The intestinal epithelium has one of the highest turnover rates in the human body, which is supported by intestinal stem cells. Culture models of intestinal physiology have been evolving to incorporate different tissue and microenvironmental elements. However, these models also display gaps that limit their similarity with native conditions. Microfluidics technology arose from the application of microfabrication techniques to fluid manipulation. Recently, microfluidic approaches have been coupled with cell culture, creating self-contained and modular in vitro models with easily controllable features named organs-on-chip. Intestine-on-chip models have enabled the recreation of the proliferative and differentiated compartments of the intestinal epithelium, the long-term maintenance of commensals, and the intraluminal perfusion of organoids. In addition, studies based on human primary intestinal cells have shown that these systems have a closer transcriptomic profile and functionality to the intestine in vivo, when compared with other in vitro models. The design flexibility inherent to microfluidic technology allows the simultaneous combination of components such as shear stress, peristalsis-like strain, 3-dimensional structure, oxygen gradient, and co-cultures with other important cell types involved in gut physiology. The versatility and complexity of the intestine-on-chip grants it the potential for applications in disease modeling, host-microbiota studies, stem cell biology, and, ultimately, the translation to the pharmaceutical industry and the clinic as a reliable high-throughput platform for drug testing and personalized medicine, respectively. This review focuses on the physiological importance of several components that have been incorporated into intestine-on-chip models and highlights interesting features developed in other types of in vitro models that might contribute to the refinement of these systems.

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Small bowel obstruction is one of the most common causes for acute abdominal pain leading to surgical admissions, occurring most frequently due to postoperative adhesions. Although less common, internal hernia is also a possible etiology, in which a delay on its therapy may lead to a not so dismal morbidity and mortality. Here, we report the case of a 24 year old Caucasian man that was admitted in our emergency department with an inaugural episode of sudden-onset epigastric pain associated with vomiting. After observation and diagnostic workup, the patient underwent urgent laparotomy that revealed an ischemic small bowel due to a double omental hernia, being successfully treated without enteric resection.

Venous thromboembolism (VTE) is a leading cause of death among cancer patients. Khorana score (KS) is the most studied tool to predict cancer-related VTE, however, it exerts poor sensitivity. Several single-nucleotide polymorphisms (SNPs) have been associated with VTE risk in the general population, but whether they are predictors of cancer-related VTE is a matter of discussion. Compared to other solid tumours, little is known about VTE in the setting of cervical cancer (CC) and whether thrombogenesis-related polymorphisms could be valuable biomarkers in patients with this neoplasia. This study aims to analyse the effect of VTE occurrence on the prognosis of CC patients, explore the predictive capability of KS and the impact of thrombogenesis-related polymorphisms on CC-related VTE incidence and patients’ prognosis regardless of VTE. A profile of eight SNPs was evaluated. A retrospective hospital-based cohort study was conducted with 400 CC patients under chemoradiotherapy. SNP genotyping was carried on by using TaqMan® Allelic Discrimination methodology. Time to VTE occurrence and overall survival were the two measures of clinical outcome evaluated. The results indicated that VTE occurrence (8.5%) had a significant impact on the patient’s survival (log-rank test, P < 0.001). KS showed poor performance (KS ≥ 3, χ2, P = 0.191). PROCR rs10747514 and RGS7 rs2502448 were significantly associated with the risk of CC-related VTE development (P = 0.021 and P = 0.006, respectively) and represented valuable prognostic biomarkers regardless of VTE (P = 0.004 and P = 0.010, respectively). Thus, thrombogenesis-related genetic polymorphisms may constitute valuable biomarkers among CC patients allowing a more personalized clinical intervention.

Background: The recent COVID-19 outbreak in Italy required timely adoption of efficient triage procedures (TPs) with the aim to minimize the risk of infection spreading in the hospitals. We developed a written questionnaire (items explored: fever, respiratory symptoms, previous contacts or personal positivity for COVID-19) together with body temperature (BT) measurement, to intercept patients (pts) with suspect of COVID-19 infection.Methods: We conducted a monocentric observational study of a consecutive series of outpatients with diagnosis of solid tumor, accessing the Day Unit of Oncology Department at Udine Academic Cancer Center (Northern Italy) from 30 March 2020 to 30 April 2020. In this abstract we present the preliminary results of the TPs performed until 10 April 2020.Results: 1054 TPs were performed out of 586 pts, with a median of 2 TPs per pt. Median age was 64.9 years, males were 35.4%. Overall, 82.5% of TPs were made because of access for therapy, 10.7% for programmed procedures, radiological exams or nononcological consultations, 1.2% for unplanned presentation (e.g. urgencies). The stage of neoplasm was early in 30.7% and advanced in 69.3% of pts. TPs were made in pts receiving chemotherapy (58.2%), immunotherapy (10.8%), targeted therapy (18.9%), other therapies (5.2%) and in pts without active oncological therapy (6.9%). The questionnaires resulted positive in 5.5% of cases; 2.9% were positive for fever, 2.9% for respiratory symptoms, 0.1% for previous contact with a case of COVID-19. Concomitant presence of 2 or more items was observed in 0.5% of questionnaires. Of note, 6 TPs required medical evaluation despite a negative questionnaire and were considered to be clinically suspect. BT37 C was observed in 7 TPs. Overall, the oncologic program was postponed in 0.9% of the TPs, while in 0.5% a test for SARS-CoV-2 was performed for clinical suspect: no one resulted positive. At multivariate analysis, factors associated with positive triage were diagnosis of thoracic cancer (OR 2.06; 95%CI 1.02-4.12; p¼0.04) and prior test for SARS-CoV-2 (OR 2.81; 95%CI 1.46-5.41; p¼0.001).

HighlightsIntramural small bowel hematoma is a haemorrhagic complication of anticoagulant therapy.Abdominal complaints and elevated INR value should prompt suspicion.CT scan is the preferred imaging method.Immediate suspension of anticoagulant drugs and antidote administration is required.

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