Therapeutic option for children with esophageal caustic stenosis

Caustic ingestion is a leading cause of esophageal stenosis in children. Herein we report four cases using mitomycin C (MMC), a drug that inhibits cell division, protein synthesis and fibroblast proliferation and has been used as an adjuvant therapy for caustic esophageal stenosis that is recalcitrant to conventional dilation techniques. A retrospective chart review was performed on four pediatric patients with severe, recurrent esophageal stricture after caustic ingestion. The patients had required six to 20 esophageal dilations over a 4-16-month period before MMC application. MMC was applied after an endoscopic dilation on saturated pledgets at a dose of 0.1 mg/mL for 2 min in the area where the strictures had been lyzed. From the four children treated with MMC, two have been asymptomatic for 16 and 20 months and two still require esophageal dilation, however, at longer intervals. All patients have shown satisfactory weight gain with food intake exclusively per oral. Although further studies are required, there is strong evidence that MMC is a safe and effective adjuvant therapy in the treatment of esophageal caustic stenosis. © 2008 The Authors.

Effects of pentoxifylline and n-acetylcysteine on injuries caused by ischemia and reperfusion of splanchnic organs in rats

Aim. Occlusion and reperfusion of splanchnic arteries cause local and systemic changes due to the release of cytotoxic substances and the interaction between neutrophils and endothelial cells. This study evaluated the role of pentoxifylline (PTX) and n-acetylcysteine (NAC) in the reduction of ischemia, reperfusion shock and associated intestinal injury. Methods. Sixty rats were divided into 6 groups of 10 animals. Rats in three groups underwent mesenteric ischemia for 30 minutes followed by 120 minutes of reperfusion, and were treated with saline (SAL-5 mL/kg/ h), pentoxifylline (PTX-50 mg/kg) or n-acetylcysteine (NAC-430 mg/kg/h). The other 3 groups underwent sham ischemia and reperfusion (I/R) and received the same treatments. Hemodynamic, biochemical and histological parameters were evaluated. Results. No significant hemodynamic or intestinal histological changes were seen in any sham group. No histological changes were found in the lung or liver of animals in the different groups. There was a progressive decrease in mean arterial blood pressure, from mean of 111.53 mmHg (30 minutes of ischemia) to 44.30±19.91 mmHg in SAL-I/R. 34.52±17.22 mmHg in PTX-I/R and 33.81±8.39 mmHg in NAC-I/R (P<0.05). In all I/R groups, there was a progressive decrease in: aortic blood flow, from median baseline of 19.00 mL/min to 2.50±5.25 mL/min in SAL-I/ R; 2.95±6.40 mL/min in PTX-I/R and 3.35±3.40 mL/min in NAC-I/R (P<0.05); in the heart rate, from mean baseline of 311.74 bpm to 233.33±83.88 bpm in SAL-I/R, 243.20±73.25 bpm in PTX-I/R and 244.92±76.05 bpm in NAC-I/R (P<0.05); and esophageal temperature, from mean baseline of 33.68°C to 30.53±2.05°C in SAL-I/R, 30.69±2.21°C in PTX-I/R and 31.43±1.03°C in NAC-I/R (P<0.05). In the other hand, there was an attenuation of mucosal damage in the small intestine of the animals receiving PTX, and only in the ileum of the animals receiving NAC. No changes were found in ileum or plasma malondialdehyde levels in any group. Conclusion. PTX was more efficient in reducing histological lesions than NAC, but neither treatment prevented hemodynamic changes during splanchnic organs I/R.

The relationship between visceral fat thickness and bone mineral density in sedentary obese children and adolescents

Background: Among adults, obesity has been positively related to bone mineral density. However, recent findings have pointed out that abdominal obesity could be negatively related to bone density. The above mentioned relationship is not clear among pediatric populations. Therefore, this cross-sectional study analyzed the relationship between thickness of abdominal adipose tissue and bone mineral variables in sedentary obese children and adolescents.Methods: One hundred and seventy five obese children and adolescents (83 male and 92 female) with ages ranging from 6 to 16 years-old were analyzed. Bone mineral content and density were estimated by dual-energy X-ray absorptiometry and ultrasound equipment which estimated the thickness of the abdominal adipose tissue. Pubertal stage was self-reported by the participants.Results: The mean age was 11.1 (SD = 2.6). Thickness of the abdominal adipose tissue was negatively related to bone mineral density (r = -0.17 [r95%CI: -0.03;-0.32]), independent of gender, pubertal stage and other confounders (β = -0.134 ± 0.042 [β95%CI: -0.217; -0.050]).Conclusions: In sedentary obese children and adolescents abdominal obesity is negatively related to bone mineral density, suggesting a potential link between abdominal obesity and osteoporosis. © 2013 Júnior et al.; licensee BioMed Central Ltd.

Atrophic gastritis: Risk factor for esophageal squamous cell carcinoma in a Latin-American population

AIM: To study the association between atrophic gastritis (AG) and esophageal squamous cell carcinoma (ESCC) in a Latin-America population. METHODS: A case-control study was performed at two reference Brazilian hospitals including patients diagnosed with advanced ESCC and dyspeptic patients who had been subjected to upper gastrointestinal endoscopy, with biopsies of the gastric antrum and body. All cases with ESCC were reviewed by a single pathologist, who applied standard criteria for the diagnosis of mucosal atrophy, intestinal metaplasia, and dysplasia, all classified as AG. The data on the patients' age, sex, smoking status, and alcohol consumption were collected from clinical records, and any missing information was completed by telephone interview. The association between AG and ESCC was assessed by means of univariate and multiple conditional logistic regressions. RESULTS: Most patients were male, and the median age was 59 years (range: 37-79 years) in both the ESCC and control groups. Univariate analysis showed that an intake of ethanol greater than 32 g/d was an independent risk factor that increased the odds of ESCC 7.57 times (P = 0.014); upon multiple analysis, alcohol intake of ethanol greater than 32 g/d exhibited a risk of 4.54 (P = 0.081), as adjusted for AG and smoking. Smoking was shown to be an independent risk factor that increased the odds of ESCC 14.55 times (P = 0.011) for individuals who smoked 0 to 51 packs/year and 21.40 times (P = 0.006) for those who smoked more than 51 packs/year. Upon multiple analyses, those who smoked up to 51 packs/year exhibited a risk of 7.85 (P = 0.058), and those who smoked more than 51 packs/year had a risk 11.57 times higher (P = 0.04), as adjusted for AG and alcohol consumption. AG proved to be a risk factor that increased the odds of ESCC 5.33 times (95%CI: 1.55-18.30, P = 0.008) according to the results of univariate conditional logistic regression. CONCLUSION: There was an association by univariate conditional logistic regression between AG and ECSS in this sample of Latin-American population. © 2013 Baishideng.

Esophageal transit time assessed by magnetic methods: An in vitro feasibility study of the novel alternating current biosusceptometry with 3-axis magnetorresistor

A hybrid magnetic instrumentation to detect a magnetic field from a permanent magnet, and to detect magnetic markers and tracers using alternating current biosusceptometry (ACB) is discussed. The instrument was used to in vitro evaluation of the esophageal transit time. The sensitivity between both magnetic methods was compared, showing sensitivity for in vivo applications. © 2013 Springer-Verlag.

Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

Background: Previous studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents.Methods: Cross-sectional study. Subjects: 182 obese sedentary children and adolescents (aged 6 to 16 y), identified by the body mass index (BMI). Measurements: Body composition and trunk fat by dual-energy X-ray absorptiometry- DXA; lipid profile, blood pressure and pubertal stage were also assessed. NAFLD was classified as absent (0), mild (1), moderate (2) and severe (3), and intra-abdominal and subcutaneous abdominal fat thickness were identified by ultrasound. The MS was identified according to the cut offs proposed by World Health Organization adapted for children and adolescents. The chi-square test was used to compare categorical variables, and the binary logistic regression indicated the magnitude of the associations adjusted by potential cofounders (sex, age, maturation, NAFLD and HOMA-IR).Results: Higher quartile of SCAT was associated with elevated blood pressure (p = 0.015), but not associated with NAFLD (p = 0.665). Higher IAAT was positively associated with increased dyslipidemia (p = 0.001), MS (p = 0.013) and NAFLD (p = 0.005). Intermediate (p = 0.007) and highest (p = 0.001) quartile of IAAT were also associated with dyslipidemia, independently of age, sex, maturation, NAFLD and HOMA-IR (homeostatic model assessment-insulin resistance).Conclusion: Obese children and adolescents, with higher IAAT are more prone to develop MS and NAFLD than those with higher values of SCAT, independent of possible confounding variables. © 2013 Silveira et al.; licensee BioMed Central Ltd.

Encalhes de tubarões anequins e de raias-pretas no litoral do estado de São Paulo, sudeste do Brasil: Relato de casos

Stranding of oceanic-pelagic elasmo branchs in the southeastern Brazil are reported. Data comes from animals observed in the coast of São Paulo state, between 1999 and 2012. Nine individuals of two species were recorded: Pteroplatytrygon violacea (n = 5; mostly during the winter) and Isurus oxyrinchus (n = 4; two in the winter and two in the summer). For P. violacea the strandings restricted to the austral winter suggest that the species follows the intrusion of high temperatures water masses recorded in southeastern Brazil during this season, bringing some individuals to shallow waters. For I. oxyrinchus is possible that individuals escaped from hooks of the commercial pelagic long line fishery and suffered injuries in the esophagus and in the gastric wall, stranding due to difficulties in locomotion and feeding. As these stranded sharks were not necropsied and only two animals were observed during the austral summer, we cannot exclude other causes of beaching such diseases or the intrusion of cold water masses in the continental shelf during this season.

Avaliação da qualidade de vida em pacientes portadores de câncer de esôfago submetidos à inserção de stent esofágico auto-expansível

Pós-graduação em Bases Gerais da Cirurgia - FMB

Efeitos do refluxo gastroesofágico na cavidade oral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estado nutricional e níveis plasmáticos de trauma e seus precursores em pacientes portadores de neoplasias malignas de esôfago

Pós-graduação em Bases Gerais da Cirurgia - FMB

Estudos morfológicos e histoquímicos do tubo digestivo de Hemisorubim platyrhynchos (Valenciennes, 1840)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Estudo morfológico e histoquímico do tubo digestivo de eleuteroembriões e larvas de Leporinus obtusidens (Valenciennes, 1836)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise comparativa da expressão protéica em glândulas pós-faríngeas de saúva-limão, Atta sexdens rubropilosa Forel, 1908 (Hymenoptera: Formicidae) submetidas à suplementação lipídica

Pós-graduação em Ciências Biológicas (Biologia Celular e Molecular) - IBRC

Avaliação do tempo de trânsito esofágico de formas farmacêuticas sólidas pela cintilografia e biosusceptometria AC

Pós-graduação em Biologia Geral e Aplicada - IBB