Wound-healing properties of Stryphnodendron adstringens (barbatimão) in skin and mucosa injuries: a scoping review protocol.

OBJECTIVE: This review will map the literature on the types of research and methods used to investigate the wound-healing properties of Stryphnodendron adstringens ( barbatimão ) in skin and mucosa injuries. INTRODUCTION: Barbatimão is a Brazilian native plant and its wound-healing properties have been described in literature since the colonial period. It is one of the 71 plants included in the Brazilian health system's national list of medicinal plants of interest. However, existing literature reviews on the subject are limited, not comprehensive, lack a search strategy, and lack peer review. INCLUSION CRITERIA: This scoping review will include all types of published and unpublished sources that investigate the wound-healing properties of barbatimão to treat any type of skin or mucosa injury in humans, animals, or in vitro, in any context. METHODS: A scoping review will be conducted following JBI methodology. The main databases to be searched will include Embase (EBSCOhost), CINAHL (EBSCOhost), Scopus, PubMed (EBSCOhost), ScienceDirect, Lilacs, SciELO, CUIDEN, MOSAICO, Web of Science, Epistemonikos, and Google Scholar. Unpublished studies will also be considered. Two independent reviewers will examine titles and abstracts and select and read full-text sources for possible inclusion. Subsequently, the reviewers will extract and synthesize the data, which will be presented as a map, diagram, or table, according to the review objectives. REVIEW REGISTRATION: Open Science Framework osf.io/w57m4.

Desgarro perineal con mucosa vaginal íntegra tras primera relación sexual / Perineal tear with intact vaginal mucosa after first sexual intercourse

RESUMEN Las lesiones del tracto genital femenino tras relaciones sexuales son un problema frecuente en las urgencias de ginecología, pero poco estudiado salvo su aspecto médico-legal. Su incidencia es desconocida ya que muchas mujeres no llegan a consultar por miedo o pudor. El reconocimiento precoz de estas lesiones y su correcto tratamiento puede evitar la parición de secuelas que acompañarán a nuestra paciente durante el resto de su vida. Presentamos el caso de una paciente de 18 años con un desgarro perineal con mucosa vaginal íntegra tras su primera relación sexual.

ABSTRACT Injuries to the female genital tract after sexual intercourse are a frequent problem in gynecological emergencies, but little studied except for their medico-legal aspect. Its incidence is unknown since many women do not go to their specialist out of fear or embarrassment. Early recognition of these injuries and their correct treatment may prevent the appearance of sequelae that will accompany our patient for the rest of her life. We present the case of an 18-year-old patient with a perineal tear with intact vaginal mucosa after her first sexual intercourse.

Impacto da laserterapia na qualidade de vida de pacientes oncológicos portadores de mucosite oral / Impact of laser therapy on quality of life of cancer patients with oral mucositis

Introdução: O uso da laserterapia em pacientes oncológicos com mucosite oral tem efeitos biológicos por meio de processos fotofísicos e bioquímicos que aumentam o metabolismo celular, estimulando a atividade mitocondrial, atuando como analgésicos, anti-inflamatórios e reparadores da lesão da mucosa. Objetivo: Averiguar a qualidade de vida dos pacientes com mucosite oral induzida pelos tratamentos antineoplásicos previamente à aplicação de laserterapia e posterior à regressão das lesões orais. Metodologia: Trata-se de um ensaio quase-experimental com 18 pacientes oncológicos em atendimento hospitalar que desenvolveram mucosite oral. Utilizou-se um questionário sociodemográfico e o questionário de Qualidade de Vida (UW-QOL) aplicado antes das sessões com laser de baixa potência e após a regressão das lesões. Os testes estatísticos utilizados foram o teste t de Student e o teste Quiquadrado, admitindo ser significativo o p<0,05. Resultado: A faixa etária mais prevalente foi entre 65 e 74 anos, etnia branca, sexo masculino, casado, frequentou o ensino fundamental, usuários do SUS e moradores de cidades diversas. O diagnóstico oncológico mais frequente foi a Leucemia aguda, sendo a quimioterapia o tratamento em 100% dos casos e em 50%, a radioterapia. A média dos escores de qualidade de vida dos pacientes foi 456,2, anterior ao início do tratamento com laserterapia, e 678,3, posterior à intervenção. Conclusão: A qualidade de vida melhorou após as sessões de laserterapia, sendo que as mudanças mais significativas ocorreram nos domínios ligados à dor, aparência, deglutição, mastigação, fala, paladar e salivação, sendo o laser de baixa potência uma ferramenta adequada no manejo da mucosite oral.

Introduction: The use of laser therapy in cancer patients with oral mucositis have biological effects through biochemical and photophysical processes that increase the cell metabolism by stimulating mitochondrial activity, acting as analgesics, anti-inflammatory and reparative mucosal injury. Objective: The objective is to ascertain the quality of life of patients with oral mucositis induced by anticancer treatments prior to application of laser therapy and subsequent regression of oral lesions. Methodology: This is a Quasi-experimental Study with 18 cancer inpatient in hospital who developed oral mucositis. The instruments used were lifting sociodemographic data, the Survey of Quality of Life (UW-QOL) was applied before the sessions with low-power laser and after the regression of the lesions. Result: The data were analyzed was Student's t test and chi-square test, admitting be significant p<0.05. The results analyzed revealed the most prevalent age group 65-74 years old, Caucasian ethnicity, male, married, elementary school as the predominant school, US users and residents of other cities. The most common cancer diagnosis was acute leukemia; chemotherapy appeared as treatment at 100% and 50% radiation. The mean quality of life scores of patients found was 456.2 prior to initiation of treatment with laser therapy and 678.3 after the intervention. Conclusion: The quality of life improved after the sessions of laser therapy and it can be seen that the most significant changes occurred in areas related to pain, appearance, swallowing, chewing, speech, taste and salivation, and the low laser power an appropriate tool in the management of oral mucositis.

The Centers for Disease Control and Prevention definition of mucosal barrier injury-associated bloodstream infection improves accurate detection of preventable bacteremia rates at a pediatric cancer center in a low- to middle-income country.

BACKGROUND: The US National Healthcare Safety Network has provided a definition of mucosal barrier injury-associated, laboratory-confirmed bloodstream infection (MBI-LCBI) to improve infection surveillance. To date there is little information about its influence in pediatric oncology centers in low- to middle-income countries. OBJECTIVES: To determine the influence of the definition on the rate of central line-associated bloodstream infection (CLABSI) and compare the clinical characteristics of MBI versus non-MBI LCBI cases. METHODS: We retrospectively applied the National Healthcare Safety Network definition to all CLABSIs recorded at a pediatric oncology center in Tijuana, Mexico, from January 2011 through December 2014. CLABSI events were reclassified according to the MBI-LCBI definition. Clinical characteristics and outcomes of MBI and non-MBI CLABSIs were compared. RESULTS: Of 55 CLABSI events, 44% (24 out of 55) qualified as MBI-LCBIs; all were MBI-LCBI subcategory 1 (intestinal flora pathogens). After the number of MBI-LCBI cases was removed from the numerator, the CLABSI rate during the study period decreased from 5.72-3.22 infections per 1,000 central line days. Patients with MBI-LCBI were significantly younger than non-MBI-LCBI patients (P = .029) and had a significantly greater frequency of neutropenia (100% vs 39%; P = .001) and chemotherapy exposure (87% vs 58%; P = .020) and significantly longer median hospitalization (34 vs 23 days; P = .008). CONCLUSION: A substantial proportion of CLABSI events at our pediatric cancer center met the MBI-LCBI criteria. Our results support separate monitoring and reporting of MBI and non-MBI-LCBIs in low- to middle-income countries to allow accurate detection and tracking of preventable (non-MBI) bloodstream infections.

Does resectoscope size play a role in formation of urethral stricture following transurethral prostate resection?

BACKGROUND AND AIMS: To investigate the possible effect of resectoscope size on urethral stricture rate after monopolar TURP. MATERIALS AND METHODS: A retrospective study of 71 men undergoing TURP was conducted at two centers' from November 2009 to May 2013. The patients were divided into one of two groups according to the resectoscope diameter used for TURP. Resectoscope diameter was 24 F in group 1 (n=35) or 26 F in group 2 (n=36). Urethral catheter type, catheter removal time and energy type were kept constant for all patients. Urethral stricture formation in different localizations after TURP was compared between groups. RESULTS: There was no significant difference between the two groups in terms of age, pre-operative prostate gland volume (PV), prostate-specific antigen (PSA), maximal urinary flow rates (Qmax), International Prostate Symptom Score (IPSS) and post-voiding residual urine volume (PVR). The resection time and weight of resected prostate tissue were similar for both groups (p>0.05). A statistically significant higher incidence of bulbar stricture was detected in group 2 compared to group 1 (p=0.018). CONCLUSIONS: The use of small-diameter resectoscope shafts may cause a reduction in the incidence of uretral strictures in relation to urethral friction and mucosal damage.

Does resectoscope size play a role in formation of urethral stricture following transurethral prostate resection?

ABSTRACTBackground and aims:To investigate the possible effect of resectoscope size on urethral stricture rate after monopolar TURP.Materials and Methods:A retrospective study of 71 men undergoing TURP was conducted at two centers’ from November 2009 to May 2013. The patients were divided into one of two groups according to the resectoscope diameter used for TURP. Resectoscope diameter was 24 F in group 1 (n=35) or 26 F in group 2 (n=36). Urethral catheter type, catheter removal time and energy type were kept constant for all patients. Urethral stricture formation in different localizations after TURP was compared between groups.Results:There was no significant difference between the two groups in terms of age, pre-operative prostate gland volume (PV), prostate-specific antigen (PSA), maximal urinary flow rates (Qmax), International Prostate Symptom Score (IPSS) and post-voiding residual urine volume (PVR). The resection time and weight of resected prostate tissue were similar for both groups (p>0.05). A statistically significant higher incidence of bulbar stricture was detected in group 2 compared to group1 (p=0.018).Conclusions:The use of small-diameter resectoscope shafts may cause a reduction in the incidence of uretral strictures in relation to urethral friction and mucosal damage.

Rectal dexmedetomidine in rats: evaluation of sedative and mucosal effects / Dexmedetomidina retal em ratos: avaliação dos efeitos sedativos e sobre a mucosa / La dexmedetomidina rectal en ratones: evaluación de los efectos sedativos y sobre la mucosa

BACKGROUND AND OBJECTIVES: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. METHODS: Male Wistar albino rats weighing 250-300 g were divided into four groups: Group S (n = 8) was a sham group that served as a baseline for the normal basal values; Group C (n = 8) consisted of rats that received the rectal application of saline alone; Group IPDex (n = 8) included rats that received the intraperitoneal application of dexmedetomidine (100 µg kg-1); and Group RecDex (n = 8) included rats that received the rectal application of dexmedetomidine (100 µg kg-1). For the rectal drug administration, we used 22 G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1 cm into the rectum, and the rectal administration volume was 1 mL for all the rats. The latency and anesthesia time (min) were measured. Two hours after rectal administration, 75 mg kg-1 ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3 cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. RESULTS: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx (p < 0.05). In the Group RecDex, the administration of dexmedetomidine induced mild-moderate losses of mucosal architecture in the colon and rectum, 2 h after rectal inoculation. CONCLUSION: Although 100 µg kg-1 dexmedetomidine administered rectally to rats achieved a significantly longer duration of anesthesia compared with the rectal administration of saline, our histopathological evaluations showed that the rectal administration of 100 µg kg-1 dexmedetomidine led to mild-moderate damage to the mucosal structure ...

JUSTIFICATIVA E OBJETIVOS: Neste estudo pesquisamos os efeitos anestésicos e sobre a mucosa da aplicação retal de dexmedetomidina em ratos. MÉTODOS: Ratos machos albinos Wistar, com 250-300 g, foram divididos em quatro grupos: Grupo S (n = 8) foi um grupo sham que serviu de parâmetro para os valores basais normais; Grupo C (n = 8) consistiu em ratos que receberam a aplicação retal apenas de soro fisiológico; Grupo IPDex (n = 8) consistiu em ratos que receberam aplicação intraperitoneal de dexmedetomidina (100 µg kg-1) e Grupo RecDex (n = 8) consistiu em ratos que receberam a aplicação retal de dexmedetomidina (100 µg kg-1). Para a administração dos fármacos por via retal, usamos cânulas intravenosas de calibre 22, com os estiletes removidos. A administração consistiu em avançar a cânula 1 cm no reto e o volume de administração retal foi de 1 mL para todos os ratos. Os tempos (min) de latência e de anestesia foram registrados. Duas horas após a administração por via retal, 75 mg kg-1 de cetamina foram administrados a todos os grupos para anestesia intraperitoneal, seguido por remoção dos retos dos ratos a uma distância 3 cm distal por meio de procedimento cirúrgico abdominoperineal. Os retos foram histopatologicamente examinados e classificados. RESULTADOS: A anestesia foi feita em todos os ratos do grupo RecDex após a administração de dexmedetomidina. O tempo de início da anestesia no Grupo RecDex foi significativamente mais longo e com uma duração mais curta do que no Grupo IPDEx (p < 0,05). No Grupo RecDex, a administração de dexmedetomidina induziu perdas leves a moderadas da arquitetura da mucosa do cólon e reto duas horas após a inoculação retal. CONCLUSÃO: Embora a administração de 100 µg kg-1 de dexmedetomidina por via retal em ratos tenha resultado em uma duração significativamente maior da anestesia, em comparação com a administração retal de soro fisiológico, nossas avaliações histopatológicas mostraram que a administração ...

JUSTIFICACIÓN Y OBJETIVOS: En este estudio investigamos los efectos anestésicos y sobre la mucosa de la aplicación rectal de la dexmedetomidina en los ratones. MÉTODOS: Ratones machos albinos Wistar, con un peso de 250-300 g, fueron divididos en 4 grupos: el grupo S (n = 8) fue un grupo simulado que sirvió de base para los valores basales normales; el grupo C(n = 8) consistió en ratones que recibieron aplicación rectal solamente de suero fisiológico; el grupo IPDex (n = 8) estaba formado por en ratones que recibieron aplicación intraperitoneal de dexmedetomidina (100 µg/kg-1); y el grupo RecDex (n = 8) consistió en ratones que recibieron la aplicación rectal de dexmedetomidina (100 µg/kg-1). Para la administración de los fármacos por vía rectal usamos cánulas intravenosas de calibre 22 sin estiletes. La administración consistió en avanzar la cánula 1 cm en el recto y el volumen de administración rectal fue de 1 mL para todos los ratones. Los tiempos (min) de latencia y de anestesia fueron registrados. Dos horas después de la administración por vía rectal, fueron administrados 75 mg/kg-1 de ketamina a todos los grupos para la anestesia intraperitoneal, seguido de la retirada de los rectos de los ratones a una distancia 3 cm distal por medio de un procedimiento quirúrgico abdominoperineal. Los rectos fueron histopatológicamente examinados y clasificados. RESULTADOS: La anestesia fue realizada en todos los ratones del grupo RecDex después de la administración de dexmedetomidina. El inicio de la anestesia en el grupo RecDex fue significativamente más tarde y con una duración más corta que en el grupo IPDEx (p < 0,05). En el grupo RecDex, la administración de dexmedetomidina indujo pérdidas leves a moderadas de la arquitectura de la mucosa del colon y del recto 2 h después de la inoculación rectal. CONCLUSIÓN: Aunque la administración de 100 µg/kg-1 de dexmedetomidina por vía rectal en ratones logra una duración significativamente más ...

Sarcoma de Kaposi en mucosas en pacientes PPVI: a propósito de 2 casos: revisión de bibliografía / Kaposi´s Sarkoma (KS) in patiens living with HIV: apropos of 2 cases: review of literature

El Sarcoma de Kaposi (SK) es un tumor vascular que puede comprometer la piel. En 1872 el dermatólogo vienés Moritz Kaposi describió por primera esta entidad. Tradicionalmente se la ha considerado un proceso crónico, decurso lento, que afecta sobre todo a hombres ancianos del este de Europa. No recibió mayor atención hasta que apareció como epidemia en hombres que tienen sexo con hombres (HSH) en la década de los 80 y fue reconocido como marcador clínico de SIDA. Describimos nuestra experiencia en la Unidad de Atención y Control en Salud Sexual (UNACESS) de dos varones PPVI: uno con lesión en cara mucosa del prepucio y otro con lesiones palatinas.

Kaposi’s Sarcoma (KS) is a vascular tumor that can involve the skin. In 1872 the Viennese dermatologist Moritz Kaposi first described this entity. Traditionally it has been considered a chronic, slow flowing, mainly affecting elderly men of Eastern Europe. KS received no more attention until it appeared as an epidemic among men who have sex with men (MSM) in the 80s and was recognized as a clinical marker of AIDS. We describe our experience in Care and Control Unit Sexual Health (UNACESS) in two men living with VIH infection, one with penile mucosa injury and another with palatal lesions.

Total loss of the covering of a metallic stent during esophageal leak treatment.

A 41-year-old man underwent a Heller myotomy due to achalasia. An unexpected puncture in the esophageal wall was identified during the procedure. A partially covered 15cm stent (PSEMS) (UltraFlex) was placed at the mucosal defect. It was removed 26 days later and the endoscopic image showed esophageal tissue embedded in the covered portion of the stent. PSEMS covering loss is a rare complication that can have serious consequences.

Retrospective study of bone grafting procedures before implant placement.

AIM: The aim of this retrospective study was to evaluate morbidity and possible complications in augmentation procedures before implant placement. METHODS: Records from 93 consecutive patients with indication for autogenous bone grafting before implant placement, treated at Department of Oral and Maxillofacial Surgery and Implantology of Uberlândia Federal University, in a 7-year period (July 2000 until July 2007), were reviewed. The need for bone grafting was defined by the impossibility of installing implants of adequate length or diameter to fulfill prosthetic requirements or for aesthetic reasons. RESULTS: A total of 136 bone grafting procedures were performed. The mandibular external oblique line and ascending ramus were the most frequently used donor areas (59.64%) and block grafts (67.64%) were the most frequently used type of graft, frequently from the mandibular external oblique line/ascending ramus (52.18%). Platelet-rich plasma was used in 20.1% of all procedures, usually associated with particulate bone grafts. Maxillary procedures represented the majority of surgeries (75%), but with fewer complications compared with the mandible. Sinus mucosa perforation was the most frequent complication in maxillary procedures, whereas graft exposure was the most common complication in mandible. CONCLUSIONS: Alveolar reconstruction using autogenous bone followed by implant placement is a reliable treatment for patients with insufficient bone. Complications and morbidity were frequently observed. However, in only 6.6% of all procedures, the final rehabilitation with dental implants was not possible.

Anatomia microvascular do estômago canino e lesão gástrica provocada por antiinflamatórios não esteróides / Microvascular anatomy of canines stomach and gastric injury caused by nonsteroidalnti-inflammatory drugs

Os Antiinflamatórios Não Esteróides (AINEs) inibem a síntese de prostaglandinas, com subseqüente diminuição da secreção de muco e bicarbonato pelo epitélio gástrico, redução da hidrofobicida de dacamada epitelial, comprometimento da reposição celular, redução dofluxo sanguíneo e aumento da aderência de neutrófilos. Ao longo dos anos, notou-se que as lesões gástricas provocadas pelo uso de AINEs se localizam com maior freqüência nas regiões do antro pilórico e curvatura menor do estômago. A maior susceptibilidade destas regiões pode ser explicada por sua anatomia microvascular, a qual apresenta capilares estreitos, tortuosos e com menor diâmetro que em outras regiões do estômago; estes são mais separados entre si e hámenos anastomoses entre os capilares ascendentes, tornando-os mais predispostos à trombose e conseqüente lesão gástrica.(AU)

The nonsteroidal antiinflammatory drugs (NSAIs) inhibit the synthesis of prostaglandins, with subsequent reduction of mucus and bicarbonate secretion by the gastric epithelium, reduction of the hydrophobicity of the epithelial layer, impairment of cellular restitution, reduction of the blood flow and increase of neutrophils adhesive properties. It has been known that the gastric lesions secondary to NSAIDs use are more often located in the antral piloric and lesser curvature regions of the stomach. The higher susceptibility of these regions can be explained by their microvascular anatomy, which presents capillaries that are narrower and more contorted than those observed in other regions of the stomach; they also are more separated one from the other and they have fewer anastomosis between the ascending capillaries, becoming more predisposed to thrombosis, and consequently to gastric injury.(AU)

Anatomia microvascular do estômago canino e lesão gástrica provocada por antiinflamatórios não esteróides / Microvascular anatomy of canines stomach and gastric injury caused by nonsteroidalnti-inflammatory drugs

Os Antiinflamatórios Não Esteróides (AINEs) inibem a síntese de prostaglandinas, com subseqüente diminuição da secreção de muco e bicarbonato pelo epitélio gástrico, redução da hidrofobicida de dacamada epitelial, comprometimento da reposição celular, redução dofluxo sanguíneo e aumento da aderência de neutrófilos. Ao longo dos anos, notou-se que as lesões gástricas provocadas pelo uso de AINEs se localizam com maior freqüência nas regiões do antro pilórico e curvatura menor do estômago. A maior susceptibilidade destas regiões pode ser explicada por sua anatomia microvascular, a qual apresenta capilares estreitos, tortuosos e com menor diâmetro que em outras regiões do estômago; estes são mais separados entre si e hámenos anastomoses entre os capilares ascendentes, tornando-os mais predispostos à trombose e conseqüente lesão gástrica.

The nonsteroidal antiinflammatory drugs (NSAIs) inhibit thesynthesis of prostaglandins, with subsequent reduction of mucusand bicarbonate secretion by the gastric epithelium, reduction of thehydrophobicity of the epithelial layer, impairment of cellularrestitution, reduction of the blood flow and increase of neutrophilsadhesive properties. It has been known that the gastric lesionssecondary to NSAIDs use are more often located in the antral piloricand lesser curvature regions of the stomach. The higher susceptibilityof these regions can be explained by their microvascular anatomy,which presents capillaries that are narrower and more contorted thanthose observed in other regions of the stomach; they also are moreseparated one from the other and they have fewer anastomosisbetween the ascending capillaries, becoming more predisposed tothrombosis, and consequently to gastric injury.

Afecçöes das mucosas e semimucosas / Mucosal and semimucosal diseases

Devido à elevada freqüência das doenças de mucosas e semimucosas, tanto da boca quanto da região anogenital, as autoras chamam atenção para as principais afecções desses epitélios, sejam como lesões isoladas ou como manifestações de doenças cutâneas ou mesmo de outros órgãos. Estas alterações são da maior importância porque, além de poderem provocar problemas graves, ocupam não só o dermatologista, mas também, em relação à boca, o dentista, o otorrinolaringologista e o cirurgião de cabeça e pescoço, e no que se refere à região anogenital, o ginecologista, o urologista, o proctologista e o gastroenterologista, entre outros. Todos esses profissionais precisam ter conhecimento sobre as afecções destas áreas

Effect of high laryngeal mask airway intracuff pressure on the laryngopharyngeal mucosa of dogs.

OBJECTIVES: To evaluate the effect of increased of laryngeal mask airway (LMA) intracuff pressures on the laryngopharyngeal mucosa. STUDY DESIGN: Animal model. METHODS: Sixteen mixed-breed dogs were randomly allocated to two groups, G1 (intracuff volume, 30 mL; n = 8) and G2 (intracuff volume, 54 mL; n = 8), to produce, respectively, high or very high intracuff pressures. Anesthesia was induced and maintained with pentobarbital. Intracuff pressures were measured immediately after insertion and inflation of a No. 4 laryngeal mask airway (LMA) and 30, 60, 90, and 120 minutes thereafter. The dogs were euthanized, and biopsy specimens from eight predetermined areas of the laryngopharynx in contact with LMA cuff were collected for light microscopic (LM) and scanning electron microscopic (SEM) examination. RESULTS: Initial LMA cuff inflation in G1 and G2 resulted in intracuff pressures of 119 mm Hg +/- 4 mm Hg and 235 mm Hg +/- 13 mm Hg, respectively. Over a 2-hour period, the intracuff pressure decreased significantly in G1 (P < .001) and G2 (P < .01), and there was a significant difference between the groups over time (P < .001). The LM study of laryngopharyngeal mucosa in both groups showed mild congestion in the subepithelial layer. There were no differences between the groups (P > .10) or among the areas sampled (P > .10). In some areas of G2, the SEM study showed epithelial desquamation that was more intense than that in G1. CONCLUSIONS: The increase in LMA intracuff pressure caused only mild alterations in the laryngopharyngeal mucosa of the dog.

Efecto de la sonda nasogástrica sobre la mucosa del esófago / Effect of nasogastri tube on esophageal mucosa

El objetivo de este trabajo fue establecer y conocer las alteraciones endoscópicas e histológicas que provoca la sonda nasogástrica en el esófago. Estudiamos 30 pacientes en quienes se colocó una sonda nasogástrica: 20 hombres y 10 mujeres con edad promedio de 48 años. Ninguno de estos enfermos tenía historia de enfermedad esofágica ni datos clínicos, endoscópicos o histológicos de reflujo gastroesofágico. En 20 de ellos se colocó en el postoperatorio, en 7 por pancreatitis, en 3 por hemorragia del tubo digestivo, y en uno para alimentación enteral. La segunda endoscopia se realizó de 24 horas a 25 días después de colocada la sonda y en todos se tomaron biopsias del tercio distal del esófago. Las alteraciones endoscópicas que se encontraron con mayor frecuencia fueron: hiperemia de moderada a intensa, puntilleo hemorrágico submucoso, fibrina, coágulos adheridos a la pared, erosiones superficiales y úlceras profundas a nivel de la unión esofagogástrica, en 12 enfermos se encontró además hemorragia activa de origen esofágico. Las alteraciones histológicas que se encontraron desde el primer día de colocada la sonda, en orden de aparición fueron las siguientes: edema intraepitelial, congestión de los vasos, aparición de polimorfonucleares, presencia de trombos de fibrina en vasos submucosos, isquemia y regeneración del epitelio, úlcera esofágica y finalmente regeneración epitelial. Las alteraciones endoscópicas e histológicas se correlacionaron en cuanto a severidad de acuerdo al tiempo de permanencia de la sonda. La sonda nasogástrica daña al esófago en forma severa, esta lesión se produce al menos por 2 mecanismos: irritación local de la sonda sobre el epitelio esof

[Effect of nasogastric tube on esophageal mucosa]. / Efecto de la sonda nasogástrica sobre la mucosa del esófago.

We studied 30 patients. 20 were males and 10 females. Mean age was 48 year old. Esophageal disease was not present neither gastro-esophageal reflux. Biopsy was taken between 24 hours and 25 days after nasogastric tube (NG) was put into place. Endoscopic findings were: hyperemic mucosa, submucosal hemorrhage, clots, erosions and ulcers near Esophago-gastric junction. Intraepithelial edema, vessel congestion, polymorphonuclear infiltration, fibrin thrombosis of submucosal vessels, ischemia, epithelial regeneration and ulcer were common histologic findings. All endoscopic and histologic alterations were related to the length of time of NG tube contact with the esophageal mucosa. We concluded that NG tube damages the esophageal mucosa by two mechanisms: a) Local irritation that favors b) gastric reflux by decreasing lower esophageal sphincter pressure.