Letteratura scientifica selezionata sul tema "Therapy of digestive disorders"

Gastroeintestinal diseases are one of the most common groups of diseases among small domestic animals. The gastro-intestinal tract includes the oral cavity, pharynx, esophagus, stomach, pancreas, small intestine and large intestine. General signs of digestive system disorders in cats with diseases of the digestive tract are vomiting, regurgitation, capricious appetite, as well as various defecation disorders: diarrhea, coprostasis, various inclusions in feces (blood, mucus). Diseases of the gastrointestinal tract of a chronic nature often involve the manifestation of symptoms on an ongoing basis or are recur-rent in nature. Chronic gastritis, enteropathy, pancreatitis require specialized diets that normalize the functioning of the digestive tract and help improve digestive function. These therapeutic complete diets are presented in ready-made feeds in dry (pellets) and wet (pates, pouches) variations from many manufacturers of industrial feeds. Dietary therapy is required long-term or lifelong; during remission it is the basis in the treatment of chronic patients. The compositions of these diets take into account the physiological and specific needs of the animal, and are also developed on the basis of easily digestible ingredients and a reduced amount of fat, but completely replenishing the required amount of calories.

This mini-review provides an overview of pancreatic disorders, including acute and chronic pancreatitis, pancreatic cancer, and diabetes. The pancreas plays a crucial role in the digestive and endocrine systems of the body, producing enzymes that aid digestion and hormones that regulate blood sugar levels. Acute pancreatitis is a sudden and severe inflammation of the pancreas, often caused by gallstones or excessive alcohol consumption, and requires hospitalization, pain management, and intravenous fluids to support the pancreas. Chronic pancreatitis is a long-term inflammation of the pancreas that may lead to permanent damage and impairment of digestive function. Pancreatic cancer is a malignant tumor that forms in the pancreas and is often difficult to detect and diagnose in its early stages. Treatment for pancreatic cancer may include surgery, chemotherapy, and radiation therapy, depending on the type and stage of the cancer. Diabetes is a metabolic disorder that affects the body’s ability to produce or use insulin, and there are two main types of diabetes: type 1 and type 2. Type 1 diabetes is usually diagnosed in children and young adults and requires lifelong insulin therapy, while type 2 diabetes can often be managed with lifestyle modifications and medication.

The aim of the study was to identify the features of the influence of autoprobiotic and probiotic E. faecium strains on clinical and laboratory parameters in children with functional gastroenterological pathology.Patients and methods. In the period 2020–2021. 35 children over 3 years of age with functional gastrointestinal disorders (FGID) were observed on an outpatient basis, who were prescribed an autoprobiotic or probiotic strain E. faecium for therapeutic purposes and recommended a diet.The study protocol provided for clinical and anamnestic screening, FGID diagnostics; analysis of coprograms and assessment of the composition of the intestinal microbiota in children before and after a course of probiotics. The study of intestinal microbiota was carried out by RT-PCR in feces using a set of primers “Colonoflor”. One patient was excluded from the study due to refusal to take the autoprobiotic.The rest of the patients formed two groups: group 1 (n = 16)—children who received the autoprobiotic strain and group 2 (n = 18)—children who received the conditionally “reference” strain E. faecium L3. Probiotics were used in the form of a liquid form (which is a starter culture based on soy protein isolates containing 109 CFU in 1 ml) at a dose of 25 ml 2 times a day for 10 days.The results of using probiotic strains were evaluated on the basis of data from a survey of parents about the state of children and the dynamics of clinical manifestations, as well as changes in the values of indicators of coprograms and the composition of the intestinal microbiota.Statistical processing of the results was carried out using Student’s t-test, Mann-Whitney U-test; Wilcoxon test. The results were considered reliable at a significance level of p <0.05.Results. Studies of the effect of prescribing E. faecium L3 strain and an autoprobiotic strain to children with FROP revealed a positive effect on the clinical symptoms of the disease (in 29.4% and 25%, respectively) in the absence of undesirable side effects. Analysis of the dynamics of coprograms revealed an equivalent positive dynamics in the form of improvement in most of the studied stool characteristics. The study of the composition of the intestinal microbiota in the observed children revealed a low level of Lactobacilli and Enterococcus before and after the administration of probiotics. After the course of the E. faecium L3 strain, a significant increase in the content of F. prausnitzii was noted. The use of an autoprobiotic strain contributed to a significant decrease in the frequency of isolation of conditionally pathogenic bacteria in large numbersConclusion. The course appointment of autoprobiotic and probiotic E. faecium strains in children with FGID has a positive effect on clinical symptoms, improvement of most coprogram indices and normalization of the intestinal microbiota composition.

Lactose intolerance is a digestive problem with a high incidence worldwide. The disease occurs mainly due to a lack or deficiency of lactase in the body, which prevents effective digestion of lactose. Congenital lactose intolerance is caused by a genetic defect that prevents the body from producing enough lactase, and its incidence is relatively low. Secondary lactose intolerance is caused by other gastrointestinal disorders, such as celiac disease, and is relatively common. Functional lactose intolerance is the most common form of lactose intolerance, in which lactase activity is reduced or lactose absorption is impaired, but there is no apparent organic disease. This article lists several possible solutions for different types of lactose intolerance based on the latest research. In studies of lactose intolerance, scientists have found that the rate of lactose intolerance varies widely across populations, with significant differences in prevalence by race and region. In addition, several studies have shown a link between lactose intolerance and the composition of the gut microbiome. Therefore, the study of lactose intolerance has important implications for understanding how the human digestive system works and the relationship between the gut microbiome and health.

Functional dyspepsia represents a heterogeneous group of gastrointestinal disorders marked by the presence of upper abdominal pain or discomfort. Reported prevalence of dyspepsia in the world varies from 11-30%. Basic Pathophysiology of functional dyspeptic symptoms is unclear and is considered to occur due to a combination of visceral hypersensitivity, gastric motor dysfunction and psychological factors. Strategies such as acid suppression, prokinetics and H. pylori eradication have been used with some success. Transient deficiency in digestive enzymes is one of the contributors for functional dyspepsia. The primary digestive enzymes are proteases, amylases and lipases. A commonly used therapeutic approach in its treatment is the use of oral enzymes supplementation therapy. Commercially, digestive enzymes are obtained from plant, animal and microbial sources. This review summarizes the pathophysiology of functional dyspepsia, different pharmacological approaches and focuses on the safety and efficacy of digestive enzymes in managing dyspepsia. Keywords including functional dyspepsia, digestive enzymes, lipase, diastase, papain, pepsin, trypsin and chymotrypsin were searched in databases such as Google, Google Scholar, PubMed, pharmacopoeia and textbooks.

Oxygen therapy remains a cornerstone of medical practice and is generally regarded as being safe. However, there is a lack of clinical evidence to support the routine use of oxygen therapy, and in certain conditions, injudicious oxygen may cause harm. In this thesis, I will present two audits and three randomised controlled trials of oxygen therapy. Methods  A prospective audit of the prescription and use of oxygen therapy before and after the introduction of an oxygen prescription section on a drug chart  A retrospective audit of ambulance oxygen administration, in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD)  Two randomised controlled trials of high flow versus titrated oxygen in 150 patients with community acquired pneumonia and 106 patients with acute severe asthma  A randomised controlled trial of 24 subjects with obesity hypoventilation syndrome (OHS) comparing 100% oxygen with air Results  Oxygen prescription is suboptimal in hospital inpatients. Whilst an oxygen prescription section improved prescription, this intervention did not improve clinical practice  Over 70% of patients presenting with AECOPD received high flow oxygen prior to presentation to the emergency department. The risk of adverse outcomes increased progressively with increased PaO2  High concentration oxygen leads to a rise in PaCO2 compared to titrated oxygen, when administered to patients presenting with asthma or pneumonia  Breathing 100% oxygen leads to a rise in PaCO2 in patients with OHS Conclusion This series of studies has shown that further measures are warranted to ensure the safe practice of oxygen therapy in the pre-hospital and hospital setting. In addition, the findings suggest that the potential for high concentration oxygen therapy to increase PaCO2 is not limited to COPD but may occur in other respiratory conditions in which abnormal gas exchange or respiratory drive are present.

Introduction Epithelial homeostasis is guaranted by somatic stem cells wich, through different patways, such as p63 and Notch signaling, self-renew, differentiate and control tissue function and integrity. In vivo behavior of epithelial stem cells (ESCs) from different epithelia reflects differences in physiological role of the tissue. Limbal stem cells deficiency (LSCD) is characterized by conjunctival epithelial ingrowth, neovascularization, recurrent corneal erosion and persistent ulcers, as well as corneal scarring and ultimately leads to visual impairment and blindness. When the cornea is entirely covered with a fibro-vascular tissue, the chances of success of a traditional penetrating keratoplasty are virtually absent. Transplantation of autologous limbal epithelial stem cells (LESCs) or oral mucosa epithelial stem cells (OMESCs) cultured on fibrin glue has shown to be successful for unilateral or bilateral LSCD treatment, respectively. Despite that, fibrin presented several limitations including inability to repair or replace damaged corneal stroma. Aim The purpose of this work is to better understand the potentiality of somatic epithelial stem cells in order to identify possible approaches to exploit this potentiality. In the light of this, my research group has been able to identify and set up a cell therapy approach for a unique homozygous-heterozygous mosaicism of EEC Syndrome, demonstrating that epithelial stem cells have an intrinsic potential for regenerative medicine that can be exploited with a deeper characterization. We, also, aimed to test human keratoplasty lenticules (HKLs): particularly attractive, full-thickness scaffolds for corneal epithelial and stromal reconstruction that provides an interesting organotypic culture system for evaluation of growth, proliferation, and differentiation processes of epithelial stem cells (ESCs). Results During the three years of PhD I had the opportunity to collect and review cellular biology data of four diverse types of primary epithelial cells, derived from four different epithelia (skin, oral mucosa, limbus/cornea and conjunctiva) and, to better investigate the exhaustion of clonogenic potential and the self-renewal of epithelial stem cells we took in consideration also p63-defective oral mucosa primary cell lines obtained from three patients affected by EEC syndrome, already known to cause an acceleration in epithelial aging. Demonstrating that epithelial stem cells have an intrinsic potential for regenerative medicine that can be exploited with a deeper characterization, we have also been able to apply a cell therapy protocol to a patient affected by EEC syndrome in a rare form of mosaicism. We isolated the cell population with a mild phenotype from this patient, enriching these primary cells in vitro and producing well-organized and stratified epithelial sheets. The novelty and the importance of this case was related to the possibility to start a customized cell therapy approach for this unique case of EEC syndrome, based solely on epithelial stem cell manipulation. Limbal stem cells (H-LESCs) expanded onto HKLs gave rise to a keratinized stratified squamous epithelium morphologically similar to that of normal corneas. To set up the cohort of animal patients, we proceded with the characterization of cell lines obtained from biopsies of the cornea (C-CESCs) and oral mucosa (C-OMESCs) of canine origin. Primary lines were serially propagated until exhaustion in order to get life span data to compare their behavior with human limbal stem cells. For each passage, we also performed colony forming efficiency assays (CFE) to estimate the proportion of clonogenic cells present in the culture. Results showed a trend of canine cell lines comparable to human limbal cells trend, with a similar decrease of clonogenic cells number, a similar percentage of aborted colonies during serial cultivation and a similar replicative senescence. Then, primary human and canine epithelial stem cells were seeded onto HKLs. The resulting epithelia was well organized and stratified into four to five cell layers with basal cuboidal cells differentiating upward to winged cells. The layer of basal cuboidal cells was firmly attached to the underlying ECM and to the basement membrane through integrinβ4. Maintenance of stemness potential and differentiation pathways were assessed checking the expression of the stem cells marker p63 and the terminally differentiated cells marker Involucrine. Importantly, expression of the different markers resembled that observed in normal epithelia, thus suggesting that HKLs are able to support the growth and maintain the differentiation pathways of epithelial stem cells. Discussion and conclusions Our findings demonstrate that primary epithelial cells have unique characteristics with an inimitable potential that makes them a malleable tool, able to adapt to different necessities. And so on, although these data are intriguing, further investigation could provide more and more useful data for their clinical application in regenerative medicine. As a proof-of-principle that epithelial stem cells have an intrinsic potential for regenerative medicine that can be exploited with a deeper characterization, my group have been able to apply, in vitro, a cell therapy protocol to a patient affected by a rare mosaic form of EEC syndrome. HKLs appear to be particularly attractive, animal-free (feeder-free) and full-thickness scaffolds for corneal reconstruction. We have already started with the the recruitment of canine patients to assess the transplantability and functionality of these organotypic structures and, through the collaboration with different veterinary departments, we are creating a small cohort on which to start with first transplantation trials.
Introduzione L'omeostasi epiteliale è garantita da cellule staminali somatiche che, attraverso diversi pathways, come quello di p63 o di Notch, si auto-rinnovano, differenziano e controllano la funzione e l'integrità del tessuto. Il comportamento in vivo delle cellule staminali epiteliali (ESC) di diversi epiteli riflette le differenze nel ruolo fisiologico che queste cellule hanno nel tessuto di origine. Il deficit di cellule staminali limbali (LSCD) è caratterizzato da crescita epiteliale congiuntivale, neovascolarizzazione, erosione corneale ricorrente e ulcere persistenti, nonché cicatrici corneali, e porta infine a deficit visivo e cecità. Quando la cornea è interamente coperta da un tessuto fibro-vascolare, le probabilità di successo di una cheratoplastica penetrante tradizionale sono praticamente assenti. Il trapianto di cellule staminali epiteliali autologhe del limbus (LESCs) o di cellule staminali epiteliali della mucosa orale (OMESCs) coltivate su scaffold di fibrina ha dimostrato di avere successo per il trattamento unilaterale o bilaterale di LSCD, rispettivamente. Nonostante ciò, la fibrina presentava numerose limitazioni tra cui l'incapacità di riparare o sostituire lo stroma corneale danneggiato. Scopo Lo scopo di questo lavoro è quello di comprendere meglio la potenzialità delle cellule staminali epiteliali somatiche al fine di identificare possibili approcci per sfruttare questa potenzialità. Alla luce di ciò, il mio gruppo di ricerca è stato in grado di identificare e impostare un approccio di terapia cellulare per un caso unico di mosaicismo omozigote-eterozigote della Sindrome EEC, dimostrando che le cellule staminali epiteliali hanno un potenziale intrinseco per la medicina rigenerativa che può essere sfruttata con una caratterizzazione più profonda. Un secondo scopo della tesi è stato quello di testare gli Human Keratoplasty Lenticules (HKL): scaffolds particolarmente attraenti per la ricostruzione a tutto spessore della superficie anteriore dell’occhio che fornisce, anche, un interessante sistema di coltura organotipica per la valutazione dei processi di crescita, proliferazione e differenziazione delle cellule staminali epiteliali (ESCs ). Risultati Durante i tre anni di dottorato ho avuto l'opportunità di raccogliere e rivedere i dati di biologia cellulare di quattro diversi tipi di cellule epiteliali primarie, derivate da quattro diversi epiteli (pelle, mucosa orale, limbus/cornea e congiuntiva) e, per studiare meglio l'esaurimento del potenziale clonogenico e dell'auto-rinnovamento delle cellule staminali epiteliali abbiamo preso in considerazione anche delle linee cellulari primarie di mucosa orale con difetti genetici del gene p63 già noti per causare un'accelerazione nell'invecchiamento epiteliale, ottenute da tre pazienti affetti da sindrome EEC. Dimostrando che le cellule staminali epiteliali hanno un potenziale intrinseco per la medicina rigenerativa che può essere sfruttato con una caratterizzazione più profonda, siamo stati anche in grado di applicare un protocollo di terapia cellulare a un paziente affetto da sindrome EEC in una rara forma di mosaicismo. Abbiamo isolato la popolazione cellulare con un fenotipo lieve da questo paziente, arricchendo queste cellule primarie in vitro e producendo foglietti epiteliali ben organizzati e stratificati. La novità e l'importanza di questo caso è legata alla possibilità di iniziare un approccio di terapia cellulare personalizzata per questo caso unico di sindrome EEC, basata esclusivamente sulla manipolazione delle cellule staminali epiteliali. Le cellule staminali limbari (H-LESC) coltivate su HKL hanno dato origine a un epitelio squamoso stratificato cheratinizzato morfologicamente simile a quello delle cornee normali. Per costituire la coorte di pazienti animali, abbiamo proceduto alla caratterizzazione di linee cellulari ottenute da biopsie della cornea (C-CESCs) e mucosa orale (C-OMESCs) di origine canina. Le linee primarie sono state propagate in serie fino ad esaurimento al fine di ottenere dati di life span per confrontare il loro comportamento con le cellule staminali limbari umane. Per ogni passaggio, abbiamo anche eseguito analisi di Colony Forming Efficiency (CFE) per stimare la proporzione di cellule clonogeniche presenti nella coltura. I risultati hanno mostrato una tendenza delle linee cellulari canine comparabile all'andamento delle cellule limbari umane, con una diminuzione simile del numero di cellule clonogeniche, una percentuale simile di colonie abortive durante i passaggi in coltura e una simile senescenza replicativa. Quindi, cellule staminali epiteliali primarie umane e canine sono state seminate su HKL. L'epitelio risultante era ben organizzato e stratificato in quattro o cinque strati cellulari con cellule cuboidali basali che differenziano le cellule verso l'alto e quelle alate. Lo strato di cellule cuboidali basali era saldamente attaccato alla matrice extracellulare sottostante e alla membrana basale attraverso l'integrina-4. Sono stati valutati il mantenimento del pool di cellule staminali e i corretti processi di differenziamento controllando l'espressione del marcatore di cellule staminali, p63, e del marcatore di cellule terminalmente differenziate, Involucrina. È importante sottolineare che l'espressione dei diversi marcatori assomiglia a quella osservata negli epiteli normali, suggerendo quindi che gli HKL sono in grado di supportare la crescita e il mantenimento di tessuti epiteliali ricostruiti. Discussione e Conclusioni I nostri risultati dimostrano che le cellule epiteliali primarie hanno caratteristiche uniche con un potenziale inimitabile che le rende uno strumento malleabile, in grado di adattarsi alle diverse necessità. Sebbene questi dati siano intriganti, ulteriori indagini potrebbero fornire dati sempre più utili per la loro applicazione clinica nella medicina rigenerativa. Come prova di principio che le cellule staminali epiteliali hanno un potenziale intrinseco per la medicina rigenerativa che può essere sfruttato con una caratterizzazione più profonda, il mio gruppo è stato in grado di applicare, in vitro, un protocollo di terapia cellulare a un paziente affetto da un raro mosaicismo di sindrome EEC. Le HKL sembrano essere scaffold particolarmente attraenti (animal-free) per la ricostruzione a tutto spessore della cornea. Abbiamo già iniziato con il reclutamento di pazienti canini per valutare la trapiantabilità e la funzionalità di queste strutture organotipiche e, attraverso la collaborazione con diversi dipartimenti veterinari, stiamo creando una piccola coorte sulla quale iniziare con le prime prove di trapianto.

Thesis (D.C.P. / M. Sc.)--Faculty of Science, University of Sydney, 2006.
Submitted in fulfilment of the requirements for the degree of Doctor of Clinical Psychology/Master of Science to the Faculty of Science. Title from title screen (viewed 2 August 2007). Bibliography: leaves 95-107.

A new assay method for the detection of DD/E complex derived from crosslinked fibrin is developed. This assay is performed on a microtitre plate using capture/tag antibody technique, in which the monoclonal antibody against D dimer fragment (DD-3B6, MAbCO) is coated and anti-E fragment polyclonal F(ab)’2 conjugated with horse radish peroxidase is for a tag-anti body. Antigen dilution curve is drawn in the range of 0.01-1.0 pg/ml of purified DD/E complex. DD/E complex can be measured specifically and other high molecular weight derivatives from crosslinked fibrin show a little crossreaction, though fibrinogen and fibrinogen degradation products show no crossreactivities on this assay. D dimer fragment dissociated from DD/E complex after further plasmin digestion is less reactive in this assay, while this type of D dimer can be detected by DIMERTEST-EIA (MAbCO). These data suggest that an early stage of plasmin digestion of crosslinked fibrin can be detected by this method. A trace amount of DD/E complex curculating in plasma from a small thrombus is possibly detected, because this assay gives an excellent high sensitivity with the detection limit of 0.01 jug/ ml. Normal value of plasma DD/E complex (n=50) indicates below 0.12 pg/ml as 90 percentile. Patients with DIC (n=24) show high levels of DD/E complex between 0.6 and 40 g/ml. These elevated levels of DD/E complex may suggest consequently the existence of the plasmic digestion of crosslinked fibrin in the cases with DIC. In summary, it is concluded that the development of this assay will add one technique to discriminate between fibrinolysis and fibrinogenolysis and this assay is useful for the quantitative detection of DD/E complex produced in an early stage of fibrinolysis seen in various thrombotic disorders, and for the evaluation of the efficacy of thrombolytic therapy.

Review question / Objective: Is probiotic therapy as effective or more effective than existing treatments in relieving the severity of constipation and improving the patient's mental status and quality of life in elderly patients with constipation? Do probiotic treatments pose greater risks than existing treatments for older patients with constipation? Condition being studied: Constipation is a common digestive disorder with a worldwide prevalence of 14-30%, and the prevalence increases with age. Constipation seriously impairs patients' quality of life, leads to significant medical costs, and places a burden on the healthcare system. For constipation, Western medicine uses lifestyle changes, medication, psychotherapy, biofeedback, and surgery to treat the condition.

Functional disorders of digestive organs (FDOD) are frequently diagnosed disorders in childs in the first year of life. An interactive dialogue simulator has been developed for studying FROP in children. The dialogue simulator was created in the iSpring Suite program. The dialogue simulator allows students repeat the algorithm for diagnosing and treating FROP many times. It is expected, that using of interactive dialogue simulator in the discipline of faculty pediatrics will help students master their skills of diagnosing and treating FROP in childs. The using of our interactive simulator will contribute to the development of self-control in students and more solid assimilation of knowledge.