Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Bakgrund: Inflammatorisk mag-tarmsjukdom är ett samlingsnamn för Ulcerös kolit och Crohns sjukdom. Gemensamt för sjukdomarna är att de är kroniska och att de går i skov, vilket innebär att sjukdomen är mer aktiv i vissa perioder och mindre aktiv under andra. Inflammatorisk mag-tarmsjukdom påverkar patienterna fysiskt, psykiskt och socialt, vilket påverkar deras livskvalitet. Inflammatoriska mag-tarmsjukdomar kan resultera i psykiska besvär, därför har patienterna ett behov av goda copingstrategier och en god anpassning till livet med sjukdomen. Genom evidensbaserad och personcentrerad vård har sjuksköterskan en stödjande funktion i vården av dessa patienter.  Syfte: Syftet med litteraturstudien var att undersöka patienternas upplevelser av att leva med inflammatorisk mag-tarmsjukdom för att kunna belysa deras behov av stöd. Metod: En litteraturstudie med boolesk sökteknik gjordes i databaserna Cinahl, PubMed och PsycINFO där tio artiklar valdes ut genom granskning med SBU:s granskningsmall.    Resultat: När resultatet av tio artiklar sammanställts framkom fyra teman; patienters upplevelser av att leva med inflammatorisk mag-tarmsjukdom, patienternas behov av stöd, stöd i att acceptera och leva med sjukdomen samt stöd i form av utbildning. Slutsats: Patienter med inflammatorisk mag-tarmsjukdom har behov av stöd både fysiskt, psykiskt och socialt, från både sjukvårdspersonal och anhöriga. Patienterna har ett behov av stöd i form av information, undervisning samt psykiskt och emotionellt stöd. Sjuksköterskans stöd genom personcentrerad och empatisk kommunikation hjälper patienterna att acceptera sjukdomen och deras “nya normala”, vilket främjar deras självständighet, självkännedom och eget ansvar i sjukdomshanteringen. Patientutbildning bidrar till bättre egenvårdsstrategier, ökad följsamhet till behandling och livsstils anpassningar, vilket även bidrar till ökat självförtroende och välmående.

<p dir="ltr">The gastrointestinal (GI) tract and its diverse microbial community play a significant role in overall health, impacting various aspects such as metabolism, physiology, nutrition, and immune function. Disruptions in the gut microbiota have been associated with metabolic diseases, colorectal cancer, diabetes, obesity, inflammatory bowel disease, Alzheimer's disease, and depression. Despite recognizing the importance of the gut microbiota, the interrelationship between microbiota, diet, and disease prevention remains unclear. Current techniques for monitoring the microbiome often rely on fecal samples or invasive endoscopic procedures, limiting the understanding of spatial variations in the gut microbiota and posing invasiveness challenges. To address these limitations, this dissertation focuses on the design and development of an electronic-free smart capsule platform capable of targeted sampling of GI fluid within specific regions of the GI tract. The capsule can be retrieved for subsequent bacterial culture and sequencing analysis. The capsule design is based on stimuli-responsive polymers and superabsorbent hydrogels, chosen for their proven safety, compatibility, and scalability. By leveraging the pH variation across the GI tract, the pH-sensitive polymeric coatings dissolve at the desired region, activating the sampling process. The superabsorbent hydrogel inside the capsule collects the sampled GI fluid and facilitates capsule closure upon completion of sampling. Systematic studies were conducted to identify suitable pH-responsive polymer coatings, superabsorbent hydrogels, and processing conditions that effectively operated within the physiological conditions of the GI tract. The technology's effectiveness and safety were validated through rigorous <i>in vitro</i> and <i>in vivo</i> studies using pig models. These studies demonstrated the potential of the technology for targeted sampling of GI fluid in both small and large intestinal regions, enabling subsequent bacterial culture and gene sequencing analysis. Additionally, the capsule design was enhanced with the integration of a metal tracer, enabling traceability throughout the GI tract using X-ray imaging and portable metal detectors for ambulatory screening. This technology holds promise as a non-invasive tool for studying real-time metabolic and molecular interactions among the host, diet, and microbiota in challenging-to-access GI regions. Its application in clinical studies can provide new insights into diet-host-microbiome interactions and contribute to addressing the burden faced by patients and their families dealing with GI-related diseases.</p>

This thesis investigates how air pollution, both natural and anthropogenic, affects changes in the proximal small intestine and ileum microbiota profile, as well as intestinal barrier integrity, histological changes, and inflammation. APO-E KO mice on a high fat diet were randomly selected to be exposed by whole body inhalation to either wood smoke (WS) or mixed vehicular exhaust (MVE), with filtered air (FA) acting as the control. Intestinal integrity and histology were assessed by observing expression of well- known structural components tight junction proteins (TJPs), matrix metallopeptidase-9 (MMP-9), and gel-forming mucin (MUC2), as well known inflammatory related factors: TNF-α, IL-1β, and toll-like receptor (TLR)-4. Bacterial profiling was done using DNA analysis of microbiota within the ileum, utilizing 16S metagenomics sequencing (Illumina miSeq) technique. Overall results of this experiment suggest that air pollution, both anthropogenic and natural, cause a breach in the intestinal barrier with an increase in inflammatory factors and a decrease in beneficial bacteria. This evidence suggests the possibility of air pollution being a potential causative agent of intestinal disease as well as a possible contributing mechanism for induction of systemic inflammation.