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1.
BMC Pediatr ; 24(1): 207, 2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38521911

RESUMO

BACKGROUND: Anorectal malformations (ARMs) are the most common congenital anomaly of the digestive tract. And colostomy should be performed as the first-stage procedure in neonates diagnosed with intermediate- or high-type ARMs. However, the most classic Pe˜na's colostomy still has some disadvantages such as complicated operation procedure, susceptibility to infection, a greater possibility of postoperative incision dehiscence, difficulty of nursing and large surgical trauma and incision scarring when closing the stoma. We aimed to explore the effectiveness of middle descending colon-double lumen ostomy (MDCDLO) in the treatment of high and intermediate types of anorectal malformations. METHODS: We retrospectively reviewed the data of patients who underwent MDCDLO for high or intermediate types of ARMs between June 2016 and December 2021 in our hospital. The basic characteristics were recorded. All patients were followed up monthly to determine if any complication happen. RESULTS: There were 17 boys and 6 girls diagnosed with high or intermediate types of ARMs in our hospital between June 2016 and December 2021. All 23 patients were cured without complications such as abdominal incision infection, stoma stenosis, incisional hernia, and urinary tract infection in the postoperative follow-up time of 6 months to 6 years except one case of proximal intestinal prolapse was restored under anesthesia. CONCLUSION: MDCDLO offers the advantages of simplicity, efficiency, safety, mild trauma, and small scarring in the treatment of high and intermediate types of anorectal malformations.


Assuntos
Malformações Anorretais , Recém-Nascido , Masculino , Feminino , Humanos , Malformações Anorretais/cirurgia , Malformações Anorretais/etiologia , Estudos Retrospectivos , Cicatriz/etiologia , Colo Descendente , Colostomia/efeitos adversos , Colostomia/métodos
2.
Pharm Dev Technol ; 29(3): 212-220, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38392961

RESUMO

The current budesonide formulations are inadequate for addressing left-sided colitis, and patients might hesitate to use an enema for a prolonged time. This study focuses on developing a single-layer coating for budesonide pellets targeting the descending colon. Pellets containing budesonide (1.5%w/w), PVP K30 (5%w/w), lactose monohydrate (25%w/w) and Avicel pH 102 (68.5%w/w) were prepared using extrusion spheronization technique. Coating formulations were designed using response surface methodology with pH and time-dependent Eudragits. Dissolution tests were conducted at different pH levels (1.2, 6.5, 6.8, and 7.2). Optimal coating formulation, considering coating level and the Eudragit (S + L) ratio to the total coating weight, was determined. Budesonide pellets were coated with the optimized composition and subjected to continuous dissolution testing simulating the gastrointestinal tract. The coating, with 48% S, 12% L, and 40% RS at a 10% coating level, demonstrated superior budesonide delivery to the descending colon. Coated pellets had a spherical shape with a uniform 30 µm thickness coating, exhibiting pH and time-dependent release. Notably, zero-order release kinetics was observed for the last 9 h in colonic conditions. The study suggests that an optimized single-layer coating, incorporating pH and time-dependent polymers, holds promise for consistently delivering budesonide to the descending colon.


Assuntos
Budesonida , Sistemas de Liberação de Medicamentos , Ácidos Polimetacrílicos , Humanos , Colo , Colo Descendente , Solubilidade , Implantes de Medicamento
3.
Gan To Kagaku Ryoho ; 51(5): 561-565, 2024 May.
Artigo em Japonês | MEDLINE | ID: mdl-38881069

RESUMO

A 73-year-old woman underwent a descending colectomy for descending colon cancer. The tumor was graded as pStage Ⅲb(pT3[SS], pN1b, pM0, Cur A), according to the 9th edition of the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma. Postoperative treatment of adjuvant chemotherapy comprised oral tegafur/uracil and Leucovorin for 6 months with no evident recurrence. However, contrast-enhanced CT and FDG-PET/CT examination 8 years and 7 months after surgery revealed a 30 mm irregular recurrent tumor in the left iliac fossa. Since the tumor was adjacent to the left psoas muscle, it was considered that RM0(no tumor identified at the radial margin)could not be achieved in that region. Owing to the patient's good general condition, systemic chemotherapy with CAPOX+bevacizumab was administered. Although adverse events prompted discontinuation of the treatment during the first course, the recurrent tumor had significantly regressed. Systemic chemotherapy with mFOLFOX6+bevacizumab as selected subsequent treatment achieved a significant tumor shrinkage to date. Although a recurrence more than 5 years after curative resection of colorectal cancer is extremely rare, the possibility of late recurrence must be considered in patients with well-differentiated tumors who received adjuvant chemotherapy and had negative vascular invasion.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Colectomia , Neoplasias do Colo , Recidiva , Humanos , Idoso , Feminino , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/cirurgia , Neoplasias do Colo/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fatores de Tempo , Colo Descendente/patologia , Colo Descendente/cirurgia , Bevacizumab/administração & dosagem , Resultado do Tratamento , Leucovorina/administração & dosagem , Leucovorina/uso terapêutico
4.
Gan To Kagaku Ryoho ; 50(13): 1906-1908, 2023 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-38303248

RESUMO

A 69-year-old male patient with descending colon cancer with para-aortic lymph node metastasis underwent surgery to resect the primary tumor. After the surgery mFOLFOX6 plus panitumumab was introduced. Because 2 times drug-induced lung disease and Stevens Johnson syndrome were occurred, changes in chemotherapy regimen were required. 18 months after administration, complete response was achieved. The chemotherapy was discontinued 48 months after administration. He is alive without recurrence for 32 months after completion of treatment.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Colo Descendente , Masculino , Humanos , Idoso , Metástase Linfática/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Linfonodos/patologia , Panitumumabe
5.
Gan To Kagaku Ryoho ; 50(13): 1551-1553, 2023 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-38303338

RESUMO

A 77-year-old man with complaining of anemia and abdominal pain was admitted to our hospital. An abdominal computed tomography showed the sigmoid colon tumor with bowel obstruction. Laparoscopic transverse colostomy was performed to release intestinal obstruction. After first operation, he was diagnosed the sigmoid colon cancer: cT4b(bladder), cN0, cM0, and cStage Ⅱc. Radical laparoscopic operation(Hartmann's operation)was performed. On the 4th postoperative day, fecal juice was discharged from the abdominal drain placed in the Douglas fossa, so emergency laparotomy was performed. The intraoperative findings showed perforation in the blind end of the descending colon. The descending colon was resected from a site approximately 5 cm anal side of the transverse colostomy to the blind end. It was thought that perforation occurred due to an increase in internal pressure in the residual intestinal tract after Hartmann's surgery without blood flow disorder. We believe that further attention is required to the management of residual intestinal tract at the blind end for the obstructive colorectal cancer.


Assuntos
Obstrução Intestinal , Laparoscopia , Masculino , Humanos , Idoso , Colostomia/métodos , Colo Descendente/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Laparoscopia/métodos , Canal Anal/cirurgia , Anastomose Cirúrgica , Complicações Pós-Operatórias , Estudos Retrospectivos
7.
Magy Seb ; 77(1): 33-38, 2024 Apr 02.
Artigo em Húngaro | MEDLINE | ID: mdl-38564272

RESUMO

A felnottkori invaginatiók ritkák, klinikai megjelenésük eltér a gyerekkori formáktól. Klinikumuk igen változatos, gyakran atípusos, jellemzo, hogy egy klinikai sejtés nyomán gondolni kell az invaginatio lehetoségére. A kiegészíto vizsgálatok közül kiemelkedo szerep jut a computer tomográfiának (CT), ami magas érzékenységgel és fajlagossággal képes kimutatni a béltraktus invaginatióját. Gyógyításuk az esetek legnagyobb részében sebészi, sokszor csak a mutét során lehetséges felismerni a kiváltó okot. Esetismertetésünkben egy rendkívül ritka, felnottkori, passage-zavart okozó colo-colicus, a bal colonfelet érinto, a colon-flexura lienalis-descendens határra lokalizált invaginatio klinikai jellemzoit, diagnosztikáját és definitív megoldásaként a laparoscoposan asszisztált bal oldali haemicolectomia mutéti megoldását mutatjuk be. Munkánkban összefoglaljuk a felnottkori invaginatiókra vonatkozó kórélettani fogalmakat, diagnosztikai lehetoségeket, a leggyakoribb kiváltó tényezoket és terápiás lehetoségeket.


Assuntos
Citrus , Intussuscepção , Adulto , Humanos , Colo , Colo Descendente
8.
Clin Transl Gastroenterol ; 15(5): e00692, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38363861

RESUMO

INTRODUCTION: Factors affecting mucosal permeability (MP) in ulcerative colitis (UC) are largely unknown. We aimed to investigate the difference in MP among patients with UC classified according to the colonic locations and to evaluate the correlations between local MP and endoscopic or histological activity of UC. METHODS: The transepithelial electrical resistance (TER), which is inversely proportional to permeability, of tissue samples from the mucosa of the ascending colon, descending colon, and rectum of patients with UC and healthy individuals (HIs) was measured by using the Ussing chamber. TERs were compared between patients with UC and HIs and evaluated according to colonic locations and disease activity of UC. RESULTS: Thirty-eight patients with UC and 12 HIs were included in this study. Both in HIs and patients with UC, MP tends to be higher in the anal side. TER in the ascending colon was significantly lower in patients with UC than in HIs (45.3 ± 9.0 Ω × cm 2 vs 53.5 ± 9.7 Ω × cm 2 , P = 0.01). The increased permeability in UC was observed also in the descending colon, only when the inflammation involved the location. A significant correlation between TER and endoscopic activity was found in the rectum only ( r = -0.49, P = 0.002). There were no significant correlations between TERs and UC histology. DISCUSSION: The MP in the colon differs according to the colonic location. The ascending colon among patients with UC showed disease-specific changes in MP, whereas the MP is increased in proportion to the endoscopic activity in the rectum.


Assuntos
Colite Ulcerativa , Impedância Elétrica , Mucosa Intestinal , Permeabilidade , Reto , Humanos , Colite Ulcerativa/patologia , Masculino , Mucosa Intestinal/patologia , Mucosa Intestinal/metabolismo , Feminino , Adulto , Pessoa de Meia-Idade , Reto/patologia , Colo Ascendente/patologia , Colonoscopia , Colo Descendente/patologia , Estudos de Casos e Controles , Índice de Gravidade de Doença , Colo/patologia , Colo/diagnóstico por imagem , Idoso , Adulto Jovem
9.
Korean J Gastroenterol ; 82(6): 300-303, 2023 12 25.
Artigo em Inglês | MEDLINE | ID: mdl-38130000

RESUMO

Epiploic appendagitis (EA) is an uncommon intraabdominal pathology resulting in transient, localized pain. The condition is caused by ischemia of one of the epiploic appendages, which are distributed axially along the length of the colon. EA is often mistaken for other more common etiologies of an acute abdomen. Generally, the patients experience focal abdominal pain with no further symptoms or laboratory abnormalities. The authors encountered a 79-year-old male with severe sepsis and acute respiratory failure requiring intubation. He recovered rapidly after the identification and removal of a single EA. This paper reports the first case of EA leading to the systemic dysregulation of sepsis.


Assuntos
Colite Isquêmica , Insuficiência Respiratória , Sepse , Masculino , Humanos , Idoso , Colo Descendente , Tomografia Computadorizada por Raios X/métodos , Dor Abdominal/etiologia , Colite Isquêmica/complicações , Sepse/complicações , Sepse/diagnóstico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/complicações
11.
Oncología (Guayaquil) ; 32(2): 180-193, 2 de Agosto del 2022.
Artigo em Espanhol | LILACS | ID: biblio-1391900

RESUMO

Introducción: La cirugía laparoscópica es una alternativa segura para el tratamiento en el cáncer de colon y además permite todas las ventajas de un procedimiento de mínima invasión. El objetivo de la presente investigación fue medir el impacto en la morbilidad de la técnica quirúrgica abierta vs cerrada en cáncer de colon. Metodología: El estudio se realizó en el Hospital Solón Espinosa Ayala, en Quito-Ecuador, período marzo del 2012 hasta marzo del 2017, con una muestra no probabilística, se incluyeron pacientes mayores de edad, con cáncer de colon. Se incluyen variables socio-demográficas, histología, días de hospitalización, sangrado quirúrgico, tiempo quirúrgico, estancia hospitalaria, márgenes quirúrgicos, ganglios reseca-dos, inicio de dieta, % de conversión quirúrgica, complicación quirúrgica, recidiva, morbilidad quirúrgica, mortalidad quirúrgica. Se utiliza estadística descriptiva univariada y bivariada.Resultados: Se analizan 85casos, 52 casos se realizaron cirugía abierta y 33 casos se realizaron cirugía laparoscópica.La conversión quirúrgica fue 75% por adherencias y 25% por infiltración a duodeno. El tiempo quirúrgico similar 121 a 180 minutos 61%. Complicaciones laparoscópicas 2,3% y 9,4% abierta (colecciones pélvicas y fistulas intestinales 2.4% vs 1.7%). La desnutrición no presentó relación. Inicio de dieta 2 a4 días 83% laparoscópica y 67% abierta. Hospitalización de 4 a 8 días fue laparoscópica 87% y abierta 78%. Pérdida sanguínea menor a 100cc fue laparoscópicas 82%, y abiertas 60%. La resección de ganglios (+13) en laparoscopía 69.6% y abierta 68.1%. El margen proximal de pieza quirúrgica por laparoscopía 5.1 a 10cm (43.5%), por abierta (55.3%), la recaída tumoral del 56.2%y 52.3%. El estado vital por laparoscopía fue fallecido 12.5%, y abierta 28.8%, en relación a su enfermedad tumoral Conclusión: Las comorbilidades quirúrgicas y recuperación fueron menores por laparoscopía, pero la cirugía abierta mostro mejores resultados anatomopatológicos post quirúrgicos


Introduction:Laparoscopic surgery is a safe alternative for colon cancer treatment and allows all the advantages of a minimally invasive procedure. The objective of the present investigation was to measure the impact on morbidity of the open vs. closed surgical technique in colon cancer.Methodology: The study was carried out at the Solón Espinosa Ayala Hospital, in Quito-Ecuador, from March 2012 to March 2017, with a non-probabilistic sample, including elderly patients with colon cancer. Socio-demographic variables, histology, days of hospitalization, surgical bleeding, surgical time, hospital stay, surgical margins, resected lymph nodes, the start of the diet, % surgical conversion, surgical com-plication, recurrence, surgical morbidity, and surgical mortality are included. Univariate and bivariate de-scriptive statistics are used.Results: 85 cases are analyzed; 52 underwent open surgery, and 33 underwent laparoscopic surgery. The surgical conversion was 75% due to adhesions and 25% due to duodenal infiltration. The similar surgical time is 121 to 180 minutes 61%. Laparoscopic complications 2.3% and 9.4% open (pelvic col-lections and intestinal fistulas 2.4% vs 1.7%). Malnutrition was not related. Start of diet 2 to 4 days 83% laparoscopic and 67% open. Hospitalization from 4 to 8 days was laparoscopic 87% and open 78%. Blood loss less than 100cc was laparoscopic in 82% and opened in 60%. Lymph node resection (+13) in lapa-roscopy 69.6% and open 68.1%. The proximal margin of the surgical piece by laparoscopy is 5.1 to 10cm (43.5%), by open (55.3%), the tumor recurrenceof 56.2% and 52.3%. The mortality in laparoscopy surgery was 12.5%, and in open surgery was 28.8%.Conclusion: Laparoscopy's surgical comorbidities and recovery were lower, but open surgery showed better post-surgical pathological results


Assuntos
Neoplasias , Laparoscopia , Colectomia , Colo , Colo Ascendente , Colo Descendente
12.
J. health med. sci. (Print) ; 7(3): 201-206, jul.-sept. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1391545

RESUMO

Presentamos el caso de un paciente masculino de 40 años de edad, con estreñimiento de un año de evolución y antecedentes de enfermedad por reflujo gastroesofágico, se realiza endoscopia digestiva alta y baja y se realiza diagnóstico sincrónico de adenocarcinoma de estómago, recto y colon descendente, realizamos tomografía por emisión de positrones con tomografía computarizada pre quirúrgico y cirugía como tratamiento primario. Mostramos una descripción del caso y una revisión de la bibliografía.


We present the case of a 40-year-old man with a one year evolution constipation and a history of GERD. An upper and lower digestive endoscopy was performed and a synchronous diagnosis of adenocarcinoma of the stomach, rectum and descending colon was established. A PET-CT pre-surgical was performed and the surgery was carried out as primary treatment. We show a description of the case and a bibliographic review.


Assuntos
Humanos , Masculino , Adulto , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/epidemiologia , Prognóstico , Tomografia Computadorizada por Raios X , Incidência , Endoscopia do Sistema Digestório/métodos , Colo Descendente , Tomografia por Emissão de Pósitrons , Consentimento Livre e Esclarecido , Estadiamento de Neoplasias
13.
Arq. bras. med. vet. zootec. (Online) ; 69(4): 830-834, jul.-ago. 2017. ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-876587

RESUMO

The aim of this report was to describe the clinical findings and therapeutic management of a case of papillary adenocarcinoma of the descending colon in a Beagle. The patient presented soft stools, haematochezia, tenesmus, and dyschezia. Clinical examination revealed alterations on the ultrasonographic features of the descending colon suggestive of colitis and neoplasia. Following local mass resection, histopathology analysis revealed mild lymphoplasmocytic enteritis and papillary adenocarcinoma of the colon. Enterectomy for tumoral resection and biopsy of locoregional lymph nodes were carried out. Subsequent to the surgical procedure, it was possible to confirm the previous diagnosis and the tumor was classified as intestinal intraluminal papillary adenocarcinoma, with incomplete surgical margins. Adjuvant chemotherapy was performed using carboplatin, cyclophosphamide, and piroxicam, leading to remission of clinical signs and absence of any clinical or imaging alterations compatible with the patient's previous clinical condition.(AU)


O objetivo desse relato de caso foi descrever os achados clínicos e manejo terapêutico de um caso de adenocarcinoma papilífero do cólon descendente em um Beagle. O paciente apresentou fezes amolecidas, hematoquesia, tenesmo e disquesia. Exame clínico revelou alteração de achados ultrassonográficos do cólon descendente sugerindo colite e neoplasia. Após ressecção de massa local, análise histopatológica revelou enterite linfmoplasmocito leve e adenocarcinoma papilar do cólon. Enterectomia para ressecção tumoral e biopsia das lesões locais e tumores linfonodais foram realizadas. Após procedimento cirúrgico foi possível confirmar o diagnóstico prévio e o tumor foi classificado como adenocarcinoma papilar intraluminal intestinal, com margens cirúrgicas incompletas. Quimioterapia adjuvante foi realizada utilizando carboplatina, ciclofosfamida e piroxano, levando a remissão de sinais clínicos e ausência de alterações de imagem compatíveis com situação clínica prévia do paciente.(AU)


Assuntos
Animais , Cães , Adenocarcinoma Papilar/veterinária , Colo Descendente/patologia , Neoplasias Intestinais/veterinária
14.
J. coloproctol. (Rio J., Impr.) ; 36(4): 240-243, Oct.-Dec. 2016. ilus
Artigo em Inglês | LILACS | ID: biblio-829117

RESUMO

Intestinal lipomas can occur anywhere in the gastrointestinal tract, and these tumors are more frequent in the colon. By being largely asymptomatic, colonic lipomas are usually found incidentally, as findings in colonoscopy examinations, in association with biopsy. Endoscopic or surgical resection is the therapeutic option, depending on the size of the tumor, its location, and the presence or absence of symptoms. In this study, we present a case of a 59-year old woman, with a descending colon lipoma histologically diagnosed only after surgical resection of the lesion. The approach was adopted according to the patient's clinical picture (intestinal bleeding, vomiting and weight loss), in addition to the occlusion of 80% of the colonic lumen observed in a colonoscopy.


Os lipomas intestinais podem ocorrer em qualquer parte do trato gastrointestinal, sendo mais frequente no cólon. Por serem em grande parte assintomáticos, os lipomas colônicos são usualmente encontrados acidentalmente como achados de exame de colonoscopia associada à biópsia. Como opções de tratamento, há a ressecção endoscópica ou cirúrgica, a depender do tamanho do tumor, sua localização e presença (ou não) de sintomas. Nesse relato, é apresentado um caso de uma mulher de 59 anos com lipoma de cólon descendente, diagnosticado histologicamente apenas após ressecção cirúrgica da lesão. A conduta foi adotada pelo quadro clínico de enterorragia, vômitos e perda ponderal, além da oclusão de 80% da luz do cólon observada em exame de colonoscopia.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Colo Descendente , Lipoma , Lipoma/cirurgia , Lipoma/diagnóstico , Colonoscopia , Colo Descendente/anatomia & histologia , Ressecção Endoscópica de Mucosa
15.
Braz. j. med. biol. res ; 47(10): 911-916, 10/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-722166

RESUMO

Anastomotic dehiscence is the most severe complication of colorectal surgery. Metalloproteinases (MMPs) and interleukins (ILs) can be used to analyze the healing process of anastomosis. To evaluate the effects of bromopride on MMP and cytokine gene expression in left colonic anastomoses in rats with or without induced abdominal sepsis, 80 rats were divided into two groups for euthanasia on the third or seventh postoperative day (POD). They were then divided into subgroups of 20 rats for sepsis induction or not, and then into subgroups of 10 rats for administration of bromopride or saline. Left colonic anastomosis was performed and abdominal sepsis was induced by cecal ligation and puncture. A colonic segment containing the anastomosis was removed for analysis of gene expression of MMP-1α, MMP-8, MMP-13, IL-β, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). On the third POD, bromopride was associated with increased MMP-1α, MMP-13, IL-6, IFN-γ, and IL-10 gene expression. On the seventh POD, all MMP transcripts became negatively modulated and all IL transcripts became positively modulated. In the presence of sepsis, bromopride administration increased MMP-8 and IFN-γ gene expression and decreased MMP-1, TNF-α, IL-6, and IL-10 gene expression on the third POD. On the seventh POD, we observed increased expression of MMP-13 and all cytokines, except for TNF-α. In conclusion, bromopride interferes with MMP and IL gene expression during anastomotic healing. Further studies are needed to correlate these changes with the healing process.


Assuntos
Animais , Masculino , Antieméticos/farmacologia , Colo Descendente/cirurgia , Expressão Gênica/efeitos dos fármacos , Interleucinas/metabolismo , Metaloproteinases da Matriz/metabolismo , Metoclopramida/análogos & derivados , Anastomose Cirúrgica , Ceco/cirurgia , Interferon gama/análise , Interleucina-1beta/análise , /análise , /análise , Interleucinas/genética , Ligadura , Metaloproteinase 1 da Matriz/análise , /análise , /análise , Metaloproteinases da Matriz/genética , Metoclopramida/farmacologia , Punções , Ratos Wistar , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sepse/etiologia , Fator de Necrose Tumoral alfa/análise , Cicatrização/efeitos dos fármacos
16.
Rev. venez. cir ; 66(4): 167-169, dic. 2013. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1392678

RESUMO

Objetivo: Determinar el tiempo de tránsito colónico (TTC) en pacientes con estreñimiento crónico debido a ciego móvil (CM). Métodos: Estudio descriptivo, prospectivo y transversal don-de se incluyeron todos los pacientes con diagnóstico de estreñimiento crónico y la presencia de ciego móvil que acudieron a la Unidad de Coloproctología del Hospital Universitario de Caracas,entre enero y octubre de 2013. La estadística se desarrolló por el análisis de la varianza ANOVA (Anova de Fisher o Análisis de varianza de Fisher). Resultados: Se incluyeron 33 pacientes, todas mujeres, comprendidas entre los 18 y 75 años, con una media de 46.5 años.Presentaron CM I 6 = 18.2%, CM II 13 = 39.3% y CM III 14 =42.4%. A todas se les practicó TTC con evaluación al quinto día.La retención de marcadores osciló entre 1 y 37. No hubo significancia para el número de marcadores del tiempo de tránsito colónico (TTC) y los tres tipos de ciego móvil (CM). Si fue significativo el número de marcadores del TTC y el segmento de colon corres-pondiente al tipo de CM I=recto, CM II=colon descendente y CM III=ciego. Conclusión: El TTC demuestra que existe tránsito lento en todas las pacientes con CM sin importar el grado, y evidenciando que el CM III presenta la retención en la región inicial de colon,el ciego(AU)


Objective: To determine the colonic transit time (CTT) inpatients with chronic constipation due to mobile cecum (MC). Methods: Descriptive prospective cross-sectional study, where all patients with diagnosis of chronic constipation and the presence of mobile cecum, who attended the Colorectal Unit at Hospital Universitario de Caracas, between January and October 2013 Statistics are developed by ANOVA analysis (ANOVA (Fisher analysis of variance or Fisher variance) Results: We included 33 patients, all women, aged between 18 and 75 years old, with an average of 46.5 years. Presented MCI 6 = 18.2%, MC II 13 = 39.3% and MC III 14 = 42.4%. Be practiced all CTT with evaluation on the fifth day. Retention of markerstilt between 1 and 37. Significance there was for the number of transit time markers colonic (CTT) and the three types of mobilececum (MC). If the number of markers of the CTT was significant and the segment of colon corresponding to the type of MC I =rectum, MC II = descending colon and MC III = cecum. Conclusion: CTT shows that there is slow transit in all patients regardless of the degree MC, and MC III showing that the retention in the initial region of colon, cecum(AU)


Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Trânsito Gastrointestinal , Ceco , Colo , Constipação Intestinal , Mulheres , Colo Ascendente , Colo Descendente
17.
Acta cir. bras ; 23(3): 230-236, May-June 2008. ilus, tab
Artigo em Inglês | LILACS | ID: lil-484381

RESUMO

PURPOSE: To elaborate an animal model with the objective of studying the continence of the biological valves surgically performed in the left colon of rats. METHODS: Thirty four rats were operated on and divided into three groups (G). G1 (sham) animals which underwent laparotomy only; G2 (perineal amputation without valves): animals which underwent amputation of the anal sphincter complex combined with a perineal colostomy; G3 (abdominoperineal amputation combined with valves): animals which underwent abdominoperineal amputation combined with three, equidistant and circumferential (360(0)), extra-mucosal seromyotomies, of the descending colon, which were sutured to create biological valves combined with perineal colostomy. Animals were euthanized in the late postoperative period and surgical valves were saved for histopathological study. RESULTS: Surgical procedure provoked intestinal dilation, as well as segmented chambers along the descending colon. Retained fecalomas between the valves and proximal to them were also noted. Six rats died of intestinal obstruction due to fecal impaction at the surgical site. The sequence of events was: stasis, obstruction, distention, perforation, peritonitis and death. Histopathology showed inflammation due to foreign body type reaction around the sutured colon causing partial concentric stenosis, capable of interfering normal mechanical activity of the distal colon. This process resulted in retardation of the intestinal transit. CONCLUSION: Extra-mucosal seromyotomies, with seromuscular suture, can be used as an operative procedure capable of causing retardation in the intestinal transit of rats.


OBJETIVO: Modelo de experimentação, com confecção de válvulas biológicas no cólon esquerdo de ratos com o objetivo de estudar o grau de continência dessas válvulas. MÉTODOS: Trinta e quatro ratos foram operados e distribuidos em três grupos: G1 (grupo simulado) submetido apenas à laparotomia, G2 (grupo amputado sem válvula) submetido à amputação do conjunto esfincteral mais colostomia perineal e G3 (grupo amputado com válvula) submetido à amputação do conjunto esfincteral, confecção de três seromiotomias extra-mucosas, eqüidistantes e circunferenciais (360(0) - válvulas biológicas), no colon descendente mais colostomia perineal. No pós-operatório tardio, os animais dos três grupos foram submetidos à eutanásia para coleta da peça cirúrgica e estudo histopatológico das válvulas. RESULTADOS: Os resultados mostraram que o procedimento culminou em dilatação intestinal, confirmada pela formação de verdadeiras câmaras de segmentação e pela presença de fecalomas retidos entre as válvulas e cranialmente a elas. Seis ratos morreram em decorrência de obstrução intestinal por impacção de fezes no local operado, na seqüência: obstrução, estase, distensão, perfuração, peritonite e morte. As alterações histopatológicas confirmaram o processo inflamatório com reação do tipo corpo estranho, no perímetro do cólon suturado, proporcionando uma estenose parcial concêntrica, levando à alteração da atividade mecânica do cólon distal, resultando no retardo do trânsito intestinal. CONCLUSÃO: As seromiotomia extramucosas, com sutura seromuscular, podem ser utilizadas como técnica operatória para se obter retardo do trânsito intestinal em ratos.


Assuntos
Animais , Masculino , Ratos , Colo Descendente/patologia , Colo Descendente/cirurgia , Colostomia/métodos , Impacção Fecal/etiologia , Esvaziamento Gástrico/fisiologia , Anastomose Cirúrgica/métodos , Colo Descendente/ultraestrutura , Colostomia/efeitos adversos , Modelos Animais de Doenças , Incontinência Fecal/patologia , Fibrose/patologia , Reação a Corpo Estranho/patologia , Células Gigantes de Corpo Estranho/ultraestrutura , Linfócitos do Interstício Tumoral , Complicações Pós-Operatórias/mortalidade , Ratos Wistar , Técnicas de Sutura
18.
Arq. neuropsiquiatr ; 66(3a): 516-523, set. 2008. ilus, graf, tab
Artigo em Inglês | LILACS | ID: lil-492573

RESUMO

Alterations caused by a genotype III strain of Toxoplasma gondii were assessed with respect to the number and the morphometry of the myenteric neurons in the terminal ileum and the descending colon. Eighteen rats were divided into four groups: Acute Control Group (ACG, n=4); Acute Experimental Group (AEG, n=4); Chronic Control Group (CCG, n=5) and Chronic Experimental Group (CEG, n=5). NaCl solution was administered through gavage to the animals in the ACG and CCG. Toxoplasma gondii tachyzoites (10(4)) from a genotype III strain were orally administered to the AEG and CEG. Acute Groups were died after 24 hours, and the Chronic Groups after 30 days. Neuronal loss was not observed in both organs. The neurons atrophied in the terminal ileum as the opposite occurred with the neurons at the descending colon during the chronic phase of infection. In the terminal ileum, the neurons atrophied during the chronic phase of the infection as no alteration was found during the acute phase. For the descending colon, the neurons became hypertrophic during the chronic infection in opposition to the atrophy found during the acute phase.


Objetivou-se avaliar as alterações causadas por uma cepa genótipo III de Toxoplasma gondii, sobre o número e a morfometria de neurônios mientéricos, do íleo terminal e do cólon descendente. Dividiu-se dezoitos ratos em quatro grupos: controle agudo (GCA, n=4), experimental agudo (GEA, n=4), controle crônico (GCC, n=5) e experimental crônico (GEC, n=5). Os animais do GCA e GCC receberam solução de NaCl por gavagem, e os animais do GEA e GEC 10(4) taquizoítos de uma cepa genótipo III de T. gondii por via oral. Os grupos agudos após 24 horas foram mortos e os crônicos após 30 dias. Observou-se que não houve perda neuronal em ambos os órgãos. No íleo terminal, os neurônios atrofiaram-se na fase crônica da infecção, enquanto nenhuma alteração ocorreu na fase aguda. Já no cólon descendente, os neurônios tornaram-se hipertróficos na fase crônica da infecção, em oposição à atrofia observada na fase aguda.


Assuntos
Animais , Masculino , Ratos , Sistema Nervoso Autônomo/patologia , Íleo/patologia , Enteropatias Parasitárias/patologia , Plexo Mientérico/patologia , Toxoplasma/patogenicidade , Toxoplasmose Animal/patologia , Sistema Nervoso Autônomo/parasitologia , Colo Descendente/parasitologia , Colo Descendente/patologia , Modelos Animais de Doenças , Genótipo , Enteropatias , Íleo/parasitologia , Enteropatias Parasitárias/parasitologia , Plexo Mientérico/parasitologia , Ratos Wistar , Estatísticas não Paramétricas , Toxoplasma/genética , Toxoplasmose Animal/parasitologia
19.
Acta cir. bras ; 21(2): 97-100, Mar.-Apr. 2006. tab, graf
Artigo em Inglês | LILACS | ID: lil-423555

RESUMO

OBJETIVO: Comparação das grandezas físicas Energia Total de Ruptura e Força de Ruptura à Tração no estudo da resistência de ruptura do cólon descendente de ratos. MÉTODOS: Doze segmentos de cólon descendente de ratos foram utilizados como corpos de prova. Por meio do Teste Biomecânico Energia Total de Ruptura, obteve-se, de cada espécime, a Força de Ruptura à Tração e a Energia Total de Ruptura necessárias para promover o rompimento da parede cólica. Com esses valores, calculou-se a média, o desvio padrão, o erro padrão e o coeficiente de variação, sendo esse último atributo usado para a comparação das grandezas físicas. RESULTADOS: Os valores da média, do desvio-padrão, do erro-padrão e do coeficiente de variação da Força de Ruptura à Tração foram 380,05 gf, 98,74, 28,5 e 25,98%, respectivamente. A Energia Total de Ruptura apresentou a média de 244,85 gf, o desvio-padrão de 57,76, o erro padrão de 16,67 e o coeficiente de variação de 23,59%. CONCLUSÃO: A Energia Total de Ruptura, mesmo considerando em seus cálculos maior quantidade de atributos pertencentes aos materiais com propriedade viscoelástica não linear, tal qual a estrutura da parede cólica, apresentou menor coeficiente de variação em comparação com o coeficiente de variação da Força de Ruptura à Tração, demonstrando ser um possível parâmetro para a análise da resistência intestinal de ratos.


Assuntos
Animais , Masculino , Ratos , Fenômenos Biomecânicos , Cartilagem Articular/lesões , Colo Descendente/lesões , Força Compressiva , Modelos Animais de Doenças , Ruptura , Estresse Mecânico , Cicatrização
20.
Int. j. morphol ; 24(4): 591-597, Dec. 2006. ilus
Artigo em Inglês | LILACS | ID: lil-626847

RESUMO

We studied the effects of a severely hypoproteic diet on the quantitative aspects of the myenteric plexus of the descending colon of young rats. Eighteen rats were divided into two groups, one of them being fed with a chow having 26% protein (control) and the other with a chow having 4% protein, balanced for minerals and vitamins, during 12 weeks. The whole-mounts of the descending colon had their myenteric neurons stained either with Giemsa or NADPH diaphorase. The rats from the experimental group had deficits of body weight (54.23%) and area of the descending colon (48.14%); additionally, we observed that there was no alteration in the total number of neurons of the colon, but a decrease in the number of NADPH-diaphorase positive neurons (37.80%). The implications of these results concerning the priority that some cellular types may have when nutrients are less available are discussed.


Estudiamos los efectos crónicos de una dieta severamente hipoproteica sobre los aspectos cuantitativos del plexo mientérico del colon descendente de ratones jóvenes. 18 ratones fueron divididos en dos grupos, a uno de estos grupos se le dió ración con contenido proteico del 26% (control) y al otro, ración con contenido proteico del 4%. Se mantuvo el balance vitamínico y mineral, durante 12 semanas. Elaboramos los preparados de membrana del colon descendente y marcamos las neuronas del plexo mientérico con Giemsa y NADPH-diaforasa. Los ratones del grupo experimental presentaron déficit de peso corporal (54,23%) y del área del colon descendente (48,14%); además, observamos que no hubo alteración en el número total de neuronas en todo el colon; sin embargo, hubo una disminución en la marcación de neuronas NADPH-diaforasa positivas (37,80%). Los resultados son discutidos, respecto a la prioridad que ciertos tipos celulares pudiesen tener, con la menor disponibilidad de nutrientes.


Assuntos
Animais , Masculino , Ratos , Desnutrição Proteico-Calórica/patologia , Dieta com Restrição de Proteínas , Colo Descendente/patologia , Plexo Mientérico/patologia , Peso Corporal , Ratos Wistar , NADPH Desidrogenase/análise , Neurônios
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