Endoscopic capacity in West Africa.

Background: Levels of endoscopic demand and capacity in West Africa are unclear. Objectives: This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered. Methods: In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics. Before and after didactics, multiplechoice exams as well as questionnaires were administered to assess for course efficacy. Also, a case series of 23 patients needing upper GI endoscopy was done. Results: In surveying physicians, less than half had resources to perform an EGD and none could perform an ERCP, while waiting time for emergency endoscopy in urban populations was at least one day. In assessing improvement in medical knowledge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI course with simulation and didactics improves gastrointestinal knowledge amongst participants.

Early Adaptation of Small Intestine After Massive Small Bowel Resection in Rats

Background: It is important that the residual bowel adapts after massive resection. The necessary intestinal adaptation is a progressive recovery from intestinal failure through increase in absorptive surface area and functional capacity and includes both morphological and functional adaptations. Objectives: The aim of this study was to investigate intestinal morphological and functional adaptations of small bowel syndrome (SBS) model rats (SBS1W) 7 days after bowel resection. Materials and Methods: Male sprague–dawley rats (n = 20/group) underwent either a 75% proximal small bowel resection (SBS1W group) or a control operation (control group). Markers of morphological adaptation were revealed by TEM analysis of H&E-stained tissue samples. The intestinal barrier condition was assessed by BT, and sIgA concentration in intestinal mucus was measured by ELISA. Contractility and the slow wave rhythm of the entire intestinal remnant were measured and recorded. Results: The SBS1W group experienced more weight loss than control group and had a clearly different intestinal morphology as revealed in TEM images. Compared with control rats, the SBS1W group had a lower sIgA concentration in intestinal mucus and higher BT to lymph nodes (70% vs 40%; level I), portal blood (40% vs 10%; level II), and peripheral blood (60% vs 30%; level III). Disorder of spontaneous rhythmic contraction, irregular amplitude, and slow frequency were detected in the SBS1W group by a muscle strips test. Similarly, the slow wave of the entire intestinal remnant in the SBS1W group was irregular and uncoordinated. Conclusions: The finding of intestinal adaptation following massive SBR in SBS1W rats provides more understanding of the mechanisms of progressive recovery from the intestinal failure that underlies SBS. The mechanical, chemical, immunological, and biological barriers were all impaired at 7 days following bowel resection, indicating that the SBS model rats were still in the intestinal adaptation phase.

Spectrum-effect relationships between high performance liquid chromatography fingerprints and bioactivities of charred areca nut

Purpose: To investigate the spectrum-effect relationships between high performance liquid chromatography (HPLC) fingerprints and duodenum contractility of charred areca nut (CAN) on rats. Methods: An HPLC method was used to establish the fingerprint of charred areca nut (CAN). The promoting effect on contractility of intestinal smooth was carried out to evaluate the duodenum contractility of CAN in vitro. In addition, the spectrum-effect relationships between HPLC fingerprints and bioactivities of CAN were investigated using multiple linear regression analysis (backward method). Results: Fourteen common peaks were detected and peak 3 (5-Hydroxymethyl-2-furfural, 5-HMF) was selected as the reference peak to calculate the relative retention time of 13 other common peaks. In addition, the equation of spectrum-effect relationships {Y = 3.818 - 1.126X1 + 0.817X2 - 0.045X4 - 0.504X5 + 0.728X6 - 0.056X8 + 1.122X9 - 0.247X13 - 0.978X14 (p < 0.05, R2 = 1)} was established in the present study by the multiple linear regression analysis (backward method). According to the equation, the absolute value of the coefficient before X1, X2, X4, X5, X6, X8, X9, X13, X14 was the coefficient between the component and the parameter. Conclusion: The model presented in this study successfully unraveled the spectrum-effect relationship of CAN, which provides a promising strategy for screening effective constituents of areca nut.