Relationship between nutritional status and the Glasgow Prognostic Score in patients with colorectal cancer.

OBJECTIVE: The association between nutritional status and inflammation was assessed in patients with colorectal cancer and to verify their association with complications during anticancer treatment. The agreement between the Subjective Global Assessment (SGA) and different nutritional assessment methods was also evaluated. METHODS: A cross-sectional, prospective, and descriptive study was performed. The nutritional status was defined by the SGA and the severity of inflammation was defined by the Glasgow Prognostic Score (GPS). The complications were classified using the Common Toxicity Criteria, version 3. Anthropometric measurements such as body mass index, triceps skinfold, midarm circumference, midarm muscle area, and adductor pollicis muscle thickness were also performed, as were handgrip strength and phase angle. The chi-square test, Fisher exact test, Spearman correlation coefficient, independent t test, analysis of variance, Gabriel test, and κ index were used for the statistical analysis. P < 0.05 was considered statistically significant. RESULTS: Seventy patients with colorectal cancer (60.4 ± 14.3 y old) were included. The nutritional status according to the SGA was associated with the GPS (P < 0.05), but the SGA and GPS were not related to the presence of complications. When comparing the different nutritional assessment methods with the SGA, there were statistically significant differences. CONCLUSION: Malnutrition is highly prevalent in patients with colorectal cancer. The nutritional status was associated with the GPS.

[Squamous cell carcinoma of the rectum and traumatic recto vaginal fistula relation or coincidence? Case study]. / Carcinoma escamoso de recto y fístula rectovaginal traumática: relación o coincidencia? Reporte de un caso.

Primary squamous cell carcinoma of the rectum is rare and its cause and pathogenesis are not clear. Likewise, rectal squamous cell carcinoma in patients with rectovaginal fistula in the absence of gynecologic cancer is extremely rare. We report one of such cases that was diagnosed a year after an untreated traumatic rectovaginal fistula. We also reviewed the literature and discussed the probable association between both processes.

Immunopathological modifications in the rectal mucosa from an animal model of food allergy.

AIM: The aim is to determine immunopathological modifications in rectal mucosa from rabbit after local challenge in sensitized animals with ovalbumin (OVA). EXPERIMENTAL DESIGN: Thirty rabbits divided into three groups: G1: normal, G2: subcutaneously OVA sensitized, G3: sensitized, locally OVA challenged and sampled 4 hours after challenge. Specific anti-OVA IgE levels were evaluated by passive cutaneous anaphylaxis test (PCA). In each group 200 high microscopical power fields (HPF) were counted. Results were expressed as arithmetic mean and SE. Statistical analysis was made using Student t test. Anti-CD4, CD5, micro chain, CD25 and RLA II monoclonal antibodies were used. Avidin biotin horseradish peroxidase system was used. RESULTS: CD 4: G1: 8.3 +/- 0.06; G2: 13.4 +/- 0.08 and G3: 8.25 +/- 0.06. CD 5: G1: 7.3 +/- 0.05; G2: 9.4 +/- 0.05 and G3: 11.3 +/- 0.06. CD 25: G1: 13 +/- 0.08; G2: 15.1 +/- 0.13 and G3: 25.5 +/- 0.15. mu chain: G1: 10.4 +/- 0.06; G2: 3.8 +/- 0.02 and G3: 6.0 +/- 0.10. RLA II (DR): G1: 11.6 +/- 0.05; G2: 19.2 +/- 0.09 and G3: 19.1 +/- 0.11. In all cases, experimental groups (G2 and G3) presented statistical significant differences vs. control group (G1) (p < 0.001). CONCLUSIONS: Interleukin-2 receptor (CD25+ cells) increase in experimental groups. Cells expressing micro chain decreased in G2 and G3 likely due to activation of B cells and subsequent expression of other immunoglobulin chains in cell surface. RLA II expression is higher in G2 and G3. This receptor is considered an activation marker expressed by macrophages, T and B cells. We conclude that obtained data are important to elucidate immunopathology of local anaphylactic reaction in rectal mucosa from systemic sensitized animals.

[CD11b-positive cells expression in rectal mucosa from ovalbumin sensitized and challenged rabbits]. / Expresión de células CD11b-positivas en mucosa rectal de conejos sensibilizados y desafiados con ovoalbúmina.

Rabbit MAC-1 receptor, homologue to human CD11b is present in macrophages. The aim of the study was to determine quantitative and distributive modifications of CD11b-positive cells that participate in immune response at rectal mucosa, in an animal model of mucosal immunity. New Zealand rabbits were divided into three groups. G1: control; G2: ovalbumin (OVA) sensitized; G3: OVA-senstitized and rectal challenged. Animals were subcutaneously sensitized twice with 70 microg OVA and 30 ml aluminium hydroxide in 2 ml saline solution. Rectal challenge was developed with a solution of 50 mg OVA in 5 ml saline solution. Sensitized groups (G2 and G3) showed a positive PCA (Passive Cutaneous Anaphylaxis) at 1/160 fold dilutions. In G3 we observed a patchy mucosal edema, lymphangiectasis and eosinophil leucocyte infiltration. Cells were counted as the number of cells per high power field. G1: 9.64 (SE 0.22); G2: 18.10 (SE 0.09) and G3: 23.60 (SE 0.29). (G2 vs G1 p < 0.001; G3 vs G1 p < 0.001; G3 vs G2 p < 0.001). We conclude that there is a close relationship between the food antigen OVA penetration (after challenge) and the increase of CD11b positive cells in rectal mucosa. This fact could be due to the cellular influx to the inflammatory site by the action of chemotactic factors released after challenge.

Expresión de células CD11b-positivas en mucosa rectal de conejos sensibilizados y desafiados con ovoalbúmina / CD11 b-positive cells expression in rectal mucosa from ovalbumin sensitized and challenged rabbits

El receptor MAC-1 de conejo, homólogo al CD11b humano, es una proteína presente en los macrófagos. El objetivo del presente trabajo es establecer las modificaciones cuantitativas y distributivas de células CD11bpositivas participantes en la respuesta inmune a nivel de la mucosa rectal, en un modelo animal de inmunidad mucosa. Se estudiaron conejos neocelandeses divididos en tres grupos: G1:control, G2:sensibilizado con ovoalbúmina (OVA) y G3:sensibilizado y desafiado por vía rectal con OVA. Los conejos de los grupos 2 y 3 fueron sensibilizados por vía subcutánea en dos oportunidades, con 2 ml de una suspensión de 70 µg de OVA en 30 mg de hidróxido de aluminio/ml. El desafío rectal se realizó con una solución de 50 mg OVA en 5 ml de solución salina. La prueba de anafilaxia cutánea pasiva (PCA) fue positiva en G2 y G3 a una dilución de 1/160. En el grupo sensibilizado y desafiado se observó edema mucoso parcheado, imágenes de linfangiectasias e infiltración de eosinófilos. Las células se contaron como número de células por campo de mayor ...

Expresión de células CD11b-positivas en mucosa rectal de conejos sensibilizados y desafiados con ovoalbúmina / CD11 b-positive cells expression in rectal mucosa from ovalbumin sensitized and challenged rabbits

El receptor MAC-1 de conejo, homólogo al CD11b humano, es una proteína presente en los macrófagos. El objetivo del presente trabajo es establecer las modificaciones cuantitativas y distributivas de células CD11bpositivas participantes en la respuesta inmune a nivel de la mucosa rectal, en un modelo animal de inmunidad mucosa. Se estudiaron conejos neocelandeses divididos en tres grupos: G1:control, G2:sensibilizado con ovoalbúmina (OVA) y G3:sensibilizado y desafiado por vía rectal con OVA. Los conejos de los grupos 2 y 3 fueron sensibilizados por vía subcutánea en dos oportunidades, con 2 ml de una suspensión de 70 Ag de OVA en 30 mg de hidróxido de aluminio/ml. El desafío rectal se realizó con una solución de 50 mg OVA en 5 ml de solución salina. La prueba de anafilaxia cutánea pasiva (PCA) fue positiva en G2 y G3 a una dilución de 1/160. En el grupo sensibilizado y desafiado se observó edema mucoso parcheado, imágenes de linfangiectasias e infiltración de eosinófilos. Las células se contaron como número de células por campo de mayor ...(AU)

Gluten sensitivity in the rectal mucosa of first-degree relatives of celiac disease patients.

BACKGROUND/AIMS: Rectal gluten challenge is a simple, sensitive, and specific test of mucosal gluten sensitivity. Our aims in this study were to evaluate gluten sensitivity in a group of relatives of celiac patients and to compare these findings with those obtained on small bowel histology, celiac disease-related serology, and HLA typing. METHODS: A 4-h rectal gluten challenge was performed with 6 g of crude gluten in saline solution in 29 first-degree relatives, 20 well-diagnosed celiac patients, and 10 subjects in whom celiac disease had been excluded. The number of intraepithelial lymphocytes in pre- and postchallenge frozen rectal biopsies (pan T-cell immunocytochemistry) was quantified by computerized image analysis. RESULTS: The intraepithelial lymphocyte response after gluten instillation was significantly higher in celiac disease patients (median, 126% increase above the baseline count; 95% confidence interval: 61-213%) compared with control subjects (median, -5%; 95% confidence interval: -29-5%). Using a cut-off of 20% change in intraepithelial lymphocyte count, 14 relatives (48%) showed a celiac-like response. Two of these subjects had partial villous atrophy and increased lymphocyte counts in the small bowel mucosa. One of them also exhibited a positive celiac disease-related serology and the typical celiac human lymphocyte antibody (HLA) DQ2. The remaining 12, and all those relatives with a negative challenge, had normal small bowel mucosa and were negative for antigliadin and endomysial antibodies. The characteristic celiac HLA (DQA1 0501 DQB1 0201 heterodimer) was identified in five relatives with positive challenge (including the patient with more severe mucosal atrophy) but was also present in eight relatives with no evidence of gluten sensitivity in the rectal mucosa. CONCLUSIONS: Our study characterizes a subgroup of relatives of celiac patients who show mucosal evidence of sensitization after local instillation of gluten in the rectum but who have no other features of celiac disease.

Perforación rectosigmoide asintomática y extrusión peranal de catéter de derivación ventrículoperitoneal / Perforation rectumsigmoid asymptomatic and extrusion peranal of catheter of derivation ventricleperitoneal

Se estudia la historia clínica de un lactante de 10 meses de edad, quien fue hospitalizado por la expulsión a través del ano de la extremidad distal de un catéter de derivación ventrículoperitoneal que había sido implantado por hidrocefalia congénita. Se discute el mecanismo probable de la reducción espontánea del tubo y la forma de abordar el manejo de esta rara complicación