RESUMO
A group of 103 patients with radiologic changes of sacroiliitis were investigated and followed up over a mean period of 3.5 years. The biologic explorations (nonspecific inflammatory tests, humoral immunologic determinations and serum fibronectin assay) as well as sacroiliac and spine radiographic examinations, were repeated every 6th-12th months. In 32 patients (31%) clinical, biologic and radiologic signs of evolutive disease, were detected. In such cases, sacroiliitis representing in fact a form of onset of ankylosing spondylitis, the HLA-B27 phenotype was also determined and was found present in 8 cases. Of the biologic tests the decrease of serum fibronectin proved the most significantly correlated with evolutive tendency of sacroiliitis.
Assuntos
Articulação Sacroilíaca , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Formação de Anticorpos , Seguimentos , Humanos , Inflamação/diagnóstico por imagem , Inflamação/tratamento farmacológico , Inflamação/imunologia , Masculino , Radiografia , Articulação Sacroilíaca/diagnóstico por imagemRESUMO
The effect of nifedipine (10-20 mg) on esophageal motility was tested in 18 patients with clinical esophageal syndrome and radiologic aspect suggesting esophageal spasm. The drug was administered 20-30 min prior to the second radiologic examination. In 3 cases of achalasia the drug was administered in doses of 10 mg/day for 10 days before the second X-ray examination. Fiber esophagoscopy was performed in all the cases. The initial radiologic aspect was favourably influenced by nifedipine administration in 12 cases confirmed as esophageal spasm. The other 6 patients who did not benefit by the test were cases of organic diseases: 2 post caustic stenoses and 4 cases of eso-cardio-tuberal neoplasm. In the 3 cases of achalasia, treatment with nifedipine led to clinical improvement with relaxation of inferior esophageal contraction on radiologic examination. The study demonstrated the favourable contribution of calcium channel inhibitors to the diagnosis and treatment of esophageal motility disturbances.
Assuntos
Espasmo Esofágico Difuso/diagnóstico , Nifedipino , Diagnóstico Diferencial , Espasmo Esofágico Difuso/tratamento farmacológico , Esofagoscopia , Esôfago/diagnóstico por imagem , Esôfago/fisiopatologia , Tecnologia de Fibra Óptica , Humanos , Nifedipino/administração & dosagem , Nifedipino/uso terapêutico , Peristaltismo/efeitos dos fármacos , Radiografia , Fatores de TempoRESUMO
Gastroesophageal reflux (GER) was determined by recording the endoesophageal pH using the Heidelberg telemetering capsule in 60 patients with various esogastroduodenal diseases. Gastroesophageal reflux was found present in 29 patients (48.3%). The nature (acid in 27 cases, alkaline in 2 cases) as well as the degree of reflux (score 1-6.5) could also be determined by this method. Radiologically reflux could only be detected in 12 out of the 29 patients (41.6%) of whom 9 with hiatal hernia. Only 62% of the GER cases were symptomatic, this being in agreement with the high scores and with the presence of esophagitis confirmed histologically. In chronic ethanol consumers (24 cases) the incidence of GER was increased (70.8%) suggesting the role of alcohol in the relaxation of the lower esophageal sphincter. In conclusion this method proved useful for the detection and quantification of GER.
