Advances in the pathological mechanisms and clinical treatments of chronic visceral pain.

Chronic visceral pain stems from internal organs and is frequently associated with functional gastrointestinal disorders, like irritable bowel syndrome (IBS). Since the underlying mechanisms of visceral pain remain largely unclear, clinical management is often limited and ineffective. Comprehensive research into the pathogenesis of visceral pain, along with the development of personalized therapeutic strategies, is crucial for advancing treatment options.

Clinical Significance of histologic healing in IBD: Evidence from randomized controlled trials (RCT) and real world (RW) data.

Histologic mucosal healing (HMH) has emerged as a crucial target in managing inflammatory bowel disease, complementing the established goal of endoscopic mucosal healing. This review evaluates the significance of HMH in both Crohn's disease (CD) and ulcerative colitis (UC). In UC, strong evidence shows that HMH correlates with improved long-term outcomes, including reduced hospitalization rates, and decreased need for corticosteroids and colectomy.

Position statement of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis on the use of Telemedicine in Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD) is a chronic digestive condition that requires continuous monitoring by healthcare professionals to determine appropriate therapy and manage short- and long-term complications. Telemedicine has become an essential approach for managing chronic conditions such as IBD, improving care accessibility and continuity, decreasing hospitalization rates, and optimizing patient follow-up. It enables rapid treatment adjustments and encourages patient self-management.

Period circadian clock 3 is crucial for regulation of IL-22-producing type 3 innate lymphoid cells by flavonoids from Shen Ling Bai Zhu San to alleviate colitis.

Type 3 Innate lymphoid cells (ILC3s) functions bear complex response during Inflammatory bowel diseases (IBD). Here, our study first analyzed the main pharmacological components in Shen Ling Bai Zhu San n-butanol extracts (S-Nb), and then explored whether S-Nb administrated immune response of ILC3s, and how it regulates ILC3s. Shen Ling Bai Zhu San (SLBZS) or S-Nb were administrated for 7 days to analyze the frequency of ILC3s and their produced cytokine.

Selecting High-Risk Patients With Pediatric Crohn's Disease for Top-Down Anti-TNF as per the 2021 ECCO-ESPGHAN Guidelines: A 5-Year Nationwide Retrospective Analysis From Scotland (2016-2020).

Background: The 2021 ECCO-ESPGHAN guideline on the medical management of pediatric Crohn's disease promotes early risk stratification and top-down anti-TNF for patients deemed high risk of severe disease course.

Aims: We aimed to objectively assess the risk-benefit profile of the guideline's risk stratification policy and guidance on top-down anti-TNF in a nationwide population-based cohort study.

Methods: Using a prospectively identified nationwide cohort of all new pediatric patients (<17 years) diagnosed with Crohn's disease in Scotland between January 1, 2016 and December 31, 2020 and retrospectively applying the current management algorithm, we explored the guideline's ability to accurately risk stratify patients.

Plasma protein-based and polygenic risk scores serve complementary roles in predicting inflammatory bowel disease.

Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), has a significant genetic component and is increasingly prevalent due to environmental factors. Current polygenic risk scores (PRS) have limited predictive power and cannot inform time of symptom onset. Circulating proteomics profiling offers a novel, non-invasive approach for understanding the inflammatory state of complex diseases, enabling the creation of proteomic risk scores (ProRS).

Acute Parastomal Hernia Presentations: A 10-Year Review of Management and Outcomes.

Introduction: The acute presentation of parastomal hernia (PSH) can range from exacerbation of pain to life-threatening incarceration. Managing the acute PSH is challenging, particularly in the presence of concomitant midline incisional hernia. Most literature focuses on the outcomes of elective PSH repair.

Cracking the Codes for Congenital Diarrhea and Enteropathies (CoDEs): A Case Report and Review.

Congenital diarrhea and enteropathies (CoDEs) condition is a rare cause of chronic diarrhea in infants that can be challenging to diagnose. This article discusses key signs to recognize in considering a CoDEs diagnosis and provides an overview of the diagnostic process. We report a late preterm twin infant with intractable watery diarrhea starting shortly after birth.

Obstacles to Medication Adherence for Patients with Inflammatory Bowel Disease: A Qualitative Study in East China.

Purpose: To identify the factors impacting medication non-adherence in patients with inflammatory bowel disease (IBD) in China, and to provide a reference for effective interventions.

Patients And Methods: Individual semi-structured interviews were conducted between December 2020 and July 2021 in four tertiary hospitals in East China. A conventional content analysis method was used in data analysis to extract themes and sub-themes in IBD Patients with poor medication adherence.

An Amorphous Solid Dispersion of Baicalin and its Oral Therapeutic Effect on Ulcerative Colitis.

Objective: Ulcerative colitis (UC) treatment currently faces multiple challenges including adverse effects, prolonged therapy durations, and high costs. Baicalin (BA) has demonstrated anti-inflammatory benefits for inflammatory bowel disease, and the objective of this scholarly work is to address the challenges associated with the poor aqueous solubility and diminished oral bioavailability of the compound in question, thereby offering an innovative therapeutic approach for the management of ulcerative colitis.

Methods: We developed a baicalin-arginine complex (BA-Arg) by screening for suitable basic compounds and utilizing a freeze-drying method, resulting in an amorphous solid dispersion of BA.

Gut microbiota diversity repeatedly diminishes over time following maintenance infliximab infusions in paediatric IBD patients.

Background: The gut microbiome plays a crucial role in the pathogenesis and progression of inflammatory bowel disease (IBD). Understanding the dynamics of the gut microbiome in relation to treatment can provide valuable insights into disease management and therapy strategies. The aim of this study is to investigate if diversity and composition of the gut microbiome correlate with time since treatment and disease activity during maintenance infliximab (IFX) therapy among children with IBD.

Two-Stage Mayo Clinic Class IIIb Celiac Axis Resection for Pancreatic Adenocarcinoma: Stepwise Management.

Background: The National Comprehensive Cancer Network guidelines consider pancreatic cancer with celiac axis (CA), proper hepatic artery (PHA), and superior mesenteric artery (SMA) involvement unresectable. Thus, technical reports and video illustrations of these operations are rare. We report the stepwise management of multivascular reconstruction for Mayo Clinic class IIIb CA resections at New York University Langone Health, a dedicated center of excellence in pancreatic surgery.

Screening for frequent hospitalization risk among community-dwelling older adult between 2016 and 2023: machine learning-driven item selection, scoring system development, and prospective validation.

Background: Screening for frequent hospitalizations in the community can help prevent super-utilizers from growing in the inpatient population. However, the determinants of frequent hospitalizations have not been systematically examined, their operational definitions have been inconsistent, and screening among community members lacks tools. Nor do we know if what determined frequent hospitalizations before COVID-19 continued to be the determinant of frequent hospitalizations at the height of the pandemic.

Unraveling the gut: the pivotal role of intestinal mechanisms in Kawasaki disease pathogenesis.

Kawasaki disease (KD), an acute systemic vasculitis that primarily affects children under 5 years of age, is the leading cause of acquired heart disease in this age group. Recent studies propose a novel perspective on KD's etiology, emphasizing the gastrointestinal (GI) tract, particularly the role of gut permeability. This review delves into how disruptions in gut barrier function trigger systemic inflammatory responses, exacerbate vascular inflammation, and contribute to coronary artery aneurysms.

Treatment of Terminal Syrinx With a Syringo-Subarachnoid Shunt and the Novel Use of a Titanium Knot Fastener: A Case Report.

A syrinx involves cystic dilation of the central canal of the spinal cord due to the accumulation of cerebrospinal fluid and often results in a neurological deficit. While treatment options vary, surgical management is often utilized and requires an open durotomy. A 70-year-old female presented with one year of progressive low back pain with associated leg numbness, urinary incontinence, bilateral foot drop, and imbalance resulting in multiple falls.

Management of Fecal Incontinence: Surgical Treatment Options.

Background: Fecal incontinence (FI) is a frequent, often underestimated, health issue in adults. Its treatment is primarily nonsurgical. Only if conservative options fail to result in adequate symptom reduction should surgery be considered.

Exploring the experiences of patients who receive nutrition education for ostomy care: A qualitative research design.

Background: Ileostomy and colostomy patients benefit from more nutrition education than patients who receive bowel resections without ostomy creation. Nutrition can influence the adaptation to a stoma and may help manage complications. The impact of nutrition education on health outcomes is known, but a gap exists for the type and timing of nutrition information for patients with newly formed ostomies.

SAGES guidelines for the management of comorbidities relevant to metabolic and bariatric surgery.

Background: Patients who are under consideration for or have undergone metabolic and bariatric surgery frequently have comorbid medical conditions that may make their perioperative care more complex. These recommendations address routine intraoperative cholangiography in patients with bypass-type anatomy, the management of reflux disease after sleeve gastrectomy, and the optimal bariatric procedure for patients with comorbid inflammatory bowel disease.

Methods: A systematic review was conducted including studies published from 1990 to 2022 to address these questions.

[Work-Related Rehabilitation of Patients with Inflammatory Bowel Disease- Results of a Feasibility Study].

Purpose: Despite the increasing importance of occupational rehabilitation in chronic diseases, its role in the medical rehabilitation of patients with inflammatory bowel disease (IBD) is still limited. The aim of this study was to test a work-related concept for IBD patients with work-related problems and its acceptance by patients and rehabilitation staff. Improvements in work-related and psychosocial parameters of rehabilitants should be determined.

Rapunzel syndrome associated with trichotillomania and pica causing bowel obstruction in a 4 year-old-female: A rare case report from Nepal.

Introduction: Bezoars are an accumulation of human or vegetable fibers in the gastrointestinal tract which if extend to the small intestine are referred to as Rapunzel syndrome. They are primarily a psychiatric issue rather than a surgical condition and are associated with trichotillomania, with subsequent trichophagia, pica, and other psychiatric conditions usually seen in adolescent females. This case report describes an extremely rare diagnosis of Rapunzel syndrome in a 4-year-old female.

Single Incision Laparoscopic Surgery for Malone Antegrade Continent Enema: Optimizing Outcomes in Pediatric Bowel Management.

Background: Malone antegrade continence enemas (MACE) are increasingly being used to manage severe constipation and fecal incontinence in children. Despite advances in minimally invasive pediatric colorectal surgery, single-incision laparoscopic surgery (SILS) for MACE creation remains relatively unexplored. This study, featuring the largest cohort to date, evaluates the feasibility, safety, and clinical outcomes of SILS MACE creation in children.

Differentiated approach to management of patients with irritable bowel syndrome and ulcerative colitis in non-alcoholic fatty liver disease.

Objective: Aim: To determine the main clinical and laboratory features and severity of colon dysbiosis in irritable bowel syndrome (IBS) and IBD in patients with NAFLD.

Patients And Methods: Materials and Methods: 80 patients with NAFLD were examined. Patients were divided into two groups.

Lymph node metastasis following chemoradiotherapy in advanced rectal cancer: ypT2-focused analyses of total mesorectal excision specimens.

Background: Non-radical management is an option for good responders to neoadjuvant chemoradiotherapy in mid-to-low rectal cancer. This study aimed to analyze risk factors for lymph node metastasis in patients with ypT2 rectal cancer, exploring the possibility of non-radical management.

Methods: We included patients with ypT2 rectal cancer who received neoadjuvant chemoradiotherapy followed by total mesorectal excision between January 2004 and December 2022.

Contemporary trends in utilization of metastasectomy in the era of targeted and immunotherapies.

Background: Metastasectomy is a useful adjunct in the management of metastatic cancer. Widespread adoption of novel targeted and immunotherapies has improved the survival profiles of multiple malignancies, which has potentially altered the role of metastasectomy. This study aimed to characterize trends in metastasectomy across five primary cancers eligible for these therapies.