المؤلفون: Degro, C E, Jiménez-Vargas, N N, Schincariol, H M, Tsang, Q K, Guzman-Rodriguez, M, Lomax, A E, Reed, D E, Stein, C, Bunnett, N W, Vanner, S J

المصدر: Journal of the Canadian Association of Gastroenterology ; volume 6, issue Supplement_1, page 90-91 ; ISSN 2515-2084 2515-2092

الوصف: Background Adequate pain control in inflammatory bowel disease (IBD) can require opioids due to their high analgesic potency. The long-term use of opioids, however, is limited by the development of tolerance. This leads to reduced analgesic efficacy over time, resulting in escalating opioid dosing and thus increased risk of serious side effects. We previously demonstrated the safety and effectiveness of a novel pH-sensitive µ-opioid receptor (MOR) agonist, NFEPP, in a murine colitis pain model, but its tolerance potential with chronic administration is unknown. Purpose To assess the tolerance potential of NFEPP compared to its parent compound fentanyl during acute colitis in a preclinical mouse model. Method Acute colitis in C57BL/6 mice was induced using 2.5% dextran sulphate sodium for 5 days. NFEPP or fentanyl were then administered s.c. every 4 hours between 7am and 11pm over 5 days in daily increasing concentrations (0.4-1.5 mg/kg/d). Analgesic tolerance to opioids was assessed in conscious mice by measuring visceromotor responses (VMRs) to noxious colorectal distensions. Tolerance to the MOR agonist DAMGO in NFEPP or fentanyl treated mice was evaluated using patch-clamp recordings from dorsal root ganglion (DRG) neurons and extracellular recordings from lumbar splanchnic nerves that innervate the colon. Inflammation was assessed by macroscopic analyses, histological scoring and tissue-pH measurements of the inflamed colon. Group differences were analyzed using two-way ANOVA with Bonferroni′s or Tukey′s post-test (p-value <0.05). Result(s) NFEPP significantly reduced VMRs before and after chronic NFEPP treatment (39% reduction, p<0.05 vs. 41% reduction, p<0.05, compared to baseline at 80 µl). No differences of NFEPP induced antinociceptive actions were observed comparing VMR measurements before and after chronic administration (p=0.44). However, the analgesic activity of fentanyl decreased over time with less VMR inhibition observed after chronic treatment compared to fentanyl ...

الإتاحة: https://doi.org/10.1093/jcag/gwac036.277Test
https://academic.oup.com/jcag/article-pdf/6/Supplement_1/90/49441282/gwac036.277.pdfTest

المؤلفون: Bennett, A, Baker, C, Guzman-Rodriguez, M, Jimenez-Vargas, N, Vanner, S, Reed, D, Lomax, A

المصدر: Journal of the Canadian Association of Gastroenterology ; volume 6, issue Supplement_1, page 91-91 ; ISSN 2515-2084 2515-2092

الوصف: Background Irritable bowel syndrome (IBS) is a chronic abdominal pain disorder that affects women twice as often as men. The gut microbiota has been implicated as a key player in the modulation of abdominal pain in IBS. Given this, we hypothesised that the production of pro-nociceptive mediators within the gut lumen are increased in females, and this contributes to the female predominance of IBS. Purpose Compare the effects of FS from male and female IBS patients on abdominal pain pathways and identify the impact of female mouse estrous cycle on abdominal pain. Method Fecal supernatants (FS) were perfused through murine colonic preparations while performing extracellular colonic afferent nerve recordings to measure changes in action potential frequency in response to colonic distension. Phase of estrous cycle in female mice was determined through vaginal swabs. FS from male and female IBS patients reporting low, moderate, and high levels of abdominal pain were used. Result(s) FS from female IBS patients (N=6) increased afferent nerve discharge (p < 0.05) whereas FS from male IBS patients has no effect (N=4). However, single unit analysis of nociceptive axons revealed that male IBS FS increased nociceptor activity in female mice taken during the proestrus/estrus stage (p < 0.05), but not female mice taken during the metestrus/diestrus stage or male mice. Further investigation found that IBS FS from female patients with high abdominal pain (N=6), but not patients with moderate (N=5) or low pain (N=3), increased visceral afferent nerve discharge by 70%. Single unit analysis of nociceptive axons showed that their activation was increased by almost 50% following FS perfusion from high abdominal pain patients only (p < 0.05). Histamine concentrations and proteolytic activity are increased in FS from female IBS patients with high abdominal pain compared to male IBS patients. Conclusion(s) This work suggests that luminal mediators that impact abdominal pain are increased in female IBS ...

الإتاحة: https://doi.org/10.1093/jcag/gwac036.278Test
https://academic.oup.com/jcag/article-pdf/6/Supplement_1/91/49441280/gwac036.278.pdfTest

المؤلفون: Wood, H, Alward, T, Abu Omar, A, Guzman-Rodriguez, M, Vanner, S, Reed, D, Lomax, A

المصدر: Journal of the Canadian Association of Gastroenterology ; volume 6, issue Supplement_1, page 9-10 ; ISSN 2515-2084 2515-2092

الوصف: Background Abdominal pain is a debilitating symptom of Crohn’s disease (CD). Despite the current treatment options for this disease, abdominal pain is an unresolved problem that commonly persists in the absence of active inflammation. This suggests that something other than inflammation is driving the pain during the quiescent phase. We have previously reported that microbial proteases can directly modulate the excitability of dorsal root ganglia (DRG) neurons, many of which are pain-sensing. We hypothesize that luminal proteases of CD patients are contributing to their abdominal pain. Purpose Determine whether luminal mediators in CD fecal samples induce changes in pain signalling. Method The effects of patient (active CD [n = 3] and healthy volunteer (HV) [n = 3]) fecal supernatant (FS) samples on pain-sensing neurons were assessed using ex-vivo single unit afferent nerve recordings from mouse colons. Each sample was tested in colonic preparations from a least 5 mice. To further examine cellular mechanisms, DRG neurons were isolated and incubated overnight in media containing CD FS or HV FS media. Changes in neuronal excitability were recorded by determining the rheobase (lower rheobase=increased excitability) using patch clamp recordings (n ≥ 9 DRG neurons/group). Protease inhibitors were applied in both bioassays to determine whether these inhibited the excitatory effect of FS. Lastly, total proteolytic activity in the CD and HV fecal samples was calculated using a casein colorimetric protease detection assay. Result(s) FS from HV had no effect on afferent nerve excitability (p = 0.8920). FS from active CD patients increased action potential discharge from colonic afferent nerves by 85% (p<0.0001) and selectively increased the activation of high-threshold units, which are putative nociceptors, by 44% (p=0.0074). A protease inhibitor cocktail (1:1000) and protease-activated receptor (PAR)-2 antagonist GB83 (10µM) both blocked the excitatory effects of CD FS (p<0.05). Overnight ...

الإتاحة: https://doi.org/10.1093/jcag/gwac036.017Test
https://academic.oup.com/jcag/article-pdf/6/Supplement_1/9/49441034/gwac036.017.pdfTest

المؤلفون: Jiménez-Vargas, N N, Guzman Rodriguez, M, Yu, Y, Neary, E, Lomax, A E, Reed, D E, Vanner, S

المصدر: Journal of the Canadian Association of Gastroenterology ; volume 5, issue Supplement_1, page 134-135 ; ISSN 2515-2084 2515-2092

الوصف: Background We have shown that Irritable Bowel Syndrome diarrhea-predominant (IBS-D) patients with a history of a dysbiotic-like onset have distinct stool metabolomic profiles versus those with a non-dysbiotic-like onset. IBS stool supernatants can sensitize mouse colonic afferent nerves via both histamine and proteases. However, it is unknown if stool supernatants from the two IBS-D subgroups modulate the excitability of nociceptive neurons via different neuroactive mediators Aims To evaluate whether there are differences in neuroactive mediators within stool supernatants from subgroups of IBS-D patients that can modulate the excitability of nociceptive neurons. Methods Stool samples from healthy control (HC) (N=5) and IBS-D patients with a dysbiotic (N=7) or non-dysbiotic-like (N=7) onset, was homogenized with Krebs solution and filtered. Proteolytic activity was assessed using casein as a substrate with and without protease inhibitors. Histamine was quantified by ELISA. DRG neurons from C57BL/6 mice were incubated overnight or acutely (30 min) with stool supernatants. Some neurons were pre-incubated with PAR2 (GB83, 10 μM) or H1R (pyrilamine, 1μM) antagonists prior to supernatant incubation. Changes in neuronal excitability were assessed with perforated patch-clamp by measuring the rheobase (current that elicits an action potential). Results Proteolytic activity in dysbiotic-like (57.9 U/μg, p<0.05) but not non-dysbiotic like (37.4 U/μg) stool supernatant was increased compared to HC (25.2 U/μg). Serine inhibitor decreased proteolytic activity of dysbiotic (46.6%, p<0.05) and non-dysbiotic (34.2%, p<0.01) supernatant whereas cysteine, aspartic and metalloproteases inhibitors had no effect. Histamine was increased 78% (p<0.05) in IBS-D compared to HC. No differences in proteolytic activity and histamine concentration between IBS-D subtypes were found. In patch-clamp recordings, overnight incubation with dysbiotic (19%, p<0.05) and non-dysbiotic (22%, p< 0.01) ...

الإتاحة: https://doi.org/10.1093/jcag/gwab049.241Test
https://academic.oup.com/jcag/article-pdf/5/Supplement_1/134/42563623/gwab049.241.pdfTest

المؤلفون: Coccolini F, Coimbra R, Ordonez C, Kluger Y, Vega F, Moore EE, Biffl W, Peitzman A, Horer T, Abu-Zidan FM, Sartelli M, Fraga GP, Cicuttin E, Ansaloni L, Parra MW, Millan M, De Angelis N, Inaba K, Velmahos G, Maier R, Khokha V, Sakakushev B, Augustin G, di Saverio S, Pikoulis E, Chirica M, Reva V, Leppaniemi A, Manchev V, Chiarugi M, Damaskos D, Weber D, Parry N, Demetrashvili Z, Civil I, Napolitano L, Corbella D, Catena F, Bahouth H, Tolonen M, Fugazzola P, Serna JJ, Rodriguez F, Garcia AF, Gonzalez A, Pino LF, Guzman-Rodriguez M, Pereira BM, Kirkpatrick A, Mefire AC, Tarasconi A, Chiara O, Gomes CA, Galante J, Bala M, Perfetti P, Machado F, Romeo O, Salvetti F, Ghiadoni L, Forfori F, Malacarne P, Pini S, Pucciarelli M, Ceresoli M, Arvieux C, Khokha D, Spain DA, Isik A

المساهمون: Coccolini, F, Coimbra, R, Ordonez, C, Kluger, Y, Vega, F, Moore, Ee, Biffl, W, Peitzman, A, Horer, T, Abu-Zidan, Fm, Sartelli, M, Fraga, Gp, Cicuttin, E, Ansaloni, L, Parra, Mw, Millan, M, De Angelis, N, Inaba, K, Velmahos, G, Maier, R, Khokha, V, Sakakushev, B, Augustin, G, di Saverio, S, Pikoulis, E, Chirica, M, Reva, V, Leppaniemi, A, Manchev, V, Chiarugi, M, Damaskos, D, Weber, D, Parry, N, Demetrashvili, Z, Civil, I, Napolitano, L, Corbella, D, Catena, F, Bahouth, H, Tolonen, M, Fugazzola, P, Serna, Jj, Rodriguez, F, Garcia, Af, Gonzalez, A, Pino, Lf, Guzman-Rodriguez, M, Pereira, Bm, Kirkpatrick, A, Mefire, Ac, Tarasconi, A, Chiara, O, Gomes, Ca, Galante, J, Bala, M, Perfetti, P, Machado, F, Romeo, O, Salvetti, F, Ghiadoni, L, Forfori, F, Malacarne, P, Pini, S, Pucciarelli, M, Ceresoli, M, Arvieux, C, Khokha, D, Spain, Da, Isik, A

مصطلحات موضوعية: Adult, Classification, Guideline, Hemorrhage, Intensive care, Interventional, Liver trauma, Minor, Moderate, Non-operative management, Operative management, Pediatric, Radiology, Severe, Surgery

الوصف: Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.

وصف الملف: STAMPA

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/32228707; info:eu-repo/semantics/altIdentifier/wos/WOS:000522949800002; volume:15; issue:1; firstpage:24-1; lastpage:24-15; numberofpages:15; journal:WORLD JOURNAL OF EMERGENCY SURGERY; https://hdl.handle.net/11392/2533519Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85082792596; https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00302-7Test

الإتاحة: https://doi.org/10.1186/s13017-020-00302-7Test
https://hdl.handle.net/11392/2533519Test

المؤلفون: Ordonez, CA, Parra, MW, Millan, M, Caicedo, Y, Guzman-Rodriguez, M, Padilla, N, Salamea-Molina, JC, Garcia, A, Gonzalez-Hadad, A, Pino, LF, Herrera, MA, Rodriguez-Holguin, F, Serna, JJ, Salcedo, A, Aristizabal, G, Orlas, C, Ferrada, R, Scalea, T, Ivatury, R

المصدر: Colombia Medica

وصف الملف: application/pdf

العلاقة: https://repositorio.uchile.cl/handle/2250/190409Test

الإتاحة: https://doi.org/10.25100/cm.v51i4.4422.4365Test
https://repositorio.uchile.cl/handle/2250/190409Test

المؤلفون: Herrera, MA, Tintinago, LF, Morales, WV, Ordonez, CA, Parra, MW, Betancourt-Cajiao, M, Caicedo, Y, Guzman-Rodriguez, M, Gallego, LM, Hadad, AG, Pino, LF, Serna, JJ, Garcia, A, Serna, C, Hernandez-Medina, F

المصدر: Colombia Medica

وصف الملف: application/pdf

العلاقة: https://repositorio.uchile.cl/handle/2250/190408Test

الإتاحة: https://doi.org/10.25100/cm.v51i4.4422.4599Test
https://repositorio.uchile.cl/handle/2250/190408Test

المؤلفون: Salamea-Molina, JC, Himmler, AN, Valencia-Angel, LI, Ordonez, CA, Parra, MW, Caicedo, Y, Guzman-Rodriguez, M, Orlas, C, Granados, M, Macia, C, Garcia, A, Serna, JJ, Badiel, M, Puyana, JC

المصدر: Colombia Medica

وصف الملف: application/pdf

العلاقة: https://repositorio.uchile.cl/handle/2250/190410Test

الإتاحة: https://doi.org/10.25100/cm.v51i4.4511Test
https://repositorio.uchile.cl/handle/2250/190410Test

المؤلفون: Guzman Rodriguez, M, Hyde, R, Vanner, S, Allen-Vercoe, E, Sheth, P, Petrof, E O

المصدر: Journal of the Canadian Association of Gastroenterology ; volume 2, issue Supplement_2, page 305-306 ; ISSN 2515-2084 2515-2092

الإتاحة: https://doi.org/10.1093/jcag/gwz006.153Test
http://academic.oup.com/jcag/article-pdf/2/Supplement_2/305/28516965/gwz006.153.pdfTest

المؤلفون: Ordonez C. A., Parra M. W., Caicedo Y., Padilla N., Angamarca E., Serna J. J., Rodriguez-Holguin F., Garcia A., Salcedo A., Pino L. F., Gonzalez-Hadad A., Herrera M. A., Quintero L., Hernandez F., Franco M. J., Aristizabal G., Toro L. E., Guzman-Rodriguez M., Coccolini F., Ferrada R., Ivatury R.

المساهمون: Ordonez, C. A., Parra, M. W., Caicedo, Y., Padilla, N., Angamarca, E., Serna, J. J., Rodriguez-Holguin, F., Garcia, A., Salcedo, A., Pino, L. F., Gonzalez-Hadad, A., Herrera, M. A., Quintero, L., Hernandez, F., Franco, M. J., Aristizabal, G., Toro, L. E., Guzman-Rodriguez, M., Coccolini, F., Ferrada, R., Ivatury, R.

مصطلحات موضوعية: Anastomotic Leak, Damage Control Surgery, Deferred Anastomosi, Definitive Laparotomy, Fistula, Injury Severity Score, Laparotomy, Ostomy, Penetrating Combined Small and Large Bowel Injurie, Primary Anastomosi, Surgical Anastomosis

الوصف: Hollow viscus injuries represent a significant portion of overall lesions sustained during penetrating trauma. Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring damage control surgery. The traditional surgical dogma of ostomy has proven to be unnecessary and, in many instances, actually increases morbidity. The aim of this article is to delineate the experience obtained in the management of combined hollow viscus injuries of patients suffering from penetrating trauma. We sought out to determine if primary and/or deferred bowel injury repair via anastomosis is the preferred surgical course in patients suffering from combined small and large bowel penetrating injuries. Our experience shows that more than 90% of all combined penetrating bowel injuries can be managed via primary or deferred anastomosis, even in the most severe cases requiring the application of damage control principles. Applying this strategy, the overall need for an ostomy (primary or deferred) could be reduced to less than 10%.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34188327; info:eu-repo/semantics/altIdentifier/wos/WOS:000648900100006; volume:52; issue:2; firstpage:e4114425; journal:COLOMBIA MEDICA; http://hdl.handle.net/11568/1102766Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85108231894

الإتاحة: https://doi.org/10.25100/cm.v52i2.4425Test
http://hdl.handle.net/11568/1102766Test