulated functions. [ABSTRACT FROM AUTHOR]

Simple Summary: Although gastrointestinal stromal tumor (GIST) is a relatively rare mesenchymal neoplasm of the digestive tract, molecular advancements in GISTs over the past two decades have caused a paradigm shift in the field of precision oncology. GISTs are mainly driven by activating mutations in the KIT or PDGFRA oncogenes, rendering them sensitive to targeted therapies. However, there is a significant lack of data from Kuwait that needs to be addressed. We carried out this retrospective analysis of a cohort of 200 GIST patients at the Kuwait Cancer Center to provide much-needed insights into the genetic makeup and clinicopathological characteristics of our population. We detailed the mutational spectrum in KIT and PDGFRA, identified a small subgroup of wild-type tumors, and shed some light on the clinical implications. This study opens the doors for potential larger-scale, multi-institutional outcome studies in the Arabian Gulf region. In gastrointestinal stromal tumors (GISTs), identifying prototypical mutations in the KIT/PDGFRA oncogenes, or in rare alternate genes, is essential for prognostication and predicting response to tyrosine kinase inhibitors. Conversely, wild-type GISTs (WT-GIST), which lack known mutations, have limited treatment options. Data on the mutational landscape of GISTs and their impact on disease progression are very limited in Kuwait. Using a targeted next-generation sequencing panel, we investigated the spectrum and frequency of KIT, PDGFRA, and RAS-pathway-related mutations in 95 out of 200 GISTs diagnosed at Kuwait Cancer Center from 2005 to 2023 and assessed their correlation with clinicopathological parameters. Among the 200 tumors (median age 55 years; 15–91), 54% originated in the stomach, 33% in the small bowel, 7% in the colorectum, 1.5% in the peritoneum, and 4.5% had an unknown primary site. Of the 95 molecularly profiled cases, 88% had a mutation: KIT (61%), PDGFRA (25%), NF1 (2%), and one NTRK1 rearrangement. Ten WT-GISTs were identified (stomach = 6, small bowel = 2, and colorectum = 2). WT-GISTs tended to be smaller (median 4.0 cm; 0.5–8.0) (p = 0.018), with mitosis ≤5/5 mm2, and were of lower risk (p = 0.019). KIT mutations were an adverse indicator of disease progression (p = 0.049), while wild-type status did not significantly impact progression (p = 0.934). The genetic landscape in this cohort mirrors that of global studies, but regional collaborations are needed to correlate outcomes with genetic variants. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcocystis parasites (Apicomplexa: Sarcocystidae) exhibit a complex life cycle necessitating two hosts and infect a wide range of mammals, birds, and reptiles. Birds of prey, positioned at the apex of the food chain, serve as definitive hosts for various Sarcocystis species. This study focuses on the molecular identification of Sarcocystis species in the intestines of the Common Buzzard (Buteo buteo). For this purpose, the small intestines of 30 birds were tested. Microscopic examination of intestinal scrapings and molecular analysis showed that 73.3% of the birds examined were infected with Sarcocystis spp. Nine Sarcocystis species using birds or rodents as their intermediate hosts were confirmed in the small intestines of Common Buzzards by means of DNA analysis. The highest detection rates were established for S. glareoli (53.3%) forming cysts in the brains of rodents and for S. halieti (36.7%) forming sarcocysts in the muscles and brains of birds. In conclusion, the Common Buzzard can transmit numerous Sarcocystis spp., including pathogenic ones. The common Buzzard (Buteo buteo) was previously shown to transmit two Sarcocystis species (S. glareoli and S. microti) forming cysts in the brains of rodents. Due to a lack of research, the richness of Sarcocystis species spread by these birds of prey is expected to be much higher. A total of 30 samples of the small intestine of the Common Buzzard were collected in Lithuania and subjected to Sarcocystis species identification based on nested PCR of 28S rRNA and ITS1, following the sequencing of amplified DNA fragments. Six known Sarcocystis spp., S. cornixi, S. glareoli, S. halieti, S. kutkienae, S. turdusi, and S. wobeseri, along with three genetically distinct species (Sarcocystis sp. Rod3, Sarcocystis sp. Rod4, and Sarcocystis sp. Rod5), were identified. Phylogenetically, these three potentially new species clustered with Sarcocystis spp. characterised by a rodents-birds life cycle. Sarcocystis spp. employing rodents and birds as their intermediate hosts were detected in 66.7% and 50.0% of samples, respectively. These findings are consistent with the diet preferences of Common Buzzards. Notably, co-infections with two or more species were observed in a half of the samples. Altogether, the obtained results indicate that the Common Buzzard could serve as definitive host of various Sarcocystis species. [ABSTRACT FROM AUTHOR]

Extraosseous plasmacytomas (EPs) are rare neoplasms originating from plasma cells, often associated with multiple myeloma. EPs are classified into three subtypes: extramedullary myeloma, solitary extramedullary plasmacytoma (SEP), and multiple solitary plasmacytomas. They can manifest in various anatomical sites, including the lung, mediastinum, breast, liver, pancreas, stomach, mesentery, kidney, small and large bowel, testis, and soft tissue. Despite their rarity, EPs present a diagnostic challenge due to their non-specific imaging appearances, which can mimic other neoplastic and inflammatory conditions. This review aims to describe the radiographic features of EPs in the chest, abdomen, and pelvis based on a thorough analysis of the existing literature. While imaging plays a crucial role in the detection and characterization of EPs, histological confirmation is necessary to differentiate them from other neoplastic entities. The review underscores the importance of considering EPs in the differential diagnosis, particularly in patients with a history of multiple myeloma. Understanding the imaging characteristics of EPs is essential for accurate diagnosis and appropriate management. Early imaging is crucial in these patients to exclude the possibility of EP, as timely diagnosis can significantly impact patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Complicated perianal disease (cPD) may be the sole presentation of Crohn's disease (CD). The role of small-bowel capsule endoscopy (SBCE) in the diagnostic algorithm of cPD is unclear. We aimed to evaluate the role of SBCE as a diagnostic tool, in patients with cPD, after a negative standard workup for CD. Methods: A multicenter, retrospective, cross-sectional study, in patients with cPD, and negative standard workup for CD (ileocolonoscopy and cross-sectional imaging), who underwent SBCE for suspected CD. Demographics, biomarkers, and the Lewis Score (LS) were recorded and analyzed. An LS ≥ 135 was considered a positive SBCE for diagnosing CD. Results: Ninety-one patients were included: 65 (71.4%) males; median age: 37 (29–51) years; cPD duration: 25.1 (12.5–66.1) months. Positive SBCE: 24/91 (26.4%) patients. Fecal calprotectin (FC) positively correlated with LS (r = 0.81; p < 0.001). FC levels of 100 µg/g and 50 µg/g had a sensitivity of only 40% and 55% to rule out small-bowel CD, with a negative predictive value (NPV) of only 76% and 80%, respectively. Conclusions: SBCE contributed to CD diagnosis in a quarter of patients with cPD after a negative standard workup. FC levels correlated with the degree of inflammation defined by the LS. However, the NPV of FC was low, suggesting that SBCE should be considered for patients with cPD even after a negative standard workup. [ABSTRACT FROM AUTHOR]

Introduction: Dietary fatty acids play a pivotal role in energy metabolism and various physical functions. However, the molecular mechanisms underlying the absorption of long-chain fatty acids (LCFA) in ruminant animals remain poorly understood. To address this gap, we investigated the occurrence and distribution of genes and proteins previously characterized in nonruminant models within the gastrointestinal tract of cattle. Methods: Tissue samples from the rumen, descending duodenum, proximal jejunum, medial jejunum, distal jejunum, and distal ileum were collected at slaughter from eight Holstein steers. RT--PCR and capillary electrophoretic-based chemiluminescence were used to determine the mRNA and protein levels of genes and proteins involved in the uptake, activation, intracellular trafficking, re-esterification, and lipoprotein assembly of LCFA. Results and discussion: Measurable mRNA levels were found for 38 genes involved in the intestinal absorption of LCFA in all examined sections of the bovine gastrointestinal tract. The mRNA abundances of all genes were greater in the intestinal sections than in the rumen sections (p < 0.05). At the protein level, the expression of nine key transporters and enzymes, namely, CD36, SLC27A4, ACSL1, FABP1, FABP2, DGAT1, MTP, Apo-AI, and ACAT2, was detected in most of the intestinal sections. The distribution profile of these proteins in the small intestine suggested a prominent role for protein-mediated absorption of LCFA in the proximal and distal intestine in cattle. The low expression levels of most proteins in the rumen suggest little absorption of LCFA at this location in cattle. Overall, the findings from this study support the presence, in cattle, of genes and proteins involved in the intestinal absorption of LCFA described in models of nonruminants. Identifying the proteins involved in the absorption of LCFA in the small intestine is the first step in understanding how the expression of these proteins influences the capacity of the small intestine to absorb fatty acids in cattle. [ABSTRACT FROM AUTHOR]

In this study, the mucosa of porcine small intestine was used as the raw material to optimize the optimal process for the extraction of heparin (Hep) by high hydrostatic pressure enzymatic hydrolysis by response surface test, to study the adsorption conditions of Hep purified by macroporous resin, and to explore the stability of Hep (pH, temperature, and light). The results showed that the optimal enzymatic process was alkaline protease, 3.1 h, 55 °C, pH9.5, pressure 100 MPa, enzyme addition 9%, salt concentration 2.0%, the actual average concentration of Hep was measured to be 11.56± 0.12 U/mL. The purification of Hep was carried out by using the D958 resin, with the up-sampling flow rate of 1.5 BV/h, the concentration of the eluent of 4 mol/L NaCl, and the elution flow rate of 1.5 BV/h, the purity of Hep could reach 68.75% after purification, and the electrophoretic purity achieved. In the stability study, Hep had the best stability at pH7.5, better stability at 40 °C, and light had no effect on the stability of Hep. This study can greatly improve the extraction effect of Hep and provide theoretical and technical support for the high value processing and utilization of pig small intestine. [ABSTRACT FROM AUTHOR]

Background: An enterocutaneous fistula (ECF) is defined as an abnormal communication between the gastrointestinal tract and skin. ECFs are rarely encountered in clinical practice, yet are frequently difficult to treat. Few reports exist regarding the surgical techniques for the treatment of an ECF. Therefore, we report a case of refractory ECF with concomitant severe adhesions, in which we performed combined laparoscopic adhesiolysis and planned open conversion. Case presentation: A 57-year-old female patient underwent a laparotomy for an ovarian cyst in her 20s. At 46 years, adhesiolysis without bowel resection was performed for adhesive small bowel obstruction (SBO). However, her symptoms did not improve. Eighteen days postoperatively, she underwent a reoperation and jejunostomy. An ECF developed post-reoperation; therefore, stoma closure and radical surgery for the ECF were planned. Due to the severe adhesions, only stoma closure was performed, based on intraoperative assessments. The patient was subsequently referred to our hospital. First, skin care around the fistula was provided during an outpatient visit. Appropriate sizing of the stoma pouch was performed, to improve erosions and ulcers. Thereafter, debridement of the perifistula skin and simple closure of the ECF outlet were attempted; however, the ECF recurred shortly thereafter. After 8 years of regular skin care, with the ECF remaining stable, however, manifesting as symptomatic SBO, she underwent laparoscopic adhesiolysis. This procedure was initiated in the epigastric region, where relatively fewer adhesions were anticipated. Post-open conversion, partial resection of the small intestine at four locations, including the fistula site, was performed. Postoperatively, jejunal edema and peristaltic dysfunction, due to narrowing of the superior mesenteric artery occurred. Regular drainage by percutaneous endoscopic gastrostomy was required. However, she improved and was discharged 3 months post-operatively. Three years post-operatively, the ECF and SBO did not recur. Conclusions: We reported a case of refractory ECF in which we were able to safely perform surgery, by combining laparoscopic adhesiolysis and a planned open conversion. Therefore, the surgical approach used in this case may be an option for securing a safe surgical field, while avoiding collateral damage. [ABSTRACT FROM AUTHOR]

The prevention and treatment of gastrointestinal mucosal injury caused by a plateau hypoxic environment is a clinical conundrum due to the unclear mechanism of this syndrome; however, oxidative stress and microbiota dysbiosis may be involved. The Robinia pseudoacacia L. flower, homologous to a functional food, exhibits various pharmacological effects, such as antioxidant, antibacterial, and hemostatic activities. An increasing number of studies have revealed that plant exosome-like nanoparticles (PELNs) can improve the intestinal microbiota and exert antioxidant effects. In this study, the oral administration of Robinia pseudoacacia L. flower exosome-like nanoparticles (RFELNs) significantly ameliorated hypoxia-induced gastric and small intestinal mucosal injury in mice by downregulating hypoxia-inducible factor-1α (HIF-1α) and HIF-2α expression and inhibiting hypoxia-mediated ferroptosis. In addition, oral RFELNs partially improved hypoxia-induced microbial and metabolic disorders of the stomach and small intestine. Notably, RFELNs displayed specific targeting to the gastrointestinal tract. In vitro experiments using gastric and small intestinal epithelial cell lines showed that cell death caused by elevated HIF-1α and HIF-2α under 1% O2 mainly occurred via ferroptosis. RFELNs obviously inhibited HIF-1α and HIF-2α expression and downregulated the expression of NOX4 and ALOX5, which drive reactive oxygen species production and lipid peroxidation, respectively, suppressing ferroptosis under hypoxia. In conclusion, our findings underscore the potential of oral RFELNs as novel, naturally derived agents targeting the gastrointestinal tract, providing a promising therapeutic approach for hypoxia-induced gastric and small intestinal mucosal ferroptosis. [ABSTRACT FROM AUTHOR]

Johne's disease (JD), a chronic, infectious enteritis caused by Mycobacterium avium subsp. paratuberculosis (MAP), affects wild and domestic ruminants. There is no cure or effective prevention, and current vaccines have substantial limitations, leaving this disease widespread in all substantial dairy industries causing economic, and animal welfare implications. Mycobacteriophages (MPs) have been gaining interest in recent years and are proposed as a promising solution to curtailing MAP infection. Using a well-validated infection model, we have demonstrated the preventative potential of MPs to protect dairy calves against MAP infection. Calves were supplemented daily with a phage cocktail from birth till weaning at 2 m of age and inoculated with MAP at 2 wk of age. Infection status was measured for 4.5 mo through blood, fecal, and postmortem tissue samples. Our findings highlight the remarkable efficacy of orally administered MPs. Notably, fecal shedding of MAP was entirely eliminated within 10 wk, in contrast to the infected control group where shedding continued for the entirety of the trial period. Postmortem tissue culture analysis further supported the effectiveness of MPs, with only 1 out of 6 animals in the phage-treated group testing positive for MAP colonized tissues compared to 6 out of 6 animals in the infected control group. Additionally, plaque assay results demonstrated the ability of phages to persist within the intestinal tract. Collectively, these results underscore the potential of orally administered MP cocktails as a highly effective intervention strategy to combat JD in dairy calves and by extension in the dairy industry. [ABSTRACT FROM AUTHOR]

Introduction: Primary small bowel carcinoma in pregnant women is extremely rare. Small bowel cancer is difficult to diagnose because of its rarity, lack of specific clinical symptoms, and particular anatomical features. We experienced a case of primary small bowel adenocarcinoma with ovarian metastasis during pregnancy. This is the first reported case of a patient with small bowel adenocarcinoma whose pregnancy continued to term and ended in delivery. Case Presentation: A 32-year-old pregnant woman developed abdominal pain, and imaging examination revealed an ovarian tumor at 29 weeks of gestation. We performed laparotomy and resected the ovarian tumor, which was initially suspected to be primary ovarian cancer. The patient continued the pregnancy to term. A detailed examination of the abdominal cavity during cesarean delivery at 37 weeks revealed that the primary lesion was located in the small bowel. Conclusion: It is important to recognize that the small bowel may be the primary site of metastatic ovarian cancer. Detailed and careful examination is necessary to diagnose small bowel cancer during pregnancy. [ABSTRACT FROM AUTHOR]

Ewing sarcoma (ES)/peripheral primitive neuroectodermal tumor is a highly aggressive malignant tumor that typically presents in bone and soft tissue. Primary ES of the intestine is relatively rare, which poses a challenge in distinguishing it from other primary tumors of the small intestine through imaging. This article details a case study of ES originating in the intestine. Computed tomography (CT) imaging suggested a small intestinal stromal tumor, and so the patient underwent resection of the small bowel and omental tumor. Pathology results confirmed the diagnosis of ES of the small intestine. Following surgery, the patient underwent six cycles of chemotherapy, and a follow-up positron emission tomography-CT revealed widespread dissemination of the disease with intraperitoneal metastasis, ultimately resulting in the death of the patient. [ABSTRACT FROM AUTHOR]

Background: Chronic intestinal pseudo-obstruction (CIPO) is a type of intestinal dysfunction with symptoms of intestinal blockage but without the actual mechanical obstruction. Currently, there are no drugs available to treat this disease. Herein, we report the characterization of the PrP-SCA7-92Q transgenic (Tg) line as a valuable CIPO mouse model and investigated the tolerability and efficacy of the 5-hydroxytryptamine type-4 receptor (5HT4R) agonist velusetrag as a promising pharmacological treatment for CIPO. Methods: To test the pharmacodynamics of velusetrag, 8-week-old SCA7 Tg mice, which express human mutated Ataxin-7 gene containing 92 CAG repeats under the mouse prion protein promoter, were treated for 5 weeks by oral route with velusetrag at 1 and 3 mg/kg doses or vehicle. Body weight was monitored throughout the treatment. After sacrifice, the small intestine and proximal colon were collected for whole-mount immunostaining. Untreated, age-matched, C57BL/6J mice were also used as controls in comparison with the other experimental groups. Results: Analysis of SCA7 Tg mice showed tissue damage and alterations, mucosal abnormalities, and ulcers in the distal small intestine and proximal colon. Morphological changes were associated with significant neuronal loss, as shown by decreased staining of pan-neuronal markers, and with accumulation of ataxin-7-positive inclusions in cholinergic neurons. Administration of velusetrag reversed intestinal abnormalities, by normalizing tissue damage and re-establishing the normal level of glia/neuron's count in both the small and large intestines. Conclusion: We demonstrated that the PrP-SCA7-92Q Tg line, a model originally developed to mimic spinocerebellar ataxia, is suitable to study CIPO pathology and can be useful in establishing new therapeutic strategies, such as in the case of velusetrag. Our results suggest that velusetrag is a promising compound to treat patients affected by CIPO or intestinal dysmotility disease. [ABSTRACT FROM AUTHOR]

Background: Heterotopic gastric mucosa (HGM) can be located in various parts of the gastrointestinal tract. As a rare anomaly in the small intestine, it can become complicated by intussusception, obstruction, gastrointestinal bleeding, and even peritonitis, leading to death. Case presentation: This case report focuses on a 12-year-old Middle Eastern boy who presented with hematochezia and abdominal pain for a couple of days. A tagged Red blood cell (RBC) scan and Technetium scan revealed gastrointestinal bleeding at the lower abdomen, highly suggestive of the diagnosis of Meckel's diverticulum. Subsequently, exploratory laparotomy revealed contiguous and scattered mucosal lesions with multiple polyps of various sizes in the terminal ileum. Meckel's diverticulum was absent, and the patient was treated with resection and primary anastomosis. The resected tissue revealed extensive ectopic gastric mucosa and polypoid tissues. The patient recovered uneventfully and was discharged four days after the surgery. The symptoms did not recur within six months after his surgery. Conclusion: Our case demonstrated that despite the rarity of multiple polypoid gastric heterotopias in the terminal ileum, it should be considered as one of the differential diagnoses of gastrointestinal tract bleeding. [ABSTRACT FROM AUTHOR]

Rifaximin is FDA-approved for treatment of irritable bowel syndrome with diarrhea (IBS-D), but poor solubility may limit its efficacy against microbes in the mucus layer, e.g. Escherichia coli. Here we evaluate adding the mucolytic N-acetylcysteine (NAC) to improve rifaximin efficacy. In a resazurin checkerboard assay, combining rifaximin with NAC had significant synergistic effects in reducing E. coli levels. The optimal rifaximin + NAC combination was then tested in a validated rat model of IBS-D (induced by cytolethal distending toxin [CdtB] inoculation). Rats were inoculated with vehicle and treated with placebo (Control-PBS) or rifaximin + NAC (Control-Rif + NAC, safety), or inoculated with CdtB and treated with placebo (CdtB-PBS), rifaximin (CdtB-Rifaximin), or rifaximin + NAC (CdtB-Rif + NAC) for 10 days. CdtB-inoculated rats (CdtB-PBS) developed wide variability in stool consistency (P = 0.0014) vs. controls (Control-PBS). Stool variability normalized in rats treated with rifaximin + NAC (CdtB-Rif + NAC) but not rifaximin alone (CdtB-Rifaximin). Small bowel bacterial levels were elevated in CdtB-PBS rats but normalized in CdtB-Rif + NAC but not CdtB-Rifaximin rats. E. coli and Desulfovibrio spp levels (each associated with different IBS-D microtypes) were also elevated in CdtB-inoculated (CdtB-PBS) but normalized in CdtB-Rif + NAC rats. Cytokine levels normalized only in CdtB-Rif + NAC rats, in a manner predicted to be associated with reduced diarrhea driven by reduced E. coli. These findings suggest that combining rifaximin with NAC may improve the percentage of IBS-D patients responding to treatment. [ABSTRACT FROM AUTHOR]

Introduction and purpose of the study: Small bowel obstruction (SBO) accounts for a substantial proportion of emergency surgical admissions. Malignancy is a common cause of obstruction, either due to a primary tumour or intra-abdominal metastases. However, little is known regarding the current treatment or outcomes of patients with malignant SBO. This study aimed to characterise the treatment of malignant SBO and identify areas for potential improvement and compare overall survival of patients with malignant SBO to patients with non-malignant SBO. Materials and methods: This was a subgroup analysis of a multicentre observational study of patients admitted with SBO. Details regarding these patients' diagnoses, treatments, and outcomes up to 1-year after admission were recorded. The primary outcome was overall survival in patients with malignant SBO. Results: A total of 316 patients with small bowel obstruction were included, of whom 33 (10.4%) had malignant SBO. Out of the 33 patients with malignant SBO, 20 patients (60.6%) were treated with palliative intent although only 7 patients were seen by a palliative team during admission. Nutritional assessments were performed on 12 patients, and 11 of these patients received parenteral nutrition. 23 patients underwent surgery, with the most common surgical interventions being loop ileostomies (9 patients) and gastrointestinal bypasses (9 patients). 4 patients underwent right hemicolectomies, with a primary anastomosis formed and 1 patient had a right hemicolectomy with a terminal ileostomy. Median survival was 114 days, and no difference was seen in survival between patients treated with or without palliative intent. Conclusion: Malignant SBO is associated with significant risks of short-term complications and a poor prognosis. Consideration should be given to the early involvement of senior decision-makers upon patient admission is essential for optimal management and setting expectation for a realistic outcome. [ABSTRACT FROM AUTHOR]

Necrotic enteritis (NE) is a severe gastrointestinal disease that poses a significant threat to the poultry industry. It leads to progressive damage to the small intestine, reduced performance, increased mortality rates, and substantial economic losses. With the removal of antimicrobial agents from chicken feed, there is an urgent need to find alternative approaches for NE control. Various approaches, including vaccination, prebiotics, probiotics, and plant-derived products, have been utilized to address NE in poultry management. To evaluate the efficacy of these preventive measures against NE, successful induction of NE is crucial to observe effects of these approaches in related studies. This study presents a comprehensive overview of the methods and approaches utilized for NE reproduction in related studies from 2004 to 2023. These considerations are the careful selection of a virulent Clostridium perfringens strain, preparation of challenge inoculum, choice of time and the route for challenge inoculum administration, and utilization of one or more predisposing factors to increase the rate of NE occurrence in birds under experiment. We also reviewed the different systems used for lesion scoring of NE-challenged birds. By gaining clarity on these fundamental parameters, researchers can make informed decisions regarding the selection of the most appropriate NE experimental design in their respective studies. [ABSTRACT FROM AUTHOR]

Desmoid tumors (DTs) are rare and locally aggressive with a high rate of local recurrence even with optimal surgical resection. Systemic treatments are often utilized for desmoid cases with high risk of surgical morbidity or for local and symptomatic control of recurrent disease. However, the systemic treatment options for DTs are limited with limited responses. Avapritinib is a tyrosine kinase inhibitor (TKI) approved in 2020 for adults with unresectable or metastatic gastrointestinal (GI) stromal tumors (GISTs) harboring a platelet‐derived growth factor receptor alpha (PDGFRA) Exon 18 mutation, including D842V mutations. In this case report, we describe a 55‐year‐old man with a history of D842V‐mutant gastric GIST who presented several years after complete resection of the GIST with an enlarging soft tissue mass in the small intestine. After a nondiagnostic biopsy, the patient was started on avapritinib due to concerns for recurrent D842V‐mutant GIST. The tumor had a partial response to treatment by RECIST 1.1 criteria, and the patient underwent surgical resection. The final pathology report revealed a sporadic DT. To our knowledge, this is the first known description of the activity of avapritinib in the treatment of a sporadic mesenteric DT, which is relevant given the limited treatment options for patients with this diagnosis. This clinical finding may be worth exploring in a dedicated clinical trial. [ABSTRACT FROM AUTHOR]