ABSTRACT
Introducción: el Cuestionario Gastrointestinal Corto (GSFQ) es un cuestionario diseñado para el diagnóstico de enfermedad por reflujo gastroesofágico (ERGE), con versión en español. No ha sido comparado con una prueba diagnóstica objetiva. Objetivos: determinar el poder diagnóstico del GSFQ usando como referencia la pH-metría de 24 horas en dos hospitales de tercer nivel. Métodos: pacientes adultos consecutivos con síntomas típicos de ERGE (pirosis, regurgitación), a los que se solicita pH-metría, rellenaron el GSFQ (rango puntuación 0-30, proporcional a probabilidad de ERGE). Se estableció el diagnóstico de ERGE cuando la exposición ácida del esófago distal fue superior a 4,5% o cuando la probabilidad de asociación sintomática fue superior al 95%. Se calcularon curvas ROC (receiver operator characteristic) y se determinó el mejor punto de corte, con sus correspondientes sensibilidad, especificidad y ratios de probabilidad (LR) (intervalo de confianza del 95% para cada determinación). Resultados: se incluyeron 152 pacientes (59,9% mujeres; edad 47,9 ± 13,9; 97,4% pirosis; 71,3% regurgitación). La pH-metría fue patológica en el 65,8%. La puntuación media del GSFQ fue 11,2 ± 6. El área bajo la curva ROC fue 56,5% (47- 65,9%). El punto de corte óptimo fue 13 o mayor: sensibilidad 40% (30,3-50,3%), especificidad 71,2% (56,9-82,9%), LR positiva 1,39 (0,85-2,26) y LR negativa 0,84 (0,67-1,07). Excluir las preguntas 1 y 3 del GSFQ, referidas a síntomas parecidos a los de la dispepsia, mejoró sólo marginalmente el poder diagnóstico (AUROC 59,1%). Conclusión: el GSFQ no predice los resultados de la pH-metría en pacientes con síntomas típicos de ERGE en un entorno de hospital terciario (AU)
Introduction: Gastrointestinal Short Form Questionnaire (GSFQ) is a questionnaire for gastroesophageal reflux disease (GERD) diagnosis, with a version in Spanish language, not yet compared to an objective test. Aims: To establish GSFQ diagnostic performance against 24-hour pH monitoring carried out in two tertiary care hospitals. Methods: Consecutive adult patients with typical GERD symptoms (heartburn, regurgitation) referred for pH monitoring fulfilled the GSFQ (score range 0-30, proportional to probability of GERD). Diagnosis of GERD was established when acid exposure time in distal esophagus was superior to 4.5% or symptom association probability was greater than 95%. Receiver-operator characteristic (ROC) curves were calculated and best cut-off score determined, with corresponding sensitivity, specificity and likelihood ratios (LR) (95% confidence interval for each). Results: One hundred and fifty-two patients were included (59.9% women, age 47.9 ± 13.9; 97.4% heartburn; 71.3% regurgitation). pH monitoring was abnormal in 65.8%. Mean GSFQ score was 11.2 ± 6. Area under ROC was 56.5% (47.0-65.9%). Optimal cut-off score was 13 or greater: sensitivity 40% (30.3-50.3%), specificity 71.2% (56.9-82.9%), positive LR 1.39 (0.85-2.26) and negative LR 0.84 (0.67-1.07). Exclusion of questions 1 and 3 of the original GSFQ, easily interpreted as referred to dyspepsia and not GERD, improved only marginally the diagnostic performance: AUROC 59.1%. Conclusion: The GSFQ does not predict results of pH monitoring in patients with typical symptoms in a tertiary care setting (AU)
Subject(s)
Humans , Male , Female , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/epidemiology , Sensitivity and Specificity , Heartburn/diagnosis , Heartburn/epidemiology , Endoscopy/methods , Surveys and Questionnaires/standards , Surveys and Questionnaires , Diagnostic Techniques and Procedures/statistics & numerical data , Diagnostic Techniques and Procedures/standards , Diagnostic Techniques and Procedures , Confidence Intervals , Esophageal pH Monitoring/instrumentation , Esophageal pH Monitoring/methods , Acidification/methods , Acidification/statistics & numerical dataABSTRACT
A incidência da urolitíase obstrutiva em ovinos é elevada, principalmente em machos confinados, tanto para produção de carne, quanto reprodutores de alto valor genético. A acidificação urinária é um dos métodos para prevenção desta enfermidade e pode ser realizada de forma eficaz com a suplementação de cloreto de amônio na dieta, que pode propiciar a instalação de acidose metabólica. A hemogasometria avalia o equilíbrio ácido-básico sanguíneo de forma prática e fácil. Neste trabalho, avaliou-se o efeito do cloreto de amônio sobre o equilíbrio ácido-básico e eletrolítico de ovinos em confinamento para quantificar a acidose metabólica desenvolvida. Utilizaram-se 100 ovinos, machos, confinados, com idade aproximada de três meses. Constituíram-se três grupos experimentais: Grupo I (n=40), recebeu 400mg/kg/PV de cloreto de amônio/animal/dia por 21 dias consecutivos, momento da interrupção da administração do acidificante urinário (M3) e continuidade do acompanhamento clinico até o final do experimento (M6); Grupo II (n=40), 400mg/kg/PV de cloreto de amônio/animal/dia por 42 dias consecutivos; Grupo III (n=20), não recebeu cloreto de amônio durante todo o período do experimento. Os Momentos (M) de colheita de amostras e avaliação clínica foram estabelecidos com intervalo de sete dias, sendo M0 (imediatamente antes do início do tratamento com cloreto de amônio), M1 (sete dias após), M2, M3, M4, M5 e M6, totalizando 56 dias de confinamento. A alimentação consistiu de ração total, composta por 15% de feno triturado e 85% de concentrado, água e sal mineral ad libitum. Após adaptação de 15 dias à dieta de confinamento, colheram-se de todos os animais amostras de urina para mensuração do pH, e sangue venoso para hemogasometria, nos diferentes momentos...
The incidence of obstructive urolithiasis in sheep is high, especially in feedlot males, both for meat production, or the breeder of high genetic value. The urinary acidification is one way to prevent this disease and can be performed effectively supplementation with ammonium chloride in the diet, which may facilitate the installation of metabolic acidosis. The blood gas analysis evaluates the acid-base balance of blood in a practical and easy way. In this study, it was evaluated the effect of ammonium chloride on acid-base and electrolyte in feedlot sheep blood gas analysis to determine the occurrence of metabolic acidosis. It was used 100 male lambs, in a feedlot, aged approximately three months. It was constituted three groups: Group I (n=40) that received 400mg/kg/PV of ammonium chloride/animal/day for 21 consecutive days, the time of discontinuation of the urinary acidifiers (M3) and continued clinical follow until the end of the experiment (M6); Group II (n=40), that received 400mg/kg/PV of ammonium chloride/animal/day for 42 consecutive days, Group III (n=20), that did not receive ammonium chloride throughout the experimental period. The moments (M) of samples and clinical assessment were established on seven days of interval, M0 (immediately before the beginning of the treatment with ammonium chloride), M1 (seven days after), M2, M3, M4, M5 and M6, totalizing 56 days of feedlot. The feed consisted of a total mixed ration consisting of 15% of ground hay and 85 % of concentrate, water and mineral salt ad libitum. After 15 days of adaptation to the diet of feedlot, urine samples for measurement of pH, and venous blood for blood gas analysis were collected from all animals at different moments. The urinary acidification was maintained as was the administration of ammonium chloride in GI and GII. The values of Na+ and K+ remained within the normal range for the species...
Subject(s)
Animals , Acidification/methods , Ammonium Chloride/administration & dosage , Sheep , Urine/chemistry , Urolithiasis/prevention & control , Ammonium Chloride/therapeutic use , Acid-Base Equilibrium , Urolithiasis/veterinaryABSTRACT
Introducción: la pHmetría convencional de 24 horas constituye el patrón de oro para el diagnóstico de episodios de riesgo vital aparente (ALTE). La impedanciometría intraluminal multicanal (IIM) puede aportar ventajas en el lactante. Objetivos: comparación de los resultados de IIM y pHmetría en los pacientes sometidos a IIM-pHmetría en el periodo de estudio por causa de estudio de ALTE. Material y métodos: estudio retrospectivo de IIM-pHmetrías realizadas en nuestro servicio a lactantes < 12 meses de edad ingresados por ALTE durante tres años. Resultados: 39 pacientes estudiados. La pHmetría registró 2.692 reflujos, con medianas de 24 (IQ: 15-44) reflujos/paciente, índice de reflujo de 1,30 (IQ: 0,80-2,60) reflujos/hora, 1 (IQ: 0-4) episodio de reflujo > 5 min por paciente y aclaramiento de 1,20 (IQ: 0,70-2,20) min/reflujo. Por pHmetría 14 niños (35,9 %) fueron diagnosticados de RGE. Mediante IIM se registraron 8.895 eventos; 3.219 fueron reflujos, con mediana de 75 (IQ: 54-111) reflujos/ paciente, 1,30 (IQ: 1,3-2,6) reflujos/hora. Mediante IIM-pHmetría, la media de reflujos ácidos por paciente fue de 21,60 (DE 15,21), débilmente ácidos 67,33 (DE 32,09) y no ácidos 3,34 (DE 7,23), pudiéndose diagnosticar finalmente a 33 pacientes de RGE. Conclusiones: la asociación de IMM y pHmetría proporciona información adicional que mejora el rendimiento diagnóstico, sin suponer ningún riesgo adicional para el paciente. Los reflujos no ácidos/débilmente ácidos, los cuales no son detectados mediante pHmetría, suponen un porcentaje elevado, sobre todo en lactantes; esto tiene gran importancia diagnóstica en el estudio del ALTE. Aún son necesarios estudios para valorar la normalidad en IIM en pacientes pediátricos (AU)
Introduction: The conventional 24-hour pH monitoring is the gold standard for the diagnosis of gastro-esophageal reflux (GER), a possible cause of Apparent Life Threatening Episodes (ALTE). However, multichannel intraluminal impedance (MII) may provide advantages. Objectives: Comparison of the results of MII and pH monitoring in patients undergoing MII-pH monitoring in the 3-year study period because of having suffered from ALTE. Material and methods: Prospective study of MII-pH monitoring performed in our unit to infants < 12 months of age admitted for ALTE for a 3-year period. Results: Thirty nine patients studied. 2,692 pH monitoring episodes, with median of 24 (IQ: 15-44) episodes/patient, 1.30 (IQ: 0.80-2.60) reflux/hour, 1 (IQ: 0-4) reflux episode > 5 min per patient and clearance of 1.20 (IQ: 0.70-2.20) min/reflux. With pH monitoring analysis, 14 children (35.9 %) could have been diagnosed as GER (8 mild, 4 moderate and 2 severe) based on the classical criteria. MII identified a total of 8,895 events; only 3,219 among them were refluxes, with a median of 75 (IQ: 54-111) per patient, 1.30 (IQ: 1.3-2.6) episodes/hour). With MII-pH monitoring combination there were 21.60 (SD 15.21) acid reflux episodes, 67.33 weekly acid (SD 32.09) and 3.34 (SD 7.23) non-acid, being finally diagnosed 33 patients as GER. Conclusions: The association of pH monitoring and MII provides additional information that improves GER diagnostic performance without posing any additional risk to the infant patient. The non-acid/weekly acid refluxes, not detected by pH monitoring, account for a high percentage of episodes, this may have diagnostic and therapeutic significance, especially in infants. Further studies are needed to assess the normality of MMI in pediatric patients (AU)
Subject(s)
Humans , Male , Female , Infant , Gastroesophageal Reflux/diagnosis , Fluoroscopy/methods , Fluoroscopy , Esophageal pH Monitoring/instrumentation , Esophageal pH Monitoring/trends , Esophageal pH Monitoring , Acidification/methods , Laryngopharyngeal Reflux/complications , Laryngopharyngeal Reflux/diagnosis , Retrospective Studies , Sensitivity and Specificity , Hydrogen-Ion ConcentrationABSTRACT
A tecnologia de fabricação de bebidas lácteas envolve a mistura de leite e soro, podendo ser fermentada por bactérias do iogurte ou probióticas e adicionada de polpa de fruta e outros aditivos permitidos. O produto final deve conter bactérias lácticas viáveis em número adequado. Os objetivos deste trabalho foram desenvolver bebidas lácteas probióticas a partir das misturas leite-soro e estudar sua vida-de-prateleira. O efeito da composição da cultura probiótica (Lactobacillus delbrueckii subsp. bulgaricus, L. acidophilus, L. rhamnosus e Bifidobacterium animalis subsp. lactis em co-cultura com Streptococcus salivarius subsp. thermophilus) e o efeito do pH final da fermentação na cinética de acidificação, pós-acidificação e contagem de bactérias probióticas foram estudados em soro de queijo Minas frescal e em diferentes misturas leite-soro. Bebidas lácteas probióticas foram desenvolvidas a partir das diferentes misturas leite-soro e a vida-de-prateleira foi determinada ao longo de 28 dias de armazenamento do produto a 4°C. As características dos produtos foram seguidas pelas determinações físico-químicas, microbiológicas e sensoriais. O soro apresentou efeito positivo sobre a velocidade máxima das co-culturas estudadas, bem como as diferentes composições das co-culturas influenciaram o parâmetro estudado. Todas as culturas apresentaram contagens maiores em pH final de fermentação 4,5, quando comparadas às obtidas em pH 5,5. A co-cultura StLb foi a mais rápida a fermentar os diferentes meios estudados e, a StLr, a mais lenta. Com a adição de açúcar e de estabilizante, os parâmetros cinéticos mostraram comportamento diferenciado daqueles obtidos em misturas leite-soro. Nas bebidas lácteas, as contagens de B. lactis mantiveram-se acima do limite exigido pela legislação até 28 dias de armazenamento do produto refrigerado. A pós-acidificação, cor e reologia variaram durante o período de armazenamento, influenciando a análise sensorial, cujos atributos obtiveram maior aceitação em bebidas elaboradas com 10% de sólidos lácteos. Os resultados indicaram que a bebida láctea elaborada com a co-cultura StBl foi a melhor alternativa para desenvolvimento de uma bebida funcional com boas características sensoriais
The technology of production of lactic beverages involves the mixture of milk fermented by yoghurt or probiotic bacteria and whey in appropriate proportions, and the addition of fruit pulp and other allowed additives. The final product should contain viable lactic bacteria in appropriate counts. The objective of this work was to develop a probiotic lactic beverage from milk-whey mixtures and to study its shelf-life. The effect of the composition of the probiotic culture (Lactobacillus delbrueckii ssp. bulgaricus, L. acidophilus, L. rhamnosus and Bifidobacterium animalis ssp. lactis in co-culture with Streptococcus salivarius subsp. thermophilus) and the effect of the pH of the end of fermentation in the acidification kinetics, post-acidification and counts of probiotic bacteria were studied in Minas frescal cheese whey and in different mixtures milk-whey. Probiotic lactic beverages were developed from different milk-whey mixtures and the shelf-life was determined along 28 days of storage of the product at 4°C. The characteristics of the products were followed by determination of post-acidification, total acidity, color, rheology, probiotic viability and sensorial analysis. Whey presented positive effect on maximum acidification rates of the studied co-cultures, as well as the different compositions of the co-cultures influenced the studied parameter. All cultures presented higher counts when fermentation was stopped at pH 4.5, when compared to pH 5.5. The co-culture StLb presented the fast acidification performance while StLr, the slowest. The addition of sucrose and stabilizer affected the acidification kinetic parameters. In probiotic lactic beverages, counts of B. lactis were higher than the limit required by the legislation until 28 days of cool storage of the product. The post-acidification, color and rheological parameters varied during shelf-life, influencing the sensorial analysis, whose attributes obtained higher acceptance in the elaborated beverage with 10% of total solids. The results indicated that the lactic beverage elaborated with the co-culture StBl was the best alternative for development of a functional lactic beverage with good sensorial characteristics
Subject(s)
Identity and Quality Standard for Products and Services , Acidification/methods , Cheese , Probiotics/administration & dosage , Cultured Milk Products/analysis , Functional Food , Date of Validity of Products , Whey , Food TechnologyABSTRACT
Objetivo: Avaliar a quantidade de Sólidos Solúveis Totais (SST)através da refratometria na escala Brix e o pH de bebidaslácteas (iogurtes e achocolatados) e sucos de frutas prontospara o consumo (SFPC). Método: Foram avaliadas 20 bebidaslácteas e 10 SFPC, através do experimento casualizado com 3repetições para cada amostra. As leituras do grau Brix foramfeitas por refratometria, utilizando o refratômetro de Abbé e o pHfoi avaliado por potenciometria. Resultados: O teor médio deSST variou de 13,26 a 26,30 para as bebidas lácteas e de 10,23a 13,53 para os sucos de frutas. Com relação ao pH, os valoresmédios mínimo e máximo para as bebidas lácteas e os sucos defrutas foram, respectivamente, 3,58 e 7,01 e 3,07 e 3,72.Conclusão: A elevada a concentração de SST verificada nasbebidas lácteas e sucos de frutas, associada a um baixo pHpodem contribuir para o desenvolvimento de lesões de cáriecaso estes alimentos sejam consumidos em excesso pelas crianças.
