[Microcrystals and biliary sludge: pathogenesis and clinical significance]. / Microcristais e "barro biliar": patogênese e significado clínico.

Review of the literature concerning the pathogenesis and the clinical significance of microcrystals and biliary sludge. In addition, the advantages and limitations of the available methodology of identification of these microscopic precipitates and the clinical conditions in which the investigation of the bile composition, with respect to the presence of cholesterol and calcium bilirubinate microcrystals, are discussed. In conclusion, algorithms for treatment of bileopancreatic diseases caused by microcrystals and/or biliary sludge are proposed.

[Glucagonoma: case report and literature review]. / Glucagonoma: relato de caso e revisão de literatura.

Glucagonoma is a neuroendocrine tumor of pancreatic alpha cells manifested by necrolytic migratory erythema, hyperglucagonemia, glucose intolerance, weight loss, anemia and hypopaminoacidemia. We report a case of glucagonoma in a 38 years-old patient diagnosed by the presence of a pancreatic tumor, liver metastasis, weight loss, glucose intolerance, necrolytic migratory erythema, hyperglucagonemia (1400 pg/ml; normal < 200 pg/ml) and histologic demonstration of glucagon and neurospecific enolase by immunocytochemical reaction. Actual therapeutic of glucagonoma includes surgery, chemotherapy, somatostatin or octreotide for control of the symptoms, and more recently alpha-interferon was suggested.

[Smoking and inflammatory bowel disease: an epidemiological case-control study]. / Tabagismo e doença inflamatória intestinal: estudo epidemiológico caso-controle.

Smoking is one of the most consistent epidemiological features related to occurrence and evolution of inflammatory bowel disease. Ulcerative colitis is accepted as a non or ex-smokers disease suggesting a protective role of tobacco against its development. In contrast there are more Crohn's disease cases between smokers. Sixty eight patients with inflammatory disease (36 ulcerative colitis; 32 Crohn's disease) and 136 patients with gastrointestinal functional disorders were matched for sex, age, scholarity and professional and religious patterns. They are divided in smokers, ex- and non-smokers. The inflammatory bowel disease patients were asked about the relationship between smoking and onset of the disease, and exposure, as passive smokers, during childhood. Smoking habit protected against ulcerative colitis (OR:0.30, IC:95%), but not against Crohn's disease (OR:0.81, P > 0.5). There was no increased risk for development of Crohn's disease between smokers; 72.7% of ex-smokers acquired ulcerative colitis and 44.4% Crohn's disease after tobacco habit has stopped. Exposure to environmental tobacco smoking during childhood did not increased the risk for ulcerative colitis (OR:0.93, P < 0.1) neither for Crohn's disease (OR:0.44, P < 0.2). Our results are similar to those of the literature related to protection of ulcerative colitis by smoking habit. Further experimental and clinic studies are in need to clarify the possible pharmacological and therapeutic action of tobacco products in this inflammatory disease.