Bladder augmentation in rabbits with anionic collagen membrane, with or without urotelial preservation. Cistometric and hystologic evaluation

The use of bowel segments to perform bladder augmentation is associated with several metabolic and surgical complications. A great variety of synthetic materials, biodegradable or not, have been tested. Collagen-based biomaterials have shown effectiveness for the regeneration and obtainment of a functional bladder. Assess the functional and histological response of the rabbit bladder to anionic collagen membrane (ACM), either when it is anastomosed to the bladder or it is placed onto bladder after vesicomyectomy. In 15 male rabbit a partial cystectomy was performed. After 4 weeks they were divided in 3 groups. Group 1 (G1) - bladder augmentation with ACM. Group 2 (G2) ACM is placed onto bladder after vesicomyectomy. Group 3 (G3) control group. Maximal bladder capacity (MBC) and weight were assessed with 4 (M1), 8 (M2) and 12 (M3) weeks after partial cystectomy. In M3 was performed the sacrifice and extraction of the bladder and kidneys for anatomopathologic study. There were neither bladder stones, nor implant extrusion in M3. There was a significant increase in MBC in G1 and G2 (p<0.05), but no statistical differences in G3 (p=0.35). There is no significant difference comparing G1 and G2. In M3, both groups have shown a bigger MBC than G3 (p<0.05). The microscopic assessment showed an inflammatory reaction in the bladder augmented, with urothelium preserved. The ACM was effective for the increase of MBC. The bladders with preservation of the urothelium have shown an extensive inflammatory process.

Induction of short gut syndrome and transplantation in a porcine model

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Peritoneal response to abdominal surgery: the role of equine abdominal adhesions and current prophylactic strategies

Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular, vascularized, dynamic structures that are influenced by complex signaling mechanisms. Understanding their pathogenesis could assist in applying better therapeutic strategies and in developing more effective antiadhesion products. Currently, there are no definitive strategies that prevent adhesion formation, and it is difficult to interpret the results of existing studies due to nonstandardization of an induction model and evaluation of their severity. The best clinical results have been obtained from using minimally traumatic surgical techniques, anti-inflammatory agents, antimicrobials, anticoagulants, and mechanical separation of serosal surfaces by viscous intraperitoneal solutions or physical barriers. This paper aims to review adhesion formation pathogenesis, guide the understanding of major products and drugs used to inhibit adhesion formation, and address their effectiveness in the equine species.

Anti-inflammatory effects of Brazilian ginseng (Pfaffia paniculata) on TNBS-induced intestinal inflammation: experimental evidence

Inflammatory bowel disease (IBD) is a chronic, relapsing, idiopathic inflammation of the gastrointestinal tract. Clinical studies suggest that the initiation of IBD is multifactorial, involving genetics, the immune system and environmental factors, such as diet, drugs and stress. Pfaffia paniculata is an adaptogenic medicinal plant used in Brazilian folk medicine as an anti-stress agent. Thus, we hypothesised that the P. paniculata enhances the response of animals subjected to colonic inflammation. Our aim was to investigate the intestinal anti-inflammatory activity of P. paniculata in rats before or after induction of intestinal inflammation using trinitrobenzenesulfonic acid (TNBS). The animals were divided into groups that received the vehicle, prednisolone or P. paniculata extract daily starting 14days before or 7days after TNBS induction. At the end of the procedure, the animals were killed and their colons were assessed for the macroscopic damage score (MDS), extent of the lesion (EL) and weight/length ratio, myeloperoxidase (MPO) activity and glutathione (GSH), cytokines and C-reactive protein (CRP) levels. Histological evaluation and ultrastructural analysis of the colonic samples were performed. Treatment with the 200mg/kg dose on the curative schedule was able to reduce the MDS and the EL. In addition, MPO activity was reduced, GSH levels were maintained, and the levels of pro-inflammatory cytokines and CRP were decreased. In conclusion, the protective effect of P. paniculata was related to reduced oxidative stress and CRP colonic levels, and due to immunomodulatory activity as evidenced by reduced levels of IL-1β, INF-γ, TNF-α and IL-6.

Experimental evidence of MAP kinase gene expression on the response of intestinal anti-inflammatory drugs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Experimental evidence of heparanase, Hsp70 and NF-κB gene expression on the response of anti-inflammatory drugs in TNBS-induced colonic inflammation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Associação entre concentração sérica de vitamina D e alterações da massa muscular esquelética em pacientes com doenças inflamatórias intestinais

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Desenvolvimento de nano e micropartículas de quitosana encapsulando 4-metilesculetina e avaliação no tratamento da doença inflamatória intestinal

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Qualidade de vida e capacidade funcional em pacientes com doenças inflamatórias intestinais

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estilo de vida e saúde de um grupo de idosos de Franca, SP

The increase of elderly population in Brazil and all around the world shows the need of reviewing the health cares in order to get a better quality of life. Objective: To evaluate lifestyle and health care of elderly participants of UNATI, Franca, SP. Methods: Sixty elderlies answered a questions about socio-economic issues, health care, food consumption habits and lifestyle, after, they were submitted to anthropometric and laboratory tests. Results: There was a prevalence of women (85%), aged between 60-69 years old (60%), up to high school (60%), retired (65%), income up to 5 minimum wage (73.4%). Most seniors assessed medical care (65%) were in use of long-term medicines (78.3%), they reported to control blood pressure (80%) and to not smoke (100%). About 71.7% people believed to have a healthy diet, 97% took meals at home, 85% chose and prepared their own food, 65% had 5-6 meals/day, 63% drank 1L of water/day, 90% had bowel function and 43.3% practices a regular physical activity. Only 13.3% have done hormone replacement therapy, 18.3% take dietary supplements and 21.7% drink alcoholic drinks. The participants presented a BMI of 27.49 ± 4.5kg/m², prevalence of overweight and eutrophy, which values decreased with age. Leg circumference (LC) (36.27 ± 3.84 cm), Arm circumference (AC) (31.39 ± 4.08 cm) and triceps skinfolds (TS) (20.58±7.54mm) values were suit in most cases (96.7, 85 and 83.3%, respectively). Serum total cholesterol values were 198.53 ± 35.2mg/dL, 55% were considered optimum. About 63.3% and 68.3% of the elderlies, respectively, presented a high density lipoproteins (HDL) (53.58± 10.9mg/dL) and triglycerides (TG) (143.97 ± 92.37mg/dL) according to the recommendation and 51.7% of the elderlies had normal glycemia, 38.3% had risk and 10% showed high blood glucose, indicating diabetes. Conclusion: Many elderlies had body mass index (BMI) above normal, indicating overweight or obesity, but the participants can be considered healthy because of AC, LC and TS values, diet habits, health care and lifestyle.

Avaliação clínico-laboratorial e da expressão de metaloproteinases 2 e 9 de equinos com obstrução experimental do cólon menor

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Encoprese e intervenção psicológica: revisão de literatura

Studies have shown that encopresis, related to bowel control disorder, can bring significant impact for the individual life, such as low self-esteem and deficits in social interaction. Despite the significant impairment recognized that this disorder can have on child development, the scientific literature has given little attention to the theme, with a low number of publications on the subject. Thus, this paper investigated Brazilian publications in psychology related to encopresis between 1994 and 2013 in data base Lilacs and Scielo. 231 articles were found and were selected those that reported only intervention in encopresis. There were five articles and four published by the same journal and described behavioral interventions, and one author wrote three. The other one was psychoanalytic. The surveys were conducted with children and adolescents and behavioral interventions have been successful with remission of encopresis symptoms. The data affirm the deficiency in publications in the area and possibly limited number of psychologists investigating the issue, which is of significant importance.

Biological therapy for the prevention and treatment of postoperative endoscopic recurrence in Crohn's disease: time for acceptance?

In most patients, postoperative endoscopic recurrence (PER) occurs 1 year after abdominal resection for Crohn’s disease (CD). Preventing PER is essential for disease control, as most patients develop further clinical and surgical recurrences. Conventional therapy with nitroimidazoles, aminosalicylates, and immunomodulators have limited efficacy for preventing PER. Initial trials with biological therapy (infliximab and adalimumab) showed promising results in preventing PER, and the efficacy of these drugs seems higher than that with conventional therapy. The aim of this review is to outline the results of studies that used infliximab or adalimumab for preventing and treating PER in CD patients. Data with both agents are available, and a few, small prospective trials have shown the efficacy of these drugs in patients with a high risk for recurrence. We believe that, in 2013, biological agents will be better accepted for the prevention PER in CD patients, in addition to the already existing data. Larger trials are still underway, and their results will certainly determine the role of these agents in PER, which develops after bowel resection for CD.

Diagnóstico diferencial entre Doença de Crohn e Hidradenite Supurativa: relato de caso

Crohn’s disease is a chronic infl ammatory bowel disease with segmental transmural infl ammation, which complicate with formation of fi stulas and abscesses. The hidradenitis suppurativa (HS) is characterized by recurrent abscesses, with a predilection for areas rich in apocrine glands such as the axillary, inguinal and perineal. The differential diagnosis between these diseases is diffi cult and may compromise treatment. Report case: C.R.M.A., 40 year-old, female, white, ileal and colonic Crohn’s disease complicated with perianal and rectovaginal fi stula for 12 years, treated with biological therapy since May 2010. In Sep/2010 presented with an abscess in the buttock D with purulent discharge refractory to the use of ciprofl oxacin and metronidazole. USG: collection of 30 cm3 in buttock D. The diagnosis was HS and the patient underwent extensive surgical removal of the affected areas (10 x 2 cm) with healing by secondary intention. Skin graft performed unsuccessfully in Dec/2010. The patient returned in jan/2011 with a new fi stula at the site of resection, consistent with Crohn’s disease. In fev/2011 underwent drainage of abscesses and placement of setons in perianal fi stulas. Currently in therapy with good biological evolution of fi stulas. The prevalence of HS varies from 0.3 to 4% of the population in general. The axilla is the region most affected and perianal lesions are associated with greater weakness. There are published reports of association between HS and Crohn’s disease sporadically and further studies are needed to assess a common pathogenesis. The differential diagnosis should be performed in all cases planning immediate treatment, avoiding complications and worsening of the patient’s quality of life.

P-215-Quantitative variation of some gut bacteria in Crohn's disease can be related to the patient's gender

Background: Imbalance in bacterial species composition of the gut microbiota is one of the factors associated with the cause or complication of the symptoms of Crohn's disease (CD). This disequilibrium consists in the reduction of biodiversity, decrease of genus such as Bifidobacterium and elevation of species such as Escherichia coli. Human microbiota varies among subjects of a same population irrespective of their health condition and among individuals living in distinct geographic locations. In animal models, sex related differences could also be observed in gut bacterial species composition under some pathological conditions. Experiments conducted with mice have demonstrated that the manifestation of type 1 diabetes (T1D) could be under the influence of the animal sex and its serum level of testosterone, which in turn could be modulated by a particular gut microbiota. Considering the existence of similar features between T1D and CD, such as strong genetic component and malfunctioning of the immune system, we investigated whether differences could be observed in the gut microbiota dysbiosis of male and female CD patients. Methods: Fifty and 5 gut mucosal biopsies from 25 adult CD patients (11 males and 14 females) and 43 specimens of an equivalent clinical material from 22 control subjects (11 males and 11 females) were screened for bacterial biodiversity by analyzing sequences of 16SrDNA V6 region. A number of 2-3 samples each from distinct gut segments (from ileum to rectum) were taken from each subject. The 16SrDNA sequences were obtained by sequencing PCR amplicons of the corresponding gene in the Ion torrent PGM sequencer. Identification and classification of the bacterial groups followed the Ribosomal Database Project (RDP) website pipeline. The relationships of the bacterial taxa with each of the study parameters was performed by compiling the data in a MS Excel and the level of statistical significance determined by the Chi-square test. Results: A total of 3203 16SrDNA sequences were detected in the 98 biopsies samples, the majority of which matching Proteobacteria, Firmicutes, Bacterioidetes, and Actinobacteria. The percentage of DNA sequences for each of these phyla found in Male control subjects/Male CD patients was 40.5/33, 32.7/32.4, 20.8/24.5, and 4.4/4,4 for Proteobacteria, Firmicutes, Bacterioidetes, and Actinobacteria, respectively. In Female comparisons, these values were 35.6/42, 39.2/26.3, 19.8/23.3, 5.2/7. Both Male and Female CD patients presented higher numbers of sequences of Actinobacteria and Bacterioidetes than those of control subjects of the same gender. Case-control differences for Firmicutes could be observed only in female comparisons and, for Proteobacteria, although case-control differences were observed in both genders, the nature of difference was distinct, since while in CD female patients a higher number of sequences matching this phylum was detected, in males a reduced number was observed, in comparison with controls. The species responsible for the Proteobacteria variation in both gender was Escherichia coli. Conclusions: The data presented above suggest that any analysis of dysbiosis in CD must take in account the patient's gender, an observation particularly relevant for Escherichia coli, whose association with CD has been most intensively investigated and for which the present study shows a reverse quantitative variation regarding the patients' gender.