Effect of Arrabideae chica (crajiru) extract in a model of induced experimental colitis in rats

Objective: This study aimed to investigate the effect of A. chica extract on the evolution of experimental rectocolitis in rats, and the expression of the pro-inflammatory cytokines TNF-a, IL-1β and IL-6 in colonic tissue. Methods: Wistar rats weighing 275±23g were distributed into 4 groups of 6 animals each. Rectocolitis was induced in rats by rectal administration of trinitrobenzene sulfonic acid (TNBS). Seventy-two hours after TNBS injection, animals were treated daily for 6 days. Groups: 1. Normal control group without induction of rectocolitis. Received 0.9% saline injection v.o. by gavage during treatment. 2. TNBS rectocolitis group, treated with normal saline (SN) by gavage (TNBS+SN); 3. TNBS rectocolitis group treated with A. chica extract (ACE), receiving a daily dose of 300 mg of A. chica extract by gavage (TNBS+ACE);4. TNBS rectocolitis group treated with mesalazine, receiving a daily dose of 100 mg/kg of mesalazine orally (TNBS+MEZ). Macroscopic examination of the colon and dosing of TNF-α, IL-1β and IL-6 in colon tissue were performed. Results: There was a reduction in weight in animals treated only with TNBS+NS. No difference in weight was observed comparing the animals treated with ACE and MEZ. In the control group no mucosal ulcers or edema of the colon wall were observed. Several mucosal ulcers, edema and hyperemia occurred in the colon of rats in the TNBS+SN group. In two of the animals in this group there was colon perforation, tamponated by omentum. A reduction of mucosal ulcers number in the TNBS+ACE (crajiru) group was seen, compared to the TNBS+SN and TNBS+MEZ group. There was a significant reduction of TNF-α, IL-1β and IL-6 in the colon tissue of animals treated with crajiru extract, TCBS+ACE group, when compared to the control group (p<0.001), TNBS+SN group, and TNBS+MEZ groups (p<0.001). Conclusion: This is the first study to show that A. chica extract positively influences the treatment of TNBS/induced rectocolitis through its antiinflamatory activity. More comprehensive studies are needed to understand the underlying mechanisms.

Antibiotic-associated colitis in patients with COVID-19 – from imaging to diagnosis

The purpose of the study. To identify the main CT signs of colon inflammatory in patients with COVID-19, to correlate the detected signs with clinical manifestations and therapy, as well as to assess the validity of prescribing antibacterial therapy in accordance with Temporary guidelines for the treatment of coronavirus infection.Materials and methods. The data of CT scans of the chest and medical records were analyzed in 30 patients with confirmed coronavirus infection, in whom changes in the colon wall appeared in dynamics at the scanning level during CT. Laboratory data indicators, prescribed therapy, the presence of combined diseases were evaluated.Results. According to CT data, in dynamics in all patients – circular thickening of the colon wall with loss of gaustration, thickening of the submucosal layer in 63,3%, in 93,3% – edema of paracolic fiber. Shifts in the laboratory parameters were noted at admission: leukocytosis in 16.6%, an increase in procalcitonin in 13,3%; leukocyturia, bacteriuria – in 20%. None of the patients had indications of abdominal symptoms at admission, in dynamics at least one abdominal/dyspeptic symptom appeared in 76,6%. Fecal analysis for C.difficile toxins was taken in 50% patients, in 60% the result is positive. All patients were prescribed antibiotics and other therapy in the first 1–3 days of hospitalization. In 53,3%, levofloxacin (per os) was prescribed in combination with protected generation III cephalosporin (intravenously).Conclusions. Shifts in colon with C.difficile colitis in patients with COVID-19 according to CT data are highly likely to reflect the appearance of a pathological process and necessarily require a conclusion. There was a fact of irrational prescription of antibacterial therapy. Clear criteria for prescribing antibiotics against the background of immunosuppressive therapy are needed.

A Case of Small Bowel Intimation with Sepsis

Introduction: Sepsis is a life-threatening organ failure that occurs in severely ill patients as a result of a primary infectious cause or subsequent infection of injured tissues. The systemic effects of sepsis have been extensively studied, and evidence of local alterations and repercussions in the intestinal mucosal compartment is gradually characterizing sepsis-related changes in the gut. The current study focuses on sepsis-induced intestinal barrier failure, which includes increased epithelial permeability, which may allow bacterial translocation. The small bowel, commonly known as the small intestine, is roughly 1 inch in diameter and 20 to 30 feet long. It has a lot of folds to help it fit inside the abdominal cavity. The small bowel is connected to the stomach on one end and the big intestine on the other. Patient information: He was 63 years old male admitted to Acharya Vinoba Bhave Rural hospital sawangi meghe Wardha in MICU ward with chief complaints of altering sensorium. Low urine output vomiting, loss of appetite, swelling of the abdomen crampy abdominal pain that comes and goes. The Main Diagnosis, Therapeutic Intervention and Outcomes: A CT scan revealed a thicker transverse colon wall. His flexible sigmoidoscopy revealed “patchy inflammation and an isolated area of severe deep ulceration with nodularity and edema,” according to the report. The patient was given a preliminary diagnosis of "Inflammatory Bowel Disease—likely Crohn's," and was treated with steroids and Patient was done colonoscopy and course of inj. hydrocortisone, inj. Neomol, inj. levipril. Conclusion: In the case of acute small-bowel obstruction, helical CT is a highly sensitive approach for diagnosing or ruling out intestinal ischemia. In patients with significant trauma who are being assessed for sepsis of unknown origin, abdominal computed tomographic scans accurately identify intra-abdominal foci of infection. This patient was diagnosed with small bowel intimation and sepsis.

Causes and Management of Lower Gastro-Intestinal Bleeding

Gastrointestinal (GI) bleeding from the colon is a communal reason for hospitalization and is being more frequent in older patients. Gastrointestinal bleeding is known as any bleeding that takes place in the GIT from mouth to anus. Lower GI bleeding is defined as bleeding distal to the ligament of Treitz. Lower GI bleed is typically presented as hematochezia which is the passing of bright red blood clots or burgundy stools through the rectum. The causes of lower GI bleeding are changing over the past several decades from diverticulosis (which is the protrusion of the colon wall at the site of penetrating vessels), infectious colitis, ischemic colitis, angiodysplasia, inflammatory bowel disease, colon cancer, hemorrhoids, anal fissures, rectal varices, dieulafoy lesion, radiation-induced damage following cancer treatment to post-surgical. Management of lower GI bleeding is done through assessing the severity of symptoms and the condition of the overall case.

Intraoperative Control of Hemoglobin Oxygen Saturation in the Intestinal Wall during Anastomosis Surgery

During surgery for colon cancer, monitoring of the oxygen saturation of hemoglobin in the tissues under study makes it possible to assess the degree of blood supply to the anastomosis areas of the colon. Adequate blood supply in this area is decisive in terms of the consistency of the anastomosis and can significantly reduce the risk leakage of anastomosis. In this work, we propose a new approach to assessing the hemoglobin oxygen saturation based on measuring both the diffuse reflectance and transmittance spectra of the colon wall tissues. The proposed method is based on the use of two fiber-optic tools for irradiation from both sides—the intestinal lumen and the outside of the intestinal wall. The spectra are recorded from the external side. To determine the degree of hemoglobin saturation, two algorithms, both based on the Taylor series expansion of the coefficient of light attenuation by tissues, are proposed. The results of a clinical study of the proposed approach on volunteers were obtained, allowing to draw a conclusion about the applicability of the approach in a clinical setting.

Synchronous Colorectal Carcinoma: Three Cases Report and Literature Review

Background: Multiple primary colorectal cancers (MPCC) includes synchronous colorectal carcinoma (SC) and metachronous colorectal carcinoma (MC), which are defined as multiple malignant colorectal tumors that occur simultaneously or heterochrony. Comparing to isolate colorectal cancer, the incidence of SC is still rare. At present, there are few literatures describing the cases and reviews of SC. Case presentation: Here, we present three cases of SC. The first patient was admitted to our hospital because of a 5-month history of abdominal pain associated with difficult defecation. PET-CT revealed that a mass lesion of the splenic flexure of colon and another mass in sigmoid. Colonoscopy demonstrated double lesions in splenic flexure and sigmoid. Then we performed traditional open subtotal colon resection. Postoperative pathology confirmed that there are malignant characteristics of the double lesions. Another patient was suffered from with dizziness and fatigue for more than 2 years. Abdominal contrast-enhanced CT shows irregular thickening of the ascending colon wall and colonoscopy reveals that there is a tumor in rectum and many polyps in sigmoid. Then we underwent radical resection of rectal cancer and right colon cancer in a laparoscopic operation. Postoperative pathology confirmed moderately differentiated adenocarcinoma of the rectum and ascending colon. The third patient had hematochezia for 1 year. Both rectal magnetic resonance imaging (MRI) and colonoscopy showed that there are two lesions in the rectum, and conventional laparoscopic APR surgery was performed. Postoperative pathology confirmed malignant tumors in the rectum respectively. The mini review summed up the main points about prevalence, clinical manifestation, diagnosis, pathological, treatment and molecular mechanism features of SC based on current literature, which probably has significant distinctions with solitary tumors. Conclusions: Compared with isolated colorectal cancer, SC usually has a low stage，grade and incidence, but the age, sex and location is still a controversial issue. Colonoscopy and surgery are considered to be the best diagnosis and treatment method for SC. At present, serrated adenoma, hyperplastic polyp, ulcerative colitis and Crohn's disease are considered to be closely related to SC. MSI and gene mutation are two molecular mechanisms that lead to SC.

Clinical and morphological characteristics of experimental ulcerative colitis in the conditions of using original rectal suppositories with vitamin D3

Introduction. Vitamin D3 possesses antioxidant, anti-inflammatory, immunomodulatory, and other properties, has been shown to be effective in some autoimmune diseases, which is a prerequisite for studying its effect, when applied locally, on the clinical status and morphology of the site of injury in ulcerative colitis (UC).The aims was to study the effect of vitamin D3 in the composition of original rectal suppositories on the clinical status and morphology of the lesion of colon in experimental UC.Materials and methods. UC was modeled by two-stage administration of oxazolone. Rectal suppositories were prepared on the basis of a 10% aqueous solution of vitamin D3. The clinical status was assessed using the Disease activity index (DAI) scale. In the area of colon damage, the number of neutrophils, lymphocytes, eosinophils, histiocytes, plasmocytes and fibroblasts was examined per mm² d the tissue damage index (TDI) was calculated.Results and Discussion. In experimental UC, DAI increase an ulcerative defect is recorded in the colon, the number of neutrophils, lymphocytes, eosinophils, plasma cells, histiocytes, fibroblasts, TDI increases. The use of original rectal suppositories with vitamin D3 in experimental UC leads to a decrease in DAI, the size of the ulcer and TDI, a decrease in the infiltration of the intestinal wall by neutrophils, lymphocytes, eosinophils and plasma cells, an increase in the infiltration of histiocytes, fibroblasts.Conclusions. In experimental oxazolone-induced colitis, the clinical picture and morphology of the injury site characteristic of UC are recorded. The use of original rectal suppositories with vitamin D3 a total dose of 18,000 IU leads to a decrease in the severity of clinical signs and a decrease in the representation in the colon wall of cells involved in tissue destruction, an increase in the representation of cells mediating repair, which was reflected in a decrease in the area of the ulcer and tissue damage index , the severity of clinical signs according to DAI weakens as lymphocytes and plasma cells decrease in the area of damage to the colon, decrease in the size of the ulcer and decrease in TDI, increase in histiocytes and fibroblasts.

Histopathological effects of electrosurgical interventions in an in vivo porcine model of colonic endoscopic mucosal resection

ObjectiveEndoscopic mucosal resection (EMR) in the colon has been widely adopted, but there is limited data on the histopathological effects of the differing electrosurgical currents (ESCs) used. We used an in vivo porcine model to compare the tissue effects of ESCs for snare resection and adjuvant margin ablation techniques.DesignStandardised EMR was performed by a single endoscopist in 12 pigs. Two intersecting 15 mm snare resections were performed. Resections were randomised 1:1 using either a microprocessor-controlled current (MCC) or low-power coagulating current (LPCC). The lateral margins of each defect were treated with either argon plasma coagulation (APC) or snare tip soft coagulation (STSC). Colons were surgically removed at 72 hours. Two specialist pathologists blinded to the intervention assessed the specimens.Results88 defects were analysed (median 7 per pig, median defect size 29×17 mm). For snare ESC effects, 156 tissue sections were assessed. LPCC was comparable to MCC for deep involvement of the colon wall. For margin ablation, 172 tissue sections were assessed. APC was comparable to STSC for deep involvement of the colon wall. Islands of preserved mucosa at the coagulated margin were more likely with APC compared with STSC (16% vs 5%, p=0.010).ConclusionFor snare resection, MCC and LPCC did not produce significantly different tissue effects. The submucosal injectate may protect the underlying tissue, and technique may more strongly dictate the depth and extent of final injury. For margin ablation, APC was less uniform and complete compared with STSC.

Improved diagnosis and navigation for CT colonography

This project describes the development of an automatic segmentation method and a novel navigation system that detect polyps using advanced image processing and computer graphics tecniques. The colon wall segmentation method from the CT data set of abdomen is achieved by combining the contouring model - level set method and the minima detection using mathematical morphology theory. Polyp detection is attained by analyzing surface curvature and texture information along on the colon wall. Adding texture analysis provides a new feature for improving currently existing methods. As such, polyp candidates are examined not only by their shape and size but also by their texture appearance.

Improved diagnosis and navigation for CT colonography

This project describes the development of an automatic segmentation method and a novel navigation system that detect polyps using advanced image processing and computer graphics tecniques. The colon wall segmentation method from the CT data set of abdomen is achieved by combining the contouring model - level set method and the minima detection using mathematical morphology theory. Polyp detection is attained by analyzing surface curvature and texture information along on the colon wall. Adding texture analysis provides a new feature for improving currently existing methods. As such, polyp candidates are examined not only by their shape and size but also by their texture appearance.