La fibra alimentaria y su uso terapéutico en algunas enfermedades crónicas / The alimentary fiber and their therapeutic use in some chronic diseases

La fibra dietética o fibra alimentaria, forma parte de lo que se considera una dieta equilibrada o saludable. A pesar que la fibra alimentaria no se considera un nutriente, es un componente importante de la dieta diaria. La razón principal de su importancia, es que pasa por el sistema digestivo sin ser absorbida y este hecho fisiológico, trae beneficios a la salud. La fibra alimentaria, se considera como el material alimenticio particularmente de origen vegetal que no es hidrolizado por las enzimas secretadas por el tracto digestivo humano, pero, que puede ser fermentada en el intestino grueso por la microflora colónica. El grupo de enfermedades crónicas no transmisibles, incluye: obesidad, diabetes, enfermedades cardiovasculares y cerebrovasculares, la hipertensión arterial, el cáncer y problemas articulares. Estudios epidemiológicos, muestran el efecto beneficioso de la fibra en el tratamiento terapéutico en algunas de estas enfermedades crónicas

Dietary fiber or alimentary fiber, is part of what is considered a balanced or healthy diet. Although the alimentary fiber is not considered a nutrient, is an important component of the diet. The main reason for its importance is passing through the digestive system without being absorbed and this physiological fact is beneficial to health. The alimentary fiber is considered as particularly the food material of plant origin that is not hydrolyzed by enzymes secreted by the human digestive tract, but that can be fermented in the large intestine by colonic microflora. The group of chronic non-communicable diseases, include: obesity, diabetes, cardiovascular and cerebrovascular diseases, hypertension, cancer and joint problems. Epidemiological studies show the beneficial effect of fiber in the therapeutic treatment in some of these chronic diseases

Postoperative Nutritional Effects of Early Enteral Feeding Compared with Total Parental Nutrition in Pancreaticoduodectomy Patients: A Prosepective, Randomized Study

The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.

Profile of systemic sclerosis in a tertiary care center in North India.

AIM: To study the clinical and immunological profile in patients of systemic sclerosis from North India and compare it with other ethnic groups. METHODS: Patients presenting to us between the years 2001 and 2004 and fulfilling the American Rheumatism Association (ARA) criteria for systemic sclerosis were included. There were 84 females and 16 males with the mean age of 32.5 +/-11.62 years and a mean duration of 6.49 +/- 4.34 years. All patients were admitted to the dermatology ward for detailed history and examination including Rodnan score. Investigations including hemogram, hepatic and renal functions, serum electrolytes, urine for albumin, sugar, microscopy and 24h urinary protein estimation, antinuclear antibody, chest X-ray, barium swallow, pulmonary function test, electrocardiogram and skin biopsy were done. RESULTS: The most common presenting symptoms were skin binding-down (98.5%), Raynaud's phenomenon 92.9%, pigmentary changes 91%, contracture of fingers 64.6%, fingertip ulcer 58.6%, restriction of mouth opening 55.5%, dyspnea 51.1%, joint complaints 36.7% and dysphagia in 35.2%. The mean Rodnan score was 25.81 +/- 10.04 and the mean mouth opening was 24.6 +/- 19.01 mm. The laboratory abnormalities included raised ESR in 87.8%, ANA positive in 89.1%, proteinuria in 6.0%, abnormal chest X-ray in 65.3%, abnormal barium swallow in 70.2% and reduced pulmonary function test in 85.8%. CONCLUSION: The clinical and immunological profile of systemic sclerosis in North India is similar to that of other ethnic groups except that pigmentary changes are commoner and renal involvement is relatively uncommon.

Evaluation of gastrointestinal symptoms as primary sign of severe invasive group A streptococcal infections.

BACKGROUND & OBJECTIVES: Severe invasive infections caused by group A Streptococcus (GAS) are often associated with shock and organ failure. We describe epidemiological and disease related data from the national surveillance of invasive GAS infection in Denmark in addition to three fatal cases that occurred in Denmark in 2002 with gastrointestinal (GI) symptoms as the dominating preliminary signs. METHODS: As the National Streptococcal Reference Centre The Streptococcus Unit, Statens Serum Institut (SSI) receives the vast majority of the invasive GAS isolates from patients admitted to all the hospitals in Denmark. The isolates were T-typed by slide agglutination test emm-squencing and pulsed field gel electrophoresis (PFGE) were also performed. RESULTS: During January 2002 three patients died at home and GAS were found at autopsy. Cases 1 (12 yr) and 3 (25 yr) had been ill for less than two days with nausea, diarrhoea and vomiting. Case 2 (25 yr) had the same symptoms for two weeks. None of the three had any underlying diseases. The GAS isolates from cases 1 and 2 were T-type 3-13-B3264, emm89 and SpeA-, SpeC-. The third isolate was Ttype 1, emm1 and SpeA+, SpeC-. PFGE could not discriminate between the two isolates with T-type 3-13-B3264. The PFGE patterns of the three isolates were similar to those identified from GAS isolated elsewhere in Denmark at different times and from non-fatal cases. In 1999-2002, SSI received 409 isolates from patients with invasive GAS infection, and the mortality rate was 18 per cent. In 40 patients the primary symptoms were gastrointestinal, and in 30 per cent of these the outcome was fatal. INTERPRETATION & CONCLUSION: The various early clinical manifestations of severe GAS infections are still a major challenge for clinicians because of the importance of a fast and appropriate diagnosis and immediate start of treatment.

Autosomal dominant polycystic kidney disease-clinical challenges

While not very common, the clinical anesthesiologist can expect to see between two and three patients per year with autosomal dominant polycystic kidney disease, ADPKD. Careful education and proper planning are essential to assure appropriate care for these patients. In addition, co-morbid conditions associated with the disease, make it especially challenging for the anesthesiologist who must be prepared for all contingencies. Also, decreased renal function and the systemic effects combine to create unique problems in properly anesthetizing these patients. Finally, proper preoperative assessment is essential to protect patients with ADPKD, and special care should be taken to select drugs that rely on non-renal metabolism for excretion. This review summarizes anesthetic considerations regarding epidemiologic, diagnostic, genetic, and perioperative clinical issues related to this disease

A morpho-quantitative study of the myenteric ganglia throughout the human digestive tract

Os corpos celulares dos neurônios constituintes do plexo mienterico do esofago, do estomago, do duodeno e do colo sigmoide humanos foram evidenciados em preparaçöes laminares da muscularis externa atraves de um método näo histoquimico (Giemsa). A área média dos corpos celulares foi determinada, sendo a maior verificada no plexo do esofago (489.97 um2 +- 212.35 um2) e a menor no plexo do colo sigmoide (241.64 um2 +- 122.62 um2). Näo foram observadas diferenças significantes entre as áreas medias dos neuronios do plexo do esofago (284.77 um2 +- 134.70 um2) e do duodeno (291.39 um2 +- 157.86 um2). Uma capsula ganglionar formada por fibras colagenas e do sistema elastico, da qual partem delgados septos que envolvem neuronios isolados ou grupos de neurônios, foi observada em todas as partes do tubo digestivo, näo havendo diferenças entre as regiöes. Os resultados sugerem que fatores como tamanho do corpo celular e aspectos estruturais da capsula ganglionar näo estäo relacionados com a incidência de megaesofago e de megacolo

Brucelosis: signos y síntomas gastrointestinales / Brucellosis: gastrointestinal signs and symptoms

Se presenta el caso de un paciente masculino de 18 años de edad originario de Xoltepec, Puebla, que inicia el padecimiento con evacuaciones diarreicas, sangre, pujo, tenesmo rectal y fiebre. El paciente recibió tratamiento con TMP/SMX con el que remitieron los síntomas. Sin embargo, posteriormente aparecieron nuevos episodios con las mismas características sintomáticas. Esta vez recibió tratamiento con doxicilina y rifampicina que, debido a elevación de las pruebas de funcionamiento hepático, se cambió por doxicilina y gentamicina. Seis meses después del tratamiento el paciente se encuentra asintomático

Función respiratoria y su repercusión estomatognática y orgánica / Respiratory function and its stomatognathic and organic repercussion

La funcionalidad respiratoria es extremadamente importante para el desarrollo del complejo nasomaxilar, además del desarrollo sistémico. Una respiración alterada y, en particular, una respiración de tipo bucal, tiene consecuencias específicas sobre todo el organismo. Estas han sido objeto de estudio en nuestra investigación, que se ha desarrollado con el auxilio de tres diferentes métodos rinomanométricos (rinomanometría anterior activa, rinomanometría posterior activa y rinomanometría posterior bilateral simultánea). Los resultados indican que los respiradores bucales tienen valores de resistencia nasal por encima de la media y que éstas disminuyen después del test dinámico de esfuerzo en los sujetos con patologías obstructivas de las primeras vías aéreas con base vasomotora. Se ha observado que una respiración no fisiológica está asociada a signos típicos (faciales, adenoidea, disturbios digestivos, alteraciones a nivel de columna y tórax) y una mayor susceptibilidad a las infecciones de las vías aéreas altas (amigdalitis, que pueden involucrar al oído medio (otitis) por la proximidad anatómica o llegar más profundamente (neumonías). Sería beneficioso examinar precozmente a los pacientes y someterlos a un plan de tratamiento adecuado que evitaría o haría menos grave la aparición de alteraciones irreversibles

Gastroenterological manifestations of sickle cell disease

Sickle cell hemoglobinopathy is a common genetic disorder which is prevalent in certain areas of the Kingdom of Saudi Arabia. it is characterized by repeated hemolytic and vasoocclusive crises which lead to widespread vascular occlusion and subsequent multiple organ infarctions, Affected individuals present with a wide variety of gastrointestinal disorders mimicking vasoocclusive episodes causing diagnostic confusion and delays that may catch the unwary clinician. This article briefly reviews the gastroenterological manifestations of sickle cell disease

Intolerancia a la lactosa. Su definición, su prevalencia en México y sus implicaciones en el consumo de leche / Lactose intolerance. Definition, prevalence in Mexico, and its implications in milk comsumption

El presente trabajo describe los aspectos de intolerancia a la lactosa y a la leche, discute los resultados de estudios llevados a cabo anteriormente en México, y detalla un estudio cuyo objetivo fue cuantificar el impacto de la intolerancia a la lactosa sobre el consumo habitual de leche. Se estudió la prevalencia de intolerancia a la lactosa y su efecto sobre el consumo de leche en tres regiones de México. El diseño del estudio fue prospectivo, aleatorio, doble ciego y cruzado. Se estudió la presencia de intolerancia a la leche en 960 sujetos entre 6 meses y 99 años de edad quienes recibieron según su edad, una cantidad de 240 ó 360 mL de leche intacta y la misma cantidad de leche hidrolizada. Se registró el patrón de consumo de leche y la presencia de síntomas después de cada tratamiento. De los sujetos estudiados, el 7 por ciento manifestaron síntomas de intolerancia después de la ingestión de leche intacta. La presencia de síntomas intensos en los sujetos intolerantes redujo en forma significativa (p< 0.001) el consumo de leche en comparación con los sujetos tolerantes. La presencia de síntomas con leche hidrolizada se redujo al 2 por ciento (p< 0.001). Se concluye que la intolerancia a la lactosa no es determinante para el consumo de leche en la población sana de México

Deficiencia secundaria de lactosa en niños y sus implicaciones epidemiológicas / Secondary lactase deficiency and its epidemiological implications

Se revisan las contribuciones que han tenido mayor relevancia en el conocimiento de la deficiencia secundaria de lactasa en los niños. Se hace referencia a la identificación de las diarreas fermentativas, a la descripción de sus particularidades clínicas, a la explicación de sus características fisiopatológicas, a los procedimientos para su diagnóstico, y a su manejo dietético. Se mencionan las enfermedades en cuyas manifestaciones clínicas se asocian las del síndrome por deficiencia de lactasa; con base en esta información, se hacen algunos planteamientos acerca de la magnitud y trascendencia epidemiológica de este problema