Interstitial cells of Cajal are normally distributed in both ganglionated and aganglionic bowel in Hirschsprung's disease

Surgery for Hirschsprung's disease is often complicated by post-operative bowel motility disorders. The impact of intestinal neural histology on the surgical outcome has been previously studied, but no information is available concerning the influence of the distribution of interstitial cells of Cajal (ICC) on these complications. These cells are considered to be pacemakers in the gastrointestinal tract. The aim of this study was to assess the distribution of ICC in the proximal segment of resected bowel in Hirschsprung's disease and confront these results with the clinical outcome. Using immunohistochemistry for light microscopy, we compared the pattern of distribution of ICC in the proximal segment of resected bowel in Hirschsprung's disease with that in normal colon. We correlated these results with the corresponding neural intestinal histology determined by CD56 and the protein gene product 9.5 immunohistochemistry. The distribution of ICC in the proximal segment of resected bowel is identical to that of normal colon, regardless of normal or abnormal colon innervation. ICC distribution does not seem to contribute to post-operative bowel motility disorders in patients operated for Hirschsprung's diseas

Interstitial cells of Cajal are normally distributed in both ganglionated and aganglionic bowel in Hirschsprung's disease

Surgery for Hirschsprung's disease is often complicated by post-operative bowel motility disorders. The impact of intestinal neural histology on the surgical outcome has been previously studied, but no information is available concerning the influence of the distribution of interstitial cells of Cajal (ICC) on these complications. These cells are considered to be pacemakers in the gastrointestinal tract. The aim of this study was to assess the distribution of ICC in the proximal segment of resected bowel in Hirschsprung's disease and confront these results with the clinical outcome. Using immunohistochemistry for light microscopy, we compared the pattern of distribution of ICC in the proximal segment of resected bowel in Hirschsprung's disease with that in normal colon. We correlated these results with the corresponding neural intestinal histology determined by CD56 and the protein gene product 9.5 immunohistochemistry. The distribution of ICC in the proximal segment of resected bowel is identical to that of normal colon, regardless of normal or abnormal colon innervation. ICC distribution does not seem to contribute to post-operative bowel motility disorders in patients operated for Hirschsprung's diseas

"It doesn't do any harm, but patients feel better": a qualitative exploratory study on gastroenterologists' perspectives on the role of antidepressants in inflammatory bowel disease

Background: Interest in psychological factors in patients with inflammatory bowel disease (IBD) has increased in recent years. It has even been proposed that treating psychological co-morbidities with antidepressants may control disease activity and improve quality of life. Despite this, there is no data on gastroenterologists' attitudes to, and experiences with, antidepressant therapy in patients with IBD. Methods: We conducted semi-structured interviews with 18 gastroenterologists associated with metropolitan teaching hospitals. Qualitative content analysis was used to examine their responses. Results: Seventy-eight percent of gastroenterologists had treated IBD patients with antidepressants for pain, depression and/or anxiety, and insomnia. Antidepressants were reported to be useful in improving psychosocial well-being, quality of life, and self-management of the disease by patients. However, in this group of gastroenterologists, there appears to be skepticism towards psychological disorders themselves or antidepressant therapy having a central role in either the causation of IBD or its clinical course. Nevertheless, these gastroenterologists were receptive to the idea of conducting a trial of the role of antidepressants in IBD. Conclusion: While the majority of specialists have treated IBD patients with antidepressants, there is considerable skepticism with regard to efficacy of antidepressive therapy or the role of psychological factors in the outcome of IBD patients.Antonina A Mikocka-Walus, Deborah A Turnbull, Nicole T Moulding, Ian G Wilson, Jane M Andrews and Gerald J Holtman

Comparative efficacy of the Leucofeligen™ FeLV/RCP and Purevax™ RCP FeLV vaccines against infection with circulating feline Calicivirus

Abstract Background Feline calicivirus (FCV) is a common virus, found worldwide, mainly responsible for chronic ulceroproliferative faucitis and periodontitis. This virus has a high mutation rate, leading to the presence of numerous FCV strains in the field. The objectives of this study was to evaluate and compare the efficacy of two vaccines (Leucofeligen™ FeLV/RCP and Purevax™ RCP FeLV), which differ by their nature (live vs. inactivated) and the vaccinal strains, against circulating FCV strains. Thirty 9-week-old specific pathogen free (SPF) kittens were thus randomised into 3 groups and were either not vaccinated (control) or vaccinated (2 injections, 3 weeks apart) with one of the vaccines. Four weeks after the second injection of primary vaccination, the cats were inoculated with a pathogenic strain representative of the ones circulating in Europe (FCV-FR4_01) and followed for 2 weeks. Results After challenge, significant differences (p < 0.05) between control cats and cats vaccinated with Leucofeligen™ FeLV/RCP or Purevax™ RCP FeLV were observed for body weight variation, rectal temperature rise and maximum clinical scores, reflecting the intensity of the signs (83% and 67% lower in the respective vaccinated groups than in the control group). Significant differences were observed between the vaccinated groups, as cats vaccinated with Leucofeligen™ FeLV/RCP had a lower temperature rise (p < 0.05 at days post-challenge 3 to 5) and lower virus shedding titres (p < 0.05 at days post-challenge 8, 9 and 11) than cats vaccinated with Purevax™ RCP FeLV. Finally, only cats vaccinated with Leucofeligen™ FeLV/RCP had a significantly lower cumulative score, reflecting the intensity and duration of calicivirosis clinical signs, than the control cats (77% lower vs. 62% lower for cats vaccinated with Purevax™ RCP FeLV). Conclusions Both vaccines, Leucofeligen™ FeLV/RCP and Purevax™ RCP FeLV, were found to be efficacious in reducing clinical signs induced by FCV-FR4_01, a FCV strain representative of the circulating ones. However, cats vaccinated with Leucofeligen™ FeLV/RCP were able to control the infection more efficiently than those vaccinated with Purevax™ RCP FeLV, as evidenced by the shorter duration of clinical signs and lower viral titre in excretions