Risk Factors for the Formation of Inflammatory Diseases of the Upper Digestive Tract in Children in the Republic of North Ossetia-Alania

In recent years, cases of diseases of the digestive tract among preschool and school-age children have become significantly more frequent. This article analyzes the influence of various factors (heredity, living conditions, age, gender, lifestyle) on the likelihood of morbidity. Chronic pathology of the upper digestive tract in the vast majority of children begins at preschool age with further significant growth from the moment they attend school. Close attention is required by children whose parents and immediate relatives suffer from gastroenterological diseases. Modern diagnosis of the disease will reduce the risk of development and progression of the most common pathology of the digestive organs of childhood and avoid the development of severe complications.

Migratory Foreign Body Presenting with Thyroid Abscess

Introduction The most common complication following accidental ingestion of a foreign body is entrapment in the upper digestive tract. Spontaneous penetration of a foreign body through the upper digestive tract and migration into the soft tissues of the neck is very uncommon. Consequences from such migratory foreign body can be serious and potentially fatal. Case Report Thirty six years old female presented with history of accidental ingestion of an unknown foreign body 3 days back. Clinical examination, plain radiography, hypopharyngoscopy and oesophagoscopy failed to find out the foreign body. Thereafter the patient developed thyroid abscess which was confirmed by computed tomography. Surprisingly we discovered the foreign body during surgical exploration of neck. Conclusion In a case of accidental ingestion of foreign body, even if initial evaluation with endoscopy and plain radiography are negative, the patient should be followed closely until resolution of symptoms. A high index of suspicion of migration of foreign body should be maintained. Retrieval of migratory foreign body needs surgical expertise and experience.

244 MICROBIOME ANALYSIS OF UPPER DIGESTIVE TRACT BIOPSY SAMPLES FROM INDIVIDUALS ALONG THE METAPLASIA-DYSPLASIA-ADENOCARCINOMA SEQUENCE.

The human microbiota, the collection of microbes that inhabit the human body, is increasingly being appreciated as playing a role in human health. A seminal example of this relationship is Helicobacter pylori and gastric cancer oncogenesis. The drop in H.pylori infections and non-cardia gastric cancer incidences has coincided with the rise in oesophageal adenocarcinoma (OAC) incidences. We sought to explore the relationship between the upper digestive tract microbiome and OAC oncogenesis. Methods Pinch biopsies were taken from individual’s oesophagus and stomach who were along the metaplasia-dysplasia-adenocarcinoma sequence (GERD, Barrett's oesophagus, dysplasia, OAC, metastatic OAC) as well as healthy controls. We carried out 16 s rRNA gene DNA sequencing protocols on these samples. DNA extraction and library preparation was performed with consideration to the low mass nature of oesophageal biopsies. Raw reads were processed and amplicon sequence variants (ASVs) were generated using the DADA2. We dissected ecological differences between sample site and clinical classification using a variety of approaches including examining differentially abundant taxa and inferred metabolic pathways, alpha diversity and beta-diversity. Results The upper digestive tract was found to be dominated by the genera Streptococcus, Prevotella, and Haemophilus. There was no statistically significant shift in beta diversity with respect to biopsy location. Alpha diversity was reduced in gastric biopsies compare to oesophageal biopsies. A slight yet significant shift was seen in beta diversity (Bray–Curtis Dissimilarity) with respect to clinical classification in biopsies derived from the gastroesophageal junction (GEJ) and stomach. Various taxa were found to be differentially abundant between biopsy site and with regard to clinical classification. Conclusion OAC primarily occurs at the GEJ. Community structure was shifted in samples derived from the GEJ and the stomach. Fusobacterium nucleatum was overrepresented in oesophageal biopsies from individuals with diseased oesophagus compared to individuals with a histologically normal oesophagus. This bacterium has been implicated in oncogenesis of various cancers most notably colorectal cancer. Serval ASVs assigned to the genus Prevotella were depleted in stomachs of individuals with metastatic OAC compared to all other groups.

Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications

Objective: This study used phased array imaging algorithm to explore the epidemiological characteristics of endoscopic treatment of upper gastrointestinal foreign bodies to provide a basis for nursing intervention. Methods: We collected data on the age, sex, cause, type of foreign body, success rate of removal, retention location, time and complications of patients with foreign bodies in the upper gastrointestinal tract who were treated in the emergency department of the Digestive Endoscopy Center in our hospital. The study was conducted from January 2018 to December 2020 and we also performed statistical analysis. Results: The high incidence of foreign bodies in the upper digestive tract was in 45 years old to 74 years old patients. The foreign body types were mostly food balls and sharp foreign bodies, accounting for 37.0% and 44.2%, respectively. The cause was misuse and the most accounted for 52.1%, followed by oesophageal pathological stenosis which accounted for 45.5%. The oesophagus in the retention site accounted for up to 80.0%, and the success rate of foreign body extraction was 96.4%. The complications of patients with foreign body retention within twenty four our retention were mainly esophageal scratches and traumatic esophagitis, accounting for 48.5%. 39.6%. Conclusion: There are high risks in the treatment of foreign bodies in the upper digestive tract. Targeted, prospective, and streamlined nursing interventions can provide patients with fast and professional medical care services and minimize patient pain. doi: https://doi.org/10.12669/pjms.37.6-WIT.4858 How to cite this:Liu N. Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications. Pak J Med Sci. 2021;37(6):1636-1640. doi: https://doi.org/10.12669/pjms.37.6-WIT.4858 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dynamics of Diseases of the Upper Digestive Tract in Children

In the Russian Federation, there is a tendency to increase the incidence of a number of nosologies, the prevalence of chronic diseases and the deterioration of health among children and adolescents. Diseases of the digestive organs occupy a leading place in the structure of somatic pathology of childhood. According to the statistical data of the Ministry of Health of the Republic of North Ossetia – Alania (RNO – Alania), for seven years the prevalence of pathology of the digestive organs, including inflammatory bowel diseases, among children and adolescents has increased in the republic as a whole and regions separately. By 2022, it is predicted that the level of general and newly detected morbidity among children with pathology of the upper digestive tract will increase by 1.5-2 times.

Diagnostic Performance of Conventional X-ray for Detecting Foreign Bodies in the Upper Digestive Tract: A Systematic Review and Diagnostic Meta-Analysis

Foreign body (FB) ingestion is a common clinical problem in acute settings. Detecting FBs in the upper digestive tract is challenging. The conventional X-ray is usually the first-line imaging tool to detect FBs. However, its diagnostic performance is inconsistent in the literature. In this study, we performed a systematic review and meta-analysis to determine the diagnostic performance of the conventional X-ray for detecting FBs in the upper digestive tract. We conducted a systematic search of PubMed, Embase, Cochrane Library, Web of Science, and Scopus until 1 August 2020. Prospective or retrospective studies investigating the diagnostic accuracy of conventional X-rays for detecting FBs in the upper digestive tract in patients of all ages were included. The Quality Assessment of Studies of Diagnostic Accuracy-2 tool was used to review the quality of included studies. We used a bivariate random-effects model to calculate diagnostic accuracy parameters. Heterogeneity was assessed using I2 statistics. We included 17 studies (n = 4809) in the meta-analysis. Of the 17 studies, most studies were rated as having a high risk of bias. Conventional X-rays had a pooled sensitivity of 0.58 (95% confidence interval [CI] = 0.36–0.77, I2 = 98.52) and a pooled specificity of 0.94 (95% CI = 0.87–0.98, I2 = 94.49) for detecting FBs in the upper digestive tract. The heterogeneity was considerable. The area under the summary receiver operating characteristic curve was 0.91 (95% CI = 0.88–0.93). Deek’s funnel plot asymmetry test results revealed no significant publication bias (p = 0.41). The overall sensitivity and specificity of conventional X-rays were low and high, respectively, for detecting FBs in the upper digestive tract. Hence, conventional X-rays to exclude patients without upper FBs in the digestive tract are not recommended. Further imaging or endoscopic examinations should be performed for at-risk patients.