An Investigation of Exposure to the Eyes and Thyroid of Personnel Near to Patient in Abdominal Radiography: A Phantom Study

Abdominal radiography is beneficial in a variety of clinical situations. Prior to the introduction of multiplanar imaging, it was considered as the main examination for gastrointestinal pathology. However, the radiation dose received is considered high since it is equivalent to the dose of at least 75 chest radiographs. Personnel including staff or relatives may be required to assist patients in many conditions, increasing unnecessary radiation and the likelihood of radiation-induced cancer. The purpose of this study was to determine the radiation dose received by personnel when eyes and thyroid are exposed during abdominal radiography. The Rando and body phantoms were used to represent personnel and patients in this experimental approach. The dose was measured as entrance surface dose (ESD) by using TLD-100, which was positioned at the Rando phantom's eyes and thyroid. The study included a total of twenty exposures, five times at each of four distinct sites. The mean doses (eyes/thyroid in mGy) were (0.083/0.081), (0.090/0.087), (0.093/0.092), and (0.092/0.089), respectively, at locations 1, 2, 3, and 4. The results indicated that there was no correlation between organ and location affecting ESD measurement (p=0.960). There was no significant difference in dose between the two organs (p=0.355), with the mean difference in the eyes being 0.002 more than in the thyroid. The proximity of the eyes to the tube source contributed for the increased dose observed at the eyes. Though ESD was substantial for location pairings 1 vs. 3 (p=0.001) and 1 vs. 4 (p=0.015) owing to the anode-cathode phenomena. In conclusion, personnel should avoid the tube source and cathode region, since they give a greater dose of radiation, particularly when the personnel are closest to the patient and does not have eyes or thyroid protection.

Main health impairment in the middle-aged former athletes

Objective: to obtain the main reasons for seeking medical assistance in the cohort of former athletes.Materials and methods: health records of 116 former athletes (65 males and 51 females), including 30 high qualification sportsmen were examined during 2006–2020. Mean age (M ± m) was 53.9 ± 1.8 in males and 53.9 ± 1.9 years in females. 52.4 % of males and 54.9 % of females had health records in the Center of clinical diagnostics.Results: cardiovascular pathology and musculoskeletal conditions (neck or back pain or osteoarthritis of the knee or hip) were randomly distributed among males (43.1 and 44.7 % of cases), while there was significant predominance of musculoskeletal conditions in females (62.7 %) than cardiovascular diseases (39.2 %). Gastrointestinal pathology was seen in 18.5 and 23.5 % of cases. Polymorbidity was detected in 50 % of males and in 58.6 % of females.Conclusions: age and gender differences in occurrence of cardiovascular and musculoskeletal conditions give the opportunity to realize the preventive strategy in former athletes.

Optimization of coprological studies in animals with the use of homeopathic Nux vomica 6CH

Background: Etiology of various gastrointestinal dysfunctions varies from infections and infestations to consequences of emotional stress and errors in animals’ nutrition. Taking this variability of etiology and pathogenesis into account, a lot depends not only on completeness of homeopathic history taking but also on the quality of laboratory studies. In our experience, coprology studies are especially complicated when persistent gastrointestinal disorders were preceded by massive use of allopathic remedies. This sometimes necessitates repeated examinations. That is why our interest in having reliable results and early detection of latent indigestion made us look for non-invasive methods which could be easy to use in animals but at the same time could reveal latent gastrointestinal pathology in animals. Aims: The study was aimed to determine the effect of a homeopathic medication Nux Vomica 6CH on detection of latent gastrointestinal pathology in small domestic animals. Method: Coprology studies were performed simultaneously with the use of sedimentation method and Fulleborn method (modification of Scherbovich). Infestations were diagnosed and characteristics of patient digestion were recorded. Feces test detected: 1. Presence of endoparasites (helminths, protozoa and yeast-like structures); 2. State of intestinal microflora (presence of different species and their balance with each other); 3. Degree of food absorbency (presence or lack of undigested protein, carbohydrates and fat); 4. Presence of inedible inclusions; 5. Presence of cells (lymphocytes, erythrocytes, intestinal epithelium, tumor fragments). If animal feces tests were non-informative, then all medications (except vitally important) were discontinued and Nux Vomica 6CH twice a day twenty minutes prior to food intake was prescribed for 6 days (4 globules dissolved in 10 ml of water). Results: 4500 coprology tests were performed during 3 years in cats and dogs. About 10% of the total number of examined animals (449 patients) produced very little information about the state of gastrointestinal systems at the first examination. When these cases were analyzed, the following reasons were found: long-term use of strong drugs, significant weakening of body immune system. As a result diagnostic tests were of very little value. These animals were treated by Nux Vomica 6CH for 6 days and then repeated feces test was performed. This produced a more informative picture of the state of gastrointestinal system and enabled to determine etiology and pathogenesis of the animal condition and prescribe necessary treatment. Conclusion. In such a way, Nux Vomica 6CH homeopathic remedy promoted effective optimization of coprology studies in animals. The suggested scheme of use for Nux Vomica 6CH significantly improves feces test quality. This in turn reduces time needed to choose strategy and tactics of treatment of small domestic animals with different chronic diseases.

Genomic Relatedness, Antibiotic Resistance and Virulence Traits of Campylobacter jejuni HS19 Isolates From Cattle in China Indicate Pathogenic Potential

Although campylobacteriosis is a zoonotic foodborne illness, high-risk isolates from animal sources are rarely characterized, and the pathogenic potential of zoonotic strains remains an obstacle to effective intervention against human infection. HS19 has been acknowledged as a maker serotype represented by Campylobacter jejuni (C. jejuni) isolates from patients with post-infection Guillain-Barré syndrome (GBS), which is circulation in developed countries. However, a previous serotype epidemiological study of C. jejuni isolates in an animal population revealed that HS19 was also prevalent in isolates from cattle in China. In this study, to investigate the hazardous potential of zoonotic strains, 14 HS19 isolates from cattle were systematically characterized both by genotype and phenotype. The results showed that all of these cattle isolates belonged to the ST-22 complex, a high-risk lineage represented by 77.2% HS19 clinical isolates from patients worldwide in the PubMLST database, indicating that the ST-22 complex is the prominent clonal complex of HS19 isolates, as well as the possibility of clonal spread of HS19 isolates across different regions and hosts. Nevertheless, these cattle strains clustered closely with the HS19 isolates from patients, suggesting a remarkable phylogenetic relatedness and genomic similarity. Importantly, both tetracycline genes tet(O) and gyrA (T86I) reached a higher proportional representation among the cattle isolates than among the human clinical isolates. A worrying level of multidrug resistance (MDR) was observed in all the cattle isolates, and two MDR profiles of the cattle isolates also existed in human clinical isolates. Notably, although shared with the same serotype HS19 and sequence type ST-22, 35.7% of cattle isolates induced severe gastrointestinal pathology in the IL-10–/– C57BL/6 mice model, indicating that some bacteria could change due to host adaptation to induce a disease epidemic, thus the associated genetic elements deserve further investigation. In this study, HS19 isolates from cattle were first characterized by a systematic evaluation of bacterial genomics and in vitro virulence, which improved our understanding of the potential zoonotic hazard from food animal isolates with high-risk serotypes, and provided critical information for the development of targeted C. jejuni mitigation strategies.

Attention U-Net ensemble for interpretable polyp and instrument segmentation

The difficulty associated with screening and treating colorectal polyps alongside other gastrointestinal pathology presents an opportunity to incorporate computer-aided systems. This paper develops a deep learning pipeline that accurately segments colorectal polyps and various instruments used during endoscopic procedures. To improve transparency, we leverage the Attention U-Net architecture, enabling visualisation of the attention coefficients to identify salient regions. Moreover, we improve performance by incorporating transfer learning using a pre-trained encoder, together with test-time augmentation, softmax averaging, softmax thresholding and connected component labeling to further refine predictions.

PSX-B-26 Mitotic activity of immune cells in the intestines of piglets in the treatment of gastrointestinal pathology

The study aimed to evaluate the effect of a drug based on the granulocyte-macrophage colony-stimulating factor (GM-CSF) on intestinal immune cells’ mitotic activity in treating gastrointestinal pathology. Two groups of 40 sick piglets with diarrhea at the age of 5–7 days were formed. The 1st group was the control. Animals of the 2nd group received an intramuscular injection of “Quinokol”(enrofloxacin) at a dose of 0.5 ml / 10 kg once a day for 5 days. The 3d - “Quinokol” at the same dose combined with GM-CSF at a dose of 0.1 ml/kg twice with an interval of 48 hours. From forcedly slaughtered piglets (by Directive 93/119 / EC) with the diarrheal syndrome (n = 4) and from animals of the experimental groups (n = 4), duodenum sites were taken for research. Immunohistochemical study of Ki-67 expression with additional staining with hematoxylin Karratsi was carried out according to the method described by V. Stafford. Cell counting and morphometric changes were performed using the ImageJ software. In preparations from sick piglets and piglets, which were used “Quinokol”, the main mitotic activity was 0.0036 ± 0.00047 and 0.0041 ± 0.00054 mitoses / μm2, respectively (fig 1 - A). Single Ki-67-positive cells were found in the stroma of the villi, vascular walls, and submucosa. In some areas, the bean or rod-shaped nucleus of Ki-67 positive cells was distinguished. At the samples from the 3d group (fig 1 - C, D), a sharp increase in the mitotic activity of immune cells in the stroma of the villi was noted - 0.0067 ± 0.00072 mitoses/μm2 and significantly more than in the 1st and 2nd groups by 64% and 86%, respectively (P < 0.001). The combined use of “Quinokol” with GMC-SF increased cell hyperplasia in the villous stroma, which indicates the activation of local intestinal immunity.

EP.FRI.752 Delay to Surgery in Acute Perforated and Ischaemic Gastrointestinal Pathology – A Systematic Review

Aims Patients with acute abdominal pathology requiring emergency laparotomy who experience a delay to theatre have an increased risk of morbidity, mortality and complications. The timeline between symptom onset and operation is ill-defined with international variance in assessment and management. This systematic review aims to define where delays to surgery occur and assess the evidence for previous interventions. Methods A systematic review was performed searching MEDLINE and EMBASE databases (January 1st 2005 to May 6th 2020). All studies assessing the impact of time to theatre in patients with acute abdominal pathology requiring emergency laparotomy were considered. Results 17 studies were included in the final analysis. 15 unique timepoints were identified in the patient pathway between symptom onset and operation which could be classified into four distinct phases. Time from admission to theatre (1 to 72 hours), and mortality rate (10.6-74.5%) varied greatly between studies. Mean time to surgery was significantly higher in deceased patients compared to survivors. Delays were related to imaging, diagnosis, decision-making, theatre availability and staffing. Four of five interventional studies showed a reduced mortality following introduction of an acute laparotomy pathway. Conclusions There is wide variation in the definition and measurement of time delays prior to emergency surgery with few studies exploring interventions. Given the heterogenous nature of the patient population and pathologies, an assessment and management framework from onset of symptoms to operation is proposed. This could be incorporated into national mortality prediction and audit tools and assist in the assessment of interventions.

“Stranger things” in the gut: uncommon items in gastrointestinal specimens

Organic (such as parasites or vegetable remnants) and inorganic substances may be encountered during routine pathology diagnostic work up of endoscopic gastrointestinal biopsy samples and major resections, causing possible diagnostic conundrums for the young and not so young pathologists. The main aim of this review is the description of the most frequent oddities one can encounter as foreign bodies, in gastrointestinal pathology, on the basis of the current literature and personal experience. The types of encountered substances are divided into four principal categories: parasites (helminths such as Enterobius vermicularis, Strongyloides, Schistosoma, and Anisakis, and protozoa such as Entamoeba, Giardia and some intestinal coccidia); drugs and pharmaceutical fillers (found as deposits and as bystanders, innocent or not); seeds (possibly confused with worms) and plant remnants; pollutants (secondary to post-resection or post-biopsy contamination of the sample). An ample library of images is provided in order to consent easy referencing for diagnostic routine.

Efficacy of hyperbaric oxygenation in the complex treatment of new coronavirus infection COVID-19

Purpose of the study: evaluation of the therapeutic effectiveness of hyperbaric oxygenation in the complex treatment of a new coronavirus infection – COVID-19. Materials and Methods: we studied 190 patients with COVID-19-induced pneumonia (mean age 52.2 ± 2.3 years), the study group (95 patients; 41 women, 54 men) received against the background of complex treatment courses of hyperbaric oxygenation № 3-5; at pressure 1.3-1.4 ATA for 40-60 minutes; comparison group (n = 95; 42 women; 53 men) received standard complex treatment. The concomitant diseases in most patients were: arterial hypertension (stage I-II), obesity (stage II-IV) and type 2 diabetes mellitus. Results: a more pronounced therapeutic effect was noted in the main group of patients: only 3 patients were admitted to the intensive care unit, while in the comparison group – 10 patients, 2 of whom died. The presented data suggest that the use of HBO can quickly achieve correction of hypoxia in patients with new coronavirus infection, improve lung function, as well as improve the course of related diseases, including symptoms related to gastrointestinal pathology, cardiovascular disease, mental conditions, etc., affecting the body as a biostimulant. Conclusion: hyperbaric oxygenation in patients with new coronavirus infection caused by SARS-CoV-2 virus is an effective method and has a multifactorial effect leading both to improvement of subjective state parameters of the examined patients and to increase of hemoglobin oxygen saturation, decrease of lipid peroxidation processes intensity, activation of antioxidant system of the body, restoration of pro- and antioxidants balance, normalization of apoptosis processes.