Mixed neuroendocrine-non-neuroendocrine neoplasm of the colon: case report

Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is defined as a tumor composed of cells originating from neuroendocrine cells in the embryonic intestine and elements of epithelial adenocarcinoma. To determine the differentiation grade of MiNEN, the proliferation index was used, for which at least 500 cells were examined. MiNEN is a rare neoplasm that is most frequently found in the lower gastrointestinal tract. We present a rare clinical case of surgical treatment of MiNEN of the ascending colon.

Special aspects of intensive care of patients with complicated diverticulosis of the colon

This study presented examination and treatment results of 129 patients with bleeding from the lower gastrointestinal tract who were treated at the Alexandrovskaya Hospital of St. Petersburg in the period from 2012 to 2017. Examination and treatment were performed in the intensive care unit following current clinical guidelines, taking into account the identified concomitant diseases. Endoscopic examination of the colon is the main diagnostic method for the pathological processes that caused bleeding from the lower gastrointestinal tract. Conservative therapy has been demonstrated effectiveness, and urgent surgical treatment was not needed. The main drug therapy included antifibrinolytic drugs and fresh-frozen plasma preparations. Continuous parenteral administration of proteolysis inhibitors was mandatory. Intensive therapy included correction of hemodynamic disturbances and respiratory failure and restoration of the volume of the circulating blood and plasma. Such an approach was found to be 90% effective. In patients with diverticular disease, bleeding from the colonic diverticula develops in one-third of cases. However, if additional risk factors are present, their frequency reaches 50%, often causing death. Continuous or recurrent bleeding is an indication of surgery. In our study, the conservative method of stopping bleeding from the colonic diverticula was possible in all cases. In general, the disease correlated with the age of the patients. In 68 (53%) patients, bleeding occurred despite anticoagulant or antiplatelet therapy. Patients with bleeding from colonic diverticula do not require urgent surgical intervention, and these patients may require admission to the intensive care unit. Intensive care should include the provision of antifibrinolytic drugs, proteolysis inhibitors, and fresh-frozen plasma.

Isolated jejunal necrosis following corrosive acid poisoning

Corrosive acid poisoning is common in Asian countries, and most of the time, it is of suicidal intent in adults. Commonly they lead to extensive injuries of the upper gastrointestinal tract, and isolated involvement of the lower gastrointestinal tract is rare. We present a 35-year-old male who presented to us with a history of corrosive acid ingestion mixed with alcohol. Imaging did not demonstrate any pneumoperitoneum. The patient underwent exploratory laparotomy and found to have isolated jejunal necrosis without any evidence of injury to the stomach and duodenum. Segmental resection and end-to-end anastomosis were done.

Analysis on the healing of gastrointestinal ulceration by using Hemospray

Healing of gastrointestinal ulcers after Hemospray application was reported in literature. The pathophysiological mechanism of action of hemostatic powders is not elucidated so far. A prospective animal model was performed to evaluate the effect of Hemospray application on the healing process of artificially induced ulcers of the upper and lower gastrointestinal tract. In 10 pigs, 20 ulcers were created in each the upper and the lower gastrointestinal tract by endoscopic mucosal resection. 50% of the pigs were immediately treated with Hemospray application, the others were not treated. Ulcer size was measured endoscopically on day 0, 2, and 7. On day 7 the ulcers were histopathological evaluated for capillary ingrowth and the thickness of the collagen layer. After 7 days the sizes of the ulcers decreased significantly (stomach: − 22.8% with Hemospray application, − 19% without Hemospray application; rectum: − 50.8% with Hemospray application, − 49.5% without Hemospray application; p = 0.005–0.037), but without significant difference between both groups. This study shows no significant effect of the hemostatic powder Hemospray on ulcer healing in the upper and lower gastrointestinal tract compared with untreated controls, neither harmful nor beneficial. However, some trends merit further trials in patients and may indicate a possible mechanism of accelerated mucosal healing.

Colon Capsule Endoscopy as a Diagnostic Adjunct in Patients with Symptoms from the Lower Gastrointestinal Tract

Prompted by the core idea of wireless capsule endoscopy as a painless gastrointestinal examination, and the easy adoption of small bowel capsule endoscopy, the armamentarium of the capsule-based imaging platforms has grown to include colon capsule devices as well [...]

Role of the WOR1 Promoter of Candida albicans in Opaque Commitment

Candida albicans , the most pervasive fungal pathogen colonizing humans, undergoes a phenotypic transition between a white and opaque phenotype. The unique opaque phenotype is necessary for mating and colonization of the lower gastrointestinal tract.

Histopathological study of lower gastrointestinal tract lesions

Background: The benign lesions of the lower gastrointestinal tract are responsible for a largenumber of morbidities. The microscopic examination of and determination of histological types ofmalignant lesions help to decide treatment options and to predict prognosis. The histopathologicalstudy is the Gold standard for the diagnosis of intestinal lesions. Aims and Objectives: To studythe prevalence of various lower gastrointestinal tract lesions site-wise, age-wise and gender-wiseand to compare the obtained results with other studies. Materials and methodology: Aretrospective study of 600 various lower gastrointestinal tract lesions sent for histopathologicalexamination at Pathology department of tertiary care centre, VS General Hospital, Ahmedabad iscarried out. Results: Among all the 600 cases, non-neoplastic lesions 572 (95.34%) are far morecommon than neoplastic lesions 28 (4.66%). Conclusion: Non-neoplastic lesions are common in thesmall intestine, while the large intestine harbors most malignant lesions.

Washed Microbiota Transplantation Lowers Blood Pressure in Patients With Hypertension

BackgroundAlthough transplantation of the fecal microbiota from normotensive donors has been shown to have an antihypertensive effect in hypertensive animal models, its effect on blood pressure in patients with hypertension is unclear. This study aimed to assess the effect of washed microbiota transplantation (WMT) from normotensive donors on blood pressure regulation in hypertensive patients.MethodsThe clinical data of consecutive patients treated with washed microbiota transplantation (WMT) were collected retrospectively. The blood pressures of hypertensive patients before and after WMT were compared. The factors influencing the antihypertensive effect of WMT in hypertensive patients and fecal microbial composition of donors and hypertensive patients were also analyzed.ResultsWMT exhibited an antihypertensive effect on blood pressure: the blood pressure at hospital discharge was significantly lower than that at hospital admission (change in systolic blood pressure: −5.09 ± 15.51, P = 0.009; change in diastolic blood pressure: −7.74 ± 10.42, P < 0.001). Hypertensive patients who underwent WMT via the lower gastrointestinal tract (β = −8.308, standard error = 3.856, P = 0.036) and those not taking antihypertensive drugs (β = −8.969, standard error = 4.256, P = 0.040) had a greater decrease in systolic blood pressure, and hypertensive patients not taking antihypertensive drugs also had a greater decrease in diastolic blood pressure (β = −8.637, standard error = 2.861, P = 0.004). After WMT, the Shannon Diversity Index was higher in six of eight hypertensive patients and the microbial composition of post-WMT samples tended to be closer to that of donor samples.ConclusionWMT had a blood pressure-lowering effect in hypertensive patients, especially in those who underwent WMT via the lower gastrointestinal tract and in those not taking antihypertensive drugs. Therefore, modulation of the gut microbiota by WMT may offer a novel approach for hypertension treatment.