Food intolerances and associated symptoms in patients undergoing Fobi-Capella technique without gastric ring / Intolerâncias alimentares e sintomas associados em pacientes submetidos à técnica de Fobi-Capella sem anel gástrico

BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period. .

RACIONAL: A cirurgia bariátrica é considerada o único método efetivo para tratamento da obesidade refratária e, principalmente, para aqueles em que o tratamento clínico não obteve sucesso. No entanto, o surgimento de intolerâncias alimentares e manifestações clínicas após são bastante comuns. OBJETIVO: Identificar intolerâncias alimentares e sintomas associados em pacientes submetidos à técnica de Fobi-Capella sem anel gástrico. MÉTODOS: Trata-se de um estudo transversal com pacientes adultos que possuíam no máximo um ano de pós-operatório. Foram investigados dados demográficos, antropométricos, peso e estatura pré-cirúrgicos. O estado nutricional foi classificado de acordo com os critérios estabelecidos pela World Health Organization. Considerou-se intolerância alimentar a presença de náuseas, vômitos, diarreia ou distensão abdominal após ingestão de um alimento específico. RESULTADOS: A amostra foi composta por 61 pacientes que compareceram a consulta nutricional dos quais 26 (42,6%) apresentaram intolerância alimentar, sendo a maioria relacionada à carne vermelha (n=12; 34,3%) durante os primeiros seis meses da operação, havendo redução significativa entre os períodos de 0 a 6 meses e 7 a 12 meses (p=0,02). Dentre os sintomas relatados pelos pacientes, a náusea foi o mais recorrente até o 6º mês, porém sem diferença estatística entre os dois períodos (p=0,06). CONCLUSÃO: O procedimento de Fobi-Capella sem anel gástrico promoveu elevada frequência de intolerância às carnes em geral, principalmente para a vermelha, frango e peixe, nesta sequência; a náusea foi o sintoma mais frequente. Estes dados sugerem necessidade de acompanhamento nutricional adequado durante todo o período pós-operatório. .

Relation between IL-1Beta and IL1-ra in pathogenesis of febrile convulsions

Background: febrile seizures are the most common form of childhood seizures. Fever is induced by proinflammatory cytokines during infection. The cytokine network may contribute to the generation of febrile seizures in children. Interleukin beta [IL-1Beta] and Interleukin receptor antagonist [IL-1ra] have been implicated in the pathogenesis of febrile seizures

Aim of the work: was to estimate the role of IL-1Beta and IL-Ra in febrile convulsions and their relation to pathogenesis of febrile convulsions

Methods: serum interleukin I beta [IL-1Beta] and interleukin 1 receptor antagonist [IL 1ra] were measured by ELISA technique in twenty five children with febrile seizure and twenty five age matched controls children with febrile illness without convulsion within 24 hours from onset of fever

Results: serum IL-1Beta and IL 1ra levels were significantly higher in febrile seizure patients than in fever in controls. Serum IL-1Beta and IL 1ra levels were highly significant higher in complex febrile seizures than in simple febrile seizures. Serum levels of IL-1Beta and IL 1ra were significantly positive correlated with duration of seizure in patients group

Conclusions: serum levels of IL-1Beta and IL 1ra were significantly higher in febrile seizure children. Our study suggest that the inflammatory cytokine may play role in the generation of febrile seizures in children. These information may allow the development of anti- inflammatory therapy targeting these cytokines to prevent febrile seizures or subsequent epileptogenesis

Quantitative Analysis of Tissue Injury after Minimally Invasive Total Hip Arthroplasty

BACKGROUND: We intended to clarify the hypothesis that minimally invasive total hip arthroplasty (MI-THA) leads to less tissue damage and inflammatory response than does conventional total hip arthroplasty (C-THA). METHODS: We performed 30 cases of THA between September 2005 and May 2006 and evaluated these cases prospectively. We chose 15 MI-THA cases for the study group and another 15 C-THA cases for the control group. We checked skeletal muscle marker enzymes, such as serum creatinine kinase and aldolase, the pro-inflammatory cytokines, interleukin (IL)-6 and 8, and the anti-inflammatory cytokines, IL-10 and IL-1 receptor antagonist (ra) the day before surgery and at postoperative days 1, 7, and 14. RESULTS: On postoperative days 1 and 3, the study group showed significantly lower serum creatinine kinase, IL-6, IL-10, and IL-1ra values than those in the control group. Additionally, IL-8 was significantly lower on day 7 after surgery. CONCLUSIONS: These data show that MI-THA decreased the release of muscle marker enzymes due to tissue damage immediately after surgery and minimized the inflammatory response related to the surgery during the early postoperative period.

Profile of circulating levels of IL-1Ra, CXCL10/IP-10, CCL4/MIP-1β and CCL2/MCP-1 in dengue fever and parvovirosis

Dengue virus (DENV) and parvovirus B19 (B19V) infections are acute exanthematic febrile illnesses that are not easily differentiated on clinical grounds and affect the paediatric population. Patients with these acute exanthematic diseases were studied. Fever was more frequent in DENV than in B19V-infected patients. Arthritis/arthralgias with DENV infection were shown to be significantly more frequent in adults than in children. The circulating levels of interleukin (IL)-1 receptor antagonist (Ra), CXCL10/inducible protein-10 (IP-10), CCL4/macrophage inflammatory protein-1 beta and CCL2/monocyte chemotactic protein-1 (MCP-1) were determined by multiplex immunoassay in serum samples obtained from B19V (37) and DENV-infected (36) patients and from healthy individuals (7). Forward stepwise logistic regression analysis revealed that circulating CXCL10/IP-10 tends to be associated with DENV infection and that IL-1Ra was significantly associated with DENV infection. Similar analysis showed that circulating CCL2/MCP-1 tends to be associated with B19V infection. In dengue fever, increased circulating IL-1Ra may exert antipyretic actions in an effort to counteract the already increased concentrations of IL-1β, while CXCL10/IP-10 was confirmed as a strong pro-inflammatory marker. Recruitment of monocytes/macrophages and upregulation of the humoral immune response by CCL2/MCP-1 by B19V may be involved in the persistence of the infection. Children with B19V or DENV infections had levels of these cytokines similar to those of adult patients.

Avaliação da expressão de interleucina 1 beta (IL-1 beta) e antagonista do receptor de interleucina 1 (IL-1Ra) em pacientes com hanseníase / Evaluation of the expression of interleukin 1 beta(IL-1 beta) and interleukin 1 receptor antagonist (IL-1Ra) in leprosy patients

A hanseníase é uma doença infectocontagiosa espectral que acompanha-se por uma série de eventos imunológicos desencadeados pela resposta do hospedeiro frente ao agente etiológico, o Mycobacterium leprae. Evidências sugerem que a indução e manutenção da resposta imune/inflamatória na hanseníase estão vinculadas a interações de múltiplas células e fatores solúveis, particularmente através da ação de citocinas. Nesse estudo, foram mensurados níveis de IL-1β e IL-1Ra de 37 casos novos de hanseníase acompanhados ao longo do tratamento e 30 controles sadios pelo teste ELISA. A coleta de sangue periférico foi realizada em quatro tempos para os casos de hanseníase (pré-tratamento com PQT, 2ª dose, 6ª dose e pós-PQT) e em único momento para os controles. Na comparação dos níveis das moléculas de casos no pré-PQT e controles, houve diferença estatisticamente significativa somente para IL-1β. Nossos resultados sugerem a participação dessa citocina no processo imune/inflamatório.

Leprosy is an infectious and contagious spectral disease accompanied by a series of immunological events triggered by the host's response to the etiologic agent, Mycobacterium leprae. Evidence suggests that the induction and maintenance of the immune/inflammatory response in leprosy are linked to multiple cell interactions and soluble factors, mainly through the action of cytokines. The ELISA test was used to measure the levels of IL-1β and IL-1Ra in 37 new leprosy patients followed-up during treatment and 30 healthy controls. Peripheral blood was collected four times during the treatment of leprosy patients (MDT pretreatment, 2nd dose, 6th dose and post-MDT), and only once from the controls. The comparison of molecular levels in pre-MDT patients and controls showed a statistically significant difference for IL-1β. The results suggest the participation of this cytokine in the genesis of the immune/inflammatory process.