Educação permanente em saúde sobre estomias intestinais com enfermeiros de São Bento do Sul (SC): relato de experiência / Permanent health education on intestinal ostomy with nurses from São Bento do Sul (SC): Experience report / Educación permanente en salud sobre estomales intestinales con enfermeros de São Bento do Sul (SC): Informe de experiencia

Introdução:No Brasil a pessoa estomizadaé contemplada com diretrizes e políticas públicas, além de ser entendida como uma deficiência, sendo necessário assim um cuidado integral, exigindo do profissional que presta a assistência e/ou orientação educação permanente. Objetivo:Relatar uma experiência sobre cuidados de enfermagem com estomias intestinais aos enfermeiros atuantes na Secretaria Municipal de São Bento do Sul/Santa Catarina Metodologia: Trata-se deum estudo descritivo qualitativo do tipo relato de experiência, que se deu através de capacitação realizada em Junho de 2022, com os enfermeiros que atuam na secretaria municipal de saúde de São Bento do Sul, o qual conta com 44 enfermeiros atuantes em 21 unidades básicas de saúde , com a temática cuidados de enfermagem com estomia de eliminação', tendo o mesmo sido ministrado por enfermeira estomaterapeuta no formato presencial com discussão teórica e prática.Resultados e discussão: O Ministério da Saúde vem incentivando práticas formativas aos profissionais inseridos nos serviços, amparadasna Política Nacional de Educação Permanente. Uma vez que a formação de enfermeiros no Brasil é generalista, os cursos e capacitação se tornam uma ferramenta fundamental para uma atuação reflexiva. Dos 44 enfermeiros atuantes no município, participaram do treinamento 21 (47,72%), atendendo ao critério de ao menos um profissional por UBS, podendo este ser um multiplicador de conhecimento, estratégia importante da educação permanente em saúde. Ao final do curso, foram desenvolvidos fluxos de atendimento com os participantes, buscando a descentralização do cuidado para as unidades básicas de cada enfermeiro, favorecendo a criação de vínculo dos pacientes com a equipe. Conclusões:Umprofissional orientado e seguro em sua prática implica diretamente na segurança do paciente, nesse sentido a realização de atividades como cursos, capacitações e eventos, principalmente quando se trata de pacientes estomizados se tornam importantes ferramentas de aprimoramento profissional (AU).

Introduction:In Brazil, people with a stoma are covered by guidelines and public policies, in addition to being understood as a disability, thus requiring comprehensive care, requiring permanent education from the professional who provides assistance and/or guidance. Objective:To report an experience on nursing care with intestinal ostomies to nurses working at the Municipal Secretariat of São Bento do Sul/Santa Catarina. Methodology:This is a qualitative descriptive study of the experience report type, which took place through training carried out in June 2022, with nurses who work at the municipal health department of São Bento do Sul, which has 44 nurses working in 21 basic health units, with the theme of nursing care with elimination stoma', with the same being taught by a stoma therapy nurse in a face-to-face format with theoretical and practical discussion. Results and discussion:The Ministry of Health has been encouraging training practices for professionals working in services, supported by the National Permanent Education Policy. Since the training of nurses in Brazil is generalist, courses and training become a fundamental tool for reflective action. Of the 44 nurses working in the city, 21 (47.72%) participated in the training, meeting the criteria of at least one professional per UBS, which could be a knowledge multiplier, an important strategy for continuing health education. At the end of the course, care flows were developed with the participants, seeking to decentralize care to each nurse's basic units, favoring the creation of a bond between patients and the team.Conclusion: A professional who is oriented and confident in his practice directly implies patient safety, in this sense, carrying out activities such as courses, training and events, especially when dealing with stoma patients, become important tools for professional improvement (AU).

Introducción:En Brasil, las personas ostomizadasestán cubiertas por directrices y políticas públicas, y entendidas como una discapacidad, por lo que requieren atención integral y profesionales que brinden asistencia y/o orientación en educación continua. Objetivo:Relatar la experiencia como enfermerostrabajando en la Secretaría Municipal de São Bento do Sul/Santa Catarina en la atención de ostomías intestinales. Metodología:Estudio cualitativo descriptivo, del tipo relato de experiencia, realizado a través de una capacitación realizada en junio de 2022, con cuarenta y cuatro enfermeros que actúan en la Secretaría Municipal de Salud de São Bento do Sul, con el tema "Asistencia de enfermería a la eliminación del estoma". Impartido por una enfermera estomatóloga en formato presencial con discusión teórica y práctica. Resultados y discusión:El Ministerio de Salud viene incentivando prácticas de formación de profesionales que actúan en los servicios, apoyados en la Política Nacional de Educación Permanente. Dado que la formación de enfermeros en Brasil es generalista, los cursos y capacitaciones se convierten en una herramienta fundamental para la acción reflexiva. De los 44 enfermeros que actúan en la ciudad, 21 (47,72%) participaron de la capacitación, cumpliendo con el criterio de al menos un profesionalpor UBS, lo que podría ser un multiplicador de conocimientos, una estrategia importante para la educación continua en salud. Al final del curso, se desarrollaron flujos de atención con los participantes, buscando descentralizar la atención hacia las unidades básicas de cada enfermero, favoreciendo la creación de vínculo entre los pacientes y el equipo. Conclusiones:Un profesional orientado y confiado en su práctica implica directamente la seguridad del paciente, en este sentido, la realización de actividades como cursos, capacitaciones y eventos, especialmente cuando se trata de pacientes estomáticos se convierten en importantes herramientas de superación profesional (AU).

Gastroesophageal tube of the Iguana iguana (Iguanidae): histological description, histochemical and immunohistochemical analysis of 5-HT and SS cells / Tubo gastroesofágico da Iguana iguana (Iguanidae): descrição histológica, histoquímica e análise imunohistoquímica de células 5-HT e SS

Abstract The work aims were to describe the histological and histochemical structure of the gastroesophageal tube of Iguana iguana and verify the occurrence and distribution of immunoreactive serotonin (5-HT) and somatostatin (SS) cells. Fragments of the gastrointestinal tract (GIT) of five iguanas were which underwent standard histological and immunohistochemistry technique. Immunoreactive cells for 5-HT and SS were quantified using the STEPanizer. The oesophagus has ciliated columnar pseudostratified epithelium with staining Alcian blue (AB) + and goblet cells highly reactive to periodic acid Schiff (PAS). In the cervical oesophagus, the numerical density of 5-HT cells per unit area (QA [5-HT cells]/µm2) was 4.6x10-2 ± 2.0 and celomatic oesophagus presented QA = 4.0x10-2 ± 1.0. The epithelium of the stomach is simple columnar, PAS and AB +. The cranial and middle regions of the stomach presented (QA [5-HT cells]/µm2) = 6.18x10-2 ± 3.2 and the caudal region, QA = 0.6x10-2 ± 0.2. The SS cells were only observed in the caudal stomach, with numerical density (QA [SS cells]/µm2) = 1.4x10-2 ± 0.9 In I. iguana, variation was observed in terms of the distribution of mucus secretions and the pattern of occurrence of serotonin and somatostatin-secreting enteroendocrine cells in the TGI, which possibly will result in an interspecific adaptive response.

Resumo Os objetivos do trabalho foram descrever a estrutura histológica e histoquímica do tubo gastroesofágico da Iguana iguana e verificar a ocorrência e distribuição de células serotonina (5-HT) e somatostatina (SS) imunorreativas. Fragmentos do trato gastrointestinal (TGI) de cinco iguanas foram submetidos à técnica histológica e imunohistoquímica padrão. As células imunorreativas para 5-HT e SS foram quantificadas usando o STEPanizer. O esôfago apresenta epitélio pseudoestratificado colunar ciliado Alcian blue (AB) positivo, com células caliciformes altamente reativas ao ácido periódico de Schiff (PAS). No esôfago cervical, a densidade numérica de células 5-HT por unidade de área (QA [células 5-HT] / µm2) foi de 4.6x10-2 ± 2.0 e o esôfago celomático apresentou QA = 4.0x10-2 ± 1.0. O epitélio do estômago é colunar simples, PAS e AB positivo. As regiões cranial e média do estômago apresentaram (QA [células 5-HT] / µm2) = 6.18x10-2 ± 3.2 e a região caudal, QA = 0.6x10-2 ± 0.2. As células SS foram observadas apenas no estômago caudal, com densidade numérica (QA [células SS] / µm2) = 1.4x10-2 ± 0.9. Em I. iguana, foi observada variações em termos da distribuição das secreções de muco e padrão de ocorrência das células enteroendócrinas secretoras de serotonina e somatostatina no TGI, o que possivelmente reflete uma resposta adaptativa interespecifica.

Progress in the study of intragastric occupancy device for weight reduction / 中南大学学报(医学版)

Obesity is a global public health problem that imposes a heavy economic burden on society. The current main strategies for treating obesity include lifestyle interventions, pharmacological treatments, endoscopic treatments and metabolic surgery. With the development of medical technology, weight reduction by intragastric occupancy devices represented by intragastric balloons and intragastric capsules are gradually emerging. Intragastric balloons are used to reduce weight by occupying the volume of the stomach with balloons filled with different volumes of gas or liquid, among which ReShape, Orbera, Obalon, Elipse and Spatz balloons are gradually used in patients with mild to moderate obesity due to their non-invasive, high safety and reusable advantages. Intragastric capsules are recommended in overweight and obese patients for weight loss through hydrogels with transient superabsorbent swelling properties and completely noninvasive. Both approaches achieve weight loss by limiting gastric volume, increasing satiety and reducing food intake. Despite the presence of adverse gastrointestinal events associated with nausea, vomiting, and abdominal distention, they offer new ideas for the non-invasive clinical treatment of obesity.

Oral absorption and effect of macromolecules in traditional Chinese medicine: a new perspective and research mode of phase structure / 中国中药杂志

Protein polypeptides and polysaccharides, the indispensable macromolecular active components in traditional Chinese medicine, are widely found in Chinese medicine decoction after the decoction of traditional Chinese medicine. However, through oral administration, these macromolecules are digested by the stomach and intestine and thus fail to be absorbed in prototype. This is inconsistent with the actual clinical efficacy of Chinese medicine decoction. According to modern research, new phase structures and effects of the macromolecules emerge during the decoction of traditional Chinese medicine, but the phase change law caused by the interaction among the components of traditional Chinese medicine and the relationship between phase structure and effect are still unclear. Thus, this study reviewed the oral absorption of macromolecular components of traditional Chinese medicine, analyzed the internal relationship of the form of macromolecules in traditional Chinese medicine with the absorption and effect based on phase structure, and summarized the research mode of oral absorption and effect of macromolecules in traditional Chinese medicine with phase structures as the core, providing new ideas and methods for future research.

Gastroprotective potential and mechanisms of action of Hedera nepalensis

Abstract Hedera nepalensis (H. nepalensis) , belonging to the family Araliaceae, is a medicinal plant traditionally used to treat stomach problems. The current study investigated the gastroprotective potential and the mechanism of action of H. nepalensis in diclofenac-and ethanol-induced ulcer models. Anti-oxidant and lipid peroxidation inhibitory prospects of H. nepalensis were checked out by free radical scavenging assay and UV spectrophotometer respectively. Effect of H. nepalensis on the pH, gastric total acidity of gastric juice and protective effects of H. nepalensis against ulcer models have been examined. Histopathological studies have been carried out. The aqueous methanol extract of H. nepalensis (100 µg/mL) showed anti-oxidant (83.55%) and lipid peroxidation inhibitory (70.88%) potential at 1000 µg/mL; the extract had no buffer potential. The extract (400 mg/kg) significantly (81.12% and 63.46%) showed gastroprotective effect in diclofenac and ethanol-induced rat ulcer models respectively. Histopathological studies confirmed the biochemical findings. FTIR analysis showed the presence of carboxylic acid, alkanes, conjugated alkanes, aldehydes and alkyl-aryl ethers. Gallic acid, M-coumaric acid and quercetin were found by HPLC analysis. H. nepalensis exhibited significant protection against diclofenac and ethanol induced gastric damage by anti-oxidant and lipid peroxidation suppression effects suggesting potential broad utility in treatment of diseases characterized with gastric damage.

BALB/c and C57BL/6 mouse strains influence gastric function outcomes with administration of cisplatin and dexamethasone

Abstract Our aim was to evaluate the effects of cisplatin and dexamethasone alone and combined on gastric contractility and histomorphometry of BALB/c and C57BL/6 mice. BALB/c and C57BL/6 male mice (8-week-old) were randomly separated into: Control; Cisplatin (7.5 mg/Kg); Dexamethasone (2.0 mg/Kg); and Dexamethasone plus Cisplatin (2.0 mg/Kg of dexamethasone 1-hour prior to 7.5 mg/Kg of cisplatin). Drugs were administered intraperitoneally for three days. Body weight and food intake were evaluated on 2nd day. Alternating Current Biosusceptometry technique was employed to measure gastric contractions on 3rd day. Afterward, mice were killed for gastric histomorphometric analysis. Cisplatin decreased food intake and caused bradygastria in BALB/c mice; however, the amplitude of gastric contractions decreased in both BALB/c and C57BL/6. Dexamethasone and cisplatin combined restored the gastric frequency and food intake only in BALB/c, but drug combination reduced the gastric amplitude of contractions in both strains. Dexamethasone alone increased gastric mucosa thickness in C57BL/6 and decreased muscular thickness in BALB/c. In conclusion, the mouse strains presented differences in acute effects of cisplatin and dexamethasone alone and combined on gastric function. This reinforces the importance of choosing the appropriate mouse strain for studying the acute effects of drugs on the gastrointestinal tract.

Gastroesophageal tube of the Iguana iguana (Iguanidae): histological description, histochemical and immunohistochemical analysis of 5-HT and SS cells / Tubo gastroesofágico da Iguana iguana (Iguanidae): descrição histológica, histoquímica e análise imunohistoquímica de células 5-HT e SS

The work aims were to describe the histological and histochemical structure of the gastroesophageal tube of Iguana iguana and verify the occurrence and distribution of immunoreactive serotonin (5-HT) and somatostatin (SS) cells. Fragments of the gastrointestinal tract (GIT) of five iguanas were which underwent standard histological and immunohistochemistry technique. Immunoreactive cells for 5-HT and SS were quantified using the STEPanizer. The oesophagus has ciliated columnar pseudostratified epithelium with staining Alcian blue (AB) + and goblet cells highly reactive to periodic acid Schiff (PAS). In the cervical oesophagus, the numerical density of 5-HT cells per unit area (QA [5-HT cells]/µm2) was 4.6x10-2 ± 2.0 and celomatic oesophagus presented QA = 4.0x10-2 ± 1.0. The epithelium of the stomach is simple columnar, PAS and AB +. The cranial and middle regions of the stomach presented (QA [5-HT cells]/µm2) = 6.18x10-2 ± 3.2 and the caudal region, QA = 0.6x10-2 ± 0.2. The SS cells were only observed in the caudal stomach, with numerical density (QA [SS cells]/µm2) = 1.4x10-2 ± 0.9 In I. iguana, variation was observed in terms of the distribution of mucus secretions and the pattern of occurrence of serotonin and somatostatin-secreting enteroendocrine cells in the TGI, which possibly will result in an interspecific adaptive response.

Os objetivos do trabalho foram descrever a estrutura histológica e histoquímica do tubo gastroesofágico da Iguana iguana e verificar a ocorrência e distribuição de células serotonina (5-HT) e somatostatina (SS) imunorreativas. Fragmentos do trato gastrointestinal (TGI) de cinco iguanas foram submetidos à técnica histológica e imunohistoquímica padrão. As células imunorreativas para 5-HT e SS foram quantificadas usando o STEPanizer. O esôfago apresenta epitélio pseudoestratificado colunar ciliado Alcian blue (AB) positivo, com células caliciformes altamente reativas ao ácido periódico de Schiff (PAS). No esôfago cervical, a densidade numérica de células 5-HT por unidade de área (QA [células 5-HT] / µm2) foi de 4.6x10-2 ± 2.0 e o esôfago celomático apresentou QA = 4.0x10-2 ± 1.0. O epitélio do estômago é colunar simples, PAS e AB positivo. As regiões cranial e média do estômago apresentaram (QA [células 5-HT] / µm2) = 6.18x10-2 ± 3.2 e a região caudal, QA = 0.6x10-2 ± 0.2. As células SS foram observadas apenas no estômago caudal, com densidade numérica (QA [células SS] / µm2) = 1.4x10-2 ± 0.9. Em I. iguana, foi observada variações em termos da distribuição das secreções de muco e padrão de ocorrência das células enteroendócrinas secretoras de serotonina e somatostatina no TGI, o que possivelmente reflete uma resposta adaptativa interespecifica.

Abdominal ultrasound in amazonian manatee (Trichechus inunguis) (Natterer, 1883) / Ultrassonografia abdominal em peixe boi amazônico (Trichechus inunguis (Natterer, 1883)

Morphophysiological species researches are fundamental, and diagnostic imaging is an excellent technique, already used in wild animals, with great application, not invasive and provide real-time information of each body. Amazonian manatees are on the list of endangered animals classified in the vulnerable category and knowledge of the normal pattern of ultrasound anatomy of organs and tissues is important for the maintenance and well-being of captive specimens contributing to reintroduction actions. The objective of the study was to standardize the examination technique and describe the ultrasound findings of the liver, gallbladder, stomach, urinary bladder and the subcutaneous tissue of the abdominal region in Trichechus inunguis, in order to contribute with the anatomical and sonographic knowledge and assist in the diagnosis and prognosis diseases. The study used 18 animals to describe the normal sonographic anatomy in the abdominal cavity of the Amazonian manatee. During abdominal scan, it was possible to visualize the features of the liver, gallbladder, stomach, urinary bladder obtained satisfactory results in this study. Therefore, other structures were not primarily identified by the reduced time, lots of fat and gases in intestines of animals.

Pesquisas morfofisiológicas em espécies selvagens são fundamentais, e o diagnóstico por imagem é uma excelente técnica, já usada e com grande aplicação, não invasiva e que fornece informações em tempo real de cada órgão. Peixes-boi-amazônico encontram-se na lista de animais ameaçados de extinção classificados na categoria vulnerável e o conhecimento do padrão normal da anatomia ultrassonográfica de órgãos e tecidos é importante para a manutenção e bem-estar de espécimes em cativeiro contribuindo para ações de reintrodução. O objetivo deste estudo foi padronizar a técnica de exame e descrever os achados ultrassonográficos do fígado, vesícula biliar, estômago, vesícula urinária e o tecido subcutâneo da região abdominal em Trichechus inunguis, de modo a contribuir com o conhecimento anátomo-sonográfico e auxiliar no diagnóstico e prognóstico de doenças. O estudo utilizou 18 animais para descrever a anatomia ultrassonográfica normal na cavidade abdominal de peixe-boi amazônico. Durante a varredura abdominal foi possível visualizar as características dos órgãos obtendo resultados satisfatórios neste estudo, concluindo ser uma técnica eficiente para avaliação de determinados órgãos abdominais em peixe-boi amazônico. Entretanto, outras estruturas não foram identificadas principalmente pelo tempo reduzido, muita gordura e gases nos intestinos dos animais.

Reinforcing the valuable role of gastric ultrasound for volume and content assessment: an observational study

Abstract Background Pulmonary aspiration is one of the most important complications in anesthesiology. Assessment of gastric content by ultrasound is a good method to quantify gastric volume and to determine the risk of intraoperative pulmonary aspiration. The aim of this study is to determine the accuracy of the gastric ultrasonography in the qualitative analysis of gastric content, mainly in the analysis of small amounts of liquid content. Methods Gastric ultrasound was performed to 36 patients before upper gastrointestinal endoscopy (UGI), making two longitudinal scans at the epigastric level, one in supine position and the other in right lateral decubitus position, measuring two diameters and the area of the gastric antrum and assessing the content characteristics determining whether it was an empty stomach or contained fluid or solid content. Subsequently, the ultrasound findings were compared with UGI findings. Results Gastric areas were analyzed by the trace and the lengths of the craniocaudal and anteroposterior axes concluding that there are no significant differences between the two methods. No statistically significant difference was found between UGI and US assessment technics. No statistically significant difference was found between the estimated volume by UGI and US. Conclusions Though our study has some limitations, qualitative analysis of gastric content using ultrasound followed by endoscopy enabled the conclusion that there are no differences in the qualitative assessment regarding these two techniques, supporting the important role of point-of-care gastric ultrasound (POCGUS) in the assessment of pulmonary aspiration risk by the anesthesiologist in the perioperative period.

The illustrations and terminology of Hamse-i Sânizâde written by Sânizâde Ataullah Efendi: the stomach / Las ilustraciones y terminología de Hamse-i Sânizâde escrito por Sânizâde Ataullah Efendi: el estómago

SUMMARY: The book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" written by Sânîzâde Mehmet Ataullah Efendi was the first illustrated anatomy book published in the Ottoman Empire. The aim of this study was to determine the similarities and differences between the terms and definitions of stomach anatomy used by Sânîzâde at that time and those used today. The stomach section of the "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" was examined and related plates were translated into the Turkish language. Anatomical terms and definitions of stomach anatomy in this book were compared to the stomach terminology used in "Terminologia Anatomica" which is the reference book for terminology today. The stomach section was explained under the title "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Illustrated Stomach Anatomy) in this book. Parts, margins, arteries, veins, nerves and layers of the stomach were explained with the terms and definitions of that period. Terminologia Anatomica has 33 anatomical terms related to the stomach, while 15 terms were identified in the book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Although more terms related to the stomach anatomy are used today, the fundamental information on stomach anatomy in Sânîzâde's book was compatible with much of the information used in modern anatomy books today.

El libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l- Insân" escrito por Sânîzâde Mehmet Ataullah Efendi fue el primer libro de anatomía ilustrado y publicado en el Imperio Otomano. El objetivo de este estudio fue determinar las similitudes y diferen- cias entre los términos y definiciones de la anatomía del estómago utilizados por Sânîzâde en ese momento y los que se utilizan en la actualidad. Se examinó la sección del estómago del "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" y las placas relacionadas se tradujeron al idioma turco. Los términos anatómicos y las definiciones de la anatomía del estómago en este libro se compararon con la terminología del estómago utilizada en Terminologia Anatomica, el libro de referencia para la terminología utilizado actualmente. La sección del estómago se explicó bajo el título "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Anatomía del estómago ilustrada) en este libro. Fueron definidas las partes, márgenes, arterias, venas, nervios y capas del estómago con los términos y definiciones de esa época. Terminologia Anatomica tiene 33 términos anatómicos relacionados con el estómago, mientras que 15 términos fueron identificados en el libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Aunque hoy en día se utilizan más términos relacionados con la anatomía del estómago, la información fundamental sobre la anatomía del estómago en el libro de Sânîzâde era compatible con gran parte de la información utilizada en los libros de anatomía modernos en la actualidad.

Resultados de la cirugía de sustitución esofágica con tubo gástrico invertido vía ascenso retroesternal en dos hospitales pediátricos / Results of esophageal substitution surgery with inverted gastric tube via retrosternal lift

Resumen Objetivo: Describir resultados de la cirugía de sustitución esofágica con tubo gástrico invertido, vía ascenso retroesternal en dos hospitales pediátricos durante el período marzo 2015 a marzo 2018. Materiales y Método: Un estudio observacional, transversal, con recolección de datos retrospectivo, donde se incluyeron todos los expedientes de pacientes que presentaban patología del esófago por causa adquirida o congénita que fueron operados de sustitución esofágica con tubo gástrico invertido en dos hospitales pediátricos durante 3 años. Resultados: Encontramos 29 niños sometidos a sustitución esofágica, de los cuales 27 cumplieron criterios de inclusión. La edad comprendida entre 2 y 17 años. El 63% corresponde al sexo femenino. La causa más frecuente de sustitución esofágica es por estenosis esofágica por ingesta caustica (92,59%). El 70% presentó algún tipo de complicación luego de la cirugía. La fístula esofagocutánea es la complicación principal con 33,33%. La permanencia en la unidad de cuidados intensivos es menor de 24 horas en un 74% de los niños. Se inicia la vía oral en casi la mitad de casos entre los 10-12 días de posquirúrgico, la estancia hospitalaria es en promedio 18,5 días. La mortalidad es 3,7%. Conclusión: La sustitución esofágica por tubo gástrico invertido vía ascenso retroesternal, es una técnica comparable en resultados a la interposición de colón. Para los autores, el estómago es un órgano ideal para realizar la reconstrucción esofágica, y sus complicaciones son manejables.

Aim: To describe the results of esophageal replacement surgery with an inverted gastric tube via retrosternal ascent in two pediatric hospitals during the period March 2015 to March 2018. Materials and Method: an observational, cross-sectional study with retrospective data collection that included all the records of patients with esophageal discontinuity due to acquired or congenital causes who underwent esophageal replacement surgery with an inverted gastric tube in two pediatric hospitals for 3 years. Results: We found 29 children undergoing esophageal replacement, of which 27 met inclusion criteria. The age between 2 to 17 years. 63% corresponds to the female sex. The most frequent cause of esophageal replacement is esophageal stricture due to caustic ingestion (92.59%). 70% presented some type of complication after surgery. The esophagocutaneous fistula is the main complication with 33.33%. The stay in the intensive care unit is less than 24 hours in 74% of children. The oral route is started in almost half of cases between 10-12 days after surgery; the hospital stay is on average 18.5 days. Mortality is 3.70%. Conclusión: The esophageal substitution by inverted gastric tube via retrosternal ascent is a technique comparable in results to the interposition of the colon. For the authors, the stomach is an ideal organ to perform esophageal reconstruction, and its complications are manageable.

Descripción de la variación en el tiempo del cáncer gastrointestinal en el centro occidente de Colombia / Description of the variation in time of gastrointestinal cancer In Central-Western Colombia

Introducción. A nivel mundial los tumores gastrointestinales tienen un impacto importante en la mortalidad y se asocian a diferentes factores, entre ellos regionales y sociodemográficos. El objetivo de este estudio fue describir la variación en el tiempo del cáncer gastrointestinal en una población del centro occidente de Colombia, dada su alta incidencia y desenlace frecuentemente fatal.Métodos. Se realizó un estudio retrospectivo observacional con muestreo no probabilístico en un tiempo de seis años. Se seleccionaron pacientes diagnosticados con algún tipo de neoplasia del tracto digestivo, en un hospital de tercer nivel del centro occidente de Colombia. Resultados. Se evaluaron un total de 1152 pacientes. Los tumores del tracto digestivo superior (esófago, unión esófago-gástrica y estómago) fueron los más frecuentes (44 %), seguidos de los tumores del tracto digestivo medio e inferior (intestino delgado, colon, recto y ano; 31 %) y de los tumores hepato-bilio-pancreáticos (25 %). La edad media de presentación fue 64,6 años, con una mayor frecuencia en el sexo masculino (51,6 %). El adenocarcinoma fue el tipo histológico más común.Conclusión. Los resultados de este estudio muestran que los tumores gastrointestinales son una neoplasia frecuente en nuestro país, siendo los tumores gástricos los que se presentan con mayor prevalencia, seguidos de los tumores colorrectales y las neoplasias biliopancreáticas, las cuales se mantiene en el tiempo.

Introduction. Worldwide, gastrointestinal tumors have a significant impact on mortality and are associated with different factors, including regional and sociodemographics. The objective of this study was to describe the variation over time of gastrointestinal cancer in a population from Central-Western Colombia, given its high incidence and frequently fatal outcome. Methods. An observational retrospective study with non-probabilistic sampling was carried out over a period of six years. Patients diagnosed with some type of neoplasm of the digestive tract were selected in a tertiary care hospital in the Central-Western Colombia. Results. A total of 1152 patients were evaluated. Tumors of the upper digestive tract (esophagus, esophagogastric junction, and stomach) were the most frequent (44%), followed by tumors of the middle and lower digestive tract (small intestine, colon, rectum and anus; 31%), and hepatobiliary-pancreatic tumors (25%). The mean age of presentation was 64.6 years with a higher frequency in males (51.6%). Adenocarcinoma was the most common histological type.Conclusion. The results of this study show that gastrointestinal tumors are a frequent neoplasm in our country, with gastric tumors being the most prevalent, followed by colorectal tumors and biliopancreatic neoplasms, which are maintained over time.

Comparación de la prevalencia del grupo sanguíneo A en cáncer de estómago y población donante de sangre / Comparison of the prevalence of blood group A in gastric cancer patients and blood donors

RESUMEN Antecedentes: el cáncer gástrico constituye una enfermedad con una alta incidencia y mortalidad en Uruguay. El grupo sanguíneo A ha sido considerado un factor de riesgo así como de mayor prevalencia en esta enfermedad. Objetivo: El objetivo del trabajo es comparar el porcentaje entre el grupo sanguíneo A en pacientes con diagnóstico de cáncer gástrico y población donante de sangre en Uruguay. Material y métodos: se trata de un estudio observacional y retrospectivo. El tamaño muestral se determinó mediante la fórmula de comparación de proporciones con un nivel de confianza de 95% y una potencia de 80%. El número calculado fue de 149 para cada grupo. Se incluyeron todos los pacientes del Hospital Maciel y la Cooperativa Médica de Florida que cumplieron con los criterios de ingreso y una población de donantes de sangre de ambas instituciones. El análisis se realizó mediante la prueba de χ2 (chi cuadrado) estableciéndose un nivel de significación de 0,05. Resultados: se incluyeron 153 pacientes y usuarios en cada grupo. El grupo sanguíneo A presentó menor porcentaje en los pacientes con cáncer gástrico (35,9%) en relación con la población donante de sangre (36,6%). La diferencia no fue estadísticamente significativa entre los grupos estudiados. Conclusiones: se encontró que no hay diferencia significativa entre los porcentajes del grupo sanguíneo A de los grupos comparados.

ABSTRACT Background: Gastric cancer has high incidence and mortality in Uruguay. Blood group A has been considered a risk factor for gastric cancer and has high prevalence in this disease. Objective: The aim of this study is to compare the percentage of blood group A in patients with gastric cancer and in blood donors in Uruguay. Material and methods: We conducted an observational and retrospective study. We used the sample size calculation for comparing proportions with a confidence of 95% and 80% power. The number calculated was 149 for each group. We included all the patients from Hospital Maciel and Cooperativa Médica de Florida who met the admission criteria and a population of blood donors from both institutions. The chi-square test was used and a p value < 0.05 was considered statistically significant. Results: A total of 153 patients and blood donors were included in each group. Blood group A was less common in gastric cancer patients than in blood donors (35.9% vs. 36.6%). The difference was not statistically significant between the groups studied. Conclusions: We did not find any significant difference in the percentage of blood group A in the groups compared.

Cytotoxic effect of hydroalcoholic extract of Annona Muricata against a human cell line of gastric adenocarcinoma / Efecto citotóxico del extracto hidroalcoholico de la Annona Muricata frente a la línea celular humana de adenocarcinoma gástrico

Background: Therapeutic advances against cancer have not been as successful as expected and have adverse effects that patients rarely tolerate. A study in Peru identified favorable anticancer effects of Annona muricata (AM), a medicinal plant known as soursop, in C-678 mouse gastric adenocarcinoma. However, to date, no results have been reported in human cells. Objective: The objective of this study was to determine the cytotoxic effect of AM extract against a human gastric adenocarcinoma cell line (AGS). Methodology: Experimental in vitro analytical study using a hydroalcoholic extract of AM (AMOH) leaves collected in the Amazonas. Chemical functional groups were identified by phytochemical screening. To obtain the cytotoxic effect, different dilutions of extract were added to the plates containing the cell lines and the data were extrapolated to GraphPad employing an observation card. Finally, the cytotoxic effect was expressed as the half-maximal inhibitory concentration (IC50) and nonlinear regression analysis was performed to determine the growth inhibition of cancer cells. Results: Phytochemical screening showed the presence of reducing carbohydrates, alkaloids, phenols, tannins, triterpenes, steroids, saponins, flavonoids, proteins, cardiac glycosides, and anthocyanins. A calibration curve with gallic acid was used to determine the total phenol content and, quercetin was used to identify the flavonoid content. The AGS cell line showed cytotoxic activity with AMOH with an IC50 at 24 hours of 45.81 µg/mL and 19.05 µg/mL at 48 hours. Conclusion: Several chemical functional groups of AM were identified. In addition, the AMOH showed a cytotoxic effect against the AGS cell line

Antecedente: Los avances terapéuticos frente al cáncer no han tenido el éxito esperado y presentan efectos adversos pocas veces tolerados por el paciente. Un estudio en Perú identificó el efecto anticancerígeno de la Annona muricata (AM), planta medicinal conocida como guanábana, en adenocarcinoma gástrico de ratón C-678 con resultados favorables, sin embargo, no se ha encontrado evidencia previa en células humanas. Objetivo: El objetivo de este estudio fue determinar el efecto citotóxico del extracto de AM frente a la línea celular de adenocarcinoma gástrico humano (AGS). Materiales y métodos: Estudio experimental in vitro tipo analítico con extracto hidroalcohólico de hojas de AM (AMOH) recolectadas en Amazonas. Mediante screening fitoquímico se identificaron los grupos funcionales químicos. Para obtener el efecto citotóxico, se añadieron diferentes diluciones de extracto a las placas que contienen las líneas celulares y mediante una ficha de observación los datos fueron extrapolados a GraphPad. Finalmente se expresó como la concentración inhibitoria media máxima (IC50) y se hizo un análisis de regresión no lineal con la finalidad de encontrar la cantidad de inhibición de crecimiento de células oncológicas. Resultados: En el screening fitoquímico se pudo identificar la presencia de carbohidratos reductores, alcaloides, fenoles, taninos, tritérpenos y esteroides, saponinas, flavonoides, proteínas, glicósidos cardiotónicos y antocianinas. Para identificar el contenido total de fenoles se utilizó la curva de calibración con ácido gálico el cual nos comprobó la presencia de una buena cantidad de estos metabolitos. Adicionalmente se utilizó quercetina para identificar el contenido de flavonoides, obteniendo resultados favorables ya que se hizo evidente su presencia. La línea celular AGS mostró una actividad citotóxica frente al AMOH con un IC50 a las 24 horas de 45.81ug/mL y 19.05ug/mL a las 48 horas. Conclusión: Se identifica a los grupos funcionales de la AM. Además, AMOH demostró un efecto citotóxico contra la línea celular AGS

Carangoides bartholomaei (Cuvier, 1833) stomach: a source of aspartic proteases for industrial and biotechnological applications / Estômago de Carangoides bartholomaei (Cuvier, 1833): uma fonte de proteases aspárticas para aplicações industriais e biotecnológicas

The viscera and other residues from fish processing are commonly discarded by the fishing industry. These byproducts can be a source of digestive enzymes with industrial and biotechnological potential. In this study, we aimed at the extraction, characterization, and application of acidic proteases from the stomach of Carangoides bartholomaei (Cuvier, 1833). A crude extract from the stomachs was obtained and submitted to a partial purification process by salting-out, which obtained a Purified Extract (PE) with a specific proteolytic activity of 54.0 U·mg-1. A purification of 1.9 fold and a yield of 41% were obtained. The PE presents two isoforms of acidic proteases and a maximum proteolytic activity at 45 °C and pH 2.0. The PE acidic proteolytic activity was stable in the pH range of 1.5 to 7.0 and temperature from 25 °C to 50 °C. Purified Extract kept 35% of its proteolytic activity at the presence of NaCl 15% (m/v) but was totally inhibited by pepstatin A. Purified Extract aspartic proteases presented high activity in the presence of heavy metals such as Cd2+, Hg2+, Pb2+, Al3+, and Cu2+. The utilization of PE as an enzymatic addictive in the collagen extraction from Nile tilapia scales has doubled the process yield. The results indicate the potential of these aspartic proteases for industrial and biotechnological applications.

As vísceras e outros resíduos do processamento de peixes são geralmente descartados pela indústria pesqueira. Esses resíduos podem ser uma fonte de enzimas digestivas com potencial industrial e biotecnológico. Neste estudo, objetivamos a extração, caracterização e aplicação de proteases aspárticas do estômago de Carangoides bartholomaei (Cuvier, 1833). Um extrato bruto do estômago foi obtido e submetido a um processo de purificação parcial, que obteve um Extrato Purificado (EP) com uma atividade proteolítica específica de 54,0 U·mg-1. Foi obtida uma purificação de 1,9 vezes e um rendimento de 41%. O EP apresenta duas isoformas de proteases ácidas e atividade proteolítica máxima a 45 °C e pH 2,0. A atividade proteolítica do EP foi estável na faixa de pH de 1,5 a 7,0 e temperatura de 25 °C a 50 °C. O EP manteve 35% de sua atividade proteolítica na presença de NaCl a 15% (m/v), mas foi totalmente inibida pela pepstatina A. As proteases ácidas do EP apresentaram alta atividade na presença de metais pesados como o Cd2+, Hg2+, Pb2+, Al3+ e Cu2+. A utilização de EP como aditivo enzimático na extração de colágeno a partir de escamas de tilápia do Nilo dobrou o rendimento do processo. Os resultados indicam um potencial dessas proteases para aplicações industriais e biotecnológicas.

Histochemical assessment of mucin-secreting cells in the stomach of domestic rabbit / Evaluación histoquímica de células secretoras de mucina en el estómago de conejo doméstico

SUMMARY: The mucous substances of the stomach in mammals are important not only for the protection of the gastric epithelium from the acid environment and grinding actions, but it facilitates some other functions of the stomach such as antibacterial, antimetastatic, and immunological roles. The goal of the study is to highlight the distribution of mucin-secreting cells in the gastric mucosa in domestic rabbits, including the type of mucus synthesized. The gastric samples collected from ten individual rabbits were fixed in 10 % buffered formalin and underwent later standard paraffin tissue sample processing, which included dehydration, clarification, and embedding in paraffin. The tissue sections were eventually stained histochemically by PAS reaction and by Alcian blue method (pH 2.5) for neutral and acidic mucins detection, respectively. The quantification of mucins in the cytoplasm of mucus-secreting cells was performed by grading the gastric tissue samples from negative (-) to intensely positive (++). The mucus elaboration was observed in all the regions of the stomach (i.e., cardial, fundic, and pyloric regions), but only for the neutral mucin. The acidic mucin synthesis occurred only in the secretory units of the gastric glands from the cardial region in the stomach. Pyloric glands synthesized the largest amounts of neutral mucins, followed by moderate amounts elaborated by cardial glands, while the fundic region does not synthesize it at all. The description of new microscopic features of the stomach in rabbits is fundamental not only for comprehending species-related physiological features but gastric pathological processes.

RESUMEN: Las sustancias mucosas del estómago en los mamíferos son importantes no solo para la protección del epitelio gástrico del ambiente ácido y las acciones de trituración, sino que facilitan además otras funciones del estómago, como son las funciones antibacterianas, antimetastásicas e inmunológicas. El objetivo del estudio fue resaltar la distribución de las células secretoras de mucina en la mucosa gástrica de conejos domésticos, incluido el tipo de moco sintetizado. Las muestras gástricas recolectadas de diez conejos se fijaron en formalina tamponada al 10 % y se sometieron a un procesamiento que incluyó deshidratación, clarificación e inclusión en parafina. Las secciones de tejido finalmente se tiñeron histoquímicamente mediante la reacción de PAS y el método del azul de Alcian (pH 2,5) para la detección de mucinas neutras y ácidas, respectivamente. La cuantificación de mucinas en el citoplasma de las células secretoras de moco se realizó clasificando las muestras de tejido gástrico desde negativas (-) hasta intensamente positivas (++). La elaboración de moco se observó en todas las regiones del estómago (es decir, cardias, fúndica y pilórica), pero solo para la mucina neutra. La síntesis de mucina ácida ocurrió solo en las unidades secretoras de las glándulas gástricas de la región correspondiente al cardias del estómago. Las glándulas pilóricas sintetizaron la mayor cantidad de mucinas neutras, seguidas de cantidades moderadas elaboradas por las glándulas cardiales, mientras que la región fúndica no las sintetizó en abso- luto. La descripción de nuevas características microscópicas del estómago en conejos es fundamental no solo para comprender las características fisiológicas relacionadas con las especies sino también para entender los procesos patológicos gástricos.

Formulation of stomach-specific floating microparticles of nizatidine and their radiographic evaluation

Nizatidine is an anti-secretogogue and a gastroprotective drug with a half-life of 1-2 h and is well absorbed in the stomach. This study aimed to optimize the process and develop floating microparticles of nizatidine that are based on low methoxyl pectin. Oil-in-oil dispersion method and Taguchi orthogonal array design were employed, and the prolonged residence time of the microparticles in the stomach was demonstrated. The constraints for independent variables, viz. A-polymer, B-internal solvent volume, C-surfactant, D-stirring rate and E-stirring time were set to generate the experimental runs. Particle size, percentage yield, micromeritic properties, entrapment efficiency, in vitro buoyancy and in vitro release were characterized. Surface morphology, zeta potential, in vitro release kinetics and in vivo floating performance of the optimized formulation was examined. The microparticles were free-flowing, irregular in shape and had a mean particle size distribution of 73-187 µ. Low methoxyl pectin played a predominant role in achieving buoyancy and optimum gastric retention for the modified release of the drug, suggesting Korsmeyer-Peppas model as the possible release mechanism. In vivo radiographic study in rabbits revealed that the drug was retained in the stomach for a period of 6 h. These results indicate that nizatidine floating microparticulate system provides modified drug release for the effective treatment of gastric ulcer

Comparative stomach tissue distribution profiles of four major bio-active components of Radix Astragali in normal and gastric ulcer mice

Numerous studies have demonstrated that Radix Astragali can inhibit gastric ulcers in mice. Anhydrous ethanol (0.01 mL/g) administered to mice by intragastric infusion can induce gastric ulcer injury. This study was performed to compare the stomach tissue distribution profiles of four major bioactive constituents of Radix Astragali(calycosin-7-O-ß-d-glucoside, calycosin, ononin and formononetin) after oral administration of extract of Radix Astragali (ERA)in normal and gastric ulcer mice. The abundance of Radix Astragali constituents was determined using an ultra-pressure liquid chromatograph with a photodiode array detector (UPLC-PDA), after which histograms were drawn. In comparison with normal mice, the contents of calycosin- 7-O-ß-d-glucoside, calycosin, ononin and formononetin in the stomach tissue samples of gastric ulcer mice showed significant differences at the selected time points (P < 0.05).The abundance of each of the four tested constituents in the normal groups was higher than that of the gastric ulcer groups. This study provides an empirical foundation for future studies focused on developing clinical applications of Radix Astragali

Enhancement of dissolution rate of racecadotril by liquisolid compact technology

Abstract The current investigation was used to improve the rate of dissolution of an anti-diarrheal drug i.e., racecadotril (RT) at low pH conditions (i.e., in the stomach) by reducing the water secretion and electrolyte in to the intestine by liquisolid tablets. Different formulations (liquisolid) were prepared using Avicel PH 102 as a carrier. Aerosil 200 as a coating material and sodium starch glycolate used as a disintegrant. Polyethylene glycol 200 was used as a non-volatile vehicle to dissolve the drug. FTIR, DSC, XRD and dissolution studies were conducted to characterise liquisolid tablets. Characterisation studies indicated that no interactions between carrier and drug. Solid state characterization had shown a reduction in crystallinity that further supports increment in solubility and dissolution. The optimised formulation showed a significant increase in dissolution i.e., 99.54±0.62% in 30 min compared to directly compressible tablets (38.47±0.26%). The % dissolution efficiency of racecadotril liquisolid tablets 76.86% compared to marketed tablet (27.56%) and conventional direct compression tablet (17.11%). Significant reduction in mean dissolution time of racecadotril from liquisolid tablets (6.84 min) compared to direct compression tablet (44.57 min), indicating faster release of drug and faster onset of action. Formulation of liquisolid tablets could enhance solubility, dissolution and bioavailability of racecadotril

Development of fluorescent- and radio-traceable T1307-polymeric micelles as biomedical agents for cancer diagnosis: biodistribution on 4T1 tumor-bearing mice

Abstract In recent years, nanocarriers have been studied as promising pharmaceutical tools for controlled drug-delivery, treatment-efficacy follow-up and disease imaging. Among them, X-shaped amphiphilic polymeric micelles (Tetronic®, poloxamines) display great potential due to their biocompatibility and non-toxic effects, among others. In the present work, polymeric micelles based on the T1307 copolymer were initially decorated with a 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene (BODIPY)-fluorophore in order to determinate its in vivo biodistribution on 4T1 tumor-bearing mice. However, unfavorable results with this probe led to two different strategies. On the one hand, the BODIPY-micelle-loaded, L-T1307-BODIPY, and on the other hand, the 99mTc-micelle-radiolabeled, L-T1307- 99m Tc, were analyzed separately in vivo. The results indicated that T1307 accumulates mainly in the stomach, the kidneys, the lungs and the tumor, reaching the maximum organ-accumulation 2 hours after intravenous injection. Additionally, and according to the results obtained for L-T1307- 99m Tc, the capture of the polymeric micelles in organs could be observed up to 24 hours after injection. The results obtained in this work were promising towards the development of new radiotracer agents for breast cancer based on X-shaped polymeric micelles.