Effects of erythropoietin on bacterial translocation in a rat model of experimental colitis.

OBJECTIVES: In this experimental study, it was aimed to assess the effects of erythropoietin (EPO) on bacterial translocation in a rat model of colitis. MATERIAL AND METHODS: The rats were randomly assigned into control, colitis and EPO-treated groups (n= 8 in each group). Saline solution (NS) was administered to control rats via rectal route. A trinitrobenzene sulfonic acid and ethanol mixture (TNBS-E) was used to induce colitis in the experiment groups. No treatment was administered to colitis group after induction. Starting at one day after induction of colitis with TNBS-E, EPO (1000 IU/kg) was administered subcutaneously for three days to the rats in the EPO-treated group. Colonic inflammation was assessed by gross and microscopic examination on day five. Blood samples were obtained to evaluate bacterial translocation while hepatic, mesenteric tissue samples and mesenteric lymph node (MLN) samples were collected for tissue culture. Tissue myeloperoxidase (MPO) levels, and tumor necrosis factor alpha (TNF- α) and endotoxin levels in the sera were studied. RESULTS: Significant gross and microscopic differences were found in the comparison between colitis and EPO-treated groups (p <0.05). MPO level was significantly lower when compared to the colitis group (p <0.05). Serum TNF-α and plasma endotoxin levels were significantly lower in the EPO-treated group than the colitis group (p <0.05). Bacterial translocation was lower in the liver, spleen, MLNs and systemic blood in the EPO-treated group when compared to the colitis group (p <0.05). CONCLUSION: In TNBS-E-induced rat model of colitis, EPO significantly decreased inflammation and bacterial translocation based on histopathological, biochemical and microbiological parameters.

Effects of quercitrin on bacterial translocation in a rat model of experimental colitis.

BACKGROUND: This study aimed to analyze the effects of quercitrin, which has anti-inflammatory properties, on bacterial translocation in inflammatory bowel diseases by using an experimental colitis model. METHODS: Forty male Wistar-Albino rats were used in the study. Rats were divided into 4 groups (control, colitis, treatment 1 and 2 groups). The rats in the control group were given normal drinking water. In the colitis group, colitis was induced by 5% DSS in drinking water. The control and colitis groups underwent operation on Day 7. In the 2 treatment groups, 5% DSS was added to drinking water for the first 7 days and the groups were treated with quercitrin at the doses of 1 and 5 mg/kg/day for the following 10 days. Treatment groups operated on Day 18. Blood samples were taken for blood culture and left colectomy was performed. The inflammation in the colon was macroscopically and microscopically evaluated and graded. Tissue samples were taken (liver, spleen and mesenteric lymph nodes (MLN)) for tissue culturing in order to assess bacterial translocation. Tissue myeloperoxidase (MPO), serum tumor necrosis factor-alpha (TNF-α) and plasma endotoxin levels were measured. RESULTS: When the control and colitis groups were compared, observed that colitis was induced by DSS (p < 0.05). When the colitis and treatment groups were compared, it was found that quercitrin had a significant therapeutic effect (p < 0.05). CONCLUSION: In the experimental colitis model established by using DSS, treatment with quercitrin resulted in a histopathological improvement and reduction in biochemical parameters, inflammation and in bacterial translocation (p < 0.05).

The length of necrosis and renal insufficiency predict the outcome of acute mesenteric ischemia.

BACKGROUND: Acute mesenteric ischemia (AMI) is a potentially life-threatening condition because of its diagnostic difficulty, operative challenges, and comorbidities a patient may have. The aim of this study was to identify factors associated with adverse outcomes in patients with AMI. METHODS: The hospital records and clinical data of all patients with AMI were reviewed for a recent 4-year period. Clinical outcomes and factors influencing mortality were analyzed. RESULTS: Included in the study were 104 patients (46 females and 58 males) with an overall mean age of 66 ± 13.4 years. The cause of AMI was arterial pathology in 74 (71%) patients, venous thrombosis in 15 (14%) patients, and nonocclusive ischemia in 12 (12%) patients. Abdominal pain was the most common presenting symptom (97% of patients). The 30-day mortality rate was 66%. Univariate analysis showed that mortality was associated with renal insufficiency (p = 0.004), an age greater than 70 years (p = 0.02), the presence of comorbidities (p = 0.001), a leukocyte count greater than 18,000/mL (p = 0.04), and small bowel necrosis of more than 100 cm (p < 0.0001). Logistic regression analysis showed that independent predictors of mortality were small bowel necrosis of more than 100 cm (p = 0.002) and a serum creatinine level greater than 2 mg/dL (p = 0.04). CONCLUSION: The length of the necrosis and renal insufficiency are the primary factors that result in a poor outcome in AMI patients. Prompt diagnostic evaluation and early therapeutic interventions may help to prevent the development of these fatal predictors.

A rare cause of acute mesenteric ischemia: JAK2 positivity and chronic active hepatitis B.

Short bowel syndrome occurs as a result of insufficiency in the total length of the small intestine to provide adequate supply of nutrients. Seventy-five percent of cases are due to massive intestinal resection. A 35-year-old male complaining of abdominal pain was admitted to the gastroenterology department. A CT scan was performed, showing total occlusion of the portal vein and superior mesenteric vein. During the operation, widespread edema and necrosis of the small intestine were found. The necrotic segments of the small intestine were resected. The spleen was larger than normal and, in some parts, infarcts were evident, thus asplenectomy was also performed during surgery. A second-look procedure was performed 24 hours later, and an additional 10 cm jejunal resection and anastomosis was performed. His further evaluations revealed myeloproliferative disease and chronic active hepatitis B leading to thrombosis. Essential thrombocytosis and portal vein thrombosis are common in hepatitis B infection. Patients with complaints of abdominal pain in the context of essential thrombocytosis and hepatitis B should be handled with caution as they are at risk of developing portal vein thrombosis.