Tricobezoar gástrico: relato de caso e revisão da literatura

Bezoar é a impactação de material estranho no interior do trato digestivo, originado a partir da ingestão de diversas substâncias, incluindo cabelos ou pêlos, fibras vegetais e outros. No presente estudo relata-se caso de um volumoso tricobezoar gástrico observado em uma adolescente de 16 anos, com queixa de dor e tumoração palpável na região epigástrica, diagnosticado através da endoscopia digestiva alta. Dada às proporções do bezoar, a paciente foi submetida à gastrotomia anterior com retirada de uma massa sólida de cabelos, com 1200 g, a qual moldava todo o estômago, desde o fundo até o piloro. Uma grande úlcera de pressão também foi detectada em região antral, cujas biópsias revelaram- se negativas para neoplasia. Após a alta, sem intercorrências, a paciente foi encaminhada ao Serviço de Neuropsiquiatria para o tratamento da tricofagia e prevenção da recorrência, objetivo final, ao nosso ver, de todo o tratamento.

Úlcera gastroduodenal em potros

Dentre as inúmeras patologias que acometem os eqüinos jovens, as úlceras gástricas situam-se como uma das mais importantes. MURRAY et al. (1987) trabalhando com potros clinicamente normais, constatou uma prevalência de úlceras da ordem de 51%. O mesmo autor realizando gastroscopia em 45 equinos com idade entre 1 e 24 anos, observou a presença de úlceras em 93% dos animais (MURRAY, 1988). de etiologia não completamente definida, acredita-se que inúmeros fatores estejam envolvidos na gênese das úlceras gastroduodenais, sendo o estresse um dos mais importantes. Um desequilíbrio entre os fatores de agressão e proteção da mucosa gástrica é sugerido, onde uma vez ocorrendo o predomínio dos fatores de agressão, a formação das úlceras estaria determinada. de acordo com o tipo, presença ou ausência de sinais clínicos, localização das lesões na mucosa gástrica e possíveis complicações de sua ocorrência, quatro síndromes clínicas são reconhecidas em potros: 1) úlceras assintomáticas ou silenciosas; 2) úlceras sintomáticas ou ativas; 3) úlceras perfuradas e, 4) obstrução gástrica ou duodenal. O diagnóstico deve ser baseado na história clínica, sinais clínicos, resposta à terapia e principalmente nos achados do exame gastroscópico. O tratamento pode ser feito utilizando-se drogas inibidoras da secreção ácida, protetores de mucosas, anti-ácidos, análogos da prostaglandina e estimulantes de motilidade intestinal. Quando indicado emprega-se o tratamento cirúrgico.

Período de descanso dos suínos no frigorífico e seu impacto na perda de peso corporal e em características do estômago

O manejo pré-abate dos suínos, quando realizado de maneira inadequada, pode proporcionar perdas qualitativas e quantitativas. O objetivo deste trabalho foi avaliar o efeito do período de descanso dos suínos no frigorífico (PDF) (3, 5, 7 e 9 horas) e da posição do box na carroceria do caminhão (PBO) sobre a perda de peso corporal (PPC), o peso do estômago cheio (PEC) e vazio (PEV), o peso do conteúdo estomacal (PCE) e o escore de lesão na mucosa esofágica-gástrica (ELG). Foram utilizadas 192 fêmeas, com peso vivo médio de 130,0±9,9kg. Para a análise estatística, considerou-se no modelo os efeitos de bloco (BL), relativo à estação do ano e à granja avaliada o PDF, PBO e a interação entre PDF x BL. Não houve efeito significativo do PDF nas variáveis estudadas. Verificou-se efeito significativo da PBO somente sobre a perda de peso corporal dos suínos, sendo que animais transportados na parte da frente perderam mais peso em relação aos transportados nos boxes do meio e de trás. Observou-se que somente 11% dos suínos apresentaram ELG característico de úlcera gástrica e que uma elevada porcentagem de suínos (41,9%) apresentou ELG grau 1, caracterizando paraqueratose. Conclui-se que suínos transportados em boxes localizados na parte frontal da carroceria do caminhão apresentam maior perda de peso corporal do que os demais e que a variação de 3 a 9 horas no período de descanso no frigorífico não afeta a perda de peso corporal nem as características do estômago dos animais.

Tempo de jejum dos suínos no manejo pré-abate sobre a perda de peso corporal, o peso do conteúdo estomacal e a incidência de úlcera esofágica-gástrica

O objetivo deste trabalho foi avaliar os efeitos do tempo de jejum (9, 12, 15 e 18 horas) dos animais na granja (TJG) e da posição na carroceria do caminhão (PBO) durante o transporte da granja ao frigorífico sobre: a perda de peso corporal (PPC), o peso do estômago cheio (PEC) e vazio (PEV), o peso do conteúdo estomacal (PCE) e o escore de lesão na mucosa esofágica-gástrica (ELG). Foram utilizadas 192 fêmeas, com peso vivo médio de 134,51±11,80kg. No modelo, foram considerados os efeitos de bloco (estação do ano, BL), TJG, PBO e da interação entre BL x TJG. Verificou-se efeito significativo do TJG apenas sobre o peso do conteúdo estomacal. Não se observou efeito significativo da PBO sobre qualquer das variáveis avaliadas. Dos suínos avaliados, 90,3% apresentaram PEC menor que 500 gramas e 8,56% com PEC entre 500 e 800 gramas. A prevalência de suíno com ELG foi baixa (14,97%), sendo que, dos animais com ELG, 13,90% apresentaram lesão de grau 1 e 1,09% eram grau dois. Conclui-se que animais submetidos a jejum na granja de 15 horas apresentam menor peso do conteúdo estomacal ao abate.

Intubação traqueal e o paciente com o estômago cheio

A aspiração pulmonar do conteúdo gástrico, apesar de pouco frequente, exige cuidados especiais para sua prevenção. A depressão da consciência durante a anestesia predispõe os pacientes a esta grave complicação pela diminuição na função do esfíncter esofágico e dos reflexos protetores das vias aéreas. Guias de jejum pré-operatório elaborados recentemente sugerem períodos menores de jejum, principalmente para líquidos, permitindo mais conforto aos pacientes e menor risco de hipoglicemia e desidratação, sem aumentar a incidência de aspiração pulmonar perioperatória. O uso rotineiro de agentes que diminuem a acidez e volume gástrico parece estar indicado apenas para pacientes de risco. A intubação traqueal após indução anestésica por meio da técnica de sequência rápida está indicada naqueles pacientes, com risco de aspiração gástrica, em que não há suspeita de intubação traqueal difícil. A indicação correta da técnica, sua aplicação criteriosa e a utilização racional das drogas disponíveis podem promover condições excelentes de intubação, com curto período de latência, rápido retorno da consciência e da respiração espontânea, caso haja falha na intubação traqueal.O presente artigo tem como objetivo discutir os métodos atualmente utilizados para controlar o volume e o pH do conteúdo gástrico, proteger as vias aéreas durante as manobras de intubação e reduzir o refluxo gastroesofágico.

Configuração do sistema venoso portal na cutia (Dasyprocta aguti, RODENTIA)

O estudo da veia porta quanto aos vasos confluentes para sua formação e suas tributárias foi efetuado em 10 cutias (Dasyprocta aguti), adultas (3 fêmeas e 7 machos), nas quais o sistema desta veia foi injetado com látex corado, sendo a seguir fixadas em formol a 10% e dissecadas. Verificou-se que o tronco da veia porta origina-se sempre pela confluência de duas raízes, sendo representadas em 90% dos casos, pela veia lienal e pelo tronco mesentérico comum, constituído pelas veias mesentéricas cranial e caudal e, em 10%, pela veia lienal e pela veia mesentérica cranial. O tronco da veia porta recebe como tributárias a veia pancreaticoduodenal cranial (100%), a veia gástrica direita (90%) e, ainda, a veia gastroepiplóica direita (40%).

Drying study of siloxane-PPG nanocomposites

This is a study of the structural transformations occurring in hybrid siloxane-polypropyleneglycol (PPG) nanocomposites, with different PPG molecular weight, along the drying process. The starting materials are wet gels obtained by the sol-gel procedure using as precursor the 3-(trietoxysilyl)propylisocyanate (IsoTrEOS) and polypropylenglycol bis(2-amino-propyl-ether) (NH2-PPG-NH2). The shrinkage and mass loss measurements were performed using a temperature-controlled chamber at 50 degreesC. The nanostructural evolution of samples during drying was studied in situ by small angle x-ray scattering (SAXS). The experimental results demonstrate that the drying process is highly dependent on the molecular weight of polymer. After the initial drying stage, the progressive emptying of pores leads to the formation of a irregular drying front in gels prepared from PPG of high molecular weight, like 4000 g/mol. As a consequence, an increase of the SAXS intensity due to the increase of electronic density contrast between siloxane clusters and polymeric matrix is observed. For hybrids containing PPG of low molecular weight, the pore emptying process is fast, leading to a regular drying front, without isolated nanopockets of solvents. SAXS intensity curves exhibit a maximum, which was associated to the existence of spatial correlation of the silica clusters embedded in the polymeric matrix. The spatial correlation is preserved during drying. These results also reveal that the structural transformation during drying is governed by capillary forces and depends on the entanglement of polymer chains.

Antiulcer activity and subacute toxicity of trans-dehydrocrotonin from Croton cajucara

The antiulcerogenic activity of trans-dehydrocrotonin (DHC), a nor-clerodane diterpene isolated from Croton cajucara Benth. ( Euphorbiaceae), and its subacute ( 35 days) toxicity were studied in mice and rats, respectively. For the antiulcerogenic tests, models of gastric ulcers induced in mice by ethanol/HCl or stress were used. In both models, an oral dose of DHC ( 100 mg/kg) significantly reduced (P< 0.01) the formation of gastric lesions. DHC was also tested for its ability to scavenge free radicals, but no such action was observed in rat liver mitochondria. To assess the subacute toxicity, rats were treated orally with DHC (25, 50 and 100 mg/kg) for 5 weeks. A significant increase in liver weight was observed in male and female rats at highest doses, whereas a significant reduction in plasma alkaline phosphatase and cholesterol levels and an increase in gamma glutamyl transpeptidase were observed only at the highest dose ( 100 mg/kg) in female rats. DHC caused histopathological alterations in the liver that included a turbid tumefaction, microvacuolar degeneration and nuclear alterations. Despite the beneficial antiulcerogenic activity of DHC, our results suggest that the long-term use of this compound may induce liver damage.

The muscular organization of the stomach of Capybaira (Hydrochoerus hydrochaeris): an architectural view

Twenty-two stomachs from adult capybaras were used in this study, and an acid digestion mesoscopic technique was pursued using different concentrations of nitric acid to observe the muscular organization of the stomach. The capybara's stomach possessed a muscular coat composed of four layers or strata: external longitudinal, external oblique, circular and internal oblique. Also, the cardiac and pyloric sphincter muscles were comprised of three or two different layers, respectively. Furthermore, the internal oblique fibres were observed extending from the cardiac portion of the stomach to the smaller curvature, where they participated in the formation of the Ansa cardiaca together with the external. longitudinal fibres. This muscular architectural arrangement was compared to that in small rodents (rat, hamster, guinea pig), as well as in rabbits and pigs. In conclusion, the stomach of the capybara has a very particular, complex and defined muscular organization that differs from that in other rodents, or domestic animals, in particular, pigs. (c) 2005 Elsevier GmbH. All rights reserved.

Metabolic fingerprinting using direct flow injection electrospray ionization tandem mass spectrometry for the characterization of proanthocyanidins from the barks of Hancornia speciosa

Direct flow injection electrospray ionization ion trap tandem mass spectrometry (ESI-IT-MS/MS) was used to investigate the polyphenolic compounds present in an infusion from the barks of Hancornia speciosa Gom. (Apocynaceae), a native Brazilian plant popularly known as 'mangabeira', used as a source of nutrition and against gastric disorders. After a simple sample filtration pretreatment the characteristic fingerprint of the infusion was performed in negative ion ESI mode in a few minutes. At low capillary-voltage activation, the deprotonated molecules ([M-H](-)) were observed and using collision-induced dissociation the product ion spectra showed the presence of a homologous series of B-type proanthocyanidins, as well as another series containing their respective C-glycosylated derivatives, with a degree of polymerization from 1 up to 6 units of interlinked catechins. Therefore, direct flow injection allowed us to identify the key compounds without preparative isolation of the components. Copyright (C) 2007 John Wiley & Sons, Ltd.

Crescimento pós-natal do coelho Norfolk: correlação entre parâmetros somáticos e área dos tipos de fibras musculares

Skeletal muscle fibers areas, the weight of body, carcass and muscle, the gastric content and the length of intestines and caecum of Norfolk rabbit from neonate to 26th week were measured. Types of fibers and areas were studied in -70-degrees-C frozen blocks of flexor carpo radialis muscle. Some sections were stained with Haematoxylin and Eosin and others were submitted to SDH, NADH-TR and m-ATPase, followed by acid and alkali preincubations. All parameters revealed a high degree of correlation. Carcass weight/body weight ratio reached 55,1% at 10th week. From neonate to 26th week, the areas of SO, FOG and FG muscle fibers increased of x9.1, x12.4 and x22.2. While SO and FOG fibers tend to stabilize their growth at 10th week, FG fibers were active at this age. Due to early stabilization of SO and FOG fibers growth, the additional increase in muscle tissue in attributed mainly to hypertrophy of FG fibers.

THE ROLE OF ANGIOTENSIN AT1 RECEPTORS IN THE DIURETIC, NATRIURETIC, KALIURETIC AND BLOOD-PRESSURE RESPONSES INDUCED BY ANGIOTENSIN-II ACTIVATION OF THE MEDIAN PREOPTIC NUCLEUS IN CONSCIOUS RATS

We determined the effects of two classical angiotensin II (ANG II) antagonists, [Sar(1), Ala(8)]-ANG II and [Sar(1), Thr(8)]-ANG II, and losartan (a nonpeptide and selective antagonist for the AT 1 angiotensin receptors) on diuresis, natriuresis, kaliuresis and arterial blood pressure induced by ANG II administration into the median preoptic nucleus (MnPO) of male Holtzman rats weighing 250-300 g. Urine was collected in rats submitted to a water load (5% body weight) by gastric gavage, followed by a second water load (5% body weight) 1 h later. The volume of the drug solutions injected was 0.5 mu l over 10-15 s. Pre-treatment with [Sar(1), Ala(8)]-ANG II (12 rats) and [Sar(1), Thr(8)]-ANG II (9 rats), at the dose of 60 ng reduced (13.7 +/- 1.0 vs 11.0 +/- 1.0 and 10.7 +/- 1.2, respectively), whereas losartan (14 rats) at the dose of 160 ng totally blocked (13.7 +/- 1.0 vs 7.6 +/- 1.5) the urine excretion induced by injection of 12 ng of ANG II (14 rats). [Sar(1), Ala(8)]-ANG II impaired Na+ excretion (193 +/- 16 vs 120 +/- 19): whereas [Sar(1), Thr(8)]-ANG II and losartan blocked Na+ excretion (193 +/- 16 vs 77 +/- 15 and 100 +/- 12, respectively) induced by ANG II. Similar effects induced by ANG II on K+ excretion were observed with [Sar(1), Ala(8)]-ANG II, [Sar(1), Thr(8)]-ANG II, and losartan pretreatment (133 +/- 18 vs 108 +/- 11, 80 +/- 12, and 82 +/- 15, respectively). The same doses as above of [Sar(1), Ala(8)]-ANG II (8 rats), [Sar(1), Thr(8)]-ANG II (8 rats). and losartan (9 rats) blocked the increase in the arterial blood pressure induced by 12 ng of ANG II (12 rats) (32 +/- 4 ru 4 +/- 2, 3.5 +/- 1, and 2 +/- 1: respectively. The results indicate that the AT1 receptor subtype participates in the increases of diuresis, natriuresis. kaliuresis and arterial blood pressure induced by the administration of ANG II into the MnPO.

Effects of digitonin on hyperglycaemia and dyslipidemia induced by high-sucrose intake

This study examined whether high-sucrose intake effects on lipid profile and oral glucose tolerance may be inhibited by a single administration of digitonin, a saponin from the seeds of Digitalis purpurea Male Wistar 24 rats were initially divided into two groups (n = 12): (C) was given standard chow and water; (S) received standard chow and 30% sucrose in its drinking water. After 30 days of treatments, C rats were divided into two groups (n = 6): (CC) given an intra-gastric dose 0.5 mL saline, (CD) given a single intragastric dose of 15 mg/kg digitonin. S rats were also divided into two groups (n = 6): (SC) given intra-gastric saline and (SD) given digitonin. Rats were sacrificed after the oral glucose tolerance test (OGTT) at 2 h after the digitonin administration. S rats had higher total energy intake and final body weight than C. SC rats had fasting hyperglycaemia and impaired OGTT. Digitonin in SD group improved the glucose tolerance. Triacylglycerol (TG), very-low-density lipoprotein (VLDL-C) and free fatty acid (FFA) serum concentrations were increased in SD rats from CC. Digitonin in SD rats decreased FFA and led TG and VLDL-C concentrations at the levels observed in the CC group. Despite the enhanced cholesterol in CD group from CC., the high-density lipoprotein (HDL-C) was increased in these animals. HDL-C/TG ratio was higher in CD and SD than in CC and SC, respectively. No significant differences were observed in lipid hydroperoxide(LH) between the groups. VLDL-C/LH ratio and gamma-glutamyl transferase (GGT) activity were increased in SC group and were decreased in SD rats from the SC. In conclusion digitonin enhanced glucose tolerance and had beneficial effects on serum lipids by improve antioxidant activity. (c) 2005 Elsevier Ltd. All rights reserved.

Role of 5-HT in stress, anxiety, and depression

There are conflicting results on the function of 5-HT in anxiety and depression. To reconcile this evidence, Deakin and Graeff have suggested that the ascending 5-HT pathway that originates in the dorsal raphe nucleus (DRN) and innervates the amygdala and frontal cortex facilitates conditioned fear, while the DRN-periventricular pathway innervating the periventricular and periaqueductal gray matter inhibits inborn fight/flight reactions to impending danger, pain, or asphyxia. To study the role of the DRN 5-HT system in anxiety, we microinjected 8-OH-DPAT into the DRN to inhibit 5 HT release. This treatment impaired inhibitory avoidance (conditioned fear) without affecting one-way escape (unconditioned fear) in the elevated T-maze, a new animal model of anxiety. We also applied three drug treatments that increase 5-HT release from DRN terminals: 1) intra-DRN microinjection of the benzodiazepine inverse agonist FG 4172, 2) intra-DRN microinjection of the excitatory amino acid kainic acid, and 3) intraperitoneal injection of the 5-HT releaser and uptake blocker D-fenfluramine. All treatments enhanced inhibitory avoidance in the T-maze. D-Fenfluramine and intra-DRN kainate also decreased one-way escape. In healthy volunteers, D-fenfluramine and the 5-HT agonist mCPP (mainly 5-HT2C) increased, while the antagonists ritanserin (5-HT2A/(2C)) and SR 46349B (5-HT2A) decreased skin conductance responses to an aversively conditioned stimulus (tone). In addition, D-fenfluramine decreased, whereas ritanserin increased subjective anxiety induced by simulated public speaking, thought to represent unconditioned anxiety. Overall, these results are compatible with the above hypothesis. Deakin and Graeff have suggested that the pathway connecting the median raphe nucleus (MRN) to the dorsal hippocampus promotes resistance to chronic, unavoidable stress. In the present study, we found that 24 h after electrolytic lesion of the rat MRN glandular gastric ulcers occurred, and the immune response to the mitogen concanavalin A was depressed. Seven days after the same lesion, the ulcerogenic effect of restraint was enhanced. Microinjection of 8-OH-DPAT, the nonselective agonist 5-MeO-DMT, or the 5-HT uptake inhibitor zimelidine into the dorsal hippocampus immediately after 2 h of restraint reversed the deficits of open arm exploration in the elevated plus-maze, measured 24 h after restraint. The effect of the two last drugs was antagonized by WAY-100135, a selective 5-HT1A receptor antagonist. These results are compatible with the hypothesis that the MRN-dorsal hippocampus 5-HT system attenuates stress by facilitation of hippocampal 5-HT1A-mediated neurotransmission. Clinical implications of these results are discussed, especially with regard to panic disorder and depression.

Structure of human uropepsin at 2.45 angstrom resolution

The molecular structure of human uropepsin, an aspartic proteinase from the urine produced in the form of pepsinogen A in the gastric mucosa, has been determined by molecular replacement using human pepsin as the search model. Crystals belong to space group P2(1)2(1)2(1), with unit-cell parameters a = 50.99, b = 75.56, c = 89.90 Angstrom. Crystallographic refinement led to an R factor of 0.161 at 2.45 Angstrom resolution. The positions of 2437 non-H protein atoms in 326 residues have been determined and the model contains 143 water molecules. The structure is bilobal, consisting of two predominantly beta -sheet lobes which, as observed in other aspartic proteinases, are related by a pseudo-twofold axis. A model of the uropepsin-pepstatin complex has been constructed based on the high-resolution crystal structure of pepsin complexed with pepstatin.