[Home training as a treatment of faecal incontinence and sphincter dyssynergia]. / Entrenamiento anorrectal domiciliario como tratamiento de la encopresis y disinergia esfinteriana.

OBJECTIVE: The defecation disorders represents the 3% of consultations in pediatrics patients. Our goal was to demonstrate the effectiveness and efficiency of the reeducation of the defecation maneuver through home training in patients with encopresis and sphincter dyssynergia. MATERIAL AND METHODS: Study of patients with fecal incontinence treated with home training at our center between 2014-2015. Anorectal manometry was performed and was valued defecation maneuver by expulsion of rectal probe with or without the ball. Daily sessions were performed using a Foley catheter (18-20Fr.) with progressive filling of the balloon, maximum 20cc. The response to the treatment was assessed in terms of episodes of soiling. RESULTS: Seven patients (6 males and 1 female) with a mean age of 9.7 years (range, 5-15) were included; two patients with anorectal malformation history, 1 Hirschsprung disease, 1 sacrococcygeal teratoma and 3 functional encopresis. Three patients had soiling episodes daily and 4 patients frequently. The mean basal pressure of anal channel was 32.34mmHg (range, 11.74-50.75) with negative defecation maneuver in 2 cases, deficient in 3 and dyssynergic in 2 patients. The mean time of biofeedback therapy to be asymptomatic was 5.14 months (range, 2-11), with a mean of 16.14 months (range, 3-24), with the 7 patients currently maintained clean. CONCLUSIONS: The present study suggests that re-education of defecation maneuver through home training, seems to be an effective and efficient therapy, achieving excellent results in medium term.

OBJETIVO: Los trastornos de la defecación representan el 3% de las consultas en pediatría. Nuestro objetivo fue demostrar la eficacia y eficiencia de la reeducación en la maniobra defecatoria mediante el entrenamiento domiciliario en los pacientes con encopresis y disinergia esfinteriana. MATERIAL Y METODOS: Estudio de los pacientes con encopresis tratados mediante entrenamiento domiciliario en nuestro centro entre 2014-2015. Se realizó manometría anorrectal y fue valorada la maniobra defecatoria mediante la expulsión o no de la sonda rectal con o sin balón. Se realizaron sesiones diarias de forma domiciliaria empleando una sonda de Foley (18-20 Fr.) con llenado progresivo del balón, máximo 20 cc. Se evaluó la respuesta al tratamiento en función de la presencia de manchado. RESULTADOS: Se incluyeron 7 pacientes (6 varones y 1 mujer) con edad media de 9.7 años (rango, 5-15); dos con antecedente de malformación anorrectal, una enfermedad de Hirschsprung, 1 teratoma sacrococcígeo y 3 encopresis funcionales. Tres pacientes presentaban manchado diario y 4 de forma frecuente. La media de presión basal del canal fue de 32,34 mmHg (rango, 11,74-50,75) con maniobra defecatoria negativa en 2 casos, deficiente en 3 y disinérgica en 2. La media de tiempo realizando el entrenamiento intestinal hasta lograr estar asintomáticos fue 5.14 meses (rango, 2-11), con un seguimiento medio de 16,14 meses (rango, 3-24), manteniéndose limpios actualmente los 7 pacientes. CONCLUSIONES: El presente estudio sugiere que la reeducación de la maniobra defecatoria mediante entrenamiento domiciliario parece ser una terapia eficaz y eficiente, logrando excelentes resultados a medio plazo.

Iron bioavailability from fortified fluid milk and petit suisse cheese determined by the prophylactic-preventive method.

In this research, we measure the iron bioavailability of micronized ferric orthophosphate when it is used to fortify low-fat fluid milk enriched with calcium and petit suisse cheese using the prophylactic-preventive method in rats. Four groups of male weaned rats received a basal diet (control diet; 6.5 ppm Fe), a reference standard diet (SO4Fe; 18.2 ppm Fe), a basal diet using iron-fortified fluid milk as the iron source (milk diet; Fe ppm 17.9), and a basal diet using iron-fortified petit suisse cheese as the iron source (cheese diet; 18.0 ppm Fe) for 22 d. The iron bioavailability of the different sources was calculated as the ratio between the mass of iron incorporated into hemoglobin during the experiment and the total iron intake per animal. The relative biological values with regard to the reference standard (RBV%) were 61% and 69% for the milk and cheese diet, respectively. These results show that according to this method, the iron bioavailability in both fortified foods can be considered as medium bioavailability rates.

Nutritional and technological behavior of stabilized iron-gluconate in wheat flour.

Food fortification has been shown to be an effective strategy to overcome iron malnutrition. When a new iron compound is developed for this purpose, it must be evaluated from a nutritional and technological point of view before adding it into foods. In this way, we have evaluated ferrous gluconate stabilized by glycine as a new iron source to be used in wheat flour fortification. We performed biological studies in rats as well as sensory perceptions by human subjects in wheat flour fortified with this iron source. The productions of pentane as a rancidity indicator as well as the change of the sensorial properties of the biscuits made with stabilized ferrous gluconate-fortified wheat flour were negligible. Iron absorption in water from this iron source was similar to the reference standard ferrous sulfate. Nevertheless, because of the phytic acid content, iron absorption from fortified wheat flour decrease 40% for both iron sources. The addition of zinc from different sources did not modify iron absorption from ferrous sulfate and stabilized ferrous gluconate in water and wheat flour. The iron absorption mechanism as well as the biodistribution studies demonstrate that the biological behavior of this iron source does not differ significantly from the reference standard. These results demonstrate that the iron source under study has adequate properties to be used in wheat flour fortification. Nevertheless, more research is needed before considering this iron source for its massive use in food fortification.

Normal growth rate in rats is recovered after a period of zinc deficiency by restoration of zinc supply by means of a zinc-fortified Petit Suisse cheese.

Fortification of a Petit Suisse cheese with zinc sulfate and zinc gluconate stabilized with glycine was used as a tool to overcome zinc-deficiency effects on total-body growth and skeletal growth. Animals were divided in 4 groups of 10 rats: basal (B), control (C), depletion-repletion 1 (DR1), and depletion-repletion 2 (DR2). These four groups were fed with four diets: basal (2 ppm Zn), control (30 ppm Zn), DR1, and DR2; they received a basal diet for 14 d and a control diet for the other 14 d of the experiment, using zinc sulfate for DR1 and zinc gluconate stabilized with glycine for DR2. After 28 d of the experiment, total-body weight and weight gain of the control and DR1 and DR2 animals were not statistically different (p<0.05), Femur weight and femur zinc content of DR1 and DR2 did not achieve the values of control animals (p<0.05), but they were higher than that of basal animals. Our results show that restoration of dietary zinc levels by means of food fortification normalized weight gain, as an indicator of total-body growth, and presented a trend to normalize bone weight, as a marker of skeletal growth, in young rats and independently of the zinc source used.

In vivo iron and zinc deficiency diminished T- and B-selective mitogen stimulation of murine lymphoid cells through protein kinase C-mediated mechanism.

Zinc and iron are crucial mineral components of human diet, because their deficiency leads to several disorders, including alterations of the immune function. It has been demonstrated, in both humans and rodents, that a diminished number of lymphoid cells and a loss of lymphocyte activity accompany deprivation of these essential minerals. The aim of this work was to analyze if iron and/or zinc imbalances regulate lymphocyte activity and the intracellular signals involved in the effect. Mice from the BALB/c strain were fed with iron- and/or zinc-deficient or mineral-supplemented diets, according to the American Institute of Nutrition Rodent Diets. Levels of iron and zinc were assessed in blood, liver, or bone samples. Selective mitogen stimulation of T- and B-lymphocytes were performed. We found a diminished proliferative response in T- and B-lymphocytes from zinc- and/or iron-deficient animals with respect to controls. These effects were related to decreased mitogen-induced translocation of protein kinase C (PKC) activity to cell membranes on both cell types from all animals fed with deficient diets. Our results demonstrate that iron and zinc deficiencies affect both T- and B-lymphocyte function by PKC-dependent mechanisms.

Comparative pharmacological study of hydroethanol extracts of Passiflora alata and Passiflora edulis leaves.

Several species of the genus Passiflora, known in Brazil as "maracujá", have widespread use in folk medicine as sedatives and tranquillizers. The anxiolytic activity of hydroethanol extracts of P. alata and P. edulis leaves was evaluated using the elevated plus-maze test. The extracts presented anxiolytic activity in dosages around 50, 100 and 150 mg/kg.

Psychopharmacological screening of Pfaffia glomerata Spreng. (Amarathanceae) in rodents.

The alcoholic extract of Pfaffia glomerata roots (100, 500, 1000 mg/kg, intraperitoneally (i.p.), and 500, 1000, 1500 mg/kg, per os) was studied in several behavioral animal models for the evaluation of central activity: open field, barbiturate sleeping time, pentilenotetrazole (PTZ)-induced convulsions, elevated plus-maze, step-down inhibitory avoidance and forced swimming test. The acute treatment (500 mg/kg, i.p.) interfered with the open-field habituation, decreased sleep latency and increased barbiturate-induced sleeping time, protected partially the animals of PTZ-induced convulsions, decreased the memory retention in step-down inhibitory avoidance, and did not have an important effect in the elevated plus-maze test and forced swimming test. The same extract at 1000 mg/kg per os did not cause any effect in barbiturate sleeping time and pentilenotetrazole-induced convulsions models. Thus, the effect on the memory was deeper evaluated in the step-down inhibitory avoidance task. When administered by intraperitoneal route, the extract showed a dose-dependent effect causing full amnesia at 1000 mg/kg. On the other hand, when it was given by oral route at 500, 1000 and 1500 mg/kg, no influence on the memory retention was observed. These results suggest that the alcoholic extract of P. glomerata roots presents different effects depending on the route of administration: by i.p route, it seems to be a central nervous system depressant agent; by oral route, it seems to be ineffective, at least in the tested doses.

[Zinc: concepts on an essential micronutrient]. / Cinc: conceptos actuales sobre un micronutriente esencial.

It is now well known that zinc is an essential micronutrient. Even though much information is available, there are many points that remain to be studied. zinc is absorbed by the intestine and transported in the plasma by albumin, forming a small exchangeable pool, which is rapidly exhausted even in cases of mild deficiency. zinc is essential for the activity of about 70 enzymes among other functions. Therefore, zinc deficiency produces a great number of clinical disorders, the symptoms of which may range between mild up to serious dysfunctions. These problems are corrected by a dietary supplementation with zinc. The lack of a reliable method to determine the zinc nutritional status reflects the problem to estimate the metal recommended dietary allowances, which are difficulty met specially by children, old persons and pregnant women which constitute the main risk groups. Although our knowledge concerning zinc toxicity is scarce, it is well known that the amounts of zinc that produces toxic effects are much higher than those that are contained in regular diets as well as in diets supplemented with this metal. Therefore, the need of the development of effective strategies, like food fortification with proper zinc compounds, appears as an attractive alternative in order to prevent and/or correct the deficiency of this vital element and to improve the health and the life quality of the whole population.

Cinc: conceptos actuales sobre un micronutriente esencial. / [Zinc: concepts on an essential micronutrient]

It is now well known that zinc is an essential micronutrient. Even though much information is available, there are many points that remain to be studied. zinc is absorbed by the intestine and transported in the plasma by albumin, forming a small exchangeable pool, which is rapidly exhausted even in cases of mild deficiency. zinc is essential for the activity of about 70 enzymes among other functions. Therefore, zinc deficiency produces a great number of clinical disorders, the symptoms of which may range between mild up to serious dysfunctions. These problems are corrected by a dietary supplementation with zinc. The lack of a reliable method to determine the zinc nutritional status reflects the problem to estimate the metal recommended dietary allowances, which are difficulty met specially by children, old persons and pregnant women which constitute the main risk groups. Although our knowledge concerning zinc toxicity is scarce, it is well known that the amounts of zinc that produces toxic effects are much higher than those that are contained in regular diets as well as in diets supplemented with this metal. Therefore, the need of the development of effective strategies, like food fortification with proper zinc compounds, appears as an attractive alternative in order to prevent and/or correct the deficiency of this vital element and to improve the health and the life quality of the whole population.

Anxiolytic natural and synthetic flavonoid ligands of the central benzodiazepine receptor have no effect on memory tasks in rats.

The naturally occurring flavonoids, chrysin (5,7-dihydroxyflavone) and apigenin (5,7,4'-trihydroxyflavone), and the synthetic compound, 6,3'-dinitroflavone have been recently reported to selectively bind with high affinity to the central benzodiazepine receptor, and to exert powerful anxiolytic and other benzodiazepine-like effects in rats. Their chemical analog, quercetin, shares none of these effects. In the present article we find that, in contrast to diazepam, chrysin, apigenin, and 6,3'-dinitroflavone have no amnestic effect on acquisition or retention of three different learning tasks (inhibitory avoidance, shuttle avoidance, and habituation to an open field), even when given at doses higher than those previously reported to be anxiolytic. Apigenin had a slight enhancing effect on training session performance and, when given posttraining, on test session retention, of crossing responses in the open field and hindered retention of inhibitory avoidance, and showed no anxiolytic action in an elevated plus maze. Unlike diazepam, none of these drugs had any analgesic effect in the tail-flick test. The data suggest that chrysin, apigenin, and 6,3'-dinitroflavoine, three flavonoids derivatives possessing anxioselective effects acting on central benzodiazepine receptors, may deserve clinical trials as anxiolytic agents.