Upper gastrointestinal bleeding due to Dieulafoy vascular lesion

One patient with massive upper GI bleeding due to Dieulafoy vascular lesion treated at our institution is reported. In this case, adequate control of bleeding could not be achieved by endoscopicmethods, and selective arteriography and embolization was required. A review of this uncommon cause of gastrointestinal bleeding and its management is presented.

Prevalencia de enfermedad de Fabry en pacientes en lista de trasplante y posttrasplante renal en fundación cardioinfantil Bogotá

Introducción: La Enfermedad de Fabry (EF), es una enfermedad multisistémica de almacenamiento lisosomal ligada al cromosoma X que afecta principalmente a hombres, pero también puede causar significativa morbilidad en las mujeres heterocigotas (1–5). La deficiencia de la enzyma α-galactosidaseA (α-Gal A,) provoca acumulación de glicosfingolipidos que afectan diferentes tipos celulares entre ellos el endotelio vascular en vasos de pequeño calibre, células epiteliales y Músculo liso en el sistema cardiovascular (cardiomiocitos), sistema nervioso y células epiteliales tubulares del riñón (6,7). Complicaciones como la falla renal es la causa de muerte más frecuente en la EF (7,8). La incidencia se ha calculado en 1 de cada 117.000 nacidos vivos. (9). Objetivos: Determinar la prevalencia de la Enfermedad de Fabry en pacientes con Insuficiencia renal terminal que se encuentren en lista de trasplante y Post-trasplante Renal en Fundación Cardioinfantil Bogotá. Materiales y Métodos: Se realizó un estudio observacional en donde se evaluó la prevalencia de la EF en todos los sujetos mayores de 18 años que se encuentren en lista de trasplante y post-trasplante renal. Resultados: La prevalencia de Enfermedad de Fabry en 98 pacientes con enfermedad renal crónica fue de 7.1% para la muestra general y 12.9% para la muestra con etiología idiopática Conclusiones: La Enfermedad de Fabry es una importante casusa de Enfermedad Renal Crónica Terminal principalmente en el grupo de etiología idiopática. Palabras Clave: Enfermedad de Fabry (FA)

Determinação da utilidade do exame radiográfico na avaliação da morfologia e patologia do trato gastrointestinal

Atualmente a radiografia é um exame complementar de diagnóstico presente na grande maioria dos centros clínicos veterinários, estando assim facilmente acessível, motivo pelo qual deverá na maioria das vezes ser o primeiro exame auxiliar de diagnóstico por imagem a ser empregue em estudos do abdómen. A radiografia convencional do trato gastrointestinal permite avaliar a posição do mesmo, o seu conteúdo e tamanho, não sendo no entanto o meio de diagnóstico mais eficaz para a avaliação da integridade da sua mucosa. Devido ao seu potencial diagnóstico, o exame radiográfico deve ser realizado para diagnóstico de patologia do TGI sempre que o animal se apresente à consulta com sinais clínicos compatíveis com patologia do mesmo, como: vómito, regurgitação, tenesmo, diarreia, disquézia, etc Assim, tendo em conta o referido tornou-se pertinente determinar qual a utilidade do exame radiográfico na prática clínica. Deste modo, o presente estudo retrospetivo tem como objetivo determinar a utilidade do exame radiográfico na avaliação da morfologia e patologia do trato gastrointestinal. Para tal foi utilizada uma amostra composta por 44 indivíduos, 35 da espécie canina e 9 da espécie felina, que realizaram consulta no Hospital Veterinário do Baixo Vouga, apresentando sintomatologia compatível com afeção do trato gastrointestinal e que realizaram exame radiográfico abdominal. No exame radiográfico avaliaram-se vários parâmetros da morfologia do estômago (conteúdo e tamanho), intestino delgado (conteúdo, diâmetro luminal e distribuição pela cavidade abdominal) e intestino grosso (conteúdo, diâmetro luminal). Com base nas observações registadas, pôde concluir-se que a observação dos órgãos do trato gastrointestinal é o fator que condiciona a avaliação morfológica radiográfica, pois sempre que estes são radiograficamente visíveis todos os fatores são passíveis de serem avaliados. Quanto à utilidade do exame radiográfico na avaliação da patologia do trato gastrointestinal, pôde concluir-se que este possui uma sensibilidade de 63,89% e especificidade de 25%, pelo que, apresenta razoável utilidade na prática clínica, justificando-se a sua realização.

Comparison of Computerized Dynamic Posturography (CDP) results with subjective visual vertical (SVV) test in patients with and without vestibular dysfunction: effects of horizontal headshaking

The goal of the study was to identify what effect headshaking in the horizontal plane has on Computerized Dynamic Posturography results in normals and patients with unilateral vestibular dysfunction. Additionally, the results were compared to results of the dynamic subjective visual vertical test.

Autonomic dysfunction in patients with migrane associated dizziness (MAD)

The goal of this project is to identify what effect vestibular stimulation has on the reaction of the autonomic nervous system, as measured by blood pressure, blood-oxygen saturation levels, and heart rate monitoring, on subjects with migraine associated dizziness (MAD) as compared to healthy non-MAD subjects.

Comparative study of the Gaze Stabilization Test (GST) and the Dynamic Visual Acuity Test (DVAT) for detecting patients with unilateral vestibular dysfunction

This paper compares the use of two diagnostic tests, Gaze Stabilization Test (GST) and the Dynamic Visual Acuity Test (DVAT) to detect unilateral vestibular dysfunction.

Bone morphogenetic proteins (BMP)-4,-6, and-7 potently suppress basal and luteinizing hormone-induced androgen production by bovine theca interna cells in primary culture: Could ovarian hyperandrogenic dysfunction be caused by a defect in thecal BMP signaling?

We reported recently that bovine theca interna cells in primary culture express several type-I and type-II receptors for bone morphogenetic proteins (BMPs). The same cells express at least two potential ligands for these receptors (BMP-4 and - 7), whereas bovine granulosa cells and oocytes express BMP-6. Therefore, BMPs of intrafollicular origin may exert autocrine/paracrine actions to modulate theca cell function. Here we report that BMP-4, - 6, and - 7 potently suppress both basal ( P < 0.0001; respective IC50 values, 0.78, 0.30, and 1.50 ng/ml) and LH-induced ( P < 0.0001; respective IC50 values, 5.00, 0.55, and 4.55 ng/ml) androgen production by bovine theca cells while having only a moderate effect on progesterone production and cell number. Semiquantitative RT-PCR showed that all three BMPs markedly reduced steady-state levels of mRNA for P450c17. Levels of mRNA encoding steroidogenic acute regulatory protein, P450scc, and 3 beta-hydroxysteroid dehydrogenase were also reduced but to a much lesser extent. Immunocytochemistry confirmed a marked reduction in cellular content of P450c17 protein after BMP treatment ( P < 0.001). Exposure to BMPs led to cellular accumulation of phosphorylated Smad1, but not Smad2, confirming that the receptors signal via a Smad1 pathway. The specificity of the BMP response was further explored by coincubating cells with BMPs and several potential BMP antagonists, chordin, gremlin, and follistatin. Gremlin and chordin were found to be effective antagonists of BMP-4 and - 7, respectively, and the observation that both antagonists enhanced ( P < 0.01) androgen production in the absence of exogenous BMP suggests an autocrine/paracrine role for theca-derived BMP- 4 and - 7 in modulating androgen production. Collectively, these data indicate that an intrafollicular BMP signaling pathway contributes to the negative regulation of thecal androgen production and that ovarian hyperandrogenic dysfunction could be a result of a defective autoregulatory pathway involving thecal BMP signaling.

Survivability of a probiotic Lactobacillus casei in the gastrointestinal tract of healthy human volunteers and its impact on the faecal microflora

Aim: The aim of this study was to measure the gastrointestinal survival of Lactobacillus casei and its impact on the gut microflora in healthy human volunteers. Methods and Results: Twenty healthy volunteers took part in a double-blind placebo-controlled probiotic feeding study (10 fed probiotic, 10 fed placebo). The probiotic was delivered in two 65 ml aliquots of fermented milk drink (FMD) daily for 21 days at a dose of 8.6 +/- 0.1 Log(10)Lact. casei CFU ml(-1) FMD. Faecal samples were collected before, during and after FMD or placebo consumption, and important groups of faecal bacteria enumerated by fluorescent in situ hybridization (FISH) using oligonucleotide probes targeting the 16S rRNA. The fed Lact. casei was enumerated using selective nutrient agar and colony identity confirmed by pulsed field gel electrophoresis. Seven days after ingestion of FMD, the Lact. casei was recovered from faecal samples taken from the active treatment group at 7.1 +/- 0.4 Log(10) CFU g(-1) faeces (mean +/- SD, n = 9) and numbers were maintained at this level until day 21. Lact. casei persisted in six volunteers until day 28 at 5.0 +/- 0.9 Log(10) CFU g(-1) faeces (mean +/- SD, n = 6). Numbers of faecal lactobacilli increased significantly upon FMD ingestion. In addition, the numbers of bifidobacteria were higher on days 7 and 21 than on days 0 and 28 in both FMD fed and placebo fed groups. Consumption of Lact. casei had little discernible effect on other bacterial groups enumerated. Conclusions: Daily consumption of FMD enabled a probiotic Lact. casei strain to be maintained in the gastrointestinal tract of volunteers at a stable relatively high population level during the probiotic feeding period. Significance and Impact of the Study: The study has confirmed that this probiotic version of Lact. casei survives well within the human gastrointestinal tract.

The role of the gastrointestinal microbiota in colorectal cancer

Both environmental and genetic factors contribute to cancers of the gastrointestinal tract including, the stomach, colon and rectum. The mechanisms associated with gastrointestinal cancer causation and prevention are largely unknown and the subject of much research. Many of the proposed mechanisms implicate the metabolic activities of the bacterial biota normally resident in the gastrointestinal tract. This review examines both the adverse and beneficial consequences of bacterial activity of the gastrointestinal tract focusing, in particularly on the stomach and large intestine. Studies on the role of the bacterial biota in colon carcinogenesis have also resulted in several useful biomarkers for use in human.

Bacterial biofilms in the human gastrointestinal tract

Microbial biofilms were first described in 1936 and subsequent research has unveiled their ubiquity and physiological distinction from free-living (planktonic) microorganisms. In light of their emerging significance this review examines the bacterial biofilms within the human gastrointestinal tract. Attention is paid to the nature of these mucosally- associated populations, focusing on the protected environment afforded by the continual secretion of mucus by host epithelial cells. It also examines the attributes possessed by various bacterial species that facilitate habitation of this microenvironment. Additionally, contrasts are drawn between planktonic bacteria of the lumen and sessile (biofilm) bacteria growing in close association with host cells and food particles. In particular the different fermentation profiles exhibited by these two fractions are discussed. The potential role of these communities in host health and disease, as well as the stabilisation of the lumenal population, is also considered. Reference is made to the state of mutualism that exists between these little understood populations and the host epithelia, thus highlighting their ecological significance in terms of gastrointestinal health.