Interaction between vitamin K nutriture and bacterial overgrowth in hypochlorhydria induced by omeprazole

Subjects taking a hydrogen pump blocking agent (omeprazole) develop bacterial overgrowth of the small intestine. We tested the hypothesis that this bacterial overgrowth produces menaquinones, which would meet the Vitamin requirement in situations of vitamin K deficiency. In a crossover-type design, 13 healthy Volunteers eating a phylloquinone-restricted diet for 35 d were randomly assigned to take omeprazole during the first period of study or starting on day 15 until the end of the study. Coagulation times, serum osteocalcin [total osteocalcin and undercarboxylated osteocalcin (ucOC)], plasma phylloquinone, urinary gamma-carboxyglutamic acid, and plasma undercarboxylated prothrombin (PIVKA-II) were measured. Plasma phylloquinone concentrations declined 82% with dietary phylloquinone restriction (P < 0.05) and were not significantly different in the period when the diet was combined with omeprazole treatment (P > 0.05), the mean value for PIVKA-II during the phylloquinone-restricted diet significantly increased 5.7-fold from baseline (P < 0.05); however, the combination of omeprazole treatment and the phylloquinone-restricted diet significantly reduced PIVKA-II values by 21% (P < 0.05) compared with the diet period alone. There were no alterations in total or percentage ucOC concentrations during the phylloquinone-restricted diet or during the period of diet plus omeprazole treatment. Our data support the hypothesis that bacterial overgrowth results in the synthesis and absorption of menaquinones. These menaquinones contribute to vitamin K nutriture during dietary phylloquinone restriction, but not enough to restore normal vitamin K status.

The interaction between vitamin K nutriture and warfarin administration in patients with bacterial overgrowth due to atrophic gastritis

Atrophic gastritis patients have intestinal bacterial overgrowth which could produce menaquinones. The aim of this study was to evaluate the interaction between a diet low in phylloquinone and minidoses of warfarin in subjects with and without bacterial overgrowth. Subjects with atrophic gastritis (indicated by serum pepsinogen ratio) and healthy volunteers were studied while fed a restrictive phylloquinone diet and while receiving a minidose of warfarin. Coagulation times, serum osteocalcin, serum undercarboxylated osteocalcin, plasma phylloquinone, plasma K-epoxide, plasma undercarboxylated prothrombin (PIVKA)-II and urinary gamma-carboxyglutamic acid (Gla) were measured. At baseline, there were no differences between groups for any variable measured. Comparisons between baseline and post intervention in both groups, showed significant increases in circulating levels of K-epoxide, PIVKA II and undercarboxylated osteocalcin. However, no differences were observed when comparisons were made between groups. Our data do not support the hypothesis that bacterial synthesis of menaquinones in patients with bacterial overgrowth due to atrophic gastritis confers considerable resistance to the effect of warfarin.

Prevalência, classificação e características do refluxo cecoileal diagnosticado pelo enema opaco

OBJETIVO: Verificar, retrospectivamente, a prevalência do refluxo cecoileal diagnosticado pelo enema opaco, caracterizar sua distribuição etária e sexual e classificá-lo conforme o grau de intensidade. MATERIAIS E MÉTODOS: Foram revistos 715 enemas opacos, incluindo 268 homens e 447 mulheres com idade média de 54 anos. RESULTADOS: Dos 715 casos examinados, 46,5% apresentaram refluxo cecoileal, sendo 45% do tipo leve, 37,5% do tipo moderado e 17,5% do tipo severo. Refluxo cecoileal esteve presente em 48,3% das mulheres e em 43,6% dos homens. A distribuição percentual do refluxo cecoileal por faixa etária mostrou 46,1% nos indivíduos com menos de 21 anos, 42,1% nos indivíduos entre 21-40 anos, 49,8% nos indivíduos entre 41-60 anos e 44,7% nos indivíduos com mais de 60 anos. CONCLUSÃO: Refluxo cecoileal foi achado relativamente freqüente em nosso material, correspondendo os graus moderado e severo a 25% do material examinado. Aparentemente, não há associação entre seu surgimento e sexo ou idade. A etiopatogenia e conseqüências do refluxo cecoileal são ainda pouco conhecidas. Alguns estudos sugerem que o comprometimento de componentes da junção ileocecal, como os ligamentos, pode favorecer seu aparecimento. Entre as conseqüências prováveis, incluem-se a contaminação e alteração motora ileais, resultantes do material refluído do ceco.

Causas da desnutrição pós-gastrectomia

Racional A retirada total ou parcial do estômago resulta em conseqüências nutricionais, agudas ou crônicas, perfeitamente prognosticáveis, mas nem sempre ponderadas na terapia pós-operatória. Objetivo - Rever as participações mecânicas e químicas do estômago no aproveitamento do nutriente dietético, e as conseqüências nutricionais da gastrectomia. Resultados - A deficiência energética, com conseqüente perda de peso, acompanha inversamente o volume gástrico remanescente e o tempo pós-operatório; tem a anorexia e diarréia (má absorção) como principais causas, sendo a primeira decorrente de fatores emocionais ou de mediadores químicos de ação hipotalâmica. A diarréia pode ser decorrente da maior motilidade ou do supercrescimento bacteriano intestinais, com o agravante da insuficiência pancreática exócrina e maior esvaziamento da vesícula biliar. A má absorção traz conseqüências não apenas energética-protéica com a perda fecal de gordura e nitrogênio, como também vitamínico-mineral pelo menor aproveitamento da vitamina D e cálcio dietéticos. A anemia verificada no gastrectomizado é conseqüente à diminuição da produção de HCl (e menor solubilização do ferro) e do fator intrínseco (com menor absorção da vitamina B12). Conclusão - Perda de peso e anemia são os sinais de desnutrição mais comumente observados nestes pacientes, em intensidade e duração variáveis dependentes do tipo de cirurgia e do tempo e tratamento nutricional pós-operatório, sendo recomendável o tratamento dietético supervisionado.

The small bowel flora in individuals with cecoileal reflux

RACIONAL: Fato de observação não rara, é o encontro de refluxo cecoileal durante realização de enema opaco. As causas e conseqüências deste achado têm sido pouco estudadas. OBJETIVOS: Sabendo que a junção ileocecal exerce função de barreira e proteção contra a invasão do delgado pela flora colônica, realizou-se o presente estudo com a finalidade de investigar se existe contaminação ileal em indivíduos com refluxo cecoileal ao enema opaco. MÉTODOS: Investigaram-se 36 indivíduos, 30 mulheres e 6 homens, idade média de 54 anos, 25 com e 11 com ausência refluxo cecoileal. Todos submetidos a pesquisa de contaminação bacteriana do delgado por intermédio de teste respiratório com lactulose-H2 e a determinação do tempo de trânsito orocecal por meio de biossusceptometria de corrente alternada. A caracterização da contaminação do delgado foi baseada no encurtamento do tempo de trânsito orocecal medido pelo teste da lactulose-H2. RESULTADOS: A comparação dos valores basais do H2, do tempo de trânsito orocecal-H2 e tempo de trânsito orocecal-biossusceptometria de corrente alternada não diferiram estatisticamente entre os grupos com e sem refluxo cecoileal. Quando comparados os tempo de trânsito orocecal-H2 e tempo de trânsito orocecal-biossusceptometria, foi observado aumento de tendência de redução do primeiro em relação ao último nos grupos com refluxo cecoileal e correlação significante entre os dois métodos apenas no grupo-controle, inexistindo nos com refluxo cecoileal. CONCLUSÃO: Encurtamento do tempo de trânsito orocecal-H2 e sua perda de correlação com o tempo de trânsito orocecal-biossusceptometria observado em indivíduos com refluxo cecoileal, sugerem comportamento diferenciado deste grupo em relação ao grupo-controle. Possível explicação para as diferenças registradas entre os grupos, seria a presença de flora anômala nos indivíduos com refluxo cecoileal.

Gastrointestinal changes associated to heart failure

Over the last decade, several studies were conducted on the gastrointestinal changes associated to chronic heart failure. This article presents a literature review on the physiopathology and clinical consequences of pathological digestive changes of heart failure patients. Structural and functional abnormalities of the gastrointestinal tract, such as edema of absorptive mucosa and intestinal bacterial overgrowth, have been leading to serious clinical consequences. Some of these consequences are cardiac cachexia, systemic inflammatory activation and anemia. These conditions, alone or in combination, may lead to worsening of the pre-existing ventricular dysfunction. Although currently there is no therapy specifically earmarked for gastrointestinal changes associated to heart failure, the understanding of digestive abnormalities is germane for the prevention and management of systemic consequences.

Functional Aesthetic Treatment of Patient With Phenytoin-Induced Gingival Overgrowth

Gingival overgrowth (GO) may be related to the frequent use of certain medications, such as cyclosporin, phenytoin (PHT), and nifedipine, and is therefore denominated drug-induced GO. This article reports a case of a patient who with chronic periodontitis made use of PHT and presented generalized GO. A 30-year-old man with GO was referred to the clinic of the Universidade Estadual Paulista, Brazil. The complaint was poor aesthetics because of the GO. The patient had a medical history of a controlled epileptic state, and PHT was administered as an anticonvulsant medication. The clinical examination showed generalized edematous gingival tissues and presence of bacterial plaque and calculus on the surfaces of the teeth. The diagnosis was GO associated with PHT because no other risk factors were identified. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation, prophylaxis, and daily chlorhexidine mouth rinses. After this stage, periodontal surgery was performed, and histopathologic evaluation was made. The patient has been under control for 3 years after the periodontal surgery, and up to the present time, there has been no recurrence. It can be concluded that PHT associated with the presence of irritants favored gingival growth and that the association of nonsurgical and surgical periodontal therapies was effective in the treatment of GO. Besides, motivating the patient to maintain oral hygiene is a prerequisite for the maintenance of periodontal health.

The bacterial chromosome segregation protein Spo0J spreads along DNA from parS nucleation sites

Regulation of chromosome inheritance is essential to ensure proper transmission of genetic information. To accomplish accurate genome segregation, cells organize their chromosomes and actively separate them prior to cytokinesis. In Bacillus subtilis the Spo0J protein is required for accurate chromosome segregation and it regulates the developmental switch from vegetative growth to sporulation. Spo0J is a DNA-binding protein that recognizes at least eight identified parS sites located near the origin of replication. As judged by fluorescence microscopy, Spo0J forms discrete foci associated with the oriC region of the chromosome throughout the cell cycle. In an attempt to determine the mechanisms utilized by Spo0J to facilitate productive chromosome segregation, we have investigated the DNA binding activity of Spo0J. In vivo we find Spo0J associates with several kilobases of DNA flanking its specific binding sites (parS) through a parS-dependent nucleation event that promotes lateral spreading of Spo0J along the chromosome. Using purified components we find that Spo0J has the ability to coat non-specific DNA substrates. These 'Spo0J domains' provide large structures near oriC that could potentially demark, organize or localize the origin region of the chromosome.

Molecular analysis of the bacterial diversity in a specialized consortium for diesel oil degradation

Diesel oil is a compound derived from petroleum, consisting primarily of hydrocarbons. Poor conditions in transportation and storage of this product can contribute significantly to accidental spills causing serious ecological problems in soil and water and affecting the diversity of the microbial environment. The cloning and sequencing of the 16S rRNA gene is one of the molecular techniques that allows estimation and comparison of the microbial diversity in different environmental samples. The aim of this work was to estimate the diversity of microorganisms from the Bacteria domain in a consortium specialized in diesel oil degradation through partial sequencing of the 16S rRNA gene. After the extraction of DNA metagenomics, the material was amplified by PCR reaction using specific oligonucleotide primers for the 16S rRNA gene. The PCR products were cloned into a pGEM-T-Easy vector (Promega), and Escherichia coli was used as the host cell for recombinant DNAs. The partial clone sequencing was obtained using universal oligonucleotide primers from the vector. The genetic library obtained generated 431 clones. All the sequenced clones presented similarity to phylum Proteobacteria, with Gammaproteobacteria the most present group (49.8 % of the clones), followed by Alphaproteobacteira (44.8 %) and Betaproteobacteria (5.4 %). The Pseudomonas genus was the most abundant in the metagenomic library, followed by the Parvibaculum and the Sphingobium genus, respectively. After partial sequencing of the 16S rRNA, the diversity of the bacterial consortium was estimated using DOTUR software. When comparing these sequences to the database from the National Center for Biotechnology Information (NCBI), a strong correlation was found between the data generated by the software used and the data deposited in NCBI.

Molecular detection of tick-borne bacterial agents in Brazilian and exotic captive carnivores

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

Bacterial diversity in soil in response to different plans, phosphate fertilizers and liming

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

Bacterial diversity of terra preta and pristine forest soil from the Western Amazon

The survey presented here describes the bacterial diversity and community structures of a pristine forest soil and an anthropogenic, terra preta from the Western Amazon forest using molecular methods to identify the predominant phylogenetic groups. Bacterial community similarities and species diversity in the two soils were compared using oligonucleotide fingerprint grouping of 16S rRNA gene sequences for 1500 clones (OFRG) and by DNA sequencing. The results showed that both soils had similar bacterial community compositions over a range of phylogenetic distances, among which Acidobacteria were predominant, but that terra preta supported approximately 25% greater species richness. The survey provides the first detailed analysis of the composition and structure of bacterial communities from terra preta anthrosols using noncultured-based molecular methods. (c) 2006 Elsevier Ltd. All rights reserved.

Bacterial functional redundancy along a soil reclamation gradient

A strategy to measure bacterial functional redundancy was developed and tested with soils collected along a soil reclamation gradient by determining the richness and diversity of bacterial groups capable of in situ growth on selected carbon substrates. Soil cores were collected from four sites along a transect from the Jamari tin mine site in the Jamari National Forest, Rondonia, RO, Brazil: denuded mine spoil, soil from below the canopy of invading pioneer trees, revegetated soil under new growth on the forest edge, and the forest floor of an adjacent preserved forest. Bacterial population responses were analyzed by amending these soil samples with individual carbon substrates in the presence of bromodeoxyuridine (BrdU), BrdU-labeled DNA was then subjected to a 16S-23S rRNA intergenic analysis to depict the actively growing bacteria from each site, the number and diversity of bacterial groups responding to four carbon substrates (L-serine, L-threonine, sodium citrate, and or-lactose hydrate) increased along the reclamation-vegetation gradient such that the preserved forest soil samples contained the highest functional redundancy for each substrate. These data suggest that bacterial functional redundancy increases in relation to the regrowth of plant communities and may therefore represent an important aspect of the restoration of soil biological functionality to reclaimed mine spoils. They also suggest that bacterial functional redundancy may be a useful indicator of soil quality and ecosystem functioning.

A novel system for large-scale gene expression analysis: bacterial colonies array

In the present work, we report the use of bacterial colonies to optimize macroarray technique. The devised system is significantly cheaper than other methods available to detect large-scale differential gene expression. Recombinant Escherichia coli clones containing plasmid-encoded copies of 4,608 individual expressed sequence tag (ESTs) were robotically spotted onto nylon membranes that were incubated for 6 and 12 h to allow the bacteria to grow and, consequently, amplify the cloned ESTs. The membranes were then hybridized with a beta-lactamase gene specific probe from the recombinant plasmid and, subsequently, phosphorimaged to quantify the microbial cells. Variance analysis demonstrated that the spot hybridization signal intensity was similar for 3,954 ESTs (85.8%) after 6 h of bacterial growth. Membranes spotted with bacteria colonies grown for 12 h had 4,017 ESTs (87.2%) with comparable signal intensity but the signal to noise ratio was fivefold higher. Taken together, the results of this study indicate that it is possible to investigate large-scale gene expression using macroarrays based on bacterial colonies grown for 6 h onto membranes.