Gastrointestinal Diseases
Victor A. Bernstam in Pocket Guide to GENE LEVEL DIAGNOSTICS in Clinical Practice, 2019
Molecular cytogenetic approaches hold the promise of developing the least invasive means of objective assessment of gastrointestinal diseases. Tumor suppressor genes, known to be consistently altered or deleted in various neoplasias, including those of the gastrointestinal tract, encode products essential for the maintenance of normal growth controls. Normal human gastrointestinal mucosa contains T cell growth factor α and urogastrone epidermal growth factor. Deoxyribonucleic acid (DNA) content has been proposed as an objective criterion for differential diagnosis and/or prognosis of colorectal neoplasias. In adenocarcinomas histopathological evaluation suggested that DNA content can be used for prognostic purposes: a better prognosis could be entertained for cases of polyploid DNA content of carcinomas compared to those with an aneuploid pattern. Multiple sampling is strongly advocated to reduce the effects of marked heterogeneity of ploidy characteristics in individual samples from colorectal carcinomas. DNA ploidy assessment has some prognostic value in gastric carcinomas, but only in advanced tumors with lymph node metastases.
Assessing risk and making decisions
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol in Handbook of Aviation and Space Medicine, 2019
Assessment of potential clinical risk is the raison d’etre of the aeromedical examiner and others involved in aircrew health. Determining risk of incapacitation is the usual benchmark, but distraction may be as likely to jeopardize safe flight operations. The most common cause of in-flight incapacitation is acute gastrointestinal disease, which is usually mild in nature and self-limiting. Conditions that cause acute pain or loss of consciousness are likely to be immediately incapacitating; loss of mental capacity may render aircrew unable to safely perform critical flight duties. Single-seat aircrew, especially if flying high-performance aircraft, do not have much leeway with regards to conditions that distract or incapacitate. Most multi-crew pilots can expect to return to flying duties if their condition and/or treatment has a 10-year incapacitation risk of less than 10%. For non-pilot aircrew a 10-year incapacitation risk may be acceptable, depending on flight/mission or safety criticality of their role.
veterinary care
Jeffrey D. Fortman, Terry A. Hewett, Lisa C. Halliday in The Laboratory Nonhuman Primate, 2017
A key component of veterinary care is an effective preventative health program. This chapter provides a basic overview of some of the common elements of a preventative health program as it pertains to nonhuman primates in both a quarantine and conditioned colony. The basic goals of a quarantine program are to protect the animals in the existing colony from the introduction of infectious diseases, to protect personnel from zoonotic diseases, and to optimize the health and condition of newly acquired animals. The tuberculin skin test is currently the most practical and reliable method of detecting active tuberculosis in nonhuman primates. The body weight and body condition of a nonhuman primate provide important information on the animal's health and well-being. The chapter reviews some of the more common clinical problems seen in nonhuman primates. In general, the most common health problems encountered in a nonhuman primate colony involve gastrointestinal disease and traumatic injuries.
The role of therapeutic endoscopic ultrasound now and for the future
Published in Expert Review of Gastroenterology & Hepatology, 2014
Vinay Dhir, Rajesh Kumar Paramasivam, Josef Carlo Lazaro, Amit Maydeo
Therapeutic endoscopic ultrasound (EUS) became possible after the advent of the linear echoendoscope and the EUS guided fine needle aspiration. Over the past two decades, the indications for therapeutic EUS have expanded and evidence regarding its utility has been steadily accumulating. Randomized studies have shown EUS to be effective for cancer pain relief (celiac plexus neurolysis), pancreatic fluid collection drainage, and biliary drainage. Prospective studies have shown EUS-guided biliary drainage to be safe and effective in patients with failed ERCP. There is evidence to suggest that EUS is effective for pancreatic duct drainage, gallbladder drainage, and drainage of pelvic collections. EUS may also be useful for targeted cancer treatment via brachytherapy, radiofrequency ablation, or injection therapy. Therapeutic EUS is likely to play an increasingly important role in endoscopic therapy of gastrointestinal diseases in the near future.
Effect of commensals and probiotics on visceral sensitivity and pain in irritable bowel syndrome
Published in Gut Microbes, 2014
Vassilia Theodorou, Afifa Ait-Belgnaoui, Simona Agostini, Helene Eutamene
The last ten years’ wide progress in the gut microbiota phylogenetic and functional characterization has been made evidencing dysbiosis in several gastrointestinal diseases including inflammatory bowel diseases and irritable bowel syndrome (IBS). IBS is a functional gut disease with high prevalence and negative impact on patient’s quality of life characterized mainly by visceral pain and/or discomfort, representing a good paradigm of chronic gut hypersensitivity. The IBS features are strongly regulated by bidirectional gut-brain interactions and there is increasing evidence for the involvement of gut bacteria and/or their metabolites in these features, including visceral pain. Further, gut microbiota modulation by antibiotics or probiotics has been promising in IBS. Mechanistic data provided mainly by animal studies highlight that commensals or probiotics may exert a direct action through bacterial metabolites on sensitive nerve endings in the gut mucosa, or indirect pathways targeting the intestinal epithelial barrier, the mucosal and/or systemic immune activation, and subsequent neuronal sensitization and/or activation.
Recent advances in the diagnosis of irritable bowel syndrome
Published in Expert Review of Gastroenterology & Hepatology, 2015
The symptom-based diagnosis of irritable bowel syndrome (IBS) has not been established in everyday clinical practice, and the diagnosis of this disorder remains one of exclusion. It has been demonstrated that the densities of duodenal chromogranin A, rectal peptide YY and somatostatin cells are good biomarkers for the diagnosis of sporadic IBS, and low-grade mucosal inflammation is a promising biomarker for the diagnosis of postinfectious IBS. Genetic markers are not useful as biomarkers for IBS since the potential risk genes have yet to be validated, and the intestinal microbiota cannot be used because of the lack of an association between a specific bacterial species and IBS. Furthermore, gastrointestinal dysmotility and visceral hypersensitivity tests produce results that are too nonconsistent and noncharacteristic to be used in the diagnosis of IBS. A combination of symptom-based assessment, exclusion of overlapping gastrointestinal diseases and positive biomarkers appears to be the best way to diagnose IBS.
Related Knowledge Centers
- Duodenum
- Hypersensitivity
- Fever
- Biliary Tract
- Digestive System Diseases
- Viscera
- Abdominal Pain