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1.
Clin J Gastroenterol ; 12(6): 552-555, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30955165

RESUMO

Everolimus is an mTOR (the mammalian target of rapamycin) inhibitor, which is used for the treatment of advanced renal cell carcinoma. Life-threatening hemorrhages are extremely rare adverse effect of everolimus. We herein report a successfully treated case of severe everolimus-related gastrointestinal hemorrhage by emergency surgical resection for patient with advanced renal cell carcinoma. A 72-year-old male was diagnosed with renal cell carcinoma, for which everolimus was administered after unsuccessful treatment with sunitinib and sorafenib. The patient suddenly developed hematemesis 4 weeks after administration. Upper gastrointestinal endoscopy showed gastric antral vascular ectasia. Once the hemorrhage was successfully cauterized by argon plasma coagulation, everolimus was discontinued. However, the patient after re-administration of everolimus developed hematemesis again and exhibited hemorrhage shock. Since therapeutic endoscopy could not achieve hemostasis, the patient underwent emergency distal gastrectomy with Billroth I reconstruction. The patient's vital signs and hemoglobin level stabilized after the surgery. Thereafter, the patient made a satisfactory recovery, and was discharged on postoperative day 10.


Assuntos
Antineoplásicos/efeitos adversos , Everolimo/efeitos adversos , Hematemese/induzido quimicamente , Gastropatias/induzido quimicamente , Idoso , Coagulação com Plasma de Argônio , Carcinoma de Células Renais/tratamento farmacológico , Cauterização/métodos , Substituição de Medicamentos , Hematemese/prevenção & controle , Humanos , Neoplasias Renais/tratamento farmacológico , Masculino , Gastropatias/prevenção & controle
2.
Nitric Oxide ; 78: 60-71, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29857061

RESUMO

Activation of 5' adenosine monophosphate-activated protein kinase (AMPK) stimulates production of the gaseous mediators nitric oxide (NO) and carbon monoxide (CO), which are involved in mucosal defense and gastroprotection. As AMPK itself has gastroprotective effects against several gastric ulcer etiologies, in the present study, we aimed to elucidate whether AMPK may also prevent ethanol-induced injury and play a key role in the associated gastroprotection mediated by hydrogen sulfide (H2S), NO, and CO. Mice were pretreated with AICAR (20 mg/kg, an AMPK activator) alone or with 50% ethanol. Other groups were pretreated with respective gaseous mediator inhibitors PAG, l-NAME, or ZnPP IX 30 min prior to AICAR, or with gaseous mediator donors NaHS, Lawesson's reagent and l-cysteine (H2S), SNP, l-Arginine (NO), Hemin, or CORM-2 (CO) 30 min prior to ethanol with or without compound C (10 mg/kg, a non-selective AMPK inhibitor). H2S, nitrate/nitrite (NO3-/NO2-), bilirubin levels, GSH and MDA concentration were evaluated in the gastric mucosa. The gastric mucosa was also collected for histopathological analysis and AMPK expression assessment by immunohistochemistry. Pretreatment with AICAR attenuated the ethanol-induced injury and increased H2S and bilirubin levels but not NO3-/NO2- levels in the gastric mucosa. In addition, inhibition of H2S, NO, or CO synthesis exacerbated the ethanol-induced gastric damage and inhibited the gastroprotection by AICAR. Pretreatment with compound C reversed the gastroprotective effect of NaHS, Lawesson's reagent, l-cysteine, SNP, l-Arginine, CORM-2, or Hemin. Compound C also reversed the effect of NaHS on H2S production, SNP on NO3-/NO2- levels, and Hemin on bilirubin levels. Immunohistochemistry revealed that AMPK is present at basal levels mainly in the gastric mucosa cells, and was increased by pretreatment with NaHS, SNP, and CORM-2. In conclusion, our findings indicate that AMPK activation exerts gastroprotection against ethanol-induced gastric damage and mutually interacts with H2S, NO, or CO to facilitate this process.


Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Monóxido de Carbono/metabolismo , Gasotransmissores/metabolismo , Sulfeto de Hidrogênio/metabolismo , Óxido Nítrico/metabolismo , Gastropatias/prevenção & controle , Aminoimidazol Carboxamida/análogos & derivados , Aminoimidazol Carboxamida/farmacologia , Animais , Bilirrubina/metabolismo , Ativação Enzimática , Ativadores de Enzimas/farmacologia , Etanol , Feminino , Mucosa Gástrica/patologia , Masculino , Camundongos , Ribonucleotídeos/farmacologia , Gastropatias/induzido quimicamente
3.
J Gastroenterol ; 53(5): 618-630, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28856444

RESUMO

BACKGROUND: Curcumin, a pleiotropic substance used for centuries in traditional medicine, exhibits antioxidant, anti-inflammatory and antiproliferative efficacy against various tumours, but the role of curcumin in gastroprotection is little studied. We determined the effect of curcumin against gastric haemorrhagic lesions induced by 75% ethanol and alterations in gastric blood flow (GBF) in rats with cyclooxygenase-1 (COX-1) and COX-2 activity inhibited by indomethacin, SC-560 or rofecoxib, inhibited NO-synthase activity, capsaicin denervation and blockade of TRPV1 receptors by capsazepine. METHODS: One hour after ethanol administration, the gastric mucosal lesions were assessed by planimetry, the GBF was examined by H2 gas clearance, plasma gastrin was determined by radioimmunoassay, and the gastric mucosal mRNA expression of Cdx-2, HIF-1α, HO-1 and SOD 2 was analysed by RT-PCR. RESULTS: Curcumin, in a dose-dependent manner, reduced ethanol-induced gastric lesions and significantly increased GBF and plasma gastrin levels. Curcumin-induced protection was completely reversed by indomethacin and SC-560, and significantly attenuated by rofecoxib, L-NNA, capsaicin denervation and capsazepine. Curcumin downregulated Cdx-2 and Hif-1α mRNA expression and upregulated HO-1 and SOD 2, and these effects were reversed by L-NNA and further restored by co-treatment of L-NNA with L-arginine. CONCLUSIONS: Curcumin-induced protection against ethanol damage involves endogenous PG, NO, gastrin and CGRP released from sensory nerves due to activation of the vanilloid TRPV1 receptor. This protective effect can be attributed to the inhibition of HIF-1α and Cdx-2 expression and the activation of HO-1 and SOD 2 expression.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Curcumina/farmacologia , Mucosa Gástrica/patologia , Óxido Nítrico/metabolismo , Prostaglandinas/metabolismo , Gastropatias/prevenção & controle , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Fator de Transcrição CDX2/genética , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Capsaicina/análogos & derivados , Capsaicina/farmacologia , Curcumina/uso terapêutico , Inibidores de Ciclo-Oxigenase 2/farmacologia , Denervação , Regulação para Baixo/efeitos dos fármacos , Etanol , Feminino , Mucosa Gástrica/irrigação sanguínea , Mucosa Gástrica/metabolismo , Gastrinas/sangue , Expressão Gênica/efeitos dos fármacos , Heme Oxigenase (Desciclizante)/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Indometacina/farmacologia , Lactonas/farmacologia , Masculino , Óxido Nítrico Sintase/antagonistas & inibidores , Pirazóis/farmacologia , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Fluxo Sanguíneo Regional/efeitos dos fármacos , Gastropatias/induzido quimicamente , Sulfonas/farmacologia , Superóxido Dismutase/genética , Canais de Cátion TRPV/antagonistas & inibidores , Regulação para Cima/efeitos dos fármacos
4.
Vet Clin North Am Food Anim Pract ; 34(1): 83-99, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29203192

RESUMO

Displaced abomasum (DA) is a postpartum disease that causes significant economic losses in the dairy industry. Abomasal atony and excessive production of gas have been reported as prerequisites for the development of DA. The exact cause of DA is unknown, yet infectious and metabolic disease, diet composition and physical form, cow comfort, and management of dairy cows during the transition period have been associated with the occurrence of this disorder. This review article discusses different factors that lead to the development of DA and strategies for monitoring DA and its comorbidities at the herd level.


Assuntos
Abomaso/patologia , Doenças dos Bovinos/patologia , Doenças dos Bovinos/prevenção & controle , Indústria de Laticínios/métodos , Gastropatias/veterinária , Animais , Bovinos , Feminino , Gastropatias/prevenção & controle
5.
Vet Clin North Am Food Anim Pract ; 33(3): 481-498, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28823879

RESUMO

Ruminal acidosis and ruminal bloat represent the most common digestive disorders in feedlot cattle. Ruminants are uniquely adapted to digest and metabolize a large range of feedstuffs. Although cattle have the ability to handle various feedstuffs, disorders associated with altered ruminal fermentation can occur. Proper ruminal microorganism adaptation and a consistent substrate (ration) help prevent digestive disorders. Feed bunk management, sufficient ration fiber, consistent feed milling, and appropriate response to abnormal weather are additional factors important in prevention of digestive disorders. When digestive disorders are suspected, timely diagnosis is imperative.


Assuntos
Acidose/prevenção & controle , Doenças dos Bovinos/diagnóstico , Gastropatias/veterinária , Acidose/veterinária , Ração Animal/análise , Animais , Bovinos , Doenças dos Bovinos/prevenção & controle , Dieta/veterinária , Fermentação , Concentração de Íons de Hidrogênio , Rúmen/metabolismo , Gastropatias/prevenção & controle
6.
Dis Esophagus ; 30(4): 1-8, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28375478

RESUMO

Intraoperative pyloric procedures are often performed during esophagectomies to reduce the rates of gastric conduit dysfunction. They include pyloroplasty (PP), pyloromyotomy (PM), and pylorus botulinum toxin type-A injections (BI). Despite these procedures, patients frequently warrant further endoscopic interventions. The aim of this study is to compare intraoperative pyloric procedures and the rates of postoperative endoscopic interventions following minimally invasive esophagectomy (MIE). We identified patients who underwent MIE for esophageal carcinoma and grouped them as 'None' (no intervention), 'PP', 'PM', or 'BI' based on intraoperative pyloric procedure type. The rates of endoscopic interventions for the first six postoperative months were compared. To adjust for variability due to MIE type, the rates of >1 interventions were compared using a zero-inflated Poisson regression analysis. Significance was established at P < 0.05. There were 146 patients who underwent an MIE for esophageal cancer from 2008 to 2015; 77.4% were three-hole MIE, and 22.6% were Ivor- Lewis MIE. BI was most frequent in Ivor-Lewis patients (63.5%), while PP was most frequent (46.9%) in three-hole patients. Postoperative endoscopic interventions occurred in 38 patients (26.0%). The BI group had the highest percentage of patients requiring a postoperative intervention (n = 13, 31.7%). After adjusting for higher rates of interventions in three-hole MIE patients, the BI and None groups had the lowest rates of >1 postoperative interventions. Our data did not show superiority of any pyloric intervention in preventing endoscopic interventions. The patients who received BI to the pylorus demonstrated a trend toward a greater likelihood of having a postoperative intervention. However when adjusted for type of MIE, the BI and None groups had lower rates of subsequent multiple interventions. Further research is needed to determine if the choice of intraoperative pyloric procedure type significantly affects quality of life, morbidity, and overall prognosis in these patients.


Assuntos
Endoscopia Gastrointestinal/métodos , Esofagectomia/métodos , Cuidados Intraoperatórios/métodos , Cuidados Pós-Operatórios/métodos , Piloro/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Esofagectomia/efeitos adversos , Feminino , Esvaziamento Gástrico , Humanos , Cuidados Intraoperatórios/efeitos adversos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/cirurgia , Período Pós-Operatório , Análise de Regressão , Estudos Retrospectivos , Gastropatias/etiologia , Gastropatias/prevenção & controle , Gastropatias/cirurgia , Resultado do Tratamento
8.
Balkan Med J ; 34(1): 53-59, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-28251024

RESUMO

BACKGROUND: Oxidative stress has been shown to play a principal role in the pathogenesis of stress-induced gastric injury. Parsley (Petroselinum crispum) contains many antioxidants such as flavanoids, carotenoids and ascorbic acid. AIMS: In this study, the histopathological and biochemical results of nutrition with a parsley-rich diet in terms of eliminating stress-induced oxidative gastric injury were evaluated. STUDY DESIGN: Animal experimentation. METHODS: Forty male Wistar albino rats were divided into five groups: control, stress, stress + standard diet, stress + parsley-added diet and stress + lansoprazole (LPZ) groups. Subjects were exposed to 72 hours of fasting and later immobilized and exposed to the cold at +4 degrees for 8 hours to create a severe stress condition. Samples from the animals' stomachs were arranged for microscopic and biochemical examinations. RESULTS: Gastric mucosal injury was obvious in rats exposed to stress. The histopathologic damage score of the stress group (7.00±0.57) was higher than that of the control group (1.50±0.22) (p<0.05). Significant differences in histopathologic damage score were found between the stress and stress + parsley-added diet groups (p<0.05), the stress and stress + standard diet groups (p<0.05), and the stress and stress + LPZ groups (p<0.05). The mean tissue malondialdehyde levels of the stress + parsley-added group and the stress + LPZ group were lower than that of the stress group (p<0.05). Parsley supported the cellular antioxidant system by increasing the mean tissue glutathione level (53.31±9.50) and superoxide dismutase (15.18±1.05) and catalase (16.68±2.29) activities. CONCLUSION: Oral administration of parsley is effective in reducing stress-induced gastric injury by supporting the cellular antioxidant defence system.


Assuntos
Estresse Oxidativo/fisiologia , Petroselinum/metabolismo , Gastropatias/prevenção & controle , Estresse Psicológico/complicações , Animais , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/metabolismo , Masculino , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Ratos , Ratos Wistar/metabolismo , Gastropatias/tratamento farmacológico , Estresse Psicológico/psicologia
9.
Biomed Pharmacother ; 89: 47-55, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28214687

RESUMO

BACKGROUND: Croton rhamnifolioides Pax is a plant species that have been used in the folk medicine to treat ulcers, inflammations and hypertension. However, despite the relevant data obtained from ethnopharmacological studies, the pharmacological properties endorsing the efficacy of this plant to treat ulcer remain to be elucidated. HYPOTHESIS/PURPOSE: The present study aimed to characterize the chemical profile and evaluate the gastroprotective activity of the essential oil obtained from C. rhamnifolioides Pax (OECC) in mice. METHODS: The essential oil of Croton rhamnifolioides was obtained by hydrodistillation and analyzed by gas-phase chromatography coupled to mass spectrometry (GC/MS). The median lethal dose was determined employing an acute toxicity test. The gastroprotective activity of the OECC was investigated using animal models of gastric ulcer induced by the administration of absolute ethanol, acidified ethanol or indomethacin. Mechanisms of action were investigated using the physical barrier test and by in vivo evaluation of the involvement of the following molecular pathways: nitric oxide, ATP - dependent potassium channels, α2 - noradrenergic receptors, capsaicin - sensitive afferent neurons and opioid receptor. RESULTS: We identified the presence of 21 compounds in OECC, including spathulenol and 1,8 - cineole as major constituents. In orally administered mice, OECC caused no significant toxicity. OECC significantly prevented gastric lesions in all mice models. The barrier test demonstrated that the gastroprotective activity of OECC occurs in a systemic dimension. Our results demonstrated that the gastroprotective effect of OECC involves mechanisms that are related to modulation of opioid receptors and nitric oxide. CONCLUSION: In conclusion, OECC demonstrated significant gastroprotective activity associated with low toxicity, providing scientific evidences that C. rhamnifolioides have the potential for the development of new antiulcer drugs.


Assuntos
Antiulcerosos/farmacologia , Óleo de Cróton/farmacologia , Substâncias Protetoras/farmacologia , Gastropatias/prevenção & controle , Animais , Anti-Inflamatórios não Esteroides , Croton/química , Óleo de Cróton/toxicidade , Etanol , Feminino , Mucosa Gástrica/efeitos dos fármacos , Indometacina , Dose Letal Mediana , Masculino , Camundongos , Folhas de Planta/química , Transdução de Sinais/efeitos dos fármacos , Úlcera Gástrica/induzido quimicamente , Úlcera Gástrica/prevenção & controle
10.
Clin Anat ; 30(3): 336-341, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27935173

RESUMO

During laparoscopic sleeve gastrectomy (LSG), adhesions between the stomach and the pancreas are sometimes found, forming a "gastropancreatic ligament" (GPL). However, the GPL has only been described once in the literature, in 1985. The objective of this study was to determine the incidence of the GPL during LSG, describe this structure and assess its effect on the surgical technique. All patients undergoing primary LSG in our institution (n = 240) and patients referred for gastric fistula (GF) after primary LSG (n = 18) between January 2015 and December 2015 were included. The primary endpoint was the incidence of a GPL during primary LSG. The secondary endpoints were the postoperative complication rate, the postoperative GF rate, and the presence of this ligament during reoperation for GF. Among the 240 patients, a GPL was visible in 49 cases (20.4%) and was described as thin in 34 of these (69.4%). Twelve postoperative complications (5%) were observed, including seven major (2.9%). The GF rate was 2% (n = 5), not requiring reoperation. The gastric stenosis rate was 0.4% (n = 1). The GPL had been previously sectioned in one of the five patients (20%) with postoperative GF. During the study period, 18 patients were referred for GF and 14 were reoperated. A non-sectioned GPL, not described in the operating report, was observed in four patients (28.5%). A GPL was identified in 20.4% of cases. Identification of a GPL could be important in the context of LSG, as section of the ligament allows tension-free stapling to be performed and can therefore possibly reduce the risk of postoperative complications, particularly GF. Clin. Anat. 30:336-341, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Cirurgia Bariátrica/métodos , Gastrectomia/métodos , Ligamentos/anatomia & histologia , Pâncreas/anatomia & histologia , Estômago/anatomia & histologia , Adolescente , Adulto , Idoso , Constrição Patológica/etiologia , Feminino , Gastrectomia/efeitos adversos , Fístula Gástrica/etiologia , Fístula Gástrica/prevenção & controle , Humanos , Incidência , Laparoscopia , Masculino , Pessoa de Meia-Idade , Pancreatopatias/etiologia , Pancreatopatias/prevenção & controle , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Gastropatias/diagnóstico , Gastropatias/prevenção & controle , Aderências Teciduais/diagnóstico , Aderências Teciduais/prevenção & controle , Adulto Jovem
11.
Surg Obes Relat Dis ; 13(3): 385-390, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27865815

RESUMO

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is accepted as a stand-alone bariatric procedure. A specific and potentially severe complication of LSG is gastric stenosis (GS). OBJECTIVE: Reviewing the treatment and prevention of GS after LSG. SETTING: University hospital, Taiwan. MATERIALS AND METHODS: A retrospective analysis was conducted involving all of the LSG cases (n = 927) at our institution between February 2007 and December 2015. RESULTS: Eight patients (0.8%) with GS were identified in our unit and 1 patient was transferred from another institution with symptomatic GS. The median intervals from initial LSG to the presence of symptoms, endoscopic dilation, and surgical revision were 14±30 days (range, 7-103 days), 21±35.6 days (range, 9-110 days), and 36±473.9 days (range, 11-1185 days), respectively. The majority of stenoses were located at the incisura angularis (8/9 [88.9%]). Among the 9 patients, only 1 responded satisfactorily to repetitive endoscopic dilation and the remaining 8 patients required revisional laparoscopic surgery, including conversion to Roux-en-Y gastric bypass (n = 6), stricturoplasty (n = 1), and Roux-en-Y gastric bypass after failed seromyotomy (n = 1). No patients experienced recurrent symptoms of GS after revisional surgery. In September 2013, we modified our surgical techniques for the subsequent 489 patients and GS did not occur after the change in surgical procedures. CONCLUSION: A combined treatment modality, endoscopic intervention with and without surgical revision is essential for managing GSs. Based on our own experience, we emphasize the clinical significance of surgical standardization to prevent the occurrence of GS.


Assuntos
Gastrectomia/efeitos adversos , Laparoscopia/efeitos adversos , Gastropatias/prevenção & controle , Adulto , Cirurgia Bariátrica/normas , Índice de Massa Corporal , Constrição Patológica/prevenção & controle , Constrição Patológica/cirurgia , Feminino , Gastrectomia/normas , Humanos , Laparoscopia/normas , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/cirurgia , Padrões de Referência , Reoperação , Estudos Retrospectivos , Gastropatias/cirurgia
12.
J Pediatr Surg ; 52(4): 653-656, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27670959

RESUMO

INTRODUCTION: Stomach dehiscence from the abdominal wall is a serious and potentially life-threatening complication of gastrostomy tube changes. This retrospective study evaluates gastric aspiration as an inexpensive and safe alternative to endoscopic or radiographic confirmation. METHODS: From August 1998 to June 2016, 682 patients (301 female, 381 male) underwent 1713 gastrostomy tube changes in the medical setting, with an average age of 7.59years and an average site age of 3.43years. The most common diagnoses were GERD (304), aspiration (168), and failure to thrive (143). RESULTS: All newly inserted tubes were aspirated to visually inspect for gastric fluid. This procedure as a confirmatory test for intragastric placement was found to have a positive predictive value of 99.5% and negative predictive value of 77.8%, with a sensitivity of 99.8% and specificity of 63.6%. In cases with successful aspiration of gastric fluid, 75.5% of changes resulted in no complications, with intraperitoneal insertion or leak in only 0.48% of cases. CONCLUSIONS: Positive gastric aspirate is a strong predictor of proper G-tube placement with high sensitivity, eliminating the requirement of specialized equipment and the cost associated with endoscopic or radiographic guidance, and has a comparable or superior risk profile. LEVELS OF EVIDENCE: Study of diagnostic test level II.


Assuntos
Gastrostomia , Intubação Gastrointestinal/efeitos adversos , Gastropatias/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Nutrição Enteral/instrumentação , Nutrição Enteral/métodos , Feminino , Humanos , Lactente , Intubação Gastrointestinal/instrumentação , Intubação Gastrointestinal/métodos , Masculino , Estudos Retrospectivos , Risco , Sensibilidade e Especificidade , Gastropatias/diagnóstico , Gastropatias/etiologia , Sucção , Resultado do Tratamento , Adulto Jovem
13.
J Anim Physiol Anim Nutr (Berl) ; 101(5): e414-e426, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27805297

RESUMO

The impact of technical feed treatment and diet on stomach lesions and traits of the local and systemic immune system were investigated in fattening pigs. Feeding groups differed in technical feed treatment (standard ground meal vs. finely ground and pelleted feed) and diet (soya bean meal vs. rapeseed meal/DDGS/soya beans). Pigs were fattened approximately 10 weeks by ad libitum feeding and slaughtered subsequently. Gastric alterations were assessed by a macroscopic scoring system [macroscopic stomach score (MSC) 0 =  normal to 4 =  severe lesions]. For immunological investigations, lymphocytes from blood and jejunal tissues were isolated. T-cell phenotyping was carried out by staining intestinal lymphocytes with monoclonal antibodies for CD4 and CD8 and flow cytometric measurements. MSC was higher in animals fed finely ground and pelleted feed compared with their counterparts. Significant interactions between diet and feed treatment considering the MSC were observed (p = 0.027). There was no effect of diet or technical feed treatment on T cells of blood, Lymphonodi gastrici or lamina propria (LP) and intraepithelial cells. However, technical feed treatment significantly affected subsets of CD4+ , CD8+ , CD8low , CD4/CD8 double-positive T cells, the mean fluorescence intensity of CD4+ T cells and the ratio of CD8low /CD8high T cells in Peyer's patches (PP). All named parameters were reduced in PP of animals fed finely ground and pelleted feed compared with animals fed standard ground meal. Furthermore, significant differences between T cells of lymph nodes and LP were observed between animals with middle MSC (MSC = 1-2.5) and animals with high MSC (MSC = 3-4). Significant alterations in T cells of PP were observed between animals of low (MSC = 0-0.5) and high MSC. The observed effects provide the evidence that the impact of technical feed treatment is not limited on the stomach lesions. Possible stimuli and consequences of the immune system should be studied in more detail.


Assuntos
Dieta/veterinária , Manipulação de Alimentos , Gastropatias/veterinária , Doenças dos Suínos/prevenção & controle , Suínos/imunologia , Suínos/fisiologia , Imunidade Adaptativa , Ração Animal , Animais , Conteúdo Gastrointestinal , Masculino , Estômago/imunologia , Gastropatias/patologia , Gastropatias/prevenção & controle , Subpopulações de Linfócitos T/fisiologia
14.
J Pharmacol Sci ; 133(1): 1-8, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27435384

RESUMO

The therapeutic effect on HCl/ethanol induced gastric injury of Gardenia jasminoides (JXGJ-1 and JXGJ-2) were determined by a animal model. JXGJ-2 group reduced area of its gastric injury as compared to the control group, JXGJ-2 also helped in decreasing the gastric secretion volume results raised in pH value. The NO contents in serum, heart, liver, kidney and stomach of JXGJ-2 group were more than JXGJ-1 and control groups. JXGJ-2 reduce cytokine levels as compared to JXGJ-1 and control group. The serum and gastric tissue SOD, GSH-Px, GSH levels in JXGJ-2 treated mice were higher than JXGJ-1 treated and control mice, but the MDA, PC levels showed the crosscurrents, these levels were close to normal mice. Gardenia jasminoides could increase the occludin, EGF, EGFR, VEGF, IκB-α, nNOS, eNOS, Cu/Zn-SOD, Mn-SOD, CAT, GSH-Px (GSH1) mRNA and protein expressions and decrease the p38MAPK (p38), NF-κB, Bcl-2, COX-2, iNOS expressions in gastric tissues unlike to the control mice, JXGJ-2 had much better effect than JXGJ-1. JXGJ-1contained the higher genipin gentiobioside and gardenoside, they might be the key components of gastric injury inhibition. Gardenia jasminoides had a remarkable effect on gastric injury, and they were derived from two important components of genipin gentiobioside and gardenoside.


Assuntos
Etanol/efeitos adversos , Gardenia/química , Ácido Clorídrico/efeitos adversos , Iridoides/farmacologia , Gastropatias/prevenção & controle , Estômago/efeitos dos fármacos , Animais , Antioxidantes/farmacologia , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/farmacologia , Masculino , Camundongos , Estômago/patologia , Gastropatias/induzido quimicamente , Gastropatias/patologia
15.
Carbohydr Polym ; 152: 140-148, 2016 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-27516258

RESUMO

A sulfated polysaccharide (SFP) fraction from the marine alga Solieria filiformis was extracted and submitted to microanalysis, molar mass estimation and spectroscopic analysis. We evaluated its gastroprotective potential in vivo in an ethanol-induced gastric damage model and its in vitro antioxidant properties (DPPH, chelating ferrous ability and total antioxidant capacity). Its chemical composition revealed to be essentially an iota-carrageenan with a molar mass of 210.9kDa and high degree of substitution for sulfate groups (1.08). In vivo, SFP significantly (P<0.05) reduced, in a dose dependent manner, the ethanol-induced gastric damage. SFP prevents glutathione consume and increase of malondialdehyde and hemoglobin levels. SFP presented an IC50 of 1.77mg/mL in scavenging DPPH. The chelating ferrous ability was 38.98%, and the total antioxidant capacity was 2.01mg/mL. Thus, SFP prevents the development of ethanol-induced gastric damage by reducing oxidative stress in vivo and possesses relevant antioxidant activity in vitro.


Assuntos
Antioxidantes , Estresse Oxidativo/efeitos dos fármacos , Polissacarídeos , Rodófitas/química , Gastropatias/prevenção & controle , Animais , Antioxidantes/química , Antioxidantes/isolamento & purificação , Antioxidantes/farmacologia , Etanol/toxicidade , Camundongos , Polissacarídeos/química , Polissacarídeos/isolamento & purificação , Polissacarídeos/farmacologia , Gastropatias/induzido quimicamente
16.
BMC Gastroenterol ; 16(1): 58, 2016 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-27259970

RESUMO

BACKGROUND: Rebamipide is a gastroprotective agent with promising results against gastric damage induced by non-steroidal anti-inflammatory drugs. The present study evaluated if rebamipide protects against naproxen-induced gastric damage in healthy volunteers. Changes in gastric PGE2 tissue concentration were also evaluated. METHODS: After a preliminary endoscopy to rule out previous gastric macroscopic damage, twenty-four healthy volunteers of both sexes were divided into 2 groups. One group received sodium naproxen 550 mg b.i.d. plus placebo for 7 days, while the other group received sodium naproxen 550 mg b.i.d. plus rebamipide 100 mg b.i.d. At the end of treatment, a new endoscopy was performed. Gastric macroscopic damage was evaluated by the Cryer score and by the modified Lanza score. The primary outcome measure of the trial was the macroscopic damage observed in each treatment group at the end of treatment. Biopsies were collected at both endoscopies for PGE2 quantification and histopathological analysis (secondary outcomes). Tissue PGE2 was quantified by ELISA. The randomization sequence was generated using 3 blocks of 8 subjects each. Volunteers and endoscopists were blind to whether they were receiving rebamipide or placebo. RESULTS: All recruited volunteers completed the trial. Sodium naproxen induced gastric damage in both groups. At the end of the study, median Cryer score was 4 in both groups (Difference = 0; 95%CI = -1 to 0; p = 0.728). In the placebo group, the mean tissue PGE2 concentration was 1005 ± 129 pg/mL before treatment and 241 ± 41 pg/mL after treatment (p < 0.001). In the rebamipide group, the mean tissue PGE2 concentration was 999 ± 109 pg/mL before treatment, and 168 ± 13 pg/mL after treatment (p < 0.001). There was no difference in mean tissue PGE2 between the two groups (difference = 5; 95%CI from -334.870 to 345.650; p = 0.975). No significant change was observed at the histopathological evaluation, despite the evident macroscopic damage induced by naproxen. CONCLUSION: Rebamipide does not protect against naproxen-induced gastric damage in healthy volunteers. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02632812 . Registered 14 December 2015.


Assuntos
Alanina/análogos & derivados , Anti-Inflamatórios não Esteroides/efeitos adversos , Fármacos Gastrointestinais/uso terapêutico , Naproxeno/efeitos adversos , Quinolonas/uso terapêutico , Gastropatias/induzido quimicamente , Gastropatias/prevenção & controle , Adolescente , Adulto , Alanina/uso terapêutico , Dinoprostona/análise , Método Duplo-Cego , Feminino , Mucosa Gástrica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Gastropatias/patologia , Adulto Jovem
17.
Rev Gastroenterol Mex ; 81(3): 121-5, 2016.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27316593

RESUMO

INTRODUCTION AND AIMS: The chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause complications in the gastrointestinal tract. The use of proton pump inhibitors (PPIs) is recommended in high-risk patients to prevent them. OBJECTIVE: The aim of this article was to evaluate the gastroprotection measures taken in persons with chronic NSAID use. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted. The clinical records were reviewed of patients seen as outpatients at the Rheumatology Department over a 4-month period, choosing those with chronic NSAID use, and intentionally looking for gastroprotection measures according to the recommendations published by the American College of Gastroenterology. RESULTS: A total of 417 patients (347 women; mean age: 48.12±14.2 years) were included. The most frequent diagnosis was rheumatoid arthritis (65%). Nine patients (2.1%) had a history of peptic ulcer, 48 (11.5%) patients were 65 years of age or older, 26 (6.2%) patients took NSAIDs and aspirin, and 130 (31.2%) took NSAIDs with steroids. Tests for Helicobacter pylori infection were done in just 53 cases, and there were positive results in only 9 (16%). Some risk for gastrointestinal toxicity was established in 211 cases and only 65 (30.8%) received gastroprotection. In contrast, 31 (15%) patients received gastroprotection when there was no indication for it. CONCLUSION: Prophylaxis with PPIs in chronic NSAID users was inadequately employed. It was not prescribed in the majority of patients (69.2%) and it was used with no justification in others (15%).


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Guias de Prática Clínica como Assunto , Inibidores da Bomba de Prótons/uso terapêutico , Gastropatias/induzido quimicamente , Gastropatias/prevenção & controle , Adulto , Idoso , Estudos Transversais , Uso de Medicamentos , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade
18.
Intensive Care Med ; 42(6): 1018-28, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27043237

RESUMO

PURPOSE: To evaluate the potential preventive effect of probiotics on ventilator-associated pneumonia (VAP). METHODS: This was an open-label, randomized, controlled multicenter trial involving 235 critically ill adult patients who were expected to receive mechanical ventilation for ≥48 h. The patients were randomized to receive (1) a probiotics capsule containing live Bacillus subtilis and Enterococcus faecalis (Medilac-S) 0.5 g three times daily through a nasogastric feeding tube plus standard preventive strategies or (2) standard preventive strategies alone, for a maximum of 14 days. The development of VAP was evaluated daily, and throat swabs and gastric aspirate were cultured at baseline and once or twice weekly thereafter. RESULTS: The incidence of microbiologically confirmed VAP in the probiotics group was significantly lower than that in the control patients (36.4 vs. 50.4 %, respectively; P = 0.031). The mean time to develop VAP was significantly longer in the probiotics group than in the control group (10.4 vs. 7.5 days, respectively; P = 0.022). The proportion of patients with acquisition of gastric colonization of potentially pathogenic microorganisms (PPMOs) was lower in the probiotics group (24 %) than the control group (44 %) (P = 0.004). However, the proportion of patients with eradication PPMO colonization on both sites of the oropharynx and stomach were not significantly different between the two groups. The administration of probiotics did not result in any improvement in the incidence of clinically suspected VAP, antimicrobial consumption, duration of mechanical ventilation, mortality and length of hospital stay. CONCLUSION: Therapy with the probiotic bacteria B. Subtilis and E. faecalis are an effective and safe means for preventing VAP and the acquisition of PPMO colonization in the stomach.


Assuntos
Infecções Bacterianas/prevenção & controle , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Probióticos/administração & dosagem , Respiração Artificial/efeitos adversos , Gastropatias/prevenção & controle , Adulto , Bacillus subtilis , Estado Terminal , Enterococcus faecalis , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Orofaringe/microbiologia , Pneumonia Associada à Ventilação Mecânica/microbiologia , Estômago/microbiologia , Fatores de Tempo , Adulto Jovem
19.
Sci Rep ; 6: 24166, 2016 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-27053298

RESUMO

This study evaluated the protective effects of inhibiting caspase-1 activity or gastric acid secretion on acute gastric injury in mice. AC-YVAD-CMK, omeprazole, or vehicle were administered to mice before cold-restraint stress- or ethanol-induced gastric injury. Survival rates and histological evidence of gastric injury of mice pretreated with AC-YVAD-CMK or omeprazole, and exposed to cold-restraint stress, improved significantly relative to the vehicle group. The increased levels of tumour necrosis factor-α, interleukin (IL)-1ß, IL-6, and IL-18 following cold-stress injury were decreased by AC-YVAD-CMK, but not omeprazole, pretreatment. The increased expression of CD68 in gastric tissues was inhibited significantly by AC-YVAD-CMK pretreatment. Inhibiting caspase-1 activity in the NLRP3 inflammasome decreased gastric cell apoptosis, and the expression of Bax and cleaved caspase-3. AC-YVAD-CMK pretreatment significantly inhibited cold-restraint stress-induced increases in the expression of phosphorylated IκB-alpha and P38. General anatomy and histological results showed the protective effect of AC-YVAD-CMK on ethanol-induced acute gastric injury. Overall, our results showed that the caspase-1 inhibitor AC-YVAD-CMK protected against acute gastric injury in mice by affecting the NLRP3 inflammasome and attenuating inflammatory processes and apoptosis. This was similar to the mechanism associated with NF-κB and P38 mitogen-activated protein kinase signalling pathways.


Assuntos
Clorometilcetonas de Aminoácidos/farmacologia , Caspase 1/metabolismo , Inflamassomos/efeitos dos fármacos , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Gastropatias/prevenção & controle , Doença Aguda , Animais , Apoptose/efeitos dos fármacos , Western Blotting , Depressores do Sistema Nervoso Central/administração & dosagem , Depressores do Sistema Nervoso Central/toxicidade , Temperatura Baixa/efeitos adversos , Inibidores de Cisteína Proteinase/farmacologia , Citocinas/metabolismo , Etanol/administração & dosagem , Etanol/toxicidade , Mucosa Gástrica/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Inflamassomos/genética , Inflamassomos/metabolismo , Masculino , Camundongos Endogâmicos C57BL , NF-kappa B/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Restrição Física/efeitos adversos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais/efeitos dos fármacos , Estômago/efeitos dos fármacos , Estômago/patologia , Gastropatias/etiologia , Gastropatias/genética , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
20.
Biol Pharm Bull ; 39(2): 221-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26632199

RESUMO

Manassantin A, a neolignan isolated from Saururus chinensis, is a major phytochemical compound that has various biological activities, including anti-inflammatory, neuroleptic, and human acyl-CoA : cholesterol acyltransferase (ACAT) inhibitory activities. In this study, we investigated the protective effects of manassantin A against ethanol-induced acute gastric injury in rats. Gastric injury was induced by intragastric administration of 5 mL/kg body weight of absolute ethanol to each rat. The positive control group and the manassantin A group were given oral doses of omeprazole (20 mg/kg) or manassantin A (15 mg/kg), respectively, 1 h prior to the administration of absolute ethanol. Our examinations revealed that manassantin A pretreatment reduced ethanol-induced hemorrhage, hyperemia, and epithelial cell loss in the gastric mucosa. Manassantin A pretreatment also attenuated the increased lipid peroxidation associated with ethanol-induced acute gastric lesions, increased the mucosal glutathione (GSH) content, and enhanced the activities of antioxidant enzymes. The levels of pro-inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-1ß were clearly decreased in the manassantin A-pretreated group. In addition, manassantin A pretreatment enhanced the levels of cyclooxygenase (COX)-1, COX-2, and prostaglandin E2 (PGE2) and reduced the inducible nitric oxide synthase (iNOS) overproduction and nuclear factor kappa B (NF-κB) phosphorylation. Collectively, these results indicate that manassantin A protects the gastric mucosa from ethanol-induced acute gastric injury, and suggest that these protective effects might be associated with COX/PGE2 stimulation, inhibition of iNOS production and NF-κB activation, and improvements in the antioxidant and anti-inflammatory status.


Assuntos
Antiulcerosos/farmacologia , Lignanas/farmacologia , Gastropatias/induzido quimicamente , Animais , Antiulcerosos/química , Catalase , Etanol , Glutationa , Lignanas/química , Masculino , Malondialdeído , Estrutura Molecular , Omeprazol/farmacologia , Ratos , Ratos Sprague-Dawley , Saururaceae/química , Gastropatias/prevenção & controle , Superóxido Dismutase
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