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Background: Proper traction allows safer and easier endoscopic submucosal dissection; however, single-point traction may not be sufficient. In this study we assessed the safety, efficacy, and feasibility of our newly developed multipoint traction device. Methods: During an ex vivo study using a Konjac training model, two experts and two trainees resected 80 mock lesions of 20-mm diameter by performing endoscopic submucosal dissection with and without multipoint traction. The primary outcome was the success rate of the procedure involving traction. The secondary outcomes were the submucosal dissection time, dissection speed, and perforation during endoscopic submucosal dissection. During the in vivo study, to clarify the initial clinical outcomes, we used data from the electronic medical record of patients at our institution who underwent gastric and colorectal endoscopic submucosal dissection, which was performed by experts with our newly developed multipoint traction device, from March to December 2022. Results: The ex vivo study indicated that all traction procedures were successful. Higher resection speeds were observed with endoscopic submucosal dissection with traction than without traction (P < 0.001). Perforations were not observed. During the first in vivo clinical study, traction was feasible during 20 gastric and colorectal endoscopic submucosal dissection procedures. No adverse events occurred. Conclusions: Our multitraction device can increase the submucosal dissection speed and simplify endoscopic submucosal dissection techniques, thus safely reducing technical challenges. The application of this device for endoscopic submucosal dissection could lead to safer and more efficient procedures. Clinical registration UMIN Clinical Trials Registry, Japan (registration number UMIN000053384). [ABSTRACT FROM AUTHOR]

Fengsong Chen,1 Yanhua Huang,1 Yayun Qian,2 Ya Zhao,2 Chiwen Bu,3 Dong Zhang3 1Department of Gastroenterology, Haimen People’s Hospital, Nantong, 226000, People’s Republic of China; 2Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China; 3Institute of Surgery, Guanyun People’s Hospital, Guanyun, 222200, People’s Republic of ChinaCorrespondence: Dong Zhang; Chiwen Bu, Email gyxrmyykjk@163.com; gyxrmyybcw@163.comBackground: Gastric lesions pose significant clinical challenges due to their varying degrees of malignancy and difficulty in early diagnosis. Early and accurate detection of these lesions is crucial for effective treatment and improved patient outcomes.Methods: This paper proposed a label-free and highly sensitive classification method for serum of patients with different degrees of gastric lesions by combining surface-enhanced Raman scattering (SERS) and machine learning analysis. Specifically, we prepared Au lotus-shaped (AuLS) nanoarrays substrates using seed-mediated and liquid–liquid interface self-assembly method for measuring SERS spectra of serum, and then the collected spectra were processed by principal component analysis (PCA) - multi-local means based nearest neighbor (MLMNN) model to achieve differentiation.Results: By employing this pattern analysis, AuLS nanoarray substrates can achieve fast, sensitive, and label-free serum spectral detection. The classification accuracy can reach 97.5%, the sensitivity is higher than 96.7%, and the specificity is higher than 95.0%. Moreover, by analyzing the PCs loading plots, the most critical spectral features distinguishing different degrees of gastric lesions were successfully captured.Conclusion: This discovery lays the foundation for combining SERS with machine learning for real-time diagnosis and recognition of gastric lesions.Keywords: surface-enhanced Raman scattering, gastric lesions, Au lotus-shaped nanoarrays, principal component analysis, multi-local means based nearest neighbor

Background: During esophagogastroduodenoscopy performed with colonoscopy, gastric and duodenal erythema, erosions, and ulcerations are often observed. This investigation was designed to review the prevalence of gastroduodenal lesions in patients who have undergone wireless capsule endoscopy using standard bowel cleansing preparations, but no endoscopy or sedation. Methods: A retrospective analysis was conducted on patients referred for capsule endoscopy. Records and capsule reports were reviewed for the patient demographics, preparation prescribed, procedural indications, and gastroduodenal findings. The preparations studied included polyethylene glycol lavage (PEG), PEG plus bisacodyl (PEG + bis), bisacodyl (bis), oral sulfate solution (OSS), and no prep. Results: Among the 1236 records, 498 (40.3%) were men and 738 (59.7%) were women. The mean age was 56 years +/− 18 years SD. The percentage of patients with lesions after any bowel preparation was 52.7% for gastric lesions and 23.6% for duodenal lesions. The percentage of patients with gastroduodenal lesions was 58.3% with prep, compared to 38.2% without prep. These findings were statistically significant, with an RR of 1.53 [1.19–1.94] (p-value = 0.00004). This difference was more pronounced in the OSS group RR of 1.65 [1.29–2.1] and bisacodyl group RR of 1.64 [1.25–2.15] compared to the PEG group RR of 0.95 [0.7–1.3]. Conclusions: This study showed that patients undergoing wireless capsule endoscopy who received bowel preparations had a significant increase in gastric and duodenal lesions. Of the preparations studied, OSS was associated with a greater number of gastroduodenal lesions, while PEG was the least associated with lesions, with an occurrence similar to the non-prep group. The clinical significance of these lesions remains undetermined. Endoscopists should be aware that preparations are associated with gastroduodenal lesions to avoid the misinterpretation and misdiagnosis of these lesions.

Background: During esophagogastroduodenoscopy performed with colonoscopy, gastric and duodenal erythema, erosions, and ulcerations are often observed. This investigation was designed to review the prevalence of gastroduodenal lesions in patients who have undergone wireless capsule endoscopy using standard bowel cleansing preparations, but no endoscopy or sedation. Methods: A retrospective analysis was conducted on patients referred for capsule endoscopy. Records and capsule reports were reviewed for the patient demographics, preparation prescribed, procedural indications, and gastroduodenal findings. The preparations studied included polyethylene glycol lavage (PEG), PEG plus bisacodyl (PEG + bis), bisacodyl (bis), oral sulfate solution (OSS), and no prep. Results: Among the 1236 records, 498 (40.3%) were men and 738 (59.7%) were women. The mean age was 56 years +/− 18 years SD. The percentage of patients with lesions after any bowel preparation was 52.7% for gastric lesions and 23.6% for duodenal lesions. The percentage of patients with gastroduodenal lesions was 58.3% with prep, compared to 38.2% without prep. These findings were statistically significant, with an RR of 1.53 [1.19–1.94] (p-value = 0.00004). This difference was more pronounced in the OSS group RR of 1.65 [1.29–2.1] and bisacodyl group RR of 1.64 [1.25–2.15] compared to the PEG group RR of 0.95 [0.7–1.3]. Conclusions: This study showed that patients undergoing wireless capsule endoscopy who received bowel preparations had a significant increase in gastric and duodenal lesions. Of the preparations studied, OSS was associated with a greater number of gastroduodenal lesions, while PEG was the least associated with lesions, with an occurrence similar to the non-prep group. The clinical significance of these lesions remains undetermined. Endoscopists should be aware that preparations are associated with gastroduodenal lesions to avoid the misinterpretation and misdiagnosis of these lesions. [ABSTRACT FROM AUTHOR]

Introduction: Caustic substances ingestion results in a complex syndrome. The patient characteristics and severity of injury are important prognostic predictors. The monitoring of clinical changes and the multidisciplinary approach are necessary to prevent death in the early stages of the poisoning. Case description: The case report describes the suicide of a woman by ingestion of a large amount of 15% sulfuric acid for suicidal purposes (15–20 ml). The initial conditions were stable, and no changes were found on a CT scan. However, the main sign was a severe metabolic acidosis. After 7 hours, haematemesis and oedema of the larynx appeared, and oro-tracheal intubation and ICU admission were necessary. Consequent progressive haemodynamic deterioration with persistent severe metabolic acidosis, increasing lactates and septic shock appeared. A new CT scan with contrast was performed 22 hours later detecting diffuse perforations and liquid in pleurae and abdomen. A pleural sample showed necrotic liquid. The death was 24 hours after ingestion and no surgical treatment was performed because of the diffuse lesions to the thoracoabdominal districts. Conclusions: Early detection of gastroenteric lesions and the monitoring of clinical changes are mandatory to avoid the death of the patient. Gastroenteric perforations require an immediate radiological evaluation and surgical treatment. The clinical case report states the severity of prognosis was related to high doses of sulfuric acid ingestion. The immediate metabolic acidosis is related to quick subsequent severe systemic pathological lesions of the gastrointestinal tract. The severity of absorption metabolic acidosis, consequently, may be an early and prognostic sign of the late chest and abdominal lesions.

Introduction: Fever is one of the postoperative complications of endoscopic submucosal dissection (ESD) and its derivative technology. However, there are few studies on risk factors for fever after ESD and its derivative technology. The aim of this study was to determine the incidence and related risk factors after ESD and its derivative technology for gastric lesions. Materials and methods: A retrospective review of patients with gastric lesions who were treated by ESD and its derivative technology in our hospital from January 2014 to January 2019 was conducted. Results: A total of 1955 patients were included in the present study. A total of 451 (23.1 %) patients presented with fever after ESD and its derived techniques. The highest fever temperature was 37.6 ± 3.12 °C, and the number of days with fever was 1.48 ± 0.85. Through single factor and multiple factor analysis, age (OR: 1.261, 95% CI: 1.009–1.576, p

Limited access to high-quality feed protein for pigs has made it necessary to evaluate new protein sources that both promote sustainable pig production and meet the nutritional requirements of pigs. Providing pigs with roughage has positive effects on their behaviour and gut health. However, roughage is seldom given as a part of the pigs’ diet and often has a long straw length. Knowledge is lacking on the effect of feeding silage with smaller particle size and as a part of the pigs' diet on pig behaviour and welfare. This study evaluated the influence of feeding fattening pigs silage with different particle sizes on aggressive encounters, measured as the number of skin lesions, and on the occurrence of gastric lesions and ulcers. In total, 128 Swedish Yorkshire × Hampshire pigs were fed either a commercial control feed without silage (Pellet-C), or silage mixed with commercial feed, either in a pellet (Pellet-S) or in a total mixed ration (TMR) with chopped (TMR-Ch) or intensively treated silage (TMR-Ex). Skin lesions were assessed twice in the study according to the Welfare Quality® protocol. The first assessment was performed when the pigs were 105 days old and the second assessment at 132 days of age. Gastric lesions were examined in both the pars oesophagea and the pars glandularis region of the stomach. Stomachs were collected after slaughter, and gastric lesions were scored based on established scoring criteria. There was a treatment × assessment interaction on the number of skin lesions on the ear (P = 0.049). Apart from this interaction, no other effect of treatment on the number of skin lesions could be observed between the treatments or the assessment occasions. Treatment had a clear effect on the occurrence of gastric lesions and pigs fed the fresh silage (TMR-Ch and TMR-Ex) had a lower occurrence of gastric lesions and ulcers compared to the pelleted treatments (Pellet-C and Pellet-S) (P = 0.001). This study could not show any clear reduction effect of dietary silage inclusion on skin lesions. However, feeding silage in TMR significantly reduced the occurrence of stomach ulcers.

Simple Summary: Gastric lesions are a common condition in pigs, representing a critical issue in the pig industry that can cause heavy losses for farmers in terms of reduced growing performance and mortality. In heavy pig production, which is typical of Italy and is characterized by a long fattening period, the prevalence of such lesions at the abattoir has not been widely studied. Moreover, the impact of steroidal and non-steroidal anti-inflammatory drug (NSAIDs) usage on the occurrence of such lesions in heavy pigs needs to be better investigated. In this study, the prevalence of gastric lesions in heavy pigs in two large slaughterhouses was investigated. Furthermore, the association between the usage of anti-inflammatory drugs and gastric lesions was explored in a subset of farms. Most of the animals had mild or severe ulcers, and a relationship with the usage of NSAIDs was found. The results of this study suggest that gastric lesions are an important issue for heavy pig production and that non-selective NSAIDs should be used with caution on farms where the risk factors for gastric ulcers are common. Gastric lesions in pigs cause welfare and economic losses. Their prevalence in heavy pigs reared for premium products (e.g., Parma ham) requires further investigation. Stress, nutrition, and farm management are known risk factors, but the effects of steroidal and non-steroidal anti-inflammatory drugs (NSAIDs) are largely unknown. The aim of this study was to evaluate the prevalence of gastric lesions in Italian heavy pigs and their possible association with the use of anti-inflammatory drugs. A total of 9371 pig stomachs from 76 farms were evaluated. Among these, 20.3% showed no lesions, while 30.7%, 42.1%, and 6.8% were scored 1, 2 and 3, respectively. A tendency for an inverse relationship with farm size emerged. The use of steroids and NSAIDs was estimated by calculating a treatment incidence per 1000 (TI1000) in a subset of 36 farms. At least one prescription for NSAIDs and/or steroids was found in 80.6% of the farms (55.6% used NSAIDs and 63.9% used steroids). Median TI1000 was 0.07 (range: 0–30.1) and 0.18 (range: 0–6.2) for NSAIDs and steroids, respectively. Gastric scores were positively associated with NSAID use, but not with steroid use. Although the role of these drugs in gastric lesions needs to be further clarified, these findings suggest a cautious use of non-selective NSAIDs. [ABSTRACT FROM AUTHOR]

Gastric cancer is high-risk cancer in terms of both incidence and mortality. However, if it is diagnosed early, there is a high chance of survival. Therefore, an early diagnosis of gastric cancer and precancerous lesions is very important. Gastroscopy is one of the best methods for diagnosing gastric cancer and precancerous lesions, but it relies on visual observation by medical specialists. Accordingly, factors such as the experience or fatigue of specialists can influence diagnosis results. To alleviate these problems, we propose a computer-aided diagnosis system that can improve the efficiency of diagnosis and reduce misdiagnoses by providing a second opinion. We aimed to classify healthy tissue, gastric lesions, and early gastric cancer using a Transformer-based deep-learning classification model called Vision Transformer, which has achieved the best performance in transfer learning. We also proposed a Multi-Filter AutoAugment (MFAA) method, which increases the classification performance of the model given small amounts of medical data. The medical data augmented using MFAA are better for training deep-learning models than conventionally augmented data; we effectively enhanced the classification performance of the model using MFAA. In experiments, the model achieved an F1-score of 0.87 and area under the curve of 0.94 in the classification of abnormalities (gastric lesions including early gastric cancer) and healthy tissue. In addition, it obtained an F1-score of 0.92 and area under the curve of 0.97 in the classification of early gastric cancer and non-cancerous gastric lesions.

Background: Gastric cancer (GC) stands as one of the most prevalent cancer types worldwide, holding the position of the second leading cause of cancer-related deaths. Gastric lesions represent pathological alterations to the gastric mucosa, with an elevated propensity to advance to gastric cancer. Limited research has explored the potential of stem cells in the treatment of gastric lesions. Methods: This study aimed to explore the potential of intravenous transplantation of labeled bone marrow-derived mesenchymal stem cells (BMMSCs) to inhibit the progression of precancerous gastric lesions. Results: In the gastric lesion disease model group, the rat tissue exhibited noteworthy mucosal atrophy, intestinal metaplasia, dysplasia, and inflammatory cell infiltration. Following the infusion of BMMSCs, a notable decrease in gastric lesions was found, with atrophic gastritis being the sole remaining lesion, which was confirmed by morphological and histological examinations. BMMSCs that were colonized at gastric lesions could differentiate into epithelial and stromal cells, as determined by the expression of pan-keratin or vimentin. The expression of vascular endothelial growth factor was significantly elevated following BMMSC transplantation. BMMSCs could also upregulate the production of humoral immune response cytokines, including interleukin (IL)-4 and IL-10, and downregulate the production of IL-17 and interferon-gamma, which could be highly associated with the cellular immune response and inflammation severity of the lesions. Conclusions: BMMSC transplantation significantly reduced inflammation and reversed gastric lesion progression.

Background: Endoscopic full-thickness resection is a common endoscopic procedure for treating gastrointestinal submucosal tumors. Nasogastric tube placement is frequently performed after abdominal surgery, but the routine use of this approach remains controversial. The aim of this research was to explore whether nasogastric tube placement after gastric endoscopic full-thickness resection is necessary. Methods: A retrospective study enrolled patients who underwent gastric endoscopic full-thickness resection in our hospital between January 2014 and January 2019, and all the patients had a tumor size ≤ 2 cm. The patients were divided into two groups according to whether a nasogastric tube was placed. Postprocedural adverse events and hospital stay duration were compared between the two groups using 1:1 propensity score matching. Results: A total of 461 patients were enrolled in this study, including 385 patients in the nasogastric tube group (NGT group) and 76 patients in the non-nasogastric tube group (non-NGT group). After matching, the baseline characteristics of 73 patients in the NGT group and 73 patients in the non-NGT group were balanced (p > 0.05). The postprocedural fever rate in the NGT group was significantly higher than that in the non-NGT group (23.3% vs. 9.6%, p = 0.044). 6.9% (5/73) of patients experienced severe nasogastric tube-related throat discomfort. However, the duration of hospitalization stay was not different between the two groups. Conclusions: For patients with tumor size ≤ 2 cm, routine nasogastric tube placement after gastric endoscopic full-thickness resection may be unnecessary. [ABSTRACT FROM AUTHOR]

Objective: To elucidate the role of the coevolution of the human genome and Helicobacter pylori in gastric pathogenesis in a population from Nariño-Colombia. Materials and Methods: Helicobacter pylori was isolated from gastric biopsies obtained from 292 patients with Nariño gastric disease. The histological diagnosis was made by the Sydney classification. 252 H. pylori isolates were included for MLST analysis, which assigned them to ancestral populations (hpAfrica1, hpAfrica2, hpEurope, hpEAsia). Immunochip was used for human evolutionary analyses. STRUCTURE software to determine ancestry proportions by comparison with 712 global H. pylori MLST base sequences (http://pubmlst.org/helicobacter). Results: The H. pylori strains in Nariño derive from four ancestral populations: African (AA1), European (AE1 and AE2), and East Asian (AEA). The isolates contained substantial fractions of AA1 African ancestry on the coast, and AE2 European ancestry in the mountains. Because the mountain population had minimal African ancestry of the host, we wondered if AA1 increased the severity of gastric lesions in subjects of low African ancestry. Such a scenario could signify disrupted coadaptation: disruption of human-H. pylori coevolution. When we considered the 56 individuals with less than 17.6% African ancestry, we found that all individuals carrying H. pylori with >19.8% AA1 African ancestry, (n = 20) had severe lesions. Conclusion: Human and H. pylori coevolutionary relationships are important biomarkers of gastric disease, and disruption of these relationships results in more advanced gastric lesions in Nariño-Colombia. [ABSTRACT FROM AUTHOR]

Background: Allium vegetable components have antibacterial, antioxidative, and immune modulation properties, thus potentially exhibiting antitumor effects. Despite evidence from case-control studies, prospective studies linking allium vegetables with gastric cancer (GC) have been sparse. Objective: In a prospective study, we examined whether allium vegetable intake would change the risk of GC occurrence and whether the associations would be modified by vitamin supplementation, garlic supplementation, and Helicobacter pylori (H. pylori) treatment. Methods: The study was conducted on the basis of the Shandong Intervention Trial, a randomized, placebo-controlled, factorial-designed trial (1995-2003) in a well-recognized high-risk area for GC in China. Participants were continuously followed up to December 2017 for 22.3 y (1995-2017). A total of 3229 subjects were included, with information on the intake of allium vegetables (garlic vegetables and scallions), collected by structured questionnaires in 1994. The associations of total and individual allium vegetable intake with the risk of GC were examined, respectively. Results: During the follow-up, 144 incident cases of GC were identified. Garlic vegetable intake was associated with a decreased risk of incident GC (P-trend = 0.02; OR: 0.83; 95% CI: 0.70, 0.98, per 1 kg/y increment), whereas scallion intake showed no association (P-trend = 0.80). An inverse association of the risk of GC with total allium vegetable and garlic vegetable intake was particularly stronger among those receiving the placebo for vitamin supplementation or garlic supplementation, indicating potential effect modifications by nutritional supplementation on allium vegetable intake and the risk of developing GC. Similar findings were found for analyses of the combined prevalence of dysplasia or GC. Conclusions: We found a significant reduction in the risk of developing GC with increasing dietary intake of allium vegetables, particularly garlic vegetables. The findings add to the literature on the potential inverse association of garlic vegetable intake with the risk of GC, therefore holding public health implications for dietary recommendations. This trial was registered at clinicaltrials.gov as NCT00339768. [ABSTRACT FROM AUTHOR]

The presence of autoimmune metaplastic atrophic gastritis (AMAG) may lead to an increased risk of associated gastric neoplastic lesions. This study aims to investigate the prevalence of gastric neoplasia in AMAG patients and to explore the possibility of PGI/II ratio as a predictor for AMAG diagnosis. Retrospective audit of 135 patients diagnosed with AMAG on endoscopic gastric biopsy between January 2017 and December 2020 at Beijing Friendship Hospital. The study was registered in Chinese Clinical Trial Registry (ChiCTR2000041163). A total of 135 patients (the mean age 61.9 ± 10.9 years,109 female) had histologically confirmed AMAG. 31.1% (42/135) had AMAG without neoplasia on the initial biopsy; 37% (50/135) had multiple type 1 gastric neuroendocrine tumors (g-NETs), 36 grade 1 and 14 grade 2, the median diameter was 5 mm (range 1–25); 31.9% (43/135) had multiple gastric hyperplastic polyps (GHPs), including 15 cases of GHPs with neoplastic transformation, the median diameter was 14.5 mm (range 3–50). 3.7% (5/135) had single gastric low-grade dysplasia/adenoma, the median diameter was 5 mm (range 3–15). 5.9% (8/135) had single or double gastric high-grade dysplasia or adenocarcinoma, the median diameter was 15 mm (range 8–43). 40.7% (55/135) had pepsinogen (PG) I< 10 ng/ml, 45.9% (62/135) had PG I/II ratio ≤1 and each group had a median of PG I/II ratio <1. Lower serum PG I level and PGI/II ratio may be a predictor to indicate the diagnosis of AMAG. It's necessary to perform regular endoscopic surveillance for AMAG patients to recognize associated gastric neoplasia timely. [ABSTRACT FROM AUTHOR]

Background: Harungana madagascariensis Lam. ex Poir. (Hypericaceae) leaf extract is used by some communities in the Niger Delta to treat diarrhoea, ulcers, and wounds. Objectives: This study investigated the antispasmodic, antimotility and gastroprotective properties of methanol:dichloromethane (1:1) extract of H. madagascariensis leaves (HME). Materials and Methods: The antispasmodic activity was evaluated in vitro using actions on contractions of guinea pig ileum and rabbit jejunum provoked by spasmogens. The actions of HME on gastrointestinal transit was assessed in vivo using normal defaecation and charcoal meal transit time tests in rodents. The actions of HME on gastric ulcers produced by ethanol and indomethacin were investigated. The HME was also subjected to phytochemical analysis and acute toxicity tests. Results: The HME suppressed contractions of isolated rabbit jejunum and guinea pig ileum elicited by histamine and acetylcholine. The extract elicited significant (P<0.05) reduction of normal defaecation (12.50 - 100%) and gastrointestinal propulsion of charcoal meal in mice (17.60 - 43.08%). Additionally, the extract significantly (P<0.05) prevented both ethanol-and indomethacin-induced stomach ulcers. An oral LD50 >5000 mg/kg in mice was obtained by an acute toxicity assay on HME. Conclusion: The findings showed that the leaf of H. madagascariensis has gastroprotective, antispasmodic, and antimotility properties. [ABSTRACT FROM AUTHOR]

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• Equine squamous gastric disease (ESGD) was found in horses, donkeys, and mules. • Equids were all subjected to long-distance traveling, fasting, and stress. • Overall prevalence of ESGD in these equids was 83.3 %. • The margo plicatus was the most affected structure by ESGD in all three equid species. Equine Gastric Ulcer Syndrome (EGUS) occurs with variable prevalence in horses, donkeys, and mules. Due to the particularities of the mucous membranes, the syndrome is made up of Squamous Gastric Disease (ESGD) and Glandular Gastric Disease (EGGD). Given the multifactorial nature and multiple classification systems of the syndrome, significant differences have been reported between prevalence studies performed ante mortem , which are even more remarkable when compared with postmortem evaluations. This study aimed to determine the presence and grade of squamous gastric disease in horses, donkeys and mules immediately after slaughter. The postmortem examination considered the inspection of the squamous region (cardia, dorsal fundus, and margo plicatus) and the classification of the observed lesions. The general prevalence of ESGD in the entire population of study was 83.3 % (78 %, 89 %, and 83 % for horses, donkeys, and mules, respectively), compromising the margo plicatus in all cases. 75 % had more than 5 lesions and 50 % had deep lesions, lesions of varying severity and/or evidence of recent/active bleeding. The prevalence of ESGD was similar in horses, donkeys, and mules subjected to similar handling conditions prior to slaughter, including long-distance traveling, fasting, and stress factors. [ABSTRACT FROM AUTHOR]

Gastric lesions in pigs cause welfare and economic losses. Their prevalence in heavy pigs reared for premium products (e.g., Parma ham) requires further investigation. Stress, nutrition, and farm management are known risk factors, but the effects of steroidal and non-steroidal anti-inflammatory drugs (NSAIDs) are largely unknown. The aim of this study was to evaluate the prevalence of gastric lesions in Italian heavy pigs and their possible association with the use of anti-inflammatory drugs. A total of 9371 pig stomachs from 76 farms were evaluated. Among these, 20.3% showed no lesions, while 30.7%, 42.1%, and 6.8% were scored 1, 2 and 3, respectively. A tendency for an inverse relationship with farm size emerged. The use of steroids and NSAIDs was estimated by calculating a treatment incidence per 1000 (TI1000) in a subset of 36 farms. At least one prescription for NSAIDs and/or steroids was found in 80.6% of the farms (55.6% used NSAIDs and 63.9% used steroids). Median TI1000 was 0.07 (range: 0–30.1) and 0.18 (range: 0–6.2) for NSAIDs and steroids, respectively. Gastric scores were positively associated with NSAID use, but not with steroid use. Although the role of these drugs in gastric lesions needs to be further clarified, these findings suggest a cautious use of non-selective NSAIDs.

Background and Aims: Tunneled endoscopic submucosal dissection (T-ESD) and pocket creation method ESD (PCM-ESD) are considered to have technical advantages over conventional ESD (C-ESD). However, data comparing these techniques for ESD of gastric lesions is limited., Methods: PubMed and Cochrane databases were reviewed for relevant studies from their inception to October 31, 2023. Studies comparing T-ESD or PCM-ESD (T/PCM-ESD) to C-ESD for gastric lesions were included. The primary outcomes were dissection speed and en bloc resection. Secondary outcomes were R0 resection, recurrence, perforation, and post-ESD bleeding. A random effects meta-analysis was conducted., Results: Eight observational studies (359 patients - T/PCM-ESD, 670 patients - C-ESD) were included. T/PCM-ESD was associated with a significantly faster dissection speed (Mean Difference: 4.42 mm 2 /min, 95% CI: 2.05, 6.79, I 2 = 79%). There were no significant differences between the groups in terms of en bloc resection (risk ratio (RR): 1.01, 95% confidence interval (CI): 1.00-1.03, I 2 = 0%), R0 resection (RR: 1.03, 95% CI: 0.99-1.07, I 2 = 0%) and recurrence (RR: 0.73, 95% CI: 0.14-3.84, I 2 = 0%). While T/PCM-ESD was associated with a significantly lower risk of perforation (RR: 0.21, 95% CI: 0.06-0.80, I 2 = 0%), post-ESD bleeding rates were not significantly different., Conclusion: T/PCM-ESD facilitates faster and safer gastric ESD than conventional ESD with comparable en bloc resection, R0 resection, and recurrence rates. A future randomized controlled control trial is required., (Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

(1) Background: Gastric cancer, the fourth most common cause of death from tumors in the world, is closely associated with Helicobacter pylori. Timely diagnosis, therefore, is essential to achieve a higher survival rate. In Chile, deaths from gastric cancer are high, mainly due to late diagnosis. Progranulin has reflected the evolution of some cancers, but has been poorly studied in gastric lesions. Aiming to understand the role of progranulin in H. pylori infection and its evolution in development of gastric lesions, we evaluated the genic expression of progranulin in gastric tissue from infected and non-infected patients, comparing it according to the epithelial status and virulence of H. pylori strains. (2) Methods: The genic expression of progranulin by q-PCR was quantified in gastric biopsies from Chilean dyspeptic patients (n = 75) and individuals who were uninfected (n = 75) by H. pylori, after receiving prior informed consent. Bacteria were grown on a medium Columbia agar with equine-blood 7%, antibiotics (Dent 2%, OxoidTM), in a microaerophilic environment, and genetically characterized for the ureC, vacA, cagA, and iceA genes by PCR. The status of the tissue was determined by endoscopic observation. (3) Results: Minor progranulin expression was detected in atrophic tissue, with a sharp drop in the tissue colonized by H. pylori that carried greater virulence, VacAs1m1+CagA+IceA1+. (4) Conclusions: Progranulin shows a differential behavior according to the lesions and virulence of H. pylori, affecting the response of progranulin against gastric inflammation. [ABSTRACT FROM AUTHOR]

A gastric ulcer is a sore lining on the stomach, which penetrates to mucosal layer formed due to excess acid secretion or due to Helicobacter pylori (H-pylori) bacteria. The present polyherbal formulation was prepared using Ocimum tenuiflorum, Phyllanthus emblica, Moringa oleifera, Phyllanthus niruri, Acyranthes aspera, and Terminalia chebula. The above-mentioned plant powders were collected and formulated into an ayurvedic liquid dosage form arista. These plants were proven to have an anti-ulcer activity individually; hence the plant powders were combined to form a polyherbal formulation. The polyherbal formulation was screened for antiulcer activity by different in vitro and in vivo methods. In vitro antioxidant activity by nitric oxide scavenging method and proton pump inhibition assay was performed to evaluate the mechanism of action. Gastric lesions were induced by ethanol and ulcer scores were measured. Arista was served to rats at a dose of 1.8ml/kg (p.o.). Pantaprazole and normal saline were used as standard and control. The ulcer score was measured and compared for 3 groups. Antioxidant and H+K+ATPase activity showed effective results. Antioxidant activity of arista showed gastric mucosal protection by free radical scavenging action. In vivo studies proved the Polyherbal formulation (arista) has a promising anti-ulcer activity. [ABSTRACT FROM AUTHOR]

Abstract Objective To compare treatment outcomes between injection endoscopic submucosal dissection using ProKnife (P‐ESD) and conventional ESD (C‐ESD) for gastric lesions. Methods In this randomized controlled trial, we compared treatment outcomes of P‐ESD and C‐ESD for simulated gastric lesions ≥3 cm in resected porcine stomachs. Predictive factors associated with ESD difficulties were investigated using logistic regression analysis. Results Seventy lesions were screened; however, two lesions were excluded. A total of 12 endoscopists performed 68 ESDs: 34 P‐ESDs and 34 C‐ESDs. The ESD procedure time of P‐ESD (36.3 [28.4–46.8] min) was significantly shorter than that of C‐ESD (46 [36.4–64.6] min; p = 0.0014). The technical success rates did not differ between the P‐ESD and C‐ESD groups (en bloc resection rate, 100% in both groups; complete resection rate, 94.1% and 85.3%, respectively; p = 0.23). The number of injections during P‐ESD (7.5 [6–10] times) was significantly higher than during C‐ESD (4 [3–5] times; p < 0.001), but the total volume of injected solution during P‐ESD (20 [16–26.3] ml) was significantly smaller than during C‐ESD (27.5 [20–31.5] ml; p = 0.0019). In multivariate analysis, less ESD experience (odds ratio [OR], 3.9) and selection of C‐ESD as the ESD method (OR, 3.8) were independent predictive factors associated with ESD difficulties. Conclusions Compared with C‐ESD, P‐ESD had a shorter procedure time but also allowed for notable technical success and safety.

Abstract Background Endoscopic submucosal dissection (ESD) and endoscopic submucosal excavation (ESE) have been widely used and have gradually become the main endoscopic treatment for gastrointestinal mucosal and submucosal lesions. Whether antibiotics are necessary for fever after gastric ESD and ESE remain unclear. The aim of this study was to analyse the value of using antibiotics in patients without perforation after ESD or ESE with fever. Methods In this retrospective study, patients with fever without perforation after ESD or ESE from January 2014 to January 2019 were included and divided into 2 groups: the antibiotic group and the non-antibiotic group. Fever and hospitalization time were compared between the 2 groups after propensity score matching. Results Overall, 253 patients meeting the inclusion criteria were enrolled in the present study, with 186 patients in the non-antibiotic group and 67 patients in the antibiotic group before matching, 55 patients in the non-antibiotic group and 55 patients in the antibiotic group after matching with all baseline characteristics balanced (p > 0.05). The duration of fever was not significantly different between the 2 groups (p = 0.12). However, the median hospitalization stay in the antibiotic group was longer than that in the non-antibiotic group (8 vs 7, p = 0.007). Conclusions Antibiotics may be unnecessary for fever in patients without perforation and without serious co-morbidities after gastric ESD or ESE.

Assessment of glycoconjugate expression on cell membranes using the lectin histochemistry technique may be a feasible approach for evaluating the functional state of the cell. The aim of this study was to evaluate carbohydrate determinants of rat stomach mucosa cell membranes under the conditions of COX-1/-2 blockage­ with indomethacin and pretreatment with the tripeptide H-Glu-Asp-Gly-OH. Male Wistar rats were divided into 3 groups (n = 6 per group): 1st group (control) received vehicle; 2nd – indomethacin (35 mg/kg); 3rd – H-Glu-Asp-Gly-OH (10 µg) 30 min before indomethacin. Rats were sacrificed 24 hours later. Gastric mucosa (GM) carbohydrate determinants were studied by lectin-peroxidase technique. The lectins panel included α-fucose- (LABA), syalo- (WGA, SNA), mannose- (Con A, LCA) and galactose-specific (HPA, PNA, SBA) lectins. Intensity of lectin-receptor reaction was scored: 0 – no reaction; 1 – weak; 2 – mild; and 3 – strong reaction. COX-1/2 blockage caused GM lesions, attenuated by H-Glu-Asp-Gly-OH. WGA and SNA showed the highest affinity to GM. Indomethacin decreased SNA-labeling of epitheliocytes and mucocytes and LABA-labeling of chief cells. H-Glu-Asp-Gly-OH reversed the glycosylation changes, caused by COX-1/COX-2 blockage only in regards to labeling of chief cells with LABA, epitheliocytes and mucocytes with LCA, mucocytes with SNA. Predominantly H-Glu-Asp-Gly-OH under COX-1/COX-2 blockage had an effect opposite to indomethacin alone but glycosylation changes under these conditions differed significantly also from the control. COX-1/COX-2 blockage causes alteration of glycosylation processes in rat GM, mainly reduction of NeuNAc(α2-6)DGal and α-Fuc content. H-Glu-Asp-Gly-OH under the conditions of COX-1/COX-2 blockage leads to more profound changes in GM lectin-binding pattern compared to the independent effect of indomethacin and to control.

Objective: To investigate the effect of Opuntia humifusa aqueous extract on gastric ulcers. Methods: An ethanol-induced model was used to examine the protective effect of Opuntia humifusa against gastric ulcers. The gastric ulcer index was evaluated via clinical observation and image analysis. Various inflammatory indicators were determined by RT-PCR and Western blotting assays. Results: The gastric ulcer index was reduced to 8% in the group treated with Opuntia humifusa aqueous extract compared with that in the control group. RT-PCR analysis revealed that MUC5AC expression was reduced to 39% in the control group compared with the non-treated group, whereas the omeprazole and Opuntia humifusa aqueous extract-treated groups increased the expression to 95% and 79%, respectively. Moreover, the expressions of various cytokines including TNF-α, IL-1β, and IL-6 were increased in the control group, while decreasing in Opuntia humifusa aqueous extract-treated group. Opuntia humifusa aqueous extract also suppressed the expressions of iNOS, COX-2, and its transcription factor NF-κB and increased mucus content considerably as compared to the control group. Conclusions: These results suggest that Opuntia humifusa aqueous extract is suitable as an alternative remedy for gastric ulcer treatment.

Several features of drug-induced mucosal alterations have been observed in the upper gastrointestinal tract, i.e., the esophagus, stomach, and duodenum. These include pill-induced esophagitis, desquamative esophagitis, worsening of gastroesophageal reflux, chemotherapy-induced esophagitis, proton pump inhibitor-induced gastric mucosal changes, medication-induced gastric erosions and ulcers, pseudomelanosis of the stomach, olmesartan-related gastric mucosal inflammation, lanthanum deposition in the stomach, zinc acetate hydrate tablet-induced gastric ulcer, immune-related adverse event gastritis, olmesartan-asso-ciated sprue-like enteropathy, pseudomelanosis of the duodenum, and lanthanum deposition in the duodenum. For endoscopists, acquiring accurate knowledge regarding these diverse drug-induced mucosal alterations is crucial not only for the correct diagnosis of these lesions but also for differential diag-nosis of other conditions. This minireview aims to provide essential information on drug-induced mucosal alterations observed on esophagogastroduodenoscopy, along with representative endoscopic images., Competing Interests: Conflict-of-interest statement: Iwamuro M has received lecture fees from Otsuka Pharmaceutical Co., Ltd. and Ono Pharmaceutical Co., Ltd., as well as grants from Taisho Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Abbott Japan Co., Ltd. Kawano S has received lecture fees from Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Astellas Pharma Inc., AstraZeneca PLC, Viatris Inc., Zeria Pharmaceutical Co., Ltd., and EA Pharma Co., Ltd., along with grants from Taisho Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Abbott Japan Co., Ltd. Otsuka M has received lecture fees from Chugai Pharmaceutical Co., Ltd., Gilead Sciences, Inc., Merck & Co., Inc., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, AbbVie GK, EA Pharma Co., Ltd., and Kowa Company, Ltd., along with grants from Taisho Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Abbott Japan Co., Ltd., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Introduction: Caustic substances ingestion results in a complex syndrome. The patient characteristics and severity of injury are important prognostic predictors. The monitoring of clinical changes and the multidisciplinary approach are necessary to prevent death in the early stages of the poisoning., Case Description: The case report describes the suicide of a woman by ingestion of a large amount of 15% sulfuric acid for suicidal purposes (15-20 ml). The initial conditions were stable, and no changes were found on a CT scan. However, the main sign was a severe metabolic acidosis. After 7 hours, haematemesis and oedema of the larynx appeared, and oro-tracheal intubation and ICU admission were necessary. Consequent progressive haemodynamic deterioration with persistent severe metabolic acidosis, increasing lactates and septic shock appeared. A new CT scan with contrast was performed 22 hours later detecting diffuse perforations and liquid in pleurae and abdomen. A pleural sample showed necrotic liquid. The death was 24 hours after ingestion and no surgical treatment was performed because of the diffuse lesions to the thoracoabdominal districts., Conclusions: Early detection of gastroenteric lesions and the monitoring of clinical changes are mandatory to avoid the death of the patient. Gastroenteric perforations require an immediate radiological evaluation and surgical treatment. The clinical case report states the severity of prognosis was related to high doses of sulfuric acid ingestion. The immediate metabolic acidosis is related to quick subsequent severe systemic pathological lesions of the gastrointestinal tract. The severity of absorption metabolic acidosis, consequently, may be an early and prognostic sign of the late chest and abdominal lesions., Learning Points: Severity of metabolic acidosis after sulfuric acid ingestion may anticipate late damage to the gastrointestinal tract., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2024.)

Antecedentes: las úlceras gástricas son lesiones de naturaleza multifactorial que afectan a todos los équidos (caballos‚ burros y mulares)‚ con prevalencias reportadas hasta del 100 % en animales adultos y del 50 % en potros. Si bien los estudios de úlceras gástricas son abundantes en los équidos jóvenes‚ adultos y geriátricos‚ no se reporta información en fetos y neonatos menores de 48 horas. Objetivo: describir y clasificar las úlceras en mucosa escamosa y glandular de estómagos de fetos de équidos‚ obtenidos de una planta de beneficio. Métodos: un total de 25 estómagos de fetos (11 caballos‚ 13 burros y 1 mular)‚ ambos sexos (12 hembras y 13 machos)‚ fueron recolectados inmediatamente después del sacrificio de hembras con gestaciones en su último tercio (> 7‚5 meses). Los estómagos fueron sometidos a cortes longitudinales a través de la curvatura mayor entre el cardias y el antro pilórico para la exposición y evaluación de ambas mucosas gástricas. Las lesiones fueron clasificadas con la adaptación de escalas propuestas para équidos adultos‚ ante la ausencia de parámetros para fetos. Resultados: se observaron úlceras en el 91 % (10/11) de los fetos de caballos‚ en el 92 % (12/13) de los fetos de burros y en el mular‚ siendo la mucosa glandular la más afectada (88%)‚ principalmente a nivel del fundus. En general‚ 23 de los fetos evaluados‚ fueron clasificados con úlceras ≥ 2 grados. En cuatro (4) de los fetos evaluados (2 caballos y 2 burros) se observaron úlceras en ambas mucosas gástricas. Conclusiones: el presente estudio evidenció la ocurrencia de lesiones gástricas en fetos en periodo perinatal‚ una vez que solo existen reportes en neonatos a partir de 48 horas de vida‚ por tanto‚ en conocimiento de los autores‚ este es el primer reporte de lesiones en mucosa glandular y escamosa de fetos de caballos‚ burros y mulares en el mundo. Por los hallazgos anteriores‚ se requiere de estudios para dilucidar la fisiopatología e identificar factores de predisposición a estas lesiones en vida gestacional de estos ejemplares. [ABSTRACT FROM AUTHOR]

• Effect of silage particle size on skin- and gastric lesions in fattening pigs. • Fresh silage reduced the occurrence of gastric lesions in the stomach mucosa. • Pigs fed pelleted silage still had a high occurrence of gastric lesions. • Dietary treatment did not affect the number of skin lesions. • Feeding fresh silage can improve pig welfare by promoting gastric health. Limited access to high-quality feed protein for pigs has made it necessary to evaluate new protein sources that both promote sustainable pig production and meet the nutritional requirements of pigs. Providing pigs with roughage has positive effects on their behaviour and gut health. However, roughage is seldom given as a part of the pigs' diet and often has a long straw length. Knowledge is lacking on the effect of feeding silage with smaller particle size and as a part of the pigs' diet on pig behaviour and welfare. This study evaluated the influence of feeding fattening pigs silage with different particle sizes on aggressive encounters, measured as the number of skin lesions, and on the occurrence of gastric lesions and ulcers. In total, 128 Swedish Yorkshire × Hampshire pigs were fed either a commercial control feed without silage (Pellet-C), or silage mixed with commercial feed, either in a pellet (Pellet-S) or in a total mixed ration (TMR) with chopped (TMR-Ch) or intensively treated silage (TMR-Ex). Skin lesions were assessed twice in the study according to the Welfare Quality® protocol. The first assessment was performed when the pigs were 105 days old and the second assessment at 132 days of age. Gastric lesions were examined in both the pars oesophagea and the pars glandularis region of the stomach. Stomachs were collected after slaughter, and gastric lesions were scored based on established scoring criteria. There was a treatment × assessment interaction on the number of skin lesions on the ear (P = 0.049). Apart from this interaction, no other effect of treatment on the number of skin lesions could be observed between the treatments or the assessment occasions. Treatment had a clear effect on the occurrence of gastric lesions and pigs fed the fresh silage (TMR-Ch and TMR-Ex) had a lower occurrence of gastric lesions and ulcers compared to the pelleted treatments (Pellet-C and Pellet-S) (P = 0.001). This study could not show any clear reduction effect of dietary silage inclusion on skin lesions. However, feeding silage in TMR significantly reduced the occurrence of stomach ulcers. [ABSTRACT FROM AUTHOR]

(1) Background: Gastric cancer, the fourth most common cause of death from tumors in the world, is closely associated with Helicobacter pylori. Timely diagnosis, therefore, is essential to achieve a higher survival rate. In Chile, deaths from gastric cancer are high, mainly due to late diagnosis. Progranulin has reflected the evolution of some cancers, but has been poorly studied in gastric lesions. Aiming to understand the role of progranulin in H. pylori infection and its evolution in development of gastric lesions, we evaluated the genic expression of progranulin in gastric tissue from infected and non-infected patients, comparing it according to the epithelial status and virulence of H. pylori strains. (2) Methods: The genic expression of progranulin by q-PCR was quantified in gastric biopsies from Chilean dyspeptic patients (n = 75) and individuals who were uninfected (n = 75) by H. pylori, after receiving prior informed consent. Bacteria were grown on a medium Columbia agar with equine-blood 7%, antibiotics (Dent 2%, OxoidTM), in a microaerophilic environment, and genetically characterized for the ureC, vacA, cagA, and iceA genes by PCR. The status of the tissue was determined by endoscopic observation. (3) Results: Minor progranulin expression was detected in atrophic tissue, with a sharp drop in the tissue colonized by H. pylori that carried greater virulence, VacAs1m1+CagA+IceA1+. (4) Conclusions: Progranulin shows a differential behavior according to the lesions and virulence of H. pylori, affecting the response of progranulin against gastric inflammation.

Background: Endoscopic submucosal dissection (ESD) and endoscopic submucosal excavation (ESE) have been widely used and have gradually become the main endoscopic treatment for gastrointestinal mucosal and submucosal lesions. Whether antibiotics are necessary for fever after gastric ESD and ESE remain unclear. The aim of this study was to analyse the value of using antibiotics in patients without perforation after ESD or ESE with fever.Methods: In this retrospective study, patients with fever without perforation after ESD or ESE from January 2014 to January 2019 were included and divided into 2 groups: the antibiotic group and the non-antibiotic group. Fever and hospitalization time were compared between the 2 groups after propensity score matching.Results: Overall, 253 patients meeting the inclusion criteria were enrolled in the present study, with 186 patients in the non-antibiotic group and 67 patients in the antibiotic group before matching, 55 patients in the non-antibiotic group and 55 patients in the antibiotic group after matching with all baseline characteristics balanced (p > 0.05). The duration of fever was not significantly different between the 2 groups (p = 0.12). However, the median hospitalization stay in the antibiotic group was longer than that in the non-antibiotic group (8 vs 7, p = 0.007).Conclusions: Antibiotics may be unnecessary for fever in patients without perforation and without serious co-morbidities after gastric ESD or ESE. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer (GC) stands as one of the most prevalent cancer types worldwide, holding the position of the second leading cause of cancer-related deaths. Gastric lesions represent pathological alterations to the gastric mucosa, with an elevated propensity to advance to gastric cancer. Limited research has explored the potential of stem cells in the treatment of gastric lesions., Methods: This study aimed to explore the potential of intravenous transplantation of labeled bone marrow-derived mesenchymal stem cells (BMMSCs) to inhibit the progression of precancerous gastric lesions., Results: In the gastric lesion disease model group, the rat tissue exhibited noteworthy mucosal atrophy, intestinal metaplasia, dysplasia, and inflammatory cell infiltration. Following the infusion of BMMSCs, a notable decrease in gastric lesions was found, with atrophic gastritis being the sole remaining lesion, which was confirmed by morphological and histological examinations. BMMSCs that were colonized at gastric lesions could differentiate into epithelial and stromal cells, as determined by the expression of pan-keratin or vimentin. The expression of vascular endothelial growth factor was significantly elevated following BMMSC transplantation. BMMSCs could also upregulate the production of humoral immune response cytokines, including interleukin (IL)-4 and IL-10, and downregulate the production of IL-17 and interferon-gamma, which could be highly associated with the cellular immune response and inflammation severity of the lesions., Conclusions: BMMSC transplantation significantly reduced inflammation and reversed gastric lesion progression., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Published by IMR Press.)

Introduction: Fever is one of the postoperative complications of endoscopic submucosal dissection (ESD) and its derivative technology. However, there are few studies on risk factors for fever after ESD and its derivative technology. The aim of this study was to determine the incidence and related risk factors after ESD and its derivative technology for gastric lesions., Materials and Methods: A retrospective review of patients with gastric lesions who were treated by ESD and its derivative technology in our hospital from January 2014 to January 2019 was conducted., Results: A total of 1955 patients were included in the present study. A total of 451 (23.1 %) patients presented with fever after ESD and its derived techniques. The highest fever temperature was 37.6 ± 3.12 °C, and the number of days with fever was 1.48 ± 0.85. Through single factor and multiple factor analysis, age (OR: 1.261, 95% CI: 1.009-1.576, p < 0.05), procedure time (OR: 1.457, 95% CI: 1.053-2.016, p < 0.05), postoperative gastric tube placement (OR: 2.098, 95% CI: 1:616-2.723, p < 0.05), intraoperative hemorrhage (OR: 1.537, 95% CI: 1.196-1.974, p < 0.05) and perforation (OR: 1.970, 95% CI: 1.531-2.535, p < 0.05) were independent risk factors for postoperative fever., Conclusion: Age ≥56 years old, procedure time ≥60 min, gastric tube placement, intraoperative hemorrhage and perforation were independent risk factors for postoperative fever after gastric ESD and its derivative technology. Attention should be given to such patients to minimize the risk of postoperative fever., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Fatty-acid amide hydrolase (FAAH) catalyzes the intracellular hydrolysis of the endocannabinoid anandamide and other bioactive lipid amides. In the present study, we conducted a comparative characterization of the effects of the newly identified brain-impermeant FAAH inhibitor, URB937 ([3-(3-carbamoylphenyl)-4-hydroxy-phenyl] N-cyclohexylcarbamate), in various rodent models of acute and persistent pain. When administered by the oral route in mice, URB937 was highly active (median effective dose, ED(50), to inhibit liver FAAH activity: 0.3mgkg(-1)) and had a bioavailability of 5.3%. The antinociceptive effects of oral URB937 were investigated in mouse models of acute inflammation (carrageenan), peripheral nerve injury (chronic sciatic nerve ligation) and arthritis (complete Freund's adjuvant). In all models, URB937 was as effective or more effective than standard analgesic and anti-inflammatory drugs (indomethacin, gabapentin, dexamethasone) and reversed pain-related responses (mechanical hyperalgesia, thermal hyperalgesia, and mechanical allodynia) in a dose-dependent manner. ED(50) values ranged from 0.2 to 10mgkg(-1), depending on model and readout. Importantly, URB937 was significantly more effective than two global FAAH inhibitors, URB597 and PF-04457845, in the complete Freund's adjuvant model. The effects of a combination of URB937 with the non-steroidal anti-inflammatory agent, indomethacin, were examined in the carrageenan and chronic sciatic nerve ligation models. Isobolographic analyses showed that the two compounds interacted synergistically to attenuate pain-related behaviors. Furthermore, URB937 reduced the number and severity of gastric lesions produced by indomethacin, while exerting no ulcerogenic effect when administered alone. The results indicate that the peripheral FAAH inhibitor URB937 is more effective than globally active FAAH inhibitors at inhibiting inflammatory pain. Our findings further suggest that FAAH and cyclooxygenase inhibitors interact functionally in peripheral tissues, to either enhance or hinder each other's actions.

Background and Aims: Endoscopic submucosal dissection (ESD) was developed as a feasible and reliable treatment for gastrointestinal mucosal or submucosal lesions. Bacteremia may occur after ESD. Currently, the use of prophylactic antibiotics after gastric ESD is controversial. This study was designed to explore the value of prophylactic antibiotics in the treatment of gastric mucosal and submucosal lesions after ESD.Methods: In this prospective study, in total, 103 patients who underwent gastric ESD were included, and the frequency of bacteremia and changes in inflammation-related indicators before and after the procedure were investigated. The patients did not receive prophylactic antibiotics.Results: The body temperature (T), white blood cell count (WBC), and procalcitonin (PCT) and C-reactive protein (CRP) levels did not significantly differ between the perforation group (N = 40) and nonperforation group before gastric ESD (N = 63) (all P > 0.05). The T, WBC, and CRP levels (all P < 0.05) in the patients with perforation were significantly higher than those in the patients without perforation 24 h after gastric ESD. The incidence of bacteremia did not significantly differ between the two groups (all P > 0.05). In total, 6 of 309 blood cultures were cultured with bacteria. The total frequency of bacteremia in the perforation and nonperforation groups was 2.5% and 3.2%, respectively. No sepsis occurred in any patients.Conclusion: Regardless of whether perforation occurred after gastric ESD, the incidence of bacteremia was transient and low. Therefore, based on our single-center study in China, prophylactic antibiotics may not be necessary in patients with intraoperative perforation during gastric ESD.Trial Registration: A single-center prospective study at chictr.org.cn (ChiCTR1800019668). [ABSTRACT FROM AUTHOR]

Eupatorium aschenbornianum has been widely used in traditional Mexican and folk medicine for the treatment of wounds, skin lesions, hemorrhages and gastric ulcers in humans. Phytochemical studies have indicated that hexane extracts of E. aschenbornianum have anti-microbial and anti-fungal activities. In the present study, an accurate and reliable approach using a murine model was pursued to evaluate the anti-ulcer activity, lipid peroxidation properties and acute toxicity of powdered dried stem of E. aschenbornianum. The results indicated that administration of E. aschenbornianum exerted an anti-ulcerative effect and decreased lipid peroxidation in gastric ulcers induced by acetylsalicylic acid. An acute toxicity assay indicated normal behavior and no significant variations in the weight and food consumption of animals. In addition, quantitative analysis of biochemical parameters did not indicate any liver or kidney damage. The results indicated that E. aschenbornianum may be a safe therapeutic agent for the prevention of gastric ulcers. [ABSTRACT FROM AUTHOR]

We have previously shown that two enteral nutrition formulas suppressed gastric lesions induced by the oral administration of indomethacin (IND) in mice. However, the mechanism of their protective effect is unknown. In this study, the effect of the two enteral nutrition formulas on gastric lesions induced by subcutaneous IND injection was investigated, with the objective of exploring the possibility that they may interact directly with IND in the gastrointestinal tract. Ten-week-old, male, ICR mice were fasted, then orally given either purified water, Mermed® One, or 2-fold diluted Terumeal® 2.0α as enteral nutrition formula (25 mL/kg). IND was injected subcutaneously at 20 mg/kg after 30 min, and the stomach was removed 6 h later and fixed in formalin. The number and area of lesions in the stomachs of mice given enteral nutrition formula was reduced to 56–89% and 34–61%, respectively, compared with the mice given purified water. The time courses of plasma IND concentrations were comparable among the three groups. These results suggested that the effect of these enteral nutrition formulas on gastric lesions did not originate from their direct interaction with IND in the gastrointestinal tract or their effect on the disposition of IND.

The Epstein‐Barr virus (EBV) is one of the infectious agents found in stomach tissue. Recently, EBV‐associated gastric carcinoma (EBVaGC) was classified as a new subtype of gastric carcinoma. To date, there is a lack of knowledge about the distribution and prevalence of EBV infection in both the normal stomach and various gastric lesions, including EBVaGC, in the Thai population. In this study, we detected EBV in the normal stomach (NS; n = 19), chronic gastritis (CG; n = 36), intestinal metaplasia (IM; n = 40), gastric dysplasia (GD; n = 15), and gastric adenocarcinoma (GC; n = 33) by polymerase chain reaction (PCR) amplification of the latent membrane protein (LMP1) gene of EBV. EBV‐PCR amplification was positive in 42.1%, 36.1%, 22.5%, 13.3%, and 33.3% of NS, CG, IM, GD, and GC, respectively. For further clarification in EBVaGC, we performed EBV‐encoded small RNA in situ hybridization (EBER‐ISH) in PCR‐positive cases of GD and GC. Four GC cases were EBER‐ISH positive (12.1%), while both GD cases were EBER‐ISH negative. In addition, we determined the distribution of the EBV strain (type A or B) based on EBNA3C sequence and EBV variants based on LMP1 variation (wild‐type and 30‐bp deletion variants; wt‐LMP1 or del‐LMP1). The results showed that type A and wt‐LMP1 were the most prevalent in all lesions. In conclusion, EBV is common in both the NS and gastric lesions, and the frequency of EBVaGC was 12.1% in Thai patients. [ABSTRACT FROM AUTHOR]

Eradication of Helicobacter pylori has been found to be effective for gastric cancer prevention, but uncertainties remain about the possible adverse consequences such as the potential microbial dysbiosis. In our study, we investigated the association between gut microbiota and H. pylori-related gastric lesions in 47 subjects by deep sequencing of microbial 16S ribosomal RNA (rRNA) gene in fecal samples. The dominant phyla in fecal samples were Bacteroidetes, Firmicutes, and Proteobacteria with average relative abundances of 54.77, 31.37 and 12.91%, respectively. Microbial diversity analysis showed that observed species and Shannon index were increased in subjects with past or current H. pylori infection compared with negative subjects. As for the differential bacteria, the average relative abundance of Bacteroidetes was found to significantly decrease from H. pylori negative (66.16%) to past infection group (33.01%, p = 0.007), as well as from normal (76.49%) to gastritis (56.04%) and metaplasia subjects (46.83%, p = 0.027). For Firmicutes and Proteobacteria, the average relative abundances showed elevated trends in the past H. pylori infection group (47.11, 20.53%) compared to negative group (23.44, 9.05%, p = 0.068 and 0.246, respectively), and similar increased trends were also found from normal (18.23, 5.05%) to gastritis (35.31, 7.23%, p = 0.016 and 0.294, respectively) or metaplasia subjects (32.33, 20.07%, both p < 0.05). These findings suggest that the alterations of fecal microbiota, especially the dominant phyla of Bacteroidetes, Firmicutes and Proteobacteria, may be involved in the process of H. pylori-related gastric lesion progression and provide hints for future evaluation of microbial changes after H. pylori eradication.

Eradication of Helicobacter pylori has been found to be effective for gastric cancer prevention, but uncertainties remain about the possible adverse consequences such as the potential microbial dysbiosis. In our study, we investigated the association between gut microbiota and H. pylori-related gastric lesions in 47 subjects by deep sequencing of microbial 16S ribosomal RNA (rRNA) gene in fecal samples. The dominant phyla in fecal samples were Bacteroidetes, Firmicutes, and Proteobacteria with average relative abundances of 54.77, 31.37 and 12.91%, respectively. Microbial diversity analysis showed that observed species and Shannon index were increased in subjects with past or current H. pylori infection compared with negative subjects. As for the differential bacteria, the average relative abundance of Bacteroidetes was found to significantly decrease from H. pylori negative (66.16%) to past infection group (33.01%, p = 0.007), as well as from normal (76.49%) to gastritis (56.04%) and metaplasia subjects (46.83%, p = 0.027). For Firmicutes and Proteobacteria, the average relative abundances showed elevated trends in the past H. pylori infection group (47.11, 20.53%) compared to negative group (23.44, 9.05%, p = 0.068 and 0.246, respectively), and similar increased trends were also found from normal (18.23, 5.05%) to gastritis (35.31, 7.23%, p = 0.016 and 0.294, respectively) or metaplasia subjects (32.33, 20.07%, both p < 0.05). These findings suggest that the alterations of fecal microbiota, especially the dominant phyla of Bacteroidetes, Firmicutes and Proteobacteria, may be involved in the process of H. pylori-related gastric lesion progression and provide hints for future evaluation of microbial changes after H. pylori eradication. [ABSTRACT FROM AUTHOR]

Cytoprotector amifostine (AMI) was given in a dose of 50, 100 or 150 mg/kg ip in rats treated with several highly toxic doses of T-2 toxin. The best survival rate (24 h and 7 days after treatment) was obtained with AMI50 (50 mg/kg ip). After T-2 intoxication, a peak in the mean number of gastric lesions (petechiae and ulcerations) was reached on the third day (26.40 ± 6.24). Administration of AMI50 reduced, almost completely, the total number of gastric lesions in rats acutely poisoned by 0.5 LD50 T-2 (1.5 mg/kg sc), starting with day 1 after intoxication (5.60 ± 3.42). [ABSTRACT FROM AUTHOR]

Natural green clay is mostly used in pharmaceutical and cosmetic products. The effect of this raw material from different outcrops around the world demonstrates its beneficial role on human health. The green clay from southern Tunisia is widely used in local traditional medicine and cosmetic preparations but its biological activity in vivo has not been studied yet. For this reason, this work was interested in deciphering the properties of the Tunisian green clay such as mineralogy composition and biological effect. In fact, the mineralogical study of this green clay shows two types of clay minerals such as illite and kaolinite with proportion of 75% and 25%, respectively. In order to study the biological effect, green clay was administered orally to rats for 1 h at 50, 75, 100 and 125 mg/kg doses. After that, ethanol 95% was given to these rats to induce a gastric ulcer. Then, several parameters (e.g. Ulcer index, protective rate, mucus production gastric and mucosa histology) were measured to evaluate the gastroprotective activity. The histology study shows normal gastric mucosa in rats pretreated at 75, 100 and 125 mg/kg doses and the decrease of Ulcer Index (%I = 97%) and lesions areas. The oral administing mixture of Tunisian green clay with ethanol in rats induces severe mucosal lesion and hemorrhagic bands. This clay colored by methylene blue shows that clay was linked to the mucus excreted by the stomach surface. The green clay didn't neutralize ethanol gastro toxicity and formed a layer on the gastric mucosa to protect it by a mechanical action. When investigated on rats at an effective dose treatment (75 mg/kg) for 30 days, the subchronic toxicity test of green clay did not reveal any signs of mortality and toxicity, and it demonstrated the normal hematological and biochemical parameters of rats. Thus, the Tunisian green clay can be considered as a safe natural product since it has a potential gastroprotective activity on ethanol induced gastric mucosal lesions in rats. [ABSTRACT FROM AUTHOR]