Chronic pancreatitis: about some complications and features of their pathogenesis and course

The review article provides up-to-date information on the complications of pancreatitis that are important for the tactics and strategy of patient management both at the inpatient and outpatient stages of observation. The purpose of the review was to emphasize the importance of complications for the course and life of patients with chronic pancreatitis. The authors draw the attention of internists to the course of such complications as pseudocysts, cysts, fistulas, thrombohemorrhagic, cholestatic syndromes, compression syndrome of adjacent organs, pancreatic encephalopathy (acute and chronic). The symptomatology of complications of chronic pancreatitis is discussed in detail, which is very important for differential diagnosis with the corresponding diseases. Such complications include the formation of erosive and ulcerative lesions, varicose veins of the esophagus and bleeding from varicose veins of the esophagus and stomach, portal hypertension syndrome with pancreatic ascites and chronic pancreatic encephalopathy, idio­pathic non-cirrhotic portal hypertension, pancreatic cancer. The authors emphasize the need to analyze the corresponding symptoms, indicating the possibility of complications, negative consequences with each recurrence or exacerbation of chronic pancreatitis, since it concerns the prognosis and life of the patient.

COMBINATION OF SEVERE DESTRUCTIVE SPONDYLITIS IN THE ONSET OF INFLAMMATORY BOWEL DISEASE IN A 13-YEAR-OLD ADOLESCENT

The paper presents a clinical case of severe destructive ankylosing spondylitis in a 13-year-old adolescent in combination with inflammatory bowel disease, in the onset of which serious functional limitations, high inflammatory activity and multiple erosive spinal injuries were revealed. The search for the causes of such an unusually of such an unusually severe course of spondyllitis after exclusion of infectious osteomyelitis, malignant neoplasms, non-bacterial osteomyelitis led to the discovery of asymptomatic ileocolitis, with a high degree of activity, massive ulcerative lesions of the ileum and colon, despite the complete absence of clinical gastrointestinal symptoms.

Carvone Attenuates Irinotecan-Induced Intestinal Mucositis and Diarrhea in Mice

Intestinal mucositis is referring to inflammatory or ulcerative lesions of the oral or gastrointestinal tract; one of the main reasons is treatment with cancer chemotherapy. The prodrug Irinotecan is converted by carboxylesterase to the active metabolite SN-38, conjugated by UGT enzyme to SN-38G and then deconjugated by ?-glucoronidase produced by intestinal bacterial flora to produce SN-38. Irinotecan induces intestinal mucositis and diarrhea due to increased concentration of its active metabolite (SN-38).To evaluate the protective effect of carvone, I.P injection of (75mg/kg/day) of irinotecan for 4 days to induce intestinal mucositis, carvone administered to mice orally for 6 days starting from day 1. Results showed that carvone (50mg/Kg and 100mg/Kg) significantly and by dose-dependent manner attenuated body weight loss (-9.39±1.56 vs. -23.21±1.65 %), diarrhea scores (0.50±0.244 vs. 2.67±0.211) and serum TNF-? level (1361.44±55.075 vs. 3402.12±321.56 ng/ml) compared to experimental model group. In conclusion, carvone exerted a dose dependent anti-inflammatory and protective effect by attenuation irinotecan-induced intestinal mucositis.

Trichinosis in the Rostov oblast

In the Russian Federation, cases of infection with trichinosis in a population of people or animals are annually recorded. Trichinosis is intestinal and tissue helminthiasis of humans and a number of mammals, caused all over the world by nematodes. A person becomes infected with the parasite by eating meat containing live encapsulated Trichinella larvae. Mating takes place in the gastrointestinal tract, fertilized females are introduced into the intestinal mucosa with their anterior thinned ends. The clinical picture of trichinosis is accompanied by the development of myositis, degeneration of muscle fibers, and multiple edema. Deaths are not uncommon due to necrotic ulcerative lesions of the intestine and internal bleeding.

MORPHOLOGICAL CHANGES IN THE MUCOUS MEMBRANE OF THE STOMACH AND DUODENUM IN ACUTE EROSIVE - ULCERATIVE LESIONS OF VARIOUS ETIOLOGICAL ORIGIN.

The article considers morphological disorders of cellular renewal of the stomach and duodenal mucosa in acute erosive-ulcerative lesions of various etiological origins (stress ulcers)

Ulcerative Lesions of the Oral Cavity

Apart from dental and periodontal diseases, oral mucosal lesions are also frequently encountered by both general dentists and dental specialists in outpatient clinics. Although these soft tissue lesions may only reveal a localized issue, sometimes they may be the only sign of a more serious underlying systemic condition. Thus, oral ulcerations pose a unique diagnostic challenge for healthcare providers and should be cautiously handled when they last for more than two weeks, even after any possible traumatic etiologies are eliminated. There are many different classifications regarding oral ulcerations based on their etiologic or clinical features. In order to provide a logical and simple stepwise guidance to accurate diagnosis, this chapter will categorize and explain these lesions based on their clinical properties.

Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis

Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the medical records of 65 patients with unexplained chronic recurrent abdominal pain (CAP) who were assessed using VCE between 2001 and 2021. We also conducted a systematic review and meta-analysis of the literature to validate our results. The positive findings of 27 (41.5%) of the 65 patients were mostly ulcerative lesions including stricture (n = 14, 60.9%) and erosion (n = 8, 29.7%). Multivariate analysis identified elevated ESR (OR, 1.06, 95% CI, 1.02–1.1, p = 0.004) as a significant risk factor for enteropathy predicted by VCE. Three eligible studies in the meta-analysis included 523 patients with CAP. Elevated C-reactive protein (CRP) (OR, 14.09; 95% CI, 2.81–70.60; p = 0.001) and erythrocyte sedimentation rate (ESR) (OR, 14.45; 95% CI, 0.92–227.33; p = 0.06) indicated VCE-positive findings in patients with unexplained abdominal pain. Elevated levels of the inflammatory markers ESR and CRP can thus predict positive VCE findings in patients with CAP.

Oral manifestations detected in COVID-19 patients: an integrative review

The aim of this integrative review consisted of verifying whether the oral manifestations detected in patients diagnosed with COVID-19 are useful in diagnosing the disease, whether they are a manifestation resulting from the disease, or whether there is evidence that there is no correlation between the pathologies. Therefore, articles in the PubMed, Lilacs, Scopus, Science Direct, Web of Science and Embase databases were searched, in addition to the search in gray literature. The terms used in the search were: “COVID-19” or “Sars-Cov-2” or “coronavirus” and “oral conditions” or “oral health” or “oral manifestations” and “diagnosis/complications” or “symptoms”. Thus, 1.305 articles were selected, of which 61 were selected to compose this review. Most of the included studies considered oral symptoms as taste changes, xerostomia and ulcerative lesions in the oral and labial mucosa. All symptoms related to this pathology still need further studies and investigations so that all mechanisms and manifestations related to it are completely elucidated.

Initial Clinical Experience With a Simple, Home System for Early Detection and Monitoring of Diabetic Foot Ulcers: The Foot Selfie

Background: Diabetic foot ulcers (DFUs) are a leading cause of disability and morbidity. There is an unmet need for a simple, practical, home method to detect DFUs early and remotely monitor their healing. Method: We developed a simple, inexpensive, smartphone-based, “ Foot Selfie” system that enables patients to photograph the plantar surface of their feet without assistance and transmit images to a remote server. In a pilot study, patients from a limb-salvage clinic were asked to image their feet daily for six months and to evaluate the system by questionnaire at five time points. Transmitted results were reviewed weekly. Results: Fifteen patients (10 male) used the system after approximately 5 minutes of instruction. Participants uploaded images on a median of 76% of eligible study days. The system captured and transmitted diagnostic quality images of the entire plantar surface of both feet, permitting clinical-management decisions on a remote basis. We monitored 12 active wounds and 39 pre-ulcerative lesions (five wounds and 13 pre-ulcerative lesions at study outset); we observed healing of seven wounds and reversal of 20 pre-ulcerative lesions. Participants rated the system as useful, empowering, and preferable to their previous methods of foot screening. Conclusions: With minimal training, patients transmitted diagnostic-quality images from home on most days, allowing clinicians to review serial images. This system permits inexpensive home foot screening and monitoring of DFUs. Further studies are needed to determine whether it can reduce morbidity of DFUs and/or the associated cost of care. Artificial intelligence integration could improve scalability.