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1.
Br J Oral Maxillofac Surg ; 53(4): 316-20, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25623934

RESUMEN

Our aim was to find out whether pain was better controlled if morphine or tramadol was injected intra-articularly after arthrocentesis with Ringer's lactate in patients with painful temporomandibular joints (TMJ). This placebo-controlled, double-blind study involved 30 patients who had not responded to conservative treatment and who were divided randomly into 3 groups of 10 patients each. All patients had arthrocentesis, and the drugs were given as intra-articular injections immediately after the procedure. One group was give 5% Ringer's lactate 1ml, the second morphine 1mg, and the third tramadol 50mg. Visual analogue scales (VAS) for pain were recorded at maximum mouth opening and at rest before intra-articular injection and after 15 and 30min; at 1, 2, 3, 8, 12, 24, 36 and 48h; and at 1, 3, and 6 monthly follow-up. The mean (SD) VAS decreased from 6.90 (1.45) to 2.6 (2.5) in the control group, from 7.30 (1.64) to 1.20 (0.79) in the morphine group (p=0.005), and from 7.10 (1.73) to 1.50 (1.78) in the tramadol group (p=0.005). We conclude that morphine given by intra-articular injection after arthrocentesis gives a significant, sustained (6 months) improvement in pain relief compared with simple arthrocentesis alone. The effect was similar with tramadol except that it was shorter lived.


Asunto(s)
Analgésicos Opioides/administración & dosificación , Artrocentesis/métodos , Dolor Facial/tratamiento farmacológico , Morfina/administración & dosificación , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico , Tramadol/administración & dosificación , Adolescente , Adulto , Antiinflamatorios no Esteroideos/administración & dosificación , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intraarticulares , Soluciones Isotónicas/administración & dosificación , Masculino , Persona de Mediana Edad , Dimensión del Dolor/métodos , Piroxicam/administración & dosificación , Piroxicam/análogos & derivados , Placebos , Rango del Movimiento Articular/efectos de los fármacos , Lactato de Ringer , Resultado del Tratamiento , Adulto Joven
2.
Eur J Paediatr Dent ; 11(1): 19-22, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20359276

RESUMEN

AIM: We compared the efficacy of sedation with oral Midazolam and a combination of oral Midazolam and Ketamine, used as alternatives to general anaesthesia during tooth extraction. STUDY DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 30 patients aged between 3 and 9 years, who had elective tooth extraction were included in the study. Subjects in Group A (n. 15) were given 0.75 mg/kg Midazolam orally while those in Group B (n. 15) were given 0.75 mg/kg Midazolam orally+5 mg/kg ketamine. Acceptance of orally administered drugs, sedation and anxiety scores and reactions to local anaesthetic injection and tooth extraction were assessed. RESULTS: Sedation and anxiety scores in Group B were better than in Group A (p<0.05). Reactions to local anaesthetic injection and tooth extraction were very significantly less common in Group B (p<0.0001). Requirement for an additional medication was more common in Group A (p<0.05). Side effects were not observed in either group. STATISTICS: Patient demographics and time to discharge were analysed by Mann-Whitney U test, whereas Chi-square test was used to analyse compliance to sedation, anxiety and sedation scores, reaction to tooth extraction, side effects and additional drug requirement. CONCLUSION: Compared to oral Midazolam only, a combination of oral Midazolam+Ketamine resulted in better sedation and surgical comfort in children during a painful procedure such as tooth extraction.


Asunto(s)
Sedación Consciente/métodos , Antagonistas de Aminoácidos Excitadores/administración & dosificación , Hipnóticos y Sedantes/administración & dosificación , Ketamina/administración & dosificación , Midazolam/administración & dosificación , Administración Oral , Anestésicos Locales/administración & dosificación , Niño , Conducta Infantil , Preescolar , Conducta Cooperativa , Ansiedad al Tratamiento Odontológico/clasificación , Combinación de Medicamentos , Humanos , Inyecciones , Alta del Paciente , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Tiempo , Extracción Dental
3.
J Eur Acad Dermatol Venereol ; 24(2): 204-7, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19552719

RESUMEN

Inflammatory bowel disease (IBD) comprises two chronic, tissue-destructive, clinical entities: Crohn's disease (CD) and ulcerative colitis (UC), both immunologically based. Bowel symptoms are predominant, but extra-intestinal complications may occur, including involvement of the oral cavity. Oral involvement during IBD includes several types of lesions: the most common are aphthae; uncommon lesions include, among others, pyostomatitis vegetans and granulomatous lesions of CD. Starting with a presentation of six patients with oral manifestations, which were crucial for the final diagnosis of IBD, a review on the subject is presented. Oral involvement in IBD may be previous or simultaneous to the gastrointestinal symptoms. However, in the majority of cases, bowel disease precedes the onset of oral lesions by months or years. In many patients, the intestinal symptoms may be minimal and can go undetected; thus, most authors believe that the bowel must be thoroughly examined in all patients with suspected IBD even in the absence of specific symptoms. Usually, the clinical course of oral lesions is parallel to the activity of IBD; therefore, oral manifestations are a good cutaneous marker of IBD.


Asunto(s)
Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades de la Boca/complicaciones , Humanos
7.
Braz J Med Biol Res ; 37(3): 333-6, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15060699

RESUMEN

The pathogenesis of nonsteroidal anti-inflammatory drug (NSAID) enteropathy is a complex process involving the uncoupling of mitochondrial oxidative phosphorylation and inhibition of cyclooxygenase (COX). Rofecoxib, a selective inhibitor of COX-2, has shown less gastric damage, but the same beneficial effect is not clear in the case of the small bowel. Fifty-seven male Wistar rats (250-350 g) were divided into three groups (N=19 each) to evaluate the effect of this NSAID on the rat intestine. The groups received 2.5 mg/kg rofecoxib, 7.5 mg/kg indomethacin or water with 5% DMSO (control) given as a single dose by gavage 24 h before the beginning of the experiment. A macroscopic score was used to quantify intestinal lesions and intestinal permeability was measured using [51Cr]-ethylenediaminetetraacetic acid ([51Cr]-EDTA). The extent of intestinal lesion, indicated by a macroscopic score, was significantly lower when rofecoxib was administered compared to indomethacin (rofecoxib=0.0 vs indomethacin=63.6 +/- 25.9; P<0.05) and did not differ from control. The intestinal permeability to [51Cr]-EDTA was significantly increased after indomethacin (control=1.82 +/- 0.4 vs indomethacin=9.12 +/- 0.8%; P<0.0001), but not after rofecoxib, whose effect did not differ significantly from control (control=1.82 +/- 0.4 vs rofecoxib=2.17 +/- 0.4%; ns), but was significantly different from indomethacin (indomethacin=9.12 +/- 0.8 vs rofecoxib=2.17 +/- 0.4%; P<0.001). In conclusion, the present data show that rofecoxib is safer than indomethacin in rats because it does not induce macroscopic intestinal damage or increased intestinal permeability.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Inhibidores de la Ciclooxigenasa/farmacología , Indometacina/farmacología , Intestino Delgado/efectos de los fármacos , Isoenzimas/antagonistas & inhibidores , Lactonas/farmacología , Animales , Antiinflamatorios no Esteroideos/efectos adversos , Ciclooxigenasa 2 , Inhibidores de la Ciclooxigenasa 2 , Inhibidores de la Ciclooxigenasa/efectos adversos , Indometacina/efectos adversos , Mucosa Intestinal/efectos de los fármacos , Lactonas/efectos adversos , Masculino , Permeabilidad/efectos de los fármacos , Prostaglandina-Endoperóxido Sintasas , Ratas , Ratas Wistar , Sulfonas
8.
Braz. j. med. biol. res ; 37(3): 333-336, Mar. 2004. graf
Artículo en Inglés | LILACS | ID: lil-356614

RESUMEN

The pathogenesis of nonsteroidal anti-inflammatory drug (NSAID) enteropathy is a complex process involving the uncoupling of mitochondrial oxidative phosphorylation and inhibition of cyclooxygenase (COX). Rofecoxib, a selective inhibitor of COX-2, has shown less gastric damage, but the same beneficial effect is not clear in the case of the small bowel. Fifty-seven male Wistar rats (250-350 g) were divided into three groups (N = 19 each) to evaluate the effect of this NSAID on the rat intestine. The groups received 2.5 mg/kg rofecoxib, 7.5 mg/kg indomethacin or water with 5 percent DMSO (control) given as a single dose by gavage 24 h before the beginning of the experiment. A macroscopic score was used to quantify intestinal lesions and intestinal permeability was measured using [51Cr]-ethylenediaminetetraacetic acid ([51Cr]-EDTA). The extent of intestinal lesion, indicated by a macroscopic score, was significantly lower when rofecoxib was administered compared to indomethacin (rofecoxib = 0.0 vs indomethacin = 63.6 ± 25.9; P < 0.05) and did not differ from control. The intestinal permeability to [51Cr]-EDTA was significantly increased after indomethacin (control = 1.82 ± 0.4 vs indomethacin = 9.12 ± 0.8 percent; P < 0.0001), but not after rofecoxib, whose effect did not differ significantly from control (control = 1.82 ± 0.4 vs rofecoxib = 2.17 ± 0.4 percent; ns), but was significantly different from indomethacin (indomethacin = 9.12 ± 0.8 vs rofecoxib = 2.17 ± 0.4 percent; P < 0.001). In conclusion, the present data show that rofecoxib is safer than indomethacin in rats because it does not induce macroscopic intestinal damage or increased intestinal permeability.


Asunto(s)
Animales , Masculino , Ratas , Antiinflamatorios no Esteroideos , Inhibidores de la Ciclooxigenasa , Indometacina , Intestino Delgado , Mucosa Intestinal , Intestino Delgado , Permeabilidad , Ratas Wistar
9.
Braz J Med Biol Res ; 36(6): 739-45, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12792703

RESUMEN

The hypothesis of the role of iron overload associated with HFE gene mutations in the pathogenesis of nonalcoholic steatohepatitis (NASH) has been raised in recent years. In the present study, biochemical and histopathological evidence of iron overload and HFE mutations was investigated in NASH patients. Thirty-two NASH patients, 19 females (59%), average 49.2 years, 72% Caucasians, 12% Mulattoes and 12% Asians, were submitted to serum aminotransferase and iron profile determinations. Liver biopsies were analyzed for necroinflammatory activity, architectural damage and iron deposition. In 31 of the patients, C282Y and H63D mutations were tested by PCR-RFLP. Alanine aminotransferase levels were increased in 30 patients, 2.42 1.12 times the upper normal limit on average. Serum iron concentration, transferrin saturation and ferritin averages were 99.4 31.3 g/dl, 33.1 12.7% and 219.8 163.8 g/dl, respectively, corresponding to normal values in 93.5, 68.7 and 78.1% of the patients. Hepatic siderosis was observed in three patients and was not associated with architectural damage (P = 0.53) or with necroinflammatory activity (P = 0.27). The allelic frequencies (N = 31) found were 1.6 and 14.1% for C282Y and H63D, respectively, which were compatible with those described for the local population. In conclusion, no evidence of an association of hepatic iron overload and HFE mutations with NASH was found. Brazilian NASH patients comprise a heterogeneous group with many associated conditions such as hyperinsulinism, environmental hepatotoxin exposure and drugs, but not hepatic iron overload, and their disease susceptibility could be related to genetic and environmental features other than HFE mutations.


Asunto(s)
Hígado Graso/etiología , Antígenos de Histocompatibilidad Clase I/genética , Sobrecarga de Hierro/complicaciones , Proteínas de la Membrana/genética , Mutación , Adulto , Anciano , Alanina Transaminasa/análisis , Biopsia , Estudios de Cohortes , Hígado Graso/genética , Hígado Graso/patología , Femenino , Ferritinas/análisis , Proteína de la Hemocromatosis , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Transferrina/análisis
10.
Braz. j. med. biol. res ; 36(6): 739-745, June 2003. tab
Artículo en Inglés | LILACS | ID: lil-340666

RESUMEN

The hypothesis of the role of iron overload associated with HFE gene mutations in the pathogenesis of nonalcoholic steatohepatitis (NASH) has been raised in recent years. In the present study, biochemical and histopathological evidence of iron overload and HFE mutations was investigated in NASH patients. Thirty-two NASH patients, 19 females (59 percent), average 49.2 years, 72 percent Caucasians, 12 percent Mulattoes and 12 percent Asians, were submitted to serum aminotransferase and iron profile determinations. Liver biopsies were analyzed for necroinflammatory activity, architectural damage and iron deposition. In 31 of the patients, C282Y and H63D mutations were tested by PCR-RFLP. Alanine aminotransferase levels were increased in 30 patients, 2.42 + or - 1.12 times the upper normal limit on average. Serum iron concentration, transferrin saturation and ferritin averages were 99.4 + or - 31.3 g/dl, 33.1 + or - 12.7 percent and 219.8 + or - 163.8 æg/dl, respectively, corresponding to normal values in 93.5, 68.7 and 78.1 percent of the patients. Hepatic siderosis was observed in three patients and was not associated with architectural damage (P = 0.53) or with necroinflammatory activity (P = 0.27). The allelic frequencies (N = 31) found were 1.6 and 14.1 percent for C282Y and H63D, respectively, which were compatible with those described for the local population. In conclusion, no evidence of an association of hepatic iron overload and HFE mutations with NASH was found. Brazilian NASH patients comprise a heterogeneous group with many associated conditions such as hyperinsulinism, environmental hepatotoxin exposure and drugs, but not hepatic iron overload, and their disease susceptibility could be related to genetic and environmental features other than HFE mutations


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Hígado Graso , Sobrecarga de Hierro , Mutación , Alanina Transaminasa , Biopsia , Estudios de Cohortes , Hígado Graso , Ferritinas , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Transferrina
11.
Braz J Med Biol Res ; 34(3): 353-7, 2001 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11262586

RESUMEN

The objective of the present study was to assess intestinal permeability in patients with infection caused by Strongyloides stercoralis. Twenty-six patients (16 women and 10 men), mean age 45.9, with a diagnosis of strongyloidiasis were evaluated. For comparison, 25 healthy volunteers (18 women and 7 men), mean age 44.9, without digestive disorders or intestinal parasites served as normal controls. Intestinal permeability was measured on the basis of urinary radioactivity levels during the 24 h following oral administration of chromium-labeled ethylenediaminetetraacetic acid ((51)Cr-EDTA) expressed as percentage of the ingested dose. The urinary excretion of (51)Cr-EDTA was significantly reduced in patients with strongyloidiasis compared to controls (1.60 +/- 0.74 and 3.10 +/- 1.40, respectively, P = 0.0001). Intestinal permeability is diminished in strongyloidiasis. Abnormalities in mucus secretion and intestinal motility and loss of macromolecules could explain the impaired intestinal permeability.


Asunto(s)
Absorción Intestinal , Strongyloides stercoralis , Estrongiloidiasis/fisiopatología , Adulto , Anciano , Animales , Estudios de Casos y Controles , Radioisótopos de Cromo/orina , Ácido Edético/orina , Femenino , Humanos , Mucosa Intestinal/metabolismo , Masculino , Persona de Mediana Edad , Permeabilidad , Estrongiloidiasis/orina
12.
Braz. j. med. biol. res ; 34(3): 353-357, Mar. 2001. ilus
Artículo en Inglés | LILACS | ID: lil-281616

RESUMEN

The objective of the present study was to assess intestinal permeability in patients with infection caused by Strongyloides stercoralis. Twenty-six patients (16 women and 10 men), mean age 45.9, with a diagnosis of strongyloidiasis were evaluated. For comparison, 25 healthy volunteers (18 women and 7 men), mean age 44.9, without digestive disorders or intestinal parasites served as normal controls. Intestinal permeability was measured on the basis of urinary radioactivity levels during the 24 h following oral administration of chromium-labeled ethylenediaminetetraacetic acid (51Cr-EDTA) expressed as percentage of the ingested dose. The urinary excretion of 51Cr-EDTA was significantly reduced in patients with strongyloidiasis compared to controls (1.60 + or - 0.74 and 3.10 + or - 1.40, respectively, P = 0.0001). Intestinal permeability is diminished in strongyloidiasis. Abnormalities in mucus secretion and intestinal motility and loss of macromolecules could explain the impaired intestinal permeability


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Radioisótopos de Cromo/farmacocinética , Ácido Edético/farmacocinética , Absorción Intestinal , Strongyloides stercoralis , Estrongiloidiasis/parasitología , Estudios de Casos y Controles , Radioisótopos de Cromo , Radioisótopos de Cromo/orina , Ácido Edético , Ácido Edético/orina , Mucosa Intestinal/metabolismo , Permeabilidad , Estrongiloidiasis/diagnóstico
13.
Gut ; 48(2): 163-7, 2001 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-11156635

RESUMEN

BACKGROUND: The pathogenesis of non-steroidal anti-inflammatory drug (NSAID) enteropathy is complex. It involves uncoupling of mitochondrial oxidative phosphorylation which alters the intercellular junction and increases intestinal permeability with consequent intestinal damage. Metronidazole diminishes the inflammation induced by indomethacin but the mechanisms remain speculative. A direct effect on luminal bacteria has traditionally been thought to account for the protective effect of metronidazole. However, a protective effect of metronidazole on mitochondrial oxidative phosphorylation has never been tested. AIMS: To assess the protective effect of metronidazole on mitochondrial uncoupling induced by indomethacin and also on the increased intestinal permeability and macroscopic damage. MATERIAL AND METHODS: The protective effect of metronidazole was evaluated in rats given indomethacin; a macroscopic score was devised to quantify intestinal lesions, and intestinal permeability was measured by means of (51)Cr-ethylenediaminetetraacetic acid. The protective effect of metronidazole against mitochondrial uncoupling induced by indomethacin was assessed using isolated coupled rat liver mitochondria obtained from rats pretreated with metronidazole or saline. RESULTS: Metronidazole significantly reduced the macroscopic intestinal damage and increase in intestinal permeability induced by indomethacin; furthermore, at the mitochondrial level, it significantly reduced the increase in oxygen consumption in state 4 induced by indomethacin and caused less reduction of the respiratory control rate. CONCLUSION: Our study confirmed the beneficial effects of metronidazole on intestinal damage and intestinal permeability, and demonstrated, for the first time, a direct protective effect of metronidazole on uncoupling of mitochondrial oxidative phosphorylation caused by NSAIDs.


Asunto(s)
Antibacterianos/farmacología , Antiinflamatorios no Esteroideos/farmacología , Indometacina/farmacología , Metronidazol/farmacología , Mitocondrias/efectos de los fármacos , Fosforilación Oxidativa/efectos de los fármacos , Animales , Interacciones Farmacológicas , Mucosa Intestinal/efectos de los fármacos , Mucosa Intestinal/metabolismo , Masculino , Consumo de Oxígeno/efectos de los fármacos , Permeabilidad/efectos de los fármacos , Ratas , Ratas Wistar , Análisis de Regresión , Estadísticas no Paramétricas , Desacopladores/farmacología
14.
Rev Hosp Clin Fac Med Sao Paulo ; 55(6): 201-6, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-11313659

RESUMEN

A low frequency of Helicobacter pylori in the gastric mucosa of patients with alkaline gastritis has been reported. At the same time, it can be noted that the growth of bacteria can be inhibited by bile acids. We studied 40 patients with chronic gastritis related to Helicobacter pylori in order to determine the effect of ursodeoxycholic acid on this infection. Diagnoses of the infection and the inflammatory process were obtained by histologic study of gastric biopsies collected during endoscopy. Two groups were studied: group I received ursodeoxycholic acid - 300 mg/day, and group II received the placebo, twice a day, both for 28 days. The colonization by Helicobacter pylori and the intensity of the mononuclear and polymorphonuclear inflammatory infiltrate were determined before (time 1) and after (time 2) treatment. Ursodeoxycholic acid had no effect on the Helicobacter pylori infection. A significant reduction in the intensity of the mononuclear inflammatory infiltrate of the gastric antrum mucosa was observed in patients from group I, when we compared not only times 1 and 2 but also groups I and II. However, this was not the case with the body mucosa. We concluded that ursodeoxycholic acid had no action on the colonization by Helicobacter pylori or on the polymorphonuclear inflammatory infiltrate, but it caused a significant reduction in the intensity of the mononuclear inflammatory infiltrate of the gastric antrum.


Asunto(s)
Colagogos y Coleréticos/farmacología , Mucosa Gástrica/microbiología , Gastritis/microbiología , Helicobacter pylori/efectos de los fármacos , Ácido Ursodesoxicólico/farmacología , Adulto , Colagogos y Coleréticos/uso terapéutico , Femenino , Mucosa Gástrica/efectos de los fármacos , Gastritis/tratamiento farmacológico , Helicobacter pylori/crecimiento & desarrollo , Humanos , Masculino , Antro Pilórico/efectos de los fármacos , Antro Pilórico/microbiología , Ácido Ursodesoxicólico/uso terapéutico
15.
Dig Dis Sci ; 42(2): 259-64, 1997 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9052503

RESUMEN

In order to gain insight into the possible mechanisms involved in gallstone formation in colectomized ulcerative colitis patients, we studied gallbladder motility by means of ultrasonography in three groups of subjects: controls (N = 40) and ulcerative colitis patients without (N = 30) and with (N = 20) colectomy. Impaired gallbladder emptying after a liquid fatty meal stimulus was observed in ulcerative colitis patients with colectomy compared with those obtained in ulcerative colitis patients without colectomy and controls (P = 0.001). The maximum percentage of gallbladder emptying also, was significantly lower (59.8%) than those seen in ulcerative colitis patients without colectomy (74.5%) and controls (77.8%) (P = 0.001). Diminished gallbladder emptying with ensuing stasis might be a contributory factor to the increased prevalence of gallstones in colectomized patients.


Asunto(s)
Colectomía/efectos adversos , Colitis Ulcerosa/cirugía , Vaciamiento Vesicular , Adulto , Colitis Ulcerosa/patología , Colitis Ulcerosa/fisiopatología , Femenino , Vaciamiento Gástrico , Humanos , Masculino
16.
Digestion ; 58(5): 458-63, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9383637

RESUMEN

For the purpose of shedding some light upon the possible mechanisms involved in gallstone formation in patients with Crohn's disease, we have investigated gallbladder emptying by means of ultrasonography in two groups of subjects: controls (n = 40) and Crohn's disease (n = 30). Diminished gallbladder emptying after a liquid fatty-meal stimulus was observed in patients with Crohn's disease when compared with controls (p < 0.001). Also, the values for the residual gallbladder volume (RGV) and maximal decrease in gallbladder volume (MDGV), both in milliliters and percentage were, respectively, increased (RGV = 9.6 ml) and diminished (MDGV = 14.8 ml; MDGV = 60.9%) in patients with Crohn's disease when compared with controls (RGV = 5.9 ml, p < 0.001; MDGV = 19.9 ml, p = 0.003; MDGV = 77.8%, p < 0.001). Hence, reduced gallbladder emptying with consequent stasis might be a contributory factor to the increased prevalence of gallstones in Crohn's disease.


Asunto(s)
Enfermedad de Crohn/fisiopatología , Vaciamiento Vesicular/fisiología , Adulto , Estudios de Casos y Controles , Colelitiasis/etiología , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/diagnóstico por imagen , Femenino , Vesícula Biliar/diagnóstico por imagen , Vesícula Biliar/fisiopatología , Vaciamiento Gástrico/fisiología , Humanos , Masculino , Ultrasonografía
17.
Rev Hosp Clin Fac Med Sao Paulo ; 51(5): 151-3, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-9216089

RESUMEN

Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.


Asunto(s)
Vesícula Biliar/diagnóstico por imagen , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Ultrasonografía
18.
Rev Hosp Clin Fac Med Sao Paulo ; 51(5): 154-6, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-9216090

RESUMEN

In order to gain some insight into the possible influence of gastric emptying on gallbladder hypomotility in patients with Crohn's disease, the gastric emptying time (GET) was measured by means of ultrasonography in 10 healthy controls and 10 patients with Crohn's disease. No significant difference was observed between both mean values for GET studies (GET: controls, 165.0 min +/- 12.8; Crohn, 142.0 min +/- 11.5; p = 0.208) after ingestion of a liquid meal. Thus, the gallbladder hypomotility described in patients with Crohn's disease, after a liquid fatty-meal stimulus, can not be explained by prolonged gastric emptying time.


Asunto(s)
Enfermedad de Crohn/diagnóstico por imagen , Vaciamiento Gástrico , Adulto , Enfermedad de Crohn/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Ultrasonografía
20.
Ital J Gastroenterol ; 27(8): 441-5, 1995.
Artículo en Inglés | MEDLINE | ID: mdl-8775472

RESUMEN

The aim of this work was to evaluate and compare the effects of a low calorie diet (1026 kcal), simvastatin and ursodeoxycholic acid administration on biliary lipid secretion and cholic acid kinetics in dieting obese subjects. We studied 6 obese subjects before and after four weeks of a hypocaloric diet alone, after four weeks of diet plus ursodeoxycholic acid (900 mg/day) and after four weeks of diet plus simvastatin (40 mg/day), according to a Latin square design. The cholesterol saturation index was increased after diet alone, significantly reduced with diet plus ursodeoxycholic acid (p < 0.01), and unchanged during simvastatin administration. While the cholesterol output was reduced by all three regimens, diet plus ursodeoxycholic acid caused a significantly greater decrease than diet alone (p < 0.01). Cholic acid synthesis and bile acid secretion were decreased by diet and diet plus simvastatin (p < 0.05), but neither was affected by ursodeoxycholic acid. For cholic acid, all three treatments, but especially diet alone and diet plus simvastatin (p < 0.05), reduced the pool size; all three regimens also increased the turnover rate, but this was significant only for ursodeoxycholic acid (p < 0.01). Our study shows that, in obese patients, a hypocaloric diet reduces cholesterol-holding biliary lipid output and consequently increases the cholesterol saturation index. The addition of simvastatin to a hypocaloric dietary regimen reduces cholesterol secretion, but without variation in bile acid and phospholipid output thus the cholesterol saturation index remains unchanged. When ursodeoxycholic acid is added to the dietary regimen, it reduces cholesterol secretion, while maintaining bile acid output and, thus, lowers the cholesterol saturation index. Unlike simvastatin, ursodeoxycholic acid prevents the drop in cholic acid synthesis induced by a low calorie diet.


Asunto(s)
Sistema Biliar/efectos de los fármacos , Colagogos y Coleréticos/farmacología , Ácidos Cólicos/metabolismo , Dieta Reductora , Hipolipemiantes/farmacología , Metabolismo de los Lípidos , Lovastatina/análogos & derivados , Obesidad/metabolismo , Obesidad/terapia , Ácido Ursodesoxicólico/farmacología , Adulto , Sistema Biliar/metabolismo , Ácido Cólico , Ácidos Cólicos/biosíntesis , Terapia Combinada , Ingestión de Energía , Femenino , Humanos , Cinética , Lovastatina/farmacología , Masculino , Persona de Mediana Edad , Obesidad/dietoterapia , Obesidad/tratamiento farmacológico , Simvastatina
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