Ionizing radiation is commonly used to treat a number of malignancies. Although highly effective and now more targeted, many patients suffer side effects. The number of cancer survivors has increased and so there are more patients presenting with symptoms that have arisen as a result of radiotherapy. Radiation damage to small bowel tissue can cause acute or chronic radiation enteritis producing symptoms such as pain, bloating, nausea, faecal urgency, diarrhoea and rectal bleeding which can have a significant impact on patient's quality of life. This review outlines the pathogenesis of radiation injury to the small bowel along with the prevention of radiation damage via radiotherapy techniques plus medications such as angiotensin-converting enzyme inhibitors, statins and probiotics. It also covers the treatment of both acute and chronic radiation enteritis via a variety of medical (including hyperbaric oxygen), dietetic, endoscopic and surgical therapies.

NCT01426568.

The cerebellar anterior lobe may play a critical role in the execution and proper timing of learned responses. The current study was designed to monitor Purkinje cell activity in the rabbit cerebellar anterior lobe after eyeblink conditioning, and to assess whether Purkinje cells in recording locations may project to the interpositus nucleus. Rabbits were trained in an interstimulus interval discrimination procedure in which one tone signaled a 250-msec conditioned stimulus-unconditioned stimulus (CS-US) interval and a second tone signaled a 750-msec CS-US interval. All rabbits showed conditioned responses to each CS with mean onset and peak latencies that coincided with the CS-US interval. Many anterior lobe Purkinje cells showed significant learning-related activity after eyeblink conditioning to one or both of the CSs. More Purkinje cells responded with inhibition than with excitation to CS presentation. In addition, when the firing patterns of all conditioning-related Purkinje cells were pooled, it appeared that the population showed a pattern of excitation followed by inhibition during the CS-US interval. Using cholera toxin-conjugated horseradish peroxidase, Purkinje cells in recording areas were found to project to the interpositus nucleus. These data support previous studies that have suggested a role for the anterior cerebellar cortex in eyeblink conditioning as well as models of cerebellar-mediated CR timing that postulate that Purkinje cell activity inhibits conditioned response (CR) generation during the early portion of a trial by inhibiting the deep cerebellar nuclei and permits CR generation during the later portion of a trial through disinhibition of the cerebellar nuclei.Eyeblink classical conditioning has been used with great success to study the involvement of the cerebellum in motor learning. In eyeblink conditioning, a conditioned stimulus (CS), usually a tone, precedes an unconditioned stimulus (US), usually a corneal air puff, by 250-750 msec. Initially, the air puff US elicits a reliable response, in the form of a reflexive eye blink that is called an unconditioned response (UR). Over the course of a few hundred paired CS-US trials, an eye blink to the CS develops, which has a longer latency than the UR and differs in topography. This learned response is called the conditioned response (CR). One of the deep cerebellar nuclei, the interpositus nucleus, appears to be critical for learning CRs during eyeblink conditioning (e.g., Lavond et al. 1985;Yeo et al. 1985a;). In addition, lesions of some regions of cerebellar cortex (i.e., Larsell's lobule HVI) have been reported to affect CR production (e.g., Yeo et al. 1985b;Lavond and Steinmetz 1989) and recordings of Purkinje cell activity in this area have revealed inhibitory and excitatory patterns of activity that appear to be related to CS or US presentation and CR execution (e.g., Berthier and Moore 1986; Katz and Steinmetz 1997).Mauk and colleagues have presented data suggesting that another region of the cerebellar cortex, the cerebellar a...

Conformal radiotherapy techniques are an improvement on older radiotherapy techniques. IMRT may be better than 3DCRT in terms of GI toxicity, but the evidence to support this is uncertain. There is no high-quality evidence to support the use of any other prophylactic intervention evaluated. However, evidence on some potential interventions shows that they probably have no role to play in reducing RT-related GI toxicity. More RCTs are needed for interventions with limited evidence suggesting potential benefits.