RESUMEN
Twenty patients suffering from irritable bowel syndrome, 14 patients with pain and constipation and 6 patients with pain and diarrhoea, were studied in order to: a) Evaluate the symptomatic response to a Plantago Ovatae fiber medicine. b) Study with radio-opaque markers the colonic transit modifications that could explain the therapeutic responses. There were observed the following results: 1) Pain decreased or disappeared in 80
of the patients. 2) Constipation decreased or disappeared in 78.6
of the patients. 3) Diarrhoea decreased or disappeared in 5 of the 6 patients that were studied. 4) There was a significative increase of the feces weight without changes of the dry residue. 5) Taking all the patients as a whole the number of the retained radio-opaque markers was the same before and after the active treatment. If we evaluate the patients with constipation and the patients with diarrhoea separately the first group shows an acceleration of the colonic transit (fewer retained markers) and the second group shows a decrease of the colonic transit (more retained markers). We draw the conclusion that the Plantago Ovatae fiber regulates or moderates the colon motility and enables a physiological balance of the colonic transit.
RESUMEN
Fifteen patients suffering from different types of constipation were studied by means of radiopaque markers in order to know: a) If there is a correlation between the clinical state and the physiopathological motor variables of idiopatic constipation. b) The efficacy of a compound that combines its bulk action to its stimulation of the intestinal wall. Based on the results it is concluded that: The methodology is not useful in order to differentiate the colon motor behaviours in idiopatic constipation if these differences really exist. The evacuative effect of the compound was easily and objectively demonstrated by the acceleration of the radiopaque markers along the right colon. There was a good correlation between the subjective assessment done by the physician, and the patient and the objective results.
RESUMEN
Fueron evaluados mediante marcadores radio opacos, 15 pacientes constipados con las finalidades de: a) Intentar la correlacion entre las caracteristicas semiologicas y las variables motoras fisiopatologicas de la constipacion idiopatica. b) Determinar la utilidad de un compuesto evacuante que combine mecanismos de inibicion con los de estimulo motor farmacologico, dependiendo del tipo de constipacion. En base a los resultados se puede inferir que: 1) La metodologia empleada, no es de utilidad para diferenciar distintos comportamientos motores del colon en la constipacion, si es que estas diferencias realmente existen. 2) El efecto evacuante fue facilmente objetivable y dependio de la capacidad del farmaco para acelerar la movilizacion de los marcadores del colon derecho. 3) Existio una buena correlacion entre la impresion subjetiva medico-paciente y los resultados objetivos de la medicacion
Asunto(s)
Adulto , Persona de Mediana Edad , Anciano , Humanos , Femenino , EstreñimientoRESUMEN
This study was performed in 15 healthy control subjects (8 males- age 23-70 and 7 females age 20-74) as a way to compare the total and segmental colonic transit time with two different type of radiopaque markers. One type of markers was 3 mm cut sections of a radiopaque polietilene 14 French Levine tube, with a medium weight of 64.3 mg and a specific gravity (SG) of 1.28. The other type were 7 mm lenticular insoluble barium (lentils) with medium weight of 231 mg and a SG of 1.87. Each subject ingested 20 markers of each type with the breakfast and front and profile plain films of the abdomen were taken 24 and 48 hs after. The total colonic transit time for the polietilene markers was 17.7 hs and 27.3 hs for the barium type (BM) (p < 0.001). The segmental transit time for right colon was 2.4 hs (PM) and 9.7 hs (PM) and 9.7 hs (BM) (p < 0.001) in the left colon 9.5 hs (PM) and 11.3 hs (BM) and in rectoanun 5.9 hs (BM) with no statistical significance. Conclusion: the physical characteristics of the radiopaque markers can modify the results of the colonic transit times.
RESUMEN
The antrum-fundic section and re-anastomosis (AESR), liberates, in Wistar male rats, genuine antral peptic ulcers. They start within 20 days. They are progressive evolution, penetrating into all gastric walls. Between 7 and 8 months, they involve near organs (spleen, liver, pancreas) and produce a great inflammatory reaction of the peripancreatic ganglions. The antral peptic ulcer is induced if the gastric lesser curvatures nerves are sectioned and a concomitant pyloroplasty is done or not. The gastric hemisection, if anterior or posterior, break out the peptic ulcer only on the same side of the antrum-fundic interruption. In all this situations, except in cases of concomitant pyloroplasty, it is proved a pronounced and significantly increase of the gastric (g/kg), but not pancreatic index. In the AFSR series with nervous section on the lesser curvature and without pyloroplasty, the percentage of antral peptic ulcers in 56
. It is postulated the probably existence, at an antrum-fundic level, of a neuroendocrine center. Its nullification or disturbance by the section and re-anastomosis procedure could generate the antral ulcer and other histologic changes (increase of the [quot ]G[quot ] cells, hyperplasia of the parietal, ECL and [quot ]A like[quot ] cells) by one or various hypothetical ways: 1. Direct action, nullifying the normal blocking function of somatostative over the [quot ]G[quot ] cells and or parietal cells. 2. Disturbing or nullifying the motor pump effect of the gastric antrum, and on this way, enhancing the duodenum-gastric reflux with all know deleterious effects of the bile in the antrum particularly in an acid milieu. 3. Modifying, in the opposite direction, the sensitivity by one hand, of the [quot ]G[quot ] cells mass and by the other one, of the parietal, ECL and [quot ]A like[quot ] cells. The depression of the fundic sensitivity will induce the hyperplasia of the [quot ]G[quot ] cells, the hypersecretion of gastrin and, [quot ]a posteriori[quot ], all the secretory effects and trophic characteristic of it. 4. Disturbing the prostaglandins secretion, perhaps through a deficit of the nervous innervation, with the resulting epiphenomenon of a cytoprotection deficit mediated through the mucus and bicarbonate production. It is probably that the proposed physiopathogenic mechanism are associated and that the final result, the antral peptic ulcer is the consequence of an increase of the aggressive factors (acid, bile) and a concomitant depression of the defensive factors (cytoprotection), starting normally by the prostaglandins through the mucus and bicarbonate secretion.
RESUMEN
AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofskys index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3
) dialyzed patients and 55 out of 93 (53.6
) controls were Hp positive (ns). Forty-one out of 76 patients (53.9
) with a serum albumin level 3.5 g/dl and 3/17 (17.6
) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95
CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2
) with Kt/V > 1.2 and 6/13 (43.8
) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95
CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7
) with Karnofskys index > 70, and 40/78 (51.3
) with Karnofskys index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95
CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.
RESUMEN
El objetivo de este trabajo es comparar en sujetos controles sanos el tiempo de tránsito colónico total y segmentario con dos tipos de marcadores radiopacos utilizados en nuestro medio. Se estudiaron 16 personas sanas, 8 varones de 23 a 70 años de edad y 7 mujeres de 20 a 74 años con dieta habitual. Un tipo de marcadores corresponde a cilindros huecos de 3 mm de longitud onbtenidos de sondas de Levine 14 French con un peso medio de 64.3 mg y una gravedad específica (GE) de 1.28, el otro tipo de marcadores corresponde a grageas lenticulares indisolubles de bario, de 7 mm de diámetro, 231 mg de peso y GE específica de 1.87. Cada individuo ingirió luego del desayuno 20 marcadores de cada tipo y se obtuvieron radiografías simples de abdomen en decúbito dorsal y lateral izquierdo de pelvis a las 24 hs y 48 hs. El tiempo de tránsito colónico total para marcadores de polietileno fue de 17.7 hs. y para los de bario 27.3 hs. (p < 0.001). En el colon derecho fue respectivamente de 2,4 y 9,7 hs. (p < 0.001) en el izquierdo de 9,5 y 11,3 y en el recto ano de 5,9 y 6,3 (sin significancia estadística). Concluimos que los caracteres físicos de los marcadores radioopacos modifican los resultados del tiempo de tránsito colónico (AU)
Asunto(s)
Adulto , Persona de Mediana Edad , Anciano , Humanos , Masculino , Femenino , Tránsito Gastrointestinal/fisiología , Estreñimiento/diagnóstico por imagen , Colon/fisiopatología , Estreñimiento/fisiopatología , Estreñimiento/diagnóstico , Colon/diagnóstico por imagen , Medios de Contraste , Biomarcadores , Abdomen/diagnóstico por imagen , Factores de Tiempo , Polietilenos/diagnóstico , Bario/diagnóstico , Estudios ProspectivosRESUMEN
AIM: (a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population. METHODS: Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofskys index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels. RESULTS: Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofskys index > 70, and 40/78 (51.3%) with Karnofskys index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26). CONCLUSION: According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population. (AU)
Asunto(s)
Humanos , Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Diálisis/efectos adversos , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/etiología , Argentina/epidemiología , Estudios de Casos y Controles , Escolaridad , Calidad de Vida , Prevalencia , Fallo Renal Crónico/terapia , Factores de Riesgo , Estudios Seroepidemiológicos , Albúmina Sérica/análisis , Factores Socioeconómicos , Factores de TiempoRESUMEN
El sindrome de intestino corto (SIC) está caracterizado por diarrea y mala absorción de nutrientes. Los carbohidratos no absorbidos en el intestino delgado pueden contribuir a la diarrea a través de un efecto osmótico mediado por los propios azúcares sin absorber o por sus productos de fermentación bacteriana. En condiciones de normalidad los ácidos grasos volátiles (AGV) son los principales metabolitos bacterianos, son parcialmente absorbidos por la mucosa colónica estimulando la absorción de sodio y agua el acido láctico esta en muy bajas concentraciones, su absorción es lenta y trabajos experimentales demuestran que puede ocasionar daño a la mucosa colónica. En este trabajo se estudió la composición del agua fecal (pH,Na+,K+, osmolaridad, AGV y ácidos D y L-láctico) de pacientes con SIC comparando los resultados con un grupo control. El agua fecal de los pacientes con SIC mostró una disminución en la concentración de K+, de la relación K+/Na+, y un incremento del gap osmótico. Los AGV fueron los principales aniones orgánicos en las heces de los sujetos controles mientras que el ácido láctico fue el anion preponderante en el agua fecal obtenida de pacientes con SIC. Estos resultados sugieren que este cambio metabólico bacteriano puede contribuir a la diarrea observada en los pacientes con SIC. (AU)
Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adulto , Ácidos Grasos Volátiles/metabolismo , Ácido Láctico/metabolismo , Síndrome del Intestino Corto/metabolismo , DiarreaRESUMEN
Recent experimental studies have suggested that an increase in the synthesis of nitric oxide, a powerful vasodilator secreted by endothelial cells, plays a role in the hemodynamic disturbances associated to portal hypertension. The present study was addressed to investigate the effects of L-NNA (a specific inhibitor of nitric oxide) on systemic and splanchnic hemodynamics in portal hypertensive rats, induced by partial portal vein ligation. Intravenous infusion of L-NNA (50 ug/kg/min) significantly increased systemic blood pressure and decreased cardiac output as measured by radiolabeled microspheres. A significant increase in systemic and splanchnic vascular resistance was also observed in L-NNA-treated rats; whereas portal blood flow decreased significantly, L-NNA did not modify portal pressure. Pretreatment with L-arginine (300 mg/Kg, i.v.) prevented the hemodynamic changes induced by L-NNA. Similar values of endotoxin levels were detected in both groups of animals. In the control group, L-NNA caused a mild but significant increase of mean arterial pressure; no significant changes on the other hemodynamic parameters were observed. These results suggest that an increase in endogenous synthesis of nitric oxide may play an important role in hemodynamic disturbances associated with chronic portal hypertension.
RESUMEN
This study was performed in 15 healthy control subjects (8 males- age 23-70 and 7 females age 20-74) as a way to compare the total and segmental colonic transit time with two different type of radiopaque markers. One type of markers was 3 mm cut sections of a radiopaque polietilene 14 French Levine tube, with a medium weight of 64.3 mg and a specific gravity (SG) of 1.28. The other type were 7 mm lenticular insoluble barium (lentils) with medium weight of 231 mg and a SG of 1.87. Each subject ingested 20 markers of each type with the breakfast and front and profile plain films of the abdomen were taken 24 and 48 hs after. The total colonic transit time for the polietilene markers was 17.7 hs and 27.3 hs for the barium type (BM) (p < 0.001). The segmental transit time for right colon was 2.4 hs (PM) and 9.7 hs (PM) and 9.7 hs (BM) (p < 0.001) in the left colon 9.5 hs (PM) and 11.3 hs (BM) and in rectoanun 5.9 hs (BM) with no statistical significance. Conclusion: the physical characteristics of the radiopaque markers can modify the results of the colonic transit times.
RESUMEN
Colonic inflammation was produced in rats by chemotactic peptides acting on polymorphonuclear leucocytes. Instillation during one hour of formylated tripeptide: formylmethionyl-leucy-phenylalanine (FMLP) and a tetrapeptide: alanine-glycine-sefine-glutamine (AGSG) into rat colon caused erosions and exulcerations. Neutrophils increased secondary to instillation, predominantly with FMLP, and mucus depletion was marked in the cecum. Chloride ion secretion and mucosal permeability were significatively greater in the colonic lumen with the chemotactic peptides. Histamine and serotonin concentration were greater in the colonic fluid in animals treated with the peptides. These observations could suggest that the presence of chemotactic peptides at the colonic lumen produce changes at the mucosal wall, that would participate in generation and perpetuation of the colonic inflammation. (AU)