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1.
Arq Gastroenterol ; 59(2): 231-237, 2022.
Article En | MEDLINE | ID: mdl-35830034

BACKGROUND: Gastrointestinal (GI) motility disorders in type 2 diabetes mellitus (T2DM) are common. However, the endpoints in well-controlled T2DM in elderly patients are barely understood. OBJECTIVE: To evaluate GI transit and gastric myoelectric activity in elderly patients with T2DM who were undergoing treatment with metformin and to compare them with non-diabetic healthy controls. METHODS: A total of thirty participants were enrolled in this study: young non-diabetic (n=10), elderly non-diabetic controls (n=10), and patients with T2DM managed with metformin (n=10). After fasting overnight, the participants ingested a standard meal and magnetic markers for non-invasive monitoring of GI transit and gastric contractility using the alternating current biosusceptometry and electrogastrography techniques. RESULTS: Mean gastric emptying time, mean colon arrival time, and mean intestinal transit time were determined. There were no significant differences between the groups and in the parameters evaluated (P>0.05). The frequency and amplitude of gastric myoelectric activity were not different between groups; however, abnormal rhythmic index and the half-bandwidth were slightly higher for both elderly diabetic and non-diabetic groups compared with the young adults (P<0.01 and P<0.05, respectively). CONCLUSION: Our study showed unaltered gastric emptying and intestinal transit in T2DM patients with good glycemic control, and suggest changes in the gastric electrical activity can be a part of aging.


Diabetes Mellitus, Type 2 , Gastrointestinal Diseases , Metformin , Aged , Diabetes Mellitus, Type 2/complications , Gastric Emptying , Gastrointestinal Motility , Gastrointestinal Transit , Humans , Young Adult
2.
Arq. gastroenterol ; 59(2): 231-237, Apr.-June 2022. tab, graf
Article En | LILACS-Express | LILACS | ID: biblio-1383840

ABSTRACT Background: Gastrointestinal (GI) motility disorders in type 2 diabetes mellitus (T2DM) are common. However, the endpoints in well-controlled T2DM in elderly patients are barely understood. Objective: To evaluate GI transit and gastric myoelectric activity in elderly patients with T2DM who were undergoing treatment with metformin and to compare them with non-diabetic healthy controls. Methods: A total of thirty participants were enrolled in this study: young non-diabetic (n=10), elderly non-diabetic controls (n=10), and patients with T2DM managed with metformin (n=10). After fasting overnight, the participants ingested a standard meal and magnetic markers for non-invasive monitoring of GI transit and gastric contractility using the alternating current biosusceptometry and electrogastrography techniques. Results: Mean gastric emptying time, mean colon arrival time, and mean intestinal transit time were determined. There were no significant differences between the groups and in the parameters evaluated (P>0.05). The frequency and amplitude of gastric myoelectric activity were not different between groups; however, abnormal rhythmic index and the half-bandwidth were slightly higher for both elderly diabetic and non-diabetic groups compared with the young adults (P<0.01 and P<0.05, respectively). Conclusion: Our study showed unaltered gastric emptying and intestinal transit in T2DM patients with good glycemic control, and suggest changes in the gastric electrical activity can be a part of aging.


RESUMO Contexto: As desordens da motilidade gastrintestinal (GI) no diabetes mellitus tipo 2 (DM2) são comuns. No entanto, os desfechos em pacientes idosos com DM2 bem controlado são pouco compreendidos. Objetivo: Avaliar o trânsito GI e a atividade mioelétrica gástrica em idosos com DM2 em tratamento com metformina e compará-los com controles saudáveis não diabéticos. Métodos: Trinta participantes foram incluídos neste estudo: adultos jovens não diabéticos (n=10), idosos não diabéticos (n=10) e pacientes com DM2 tratados com metformina (n=10). Após jejum noturno, os participantes ingeriram uma refeição padrão e marcadores magnéticos para monitoramento não invasivo do trânsito GI e da contratilidade gástrica usando as técnicas de biosusceptometria de corrente alternada e eletrogastrografia. Resultados: Foram determinados o tempo médio de esvaziamento gástrico, o tempo médio de chegada ao cólon e o tempo médio de trânsito intestinal. Não houve diferenças significativas entre os grupos e nos parâmetros avaliados (P>0,05). A frequência e amplitude da atividade mioelétrica gástrica não foram diferentes entre os grupos; entretanto, o índice rítmico anormal e a meia largura de banda foram ligeiramente maiores para os grupos idosos diabéticos e não diabéticos em comparação com os adultos jovens (P<0,01 e P<0,05, respectivamente). Conclusão: Nosso estudo mostrou esvaziamento gástrico e trânsito intestinal inalterados em pacientes com DM2 com bom controle glicêmico, sugerindo que as alterações na atividade elétrica gástrica podem fazer parte do envelhecimento.

3.
Exp Parasitol ; 222: 108078, 2021 Mar.
Article En | MEDLINE | ID: mdl-33485874

The blood flow in the mesenteric region is crucial for nutrient absorption and immune response in the gastrointestinal tract. The presence of nematodes or their excreted/secreted products seems to provoke vascular dysfunction. However, it is unclear whether and how the intestinal nematodes with habitat in the intestinal niche could affect the mesenteric vascular resistance. In this study, male Wistar rats were infected with 2000 larvae of S. venezuelensis, and experiments were conducted at 0 (non-infected control), 10 or 30 days post-infection (DPI). Eggs were counted in rats' feces and adult worms recovered from the small intestine. Second- or third-order mesenteric arteries were extracted for concentration-response curves (CRC) to phenylephrine [PE; in the presence or absence of L-NAME or indomethacin] and acetylcholine. The number of eggs and adult worms were significantly higher in the 10 DPI group than those of 30 DPI group. Augmented PE-induced contraction was seen after 30 DPI compared to 10 DPI or control group. Hypercontractility to PE was partially prevented by L-NAME and wholly abolished by indomethacin incubation. Endothelium-dependent relaxation and endothelial nitric oxide synthase expression were unchanged among groups. COX-1 and COX-2 display a different pattern of expression over the infection. Hypercontractility observed in mesenteric resistance arteries in the resolution time of S. venezuelensis infection may represent systemic damage, which can generate significant cardiovascular and gastrointestinal repercussions.


Endothelial Cells/physiology , Intestines/blood supply , Mesenteric Arteries/physiopathology , Strongyloides/physiology , Strongyloidiasis/physiopathology , Animals , Feces/parasitology , Female , Gerbillinae , Male , Muscle Contraction , Neglected Diseases/physiopathology , Parasite Egg Count , Random Allocation , Rats , Rats, Wistar
4.
Article En | MEDLINE | ID: mdl-32368985

BACKGROUND: Triple immunosuppressive therapy is associated with several gastrointestinal disorders. The aim of this study was to investigate the effects induced by the triple immunosuppressive therapy on the gastrointestinal tract of rats. METHODS: Male Wistar rats were randomly assigned into three experimental groups: Control: filtered water; TAC + MPS + PRED: treated with Tacrolimus plus Mycophenolate Sodium plus Prednisone; and CSA + AZA + PRED: treated with Cyclosporine plus Azathioprine plus Prednisone. The treatment was done for 14 days by gavage. Gastric emptying and contractility were evaluated by the Alternating Current Biosusceptometry (ACB) and Electrogastrography (EGG). Histological, biochemical and hematological analyses were also performed. RESULTS: Gastric emptying time was slower in the CSA + AZA + PRED group in comparison with control (p<0.01) and TAC + MPS + PRED groups (p<0.001). Animals treated with TAC + MPS + PRED showed accelerated gastric emptying (p<0.05) compared to control. The amplitude of gastric contractions in both immunosuppressed groups was higher than observed in the control. The frequency of gastric contractions for the CSA + AZA + PRED group was also increased (p<0.01). Results obtained by EGG were similar to those recorded with the ACB. The thickness of the circular layer from stomach muscle decreased in both immunosuppressed groups, while the longitudinal layer was reduced only in the CSA + AZA + PRED group. CONCLUSION: Triple immunosuppressive therapy alters gastric motility, compromises the muscular layers and the association between CSA, AZA, and PRED provokes the major alterations in the structure and gastric function. Specific gastrointestinal side effects resulting from different immunosuppressive therapies still need to be elucidated in order to provide more effective and personalized therapy for patients.


Gastrointestinal Diseases/chemically induced , Gastrointestinal Diseases/immunology , Gastrointestinal Tract/drug effects , Gastrointestinal Tract/immunology , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Animals , Azathioprine/administration & dosage , Azathioprine/adverse effects , Cyclosporine/administration & dosage , Cyclosporine/adverse effects , Drug Therapy, Combination , Gastric Emptying/drug effects , Gastric Emptying/immunology , Gastrointestinal Diseases/pathology , Male , Rats , Rats, Wistar , Tacrolimus/administration & dosage , Tacrolimus/adverse effects
5.
BMC Complement Med Ther ; 20(1): 114, 2020 Apr 17.
Article En | MEDLINE | ID: mdl-32303220

BACKGROUND: Hancornia speciosa is usually used in Brazilian folk medicine to treat diabetes. The hypothesis of the present study is that this medicinal plant exerts beneficial effects on hyperglycemia, preventing diabetic complications. Therefore, the aim of this study was to evaluate the treatment effect of the aqueous extract of H. speciosa leaves on metabolic parameters of diabetic rats. METHODS: The H. speciosa extract (400 mg/Kg) was administered to both nondiabetic and severely diabetic female Wistar rats by gavage. The Oral Glucose Tolerance Test was performed and the area under the curve (AUC) was estimated on day 17 of pregnancy. After 21 days of treatment, the animals were anesthetized and killed to obtain organ weights. Blood samples were collected for an analysis of serum biochemical parameters. RESULTS: After treatment with the H. speciosa extract, the parameters of nondiabetic rats remained unchanged. In treated diabetic rats, glycemia, AUC, dyslipidemia parameters, and relative organ weights were decreased compared with nontreated diabetic rats. Severely diabetic rats showed decompensated hyperglycemia, polydipsia, hyperphagia and dyslipidemia. However, the aqueous extract of H. speciosa leaves decreased diabetes complications (indicating a lack of toxicity), reduced blood glucose levels, and exerced lipid-lowering effects. CONCLUSION: Based on or findings, the H. speciosa leaf extract may be a safe and promising candidate treatment for diabetes and other diseases.


Apocynaceae/chemistry , Blood Glucose/drug effects , Diabetes Mellitus, Experimental/drug therapy , Hypoglycemic Agents/pharmacology , Plant Extracts/pharmacology , Animals , Biomarkers/blood , Brazil , Female , Glucose Tolerance Test , Lipids/blood , Plant Leaves/chemistry , Pregnancy , Rats , Rats, Wistar , Streptozocin
6.
Acta Trop ; 194: 69-77, 2019 Jun.
Article En | MEDLINE | ID: mdl-30914242

We aimed to evaluate the effects of ivermectin treatment on gastrointestinal morphology and function after Strongyloides venezuelensis infection. Male rats composed Control (C), Parasitized (Sv), Ivermectin (IVM) and Parasitized and treated with Ivermectin (Sv/IVM) groups. IVM and Sv/IVM groups were subdivided according to IVM: single dose of 200 µg/kg (IVM1 and Sv/IVM1) or three repeated doses of 200 µg/kg at 24 h intervals (IVM3 and Sv/IVM3). First dose of IVM was administered after peak of infection. Eggs per gram (EPG), mean gastric emptying time (MGET), mean cecum arrival time (MCAT) and mean small intestinal transit time (MSITT) were evaluated. Measurements were performed before drug and at peak of infection, first day post peak of infection and 30 days post infection. Same time intervals were simulated for uninfected animals. Number of recovered worms and intestinal morphometry were also rated. Data were analyzed by ANOVA and correlated by Dunnett and Pearson (p < 0.05). Sv/IVM1 and Sv/IVM3 showed reduction of EPG and worms, although only group SV/IVM3 eradicate them. Hastened gastric emptying and slowed intestinal transit provoked by S. venezuelensis infection can be reverted by a single administration of IVM after peak of infection, even without total parasite elimination. Although three consecutive doses of IVM were more efficient to eradicate the parasite, drug administration impaired gastrointestinal function and morphology. IVM alone affected gastrointestinal parameters in uninfected animals for prolonged periods, especially in high doses. In control, there were strong negative correlations between MSITT and muscle layers. Strongyloides venezuelensis infection abolishes such correlations. Longitudinal muscle was thinner in IVM3 and Sv/IVM3 groups and circular thicker in Sv group. Revisiting the action of traditional drugs broadens knowledge in the parasite-host interface and may result in the development of more accurate therapeutic strategies.


Antiparasitic Agents/pharmacology , Intestine, Small/drug effects , Ivermectin/pharmacology , Strongyloides/drug effects , Strongyloidiasis/drug therapy , Strongyloidiasis/physiopathology , Animals , Disease Models, Animal , Feces/parasitology , Gastrointestinal Transit/physiology , Intestine, Small/parasitology , Male , Parasite Egg Count , Rats , Rats, Wistar/parasitology , Strongyloides/physiology , Strongyloidiasis/parasitology
7.
Int J Exp Pathol ; 99(1): 29-37, 2018 02.
Article En | MEDLINE | ID: mdl-29479759

Moderate hyperglycaemic levels seem to be related to abnormal gastric motility in diabetes mellitus. However, experimental models designed to evaluate the relationship between motility and diabetes over time are not yet well established. Our objective was to investigate the long-term effects of mild diabetes on gastric motility in rats. Newborn male rats received streptozotocin (mild diabetes groups - MD) or vehicle (control groups - C), and both groups were evaluated after 3 (C3 and MD3) and 6 months (C6 and MD6) postinduction. Mild diabetic animals (MD3 and MD6) showed moderately elevated blood glucose and decreased insulin levels compared with control (C3 and C6). Insulin secretion was enhanced in MD6 compared with MD3, most likely due to partial ß-cell regeneration indicated by HOMA-ß. In HOMA-IR, it was noticed that MD6 animals had impaired insulin response compared with MD3. Gastric emptying was faster, amplitude of contraction was stronger in MD6 compared with MD3, and in both groups, the differences were significant when compared with control animals. A significant abnormal rhythmic index was calculated for the mild diabetic groups, despite unchanged mean frequency of contraction. In conclusion, despite increased insulin levels over time, constant levels of moderate hyperglycaemia are also related to abnormal gastric motility and impairment of gastric function.


Blood Glucose/metabolism , Diabetes Mellitus, Experimental/complications , Gastric Emptying , Stomach Diseases/etiology , Animals , Animals, Newborn , Biomarkers/blood , Diabetes Mellitus, Experimental/blood , Diabetes Mellitus, Experimental/physiopathology , Insulin/blood , Insulin-Secreting Cells/metabolism , Insulin-Secreting Cells/pathology , Male , Rats , Stomach Diseases/blood , Stomach Diseases/physiopathology , Time Factors
8.
An. acad. bras. ciênc ; 89(1): 263-272, Jan,-Mar. 2017. tab, graf
Article En | LILACS | ID: biblio-886644

ABSTRACT Bauhinia holophylla, commonly known as "cow's hoof", is widely used in Brazilian folk medicine for the diabetes treatment. Therefore, the aim of this study was at evaluating the aqueous extract effect of Bauhinia holophylla leaves treatment on the streptozotocin-induced diabetic rats. Diabetes was induced by Streptozotocin (40 mg/Kg) in female Wistar rats. Oral administration of aqueous extract of Bauhinia holophylla leaves was given to non-diabetic and diabetic rats at a dose of 400 mg/kg during 21 days. On day 17 of treatment, the Oral Glucose Tolerance Test was performed to determine the area under the curve. At the end of the treatment, the animals were anesthetized and blood was collected for serum biochemical parameters analysis. After treatment with Bauhinia holophylla extract, non-diabetic and diabetic rats presented no glycemic changes. On the other hand, the plant treatment decreased body weight and increased ALT and AST activities. In conclusion, the treatment with aqueous extract of B. holophylla leaves given to diabetic rats presented no hypoglycemic effect in nondiabetic animals and no antidiabetic effect in diabetic animals with the doses studied. In addition, the diabetic animals treated with the B. holophylla extract showed inconvenient effects and its indiscriminate consumption requires particular carefulness.


Animals , Female , Plant Extracts/therapeutic use , Bauhinia/chemistry , Diabetes Mellitus, Experimental/drug therapy , Hypoglycemic Agents/therapeutic use , Time Factors , Blood Glucose/analysis , Blood Glucose/drug effects , Body Weight , Plant Extracts/pharmacology , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Streptozocin , Plant Leaves/chemistry , Drinking , Eating , Glucose Tolerance Test , Hypoglycemic Agents/pharmacology
9.
An Acad Bras Cienc ; 89(1): 263-272, 2017.
Article En | MEDLINE | ID: mdl-28225851

Bauhinia holophylla, commonly known as "cow's hoof", is widely used in Brazilian folk medicine for the diabetes treatment. Therefore, the aim of this study was at evaluating the aqueous extract effect of Bauhinia holophylla leaves treatment on the streptozotocin-induced diabetic rats. Diabetes was induced by Streptozotocin (40 mg/Kg) in female Wistar rats. Oral administration of aqueous extract of Bauhinia holophylla leaves was given to non-diabetic and diabetic rats at a dose of 400 mg/kg during 21 days. On day 17 of treatment, the Oral Glucose Tolerance Test was performed to determine the area under the curve. At the end of the treatment, the animals were anesthetized and blood was collected for serum biochemical parameters analysis. After treatment with Bauhinia holophylla extract, non-diabetic and diabetic rats presented no glycemic changes. On the other hand, the plant treatment decreased body weight and increased ALT and AST activities. In conclusion, the treatment with aqueous extract of B. holophylla leaves given to diabetic rats presented no hypoglycemic effect in nondiabetic animals and no antidiabetic effect in diabetic animals with the doses studied. In addition, the diabetic animals treated with the B. holophylla extract showed inconvenient effects and its indiscriminate consumption requires particular carefulness.


Bauhinia/chemistry , Diabetes Mellitus, Experimental/drug therapy , Hypoglycemic Agents/therapeutic use , Plant Extracts/therapeutic use , Animals , Blood Glucose/analysis , Blood Glucose/drug effects , Body Weight , Drinking , Eating , Female , Glucose Tolerance Test , Hypoglycemic Agents/pharmacology , Plant Extracts/pharmacology , Plant Leaves/chemistry , Rats, Wistar , Reproducibility of Results , Streptozocin , Time Factors , Treatment Outcome
10.
Dig Dis Sci ; 60(1): 174-80, 2015 Jan.
Article En | MEDLINE | ID: mdl-25146844

BACKGROUND: Immunosuppressive therapy after kidney transplant is necessary to prevent allograft rejection and it is the cause of several gastrointestinal (GI) disorders that have been scantily studied. OBJECTIVES: This study was aimed at investigating the influence of triple immunosuppressive therapy on GI transit in renal transplant patients by employing a biomagnetic technique. METHODS: Twenty-one renal transplant patients underwent triple therapy, which included either tacrolimus (TAC) or cyclosporin A (CsA) associated with prednisone and azathioprine. They were all evaluated, and fifteen other healthy individuals formed the control group. After a standardized meal, GI transit of magnetic markers was assessed using Alternating Current Biosusceptometry (ACB). RESULTS: Patients taking TAC had significantly accelerated gastric emptying and colonic arrival (p ≤ 0.001) when compared with those taking CsA and those in the control group. However, no differences were observed in small bowel transit among the groups studied. Overall, the inter-subject coefficients of variation for gastrointestinal transit parameters were higher for the TAC group and similar for the CsA and control groups. CONCLUSION: This study demonstrated that ACB is a suitable methodology when evaluating the influence of different immunosuppressive therapies on gastrointestinal transit after renal transplantation. Pronounced inter-individual variation was found in patients treated with tacrolimus, thus showing the prokinetic effect of this drug on GI motility. Studies of motility patterns in this population could be useful as complementary information toward determining the mechanisms and the relationship between motility and therapeutic doses.


Gastrointestinal Transit/drug effects , Immunosuppressive Agents/adverse effects , Adult , Cyclosporine/adverse effects , Drug Therapy, Combination , Female , Gastric Emptying/drug effects , Graft Rejection/prevention & control , Humans , Immunosuppressive Agents/administration & dosage , Kidney Transplantation , Magnetic Resonance Imaging , Magnetics , Male , Middle Aged , Monitoring, Ambulatory , Pilot Projects , Postoperative Complications , Tacrolimus/administration & dosage , Tacrolimus/adverse effects
11.
Physiol Meas ; 35(1): 69-81, 2014 Jan.
Article En | MEDLINE | ID: mdl-24345922

The relationship between time-courses of mechanical and electrical events in longstanding diabetes was investigated in rats. Magnetic markers and electrodes were surgically implanted in the gastric serosa of male rats. Simultaneous recordings were obtained by AC biosusceptometry, electromyography and electrogastrography one, three and six months after injections of saline (control) or alloxan (diabetic). Frequency and amplitude of contraction, abnormal rhythmic index and half-bandwidth were obtained (ANOVA P < 0.05). Antral hypomotility and gastric motility instability were observed in the signal waveform of diabetic rats at the three time points of study. The mean frequency (4.4 ± 0.4 cpm) was strictly similar, but the mechanical and electrical correlation was lowest for diabetics groups. Decreases in mechanical amplitude were observed for all diabetic groups compared with control; also the ranges of frequency were much wider in diabetes. The half-bandwidth increased since the first month in mechanical recordings and only after the third month in electrical. In diabetic animals, about 40% of gastric activity was abnormal (against 12% in control) and may reach 60% in the sixth month of mechanical recordings. The multi-instrumental approach showed a more substantial deterioration in mechanical activity and created an integrative view of gastric motility for longstanding diabetic model.


Diabetes Mellitus/physiopathology , Electrophysiological Phenomena , Gastrointestinal Motility , Mechanical Phenomena , Animals , Biomechanical Phenomena , Disease Models, Animal , Electromyography , Male , Rats , Rats, Wistar
12.
IEEE Trans Biomed Eng ; 59(10): 2737-43, 2012 Oct.
Article En | MEDLINE | ID: mdl-22996723

The association between anisotropic magnetoresistive (AMR) sensor and AC biosusceptometry (ACB) to evaluate gastrointestinal motility is presented. The AMR-ACB system was successfully characterized in a bench-top study, and in vivo results were compared with those obtained by means of simultaneous manometry. Both AMR-ACB and manometry techniques presented high temporal cross correlation between the two periodicals signals . The contraction frequencies using AMR-ACB were 73.9 ± 7.6 mHz and using manometry were 73.8 ± 7.9 mHz during the baseline . The amplitude of contraction using AMR-ACB was 396 ± 108 µT·s and using manometry were 540 ± 198 mmHg·s during the baseline. The amplitudes of signals for AMR-ACB and manometric recordings were similarly increased to 86.4% and 89.3% by neostigmine, and also decreased to 27.2% and 21.4% by hyoscine butylbromide in all animals, respectively. The AMR-ACB array is nonexpensive, portable, and has high-spatiotemporal resolution to provide helpful information about gastrointestinal tract.


Gastrointestinal Motility/physiology , Monitoring, Physiologic/instrumentation , Monitoring, Physiologic/methods , Signal Processing, Computer-Assisted , Animals , Anisotropy , Dogs , Electromagnetic Fields , Equipment Design , Manometry/instrumentation , Manometry/methods , Models, Theoretical
13.
J Biol Eng ; 6(1): 6, 2012 May 15.
Article En | MEDLINE | ID: mdl-22587220

AC Biosusceptometry (ACB) was previously employed towards recording gastrointestinal motility. Our data show a reliable and successful evaluation of gastrointestinal transit of liquid and solid meals in rats, considering the methods scarcity and number of experiments needed to endorsement of drugs and medicinal plants. ACB permits real time and simultaneous experiments using the same animal, preserving the physiological conditions employing both meals with simplicity and accuracy.

14.
Arq Neuropsiquiatr ; 69(3): 496-501, 2011 Jun.
Article En | MEDLINE | ID: mdl-21755129

Acquired hepatocerebral degeneration (AHD) and hepatolenticular degeneration can have similar clinical presentations, but when a chronic liver disease and atypical motor findings coexist, the distinction between AHD and hepatic encephalopathy (HE) can be even more complicated. We describe three cases of AHD (two having HE) with different neuroimaging findings, distinct hepatic diseases and similar motor presentations, all presenting chronic arterial hypertension and weight loss before the disease manifestations. The diagnosis and physiopathology are commented upon and compared with previous reports. In conclusion, there are many correlations among HE, hepatolenticular degeneration and AHD, but the overlapping of AHD and HE could be more common depending on the clinical knowledge and diagnostic criteria adopted for each condition. Since AHD is not considered a priority that affects the liver transplant list, the prognosis in AHD patients remains poor, and flow interruption in portosystemic shunts must always be taken into account.


Hepatic Encephalopathy/diagnosis , Hepatitis, Autoimmune/diagnosis , Hepatolenticular Degeneration/diagnosis , Liver Cirrhosis/diagnosis , Anti-Dyskinesia Agents/therapeutic use , Diagnosis, Differential , Disease Progression , Female , Haloperidol/therapeutic use , Hepatic Encephalopathy/drug therapy , Hepatic Encephalopathy/physiopathology , Hepatitis, Autoimmune/physiopathology , Hepatolenticular Degeneration/drug therapy , Hepatolenticular Degeneration/physiopathology , Humans , Liver Cirrhosis/physiopathology , Magnetic Resonance Imaging , Male , Middle Aged , Prognosis , Severity of Illness Index
15.
Arq. neuropsiquiatr ; 69(3): 496-501, June 2011. ilus
Article En | LILACS | ID: lil-592510

Acquired hepatocerebral degeneration (AHD) and hepatolenticular degeneration can have similar clinical presentations, but when a chronic liver disease and atypical motor findings coexist, the distinction between AHD and hepatic encephalopathy (HE) can be even more complicated. We describe three cases of AHD (two having HE) with different neuroimaging findings, distinct hepatic diseases and similar motor presentations, all presenting chronic arterial hypertension and weight loss before the disease manifestations. The diagnosis and physiopathology are commented upon and compared with previous reports. In conclusion, there are many correlations among HE, hepatolenticular degeneration and AHD, but the overlapping of AHD and HE could be more common depending on the clinical knowledge and diagnostic criteria adopted for each condition. Since AHD is not considered a priority that affects the liver transplant list, the prognosis in AHD patients remains poor, and flow interruption in portosystemic shunts must always be taken into account.


A degeneração hepatocerebral adquirida (AHD) e a degeneração hepatolenticular podem ter apresentações clínicas semelhantes, mas quando uma doença hepática crônica e achados motores atípicos coexistem, a distinção entre AHD e encefalopatia hepática (HE) pode ser ainda mais complicada. Descrevemos três casos de AHD (dois tendo HE) com diferentes achados em neuroimagem, doenças hepáticas distintas e apresentações motoras semelhantes, todos com hipertensão arterial e perda de peso antes das manifestações motoras. O diagnóstico e a fisiopatologia são comentados e comparados com relatos prévios. Concluímos que existem muitas correlações entre HE, degeneração hepatolenticular e AHD, mas a sobreposição de HE e AHD pode ser mais comum dependendo do conhecimento clínico e da acurácia dos critérios diagnósticos adotados para cada enfermidade. Como a AHD não é considerada prioridade na lista de transplante hepático, o prognóstico dos pacientes com AHD permanece ruim, e a interrupção do fluxo nos shunts portossistêmicos deve ser sempre considerada.


Female , Humans , Male , Middle Aged , Hepatic Encephalopathy/diagnosis , Hepatitis, Autoimmune/diagnosis , Hepatolenticular Degeneration/diagnosis , Liver Cirrhosis/diagnosis , Anti-Dyskinesia Agents/therapeutic use , Diagnosis, Differential , Disease Progression , Haloperidol/therapeutic use , Hepatic Encephalopathy/drug therapy , Hepatic Encephalopathy/physiopathology , Hepatitis, Autoimmune/physiopathology , Hepatolenticular Degeneration/drug therapy , Hepatolenticular Degeneration/physiopathology , Liver Cirrhosis/physiopathology , Magnetic Resonance Imaging , Prognosis , Severity of Illness Index
16.
Pharm Res ; 28(3): 438-55, 2011 Mar.
Article En | MEDLINE | ID: mdl-20949311

Biomagnetic methods have been designed for a wide range of applications. Recently, such methods have been proposed as alternatives to scintigraphy for evaluating of a number of pharmaceutical processes in vitro as well as under the influence of gastrointestinal physiological parameters. In this review, physical characterization as well as the most recent applications of Superconducting Quantum Interference Device (SQUID), Anisotropic Magnetoresistive (AMR) and AC Biosusceptometry (ACB) in the pharmaceutical research will be explored. Moreover, their current status and how these technologies can be employed to improve the knowledge about the impact of gastrointestinal physiology on drug delivery in association with pharmacokinetic outcomes, termed pharmacomagnetography, will be presented.


Drug Delivery Systems/methods , Magnetics/methods , Pharmaceutical Preparations/administration & dosage , Technology, Pharmaceutical/methods , Animals , Drug Delivery Systems/instrumentation , Gastrointestinal Tract/drug effects , Gastrointestinal Tract/metabolism , Humans , Intestinal Absorption/drug effects , Intestinal Absorption/physiology , Magnetics/instrumentation , Pharmaceutical Preparations/analysis
17.
World J Gastroenterol ; 16(46): 5861-8, 2010 Dec 14.
Article En | MEDLINE | ID: mdl-21155008

AIM: To evaluate the effects of meal size and three segmentations on intragastric distribution of the meal and gastric motility, by scintigraphy. METHODS: Twelve healthy volunteers were randomly assessed, twice, by scintigraphy. The test meal consisted of 60 or 180 mL of yogurt labeled with 64 MBq (99m)Tc-tin colloid. Anterior and posterior dynamic frames were simultaneously acquired for 18 min and all data were analyzed in MatLab. Three proximal-distal segmentations using regions of interest were adopted for both meals. RESULTS: Intragastric distribution of the meal between the proximal and distal compartments was strongly influenced by the way in which the stomach was divided, showing greater proximal retention after the 180 mL. An important finding was that both dominant frequencies (1 and 3 cpm) were simultaneously recorded in the proximal and distal stomach; however, the power ratio of those dominant frequencies varied in agreement with the segmentation adopted and was independent of the meal size. CONCLUSION: It was possible to simultaneously evaluate the static intragastric distribution and phasic contractility from the same recording using our scintigraphic approach.


Food , Radionuclide Imaging/methods , Stomach/anatomy & histology , Stomach/diagnostic imaging , Animals , Female , Gastric Emptying , Male , Organotechnetium Compounds/metabolism , Stomach/physiology
18.
Article En | MEDLINE | ID: mdl-21097331

The aim of this study was to validate the alternate current biosusceptometry (ACB) for monitoring gastric contractions in rats. In vitro data were obtained to establish the relationship between ACB and the strain-gauge (SG) signal amplitude. In vivo experiments were performed on rats with magnetic markers and SGs previously implanted under the gastric serosa. The effects of the prandial state in gastric motility profiles were obtained. The correlation between in vitro signal amplitudes was strong (R = 0.989). The temporal cross-correlation between the ACB and SG signal amplitude was higher in the postprandial than in the fasting state. Irregular signal profiles, low contraction amplitudes, and smaller signal-to-noise ratios explained the poor correlation for fasting-state recordings. The contraction frequencies using ACB were 0.068 ± 0.007 Hz (postprandial) and 0.058 ± 0.007 Hz (fasting) and those using SG were 0.066 ± 0.006 Hz (postprandial) and 0.059 ± 0.008 Hz (fasting) (P < 0.003). When a magnetic tracer was ingested, there was a strong correlation and a small phase-difference between techniques. We conclude that ACB provides an accurate and sensitive technique for studies of GI motility in the rat.


Electricity , Gastrointestinal Motility/physiology , Magnetics/methods , Muscle Contraction/physiology , Animals , Male , Rats , Rats, Wistar , Signal Processing, Computer-Assisted
19.
Physiol Meas ; 31(2): 159-69, 2010 Feb.
Article En | MEDLINE | ID: mdl-20009185

The aim of this paper was to verify whether AC biosusceptometry (ACB) is suitable for monitoring gastrointestinal (GI) contraction directly from smooth muscle in dogs, comparing with electrical recordings simultaneously. All experiments were performed in dogs with magnetic markers implanted under the serosa of the right colon and distal stomach, and their movements were recorded by ACB. Monopolar electrodes were implanted close to the magnetic markers and their electric potentials were recorded by electromyography (EMG). The effects of neostigmine, hyoscine butylbromide and meal on gastric and colonic parameters were studied. The ACB signal from the distal stomach was very similar to EMG; in the colonic recordings, however, within the same low-frequency band, ACB and EMG signals were characterized by simultaneity or a widely changeable frequency profile with time. ACB recordings were capable of demonstrating the changes in gastric and colonic motility determined by pharmacological interventions as well as by feeding. Our results reinforce the importance of evaluating the mechanical and electrical components of motility and show a temporal association between them. ACB and EMG are complementary for studying motility, with special emphasis on the colon. ACB offers an accurate method for monitoring in vivo GI motility.


Colon/physiology , Electromagnetic Fields , Monitoring, Physiologic/methods , Muscle Contraction , Muscle, Smooth/physiology , Stomach/physiology , Animals , Butylscopolammonium Bromide/pharmacology , Colon/drug effects , Dogs , Eating/physiology , Electrodes, Implanted , Electromyography , Female , Gastrointestinal Contents , Movement/drug effects , Movement/physiology , Muscle Contraction/drug effects , Muscle, Smooth/drug effects , Neostigmine/pharmacology , Parasympathomimetics/pharmacology , Serous Membrane , Stomach/drug effects
20.
Eur J Pharm Biopharm ; 74(1): 67-77, 2010 Jan.
Article En | MEDLINE | ID: mdl-19482083

AC Biosusceptometry offers an alternative to investigate noninvasively and without ionizing radiation the behavior of solid dosage forms in vitro and in the human gastrointestinal tract. This versatility allowed applying this technique in a wide field ranging from characterization of the disintegration process to elucidation of how the physiological parameters can interfere with pharmaceutical processes. It is increasingly important to understand how oral solid dosage forms behave in the human gastrointestinal tract. Once labelled, magnetic dosage forms provide an excellent opportunity to investigate complexes' interactions between dosage form and gastrointestinal physiology. In this paper, basic principles of this biomagnetic instrumentation and of the quantification based on magnetic images are reviewed. Also will be presented are some of the most recent applications of AC Biosusceptometry in the pharmaceutical research including oesophageal transit, gastric emptying and transit time of multiparticulate dosage forms, hydrophilic matrices and disintegration of tablets.


Molecular Probe Techniques , Pharmaceutical Preparations/chemistry , Pharmaceutical Preparations/metabolism , Administration, Oral , Animals , Chemistry, Pharmaceutical/methods , Dosage Forms , Electromagnetic Phenomena , Gastrointestinal Motility , Gastrointestinal Tract/physiology , Humans , Intestinal Absorption , Molecular Probe Techniques/instrumentation , Pharmacokinetics , Solubility
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