927 resultados para Intestinal obstruction
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The aim of this work was to analyze the acute oral toxicity and the effects on intestinal motility of the extract obtained through decoction 20% (m/v) of Endopleura uchi, popularly known as "uxi-amarelo", a native plant from the Brazilian Amazon. The plant is used indiscriminately against several diseases: arthritis, cholesterol, diabetes, ulcers, myomas, and intestinal illnesses in general, among others. The present results show that there were no significant alterations in intestinal motility and that the extract does not present signs of toxicity, showing its safety for consumption purposes.
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Pós-graduação em Patologia - FMB
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Aims: The objective of this study is to create an experimental model of intestinal endometriosis in pigs, which might allow better understanding of deep infiltrating endometriosis and development of new treatment techniques. As secondary objective, we intend to create endometrial implants accessible by transrectal ultrasonography (TRUS). Study Design: Surgical experimental study in swine. Place and Duration of Study: This study was performed at the Instituto de Ensino e Pesquisa do Hospital Sírio-Libanês, São Paulo, Brazil, between January 2012 and December 2012. Methodology: Two sexually mature female minipigBR pigs underwent two laparotomies (each animal). The first laparotomy was performed to implant two fragments of autologous endometrium in the rectal wall. The second one was performed thirty days later to visualize, measure and obtain tissue of the site of the implants for histopathology study. A TRUS study was performed prior to the second surgery. The Institution’s Animal Utilization Study Committee approved the study. Results: In the first laparotomy a 5-cm segment of right uterine horn was resected. The endometrium was separated from the myometrium through sub-endometrial saline injection. Two endometrial fragments (1.0 x 2.0 cm) were dissected and sutured in the intra peritoneal anterior rectal wall of the animals. Thirty days later, all implants were identified during preoperative TRUS. “En-bloc” resection of the intestinal segment with the implants was performed during the second surgery. The autologous implants of endometrium invaded the muscular layer in one of the two animals. Conclusion: We demonstrated that the creation of an animal model of deep infiltrating endometriosis with intestinal involvement is feasible through a simple surgical technique. We believe that this model can be applied in experimental and clinical studies but further studies are necessary to refine the technique.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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This study compared acid-base and biochemical changes and quality of recovery in male cats with experimentally induced urethral obstruction and anesthetized with either propofol or a combination of ketamine and diazepam for urethral catheterization. Ten male cats with urethral obstruction were enrolled for urethral catheterization and anesthetized with either ketamine-diazepam (KD) or propofol (P). Lactated Ringer's solution was administered by intravenous (IV) beginning 15 min before and continuing for 48 h after relief of urethral obstruction. Quality of recovery and time to standing were evaluated. The urethral catheter was maintained to measure urinary output. Hematocrit (Hct), total plasma protein (TPP), albumin, total protein (TP), blood urea nitrogen (BUN), creatinine, pH, bicarbonate (HCO3-), chloride, base excess, anion gap, sodium, potassium, and partial pressure of carbon dioxide in mixed venous blood (pvCO(2)) were measured before urethral obstruction, at start of fluid therapy (0 h), and at subsequent intervals. The quality of recovery and time to standing were respectively 4 and 75 min in the KD group and 5 and 16 min in the P group. The blood urea nitrogen values were increased at 0, 2, and 8 h in both groups. Serum creatinine increased at 0 and 2 h in cats administered KD and at 0, 2, and 8 h in cats receiving P, although the values were above the reference range in both groups until 8 h. Acidosis occurred for up to 2 h in both groups. Acid-base and biochemical stabilization were similar in cats anesthetized with propofol or with ketamine-diazepam. Cats that received propofol recovered much faster, but the ketamine-diazepam combination was shown to be more advantageous when treating uncooperative cats as it can be administered by intramuscular (IM) injection.
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Background & aims: Altered intestinal permeability has been shown to be associated with metabolic alterations in animal models of obesity, but not in humans. The aim of this study was to assess intestinal permeability in obese women and verify if there is any association with anthropometric measurements, body composition or biochemical variables. Methods: Twenty lean and twenty obese females participated in the study. Anthropometric measurements, body composition and blood pressure were assessed and biochemical analyses were performed. Administration of lactulose and mannitol followed by their quantification in urine was used to assess the intestinal permeability of volunteers. Results: The obese group showed lower HDL (p < 0.05), higher fasting glucose, insulin, HOMA index and lactulose excretion than the lean group (p < 0.05), suggesting increased paracellular permeability. Lactulose excretion showed positive correlation (p < 0.05) with waist and abdominal circumference. Blood insulin and the HOMA index also increased with the increase in mannitol and lactulose excretion and in the L/M ratio (p < 0.05). L/M ratio presented a negative correlation with HDL concentration (p < 0.05). Conclusions: We demonstrated that intestinal permeability parameters in obese women are positively correlated with anthropometric measurements and metabolic variables. Therapeutic interventions focused on intestine health and the modulation of intestinal permeability should be explored in the context of obesity. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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The immunoglobulin G (IgG) uptake and enterocyte nucleus position in the villous were studied in newborn goat kids fed goat or lyophilized bovine colostrum. Two groups of 15 newborn goat kids, each received 5% of body weight of goat colostrum (GC) or lyophilized bovine colostrum (LBC) containing 55 mg/mL of immunoglobulin G (IgG) at 0, 7 and 14 h of life. Three animals were sampled just after birth, receiving no colostrum intake, to be used as control. Samples of duodenum, medium jejunum and ileum were collected at 0, 18, 36 and 96 h of life. IgG vacuoles were not observed in the duodenum throughout the experiment regardless of all the experimental time points. In this segment, at 0, 18 and 36 h of life, nuclei were found in the apical, medial and basal positions in the enterocytes, and localized in the upper, medial and lower parts in the villous, respectively. At 96 h, a basal nuclei position was observed in the enterocytes, throughout the villous. In jejunum, IgG vacuoles were distributed along the villous at 18 and 36 h. In this segment at Oh the nuclei were positioned predominantly apically in the enterocytes, throughout the villous. At 18 and 36 h, no consistent nuclei pattern was verified: however at 96 h, the nuclei were positioned basally in the enterocytes, throughout the jejunal villous. In the ileum at 0, 18 and 36 h, a great number of vacuoles without IgG were verified in the medial-apical part of the villous. In this segment, at Oh of life and 96 h of life, the predominance of basal nuclei was observed. Nuclei were positioned in medial-apically part of the ileal enterocytes in the upper part of the villous at 18 and 36 h. It was found that the jejunal epithelium was the most important segment related to absorption process. The IgG absorption and nucleus position in the newborn goats were dependent on the small intestine segments and experimental time points, regardless of the colostrum source. GC or LCB. Considering the IgG uptake mechanism observed in the present study, the lyophilized bovine colostrum might be used instead of goat colostrum. (C) 2011 Elsevier B.V. All rights reserved.
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Colostrum intake in newborn goat kids is essential for the acquisition of immunoglobulins (Ig) and influencing development of gastrointestinal mucosa. The present study investigated small intestine structure in the postnatal goat kid fed lyophilized bovine colostrum, an alternative source of antibodies to small ruminants, or goat colostrum using scanning electron microscopy technique. At 0,7 and 14 h of life 15 male newborns received 5% of body weight of lyophilized bovine colostrum (LBC) and 14 goat colostrum (GC), both with 55 mg/mL of IgG. Samples of duodenum, medium jejunum and ileum were collected at 18, 36 and 96 h of life. Three animals were sampled at birth without colostrum intake (0 h). The enteric tissues were analyzed for villi density (villi/cm(2)) and morphological characteristics. The villi density did not differ between treatment, sampling time and intestinal segments (P>0.05). The morphological characteristics were not different between LBC and GC in all segments. Duodenal villi were fingerlike, thick and short, and with different heights. Duodenal folds could also be verified. Frequent anastomoses in all sampling times were observed in this segment. In the jejunum, fingerlike villi, thin and thick, of different heights were observed in all sampling times as well as leaf-shaped villi. Vacuoles with colostrum were observed in the jejunum of goats sampled at 18 h of life. In ileum, fingerlike villi were observed in all sampling times. At 0 and 96 h of life, thick and low villi were verified while at 18 and 36 h the villi showed different heights and widths. At all sampling times, regularly cell extrusion processes were observed with grouped cells at the apex of the ileum villi and with isolated cells along the villi. In the first 4 days of goat kids' life the small intestine structure was unaffected by different sources of colostrum, goat or lyophilized bovine, and by the replacement of fetal enterocytes, which are able to absorb macromolecules, by adult-type ones. (C) 2011 Elsevier B.V. All rights reserved.
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AIM: To evaluate the results of duodenal stenting for palliation of gastroduodenal malignant obstruction by using a gastric outlet obstruction score (GOOS). METHODS: A prospective, non-randomized study was performed at a tertiary center between August 2005 and April 2010. Patients were eligible if they had malignant gastric outlet obstruction (GOO) and were not candidates for surgical treatment. Medical history and patient demographics were collected at baseline. Scheduled interviews were made on the day of the procedure and 15, 30, 90 and 180 d later or unscheduled as necessary. RESULTS: Fifteen patients (6 male, 9 female; median age 61 years) with GOO who had undergone duodenal stenting were evaluated. Ten patients had metastasis at baseline (66.6%) and 14 were unable to accept oral intake (93.33%), including 7 patients who were using a feeding tube. Laboratory data showed biliary obstruction in eight cases (53.33%); all were submitted to biliary drainage. Two patients developed obstructive symptoms due to tumor ingrowth after 30 d and another due to tumor overgrowth after 180 d. Two cases of stent migration occurred. A good response to treatment was observed, with a mean time of approximately 1 d (19 h) until toleration of a liquid diet and slightly more than 2 d for both soft solids (51 h) and a solid food/normal diet (55 h). The mean time to first failure to maintain liquid intake (GODS >= 1) was 93 d. During follow-up, the mean time to first failure to maintain the previously achieved GODS of 2-3 (solid/semi-solid food), considered technical failure, was 71 d. On the basis of oral intake a GODS is defined: 0 for no oral intake; 1 for liquids only; 2 for soft solids only; 3 for low-residue or full diet. CONCLUSION: Enteral stenting to alleviate gastroduodenal malignant obstruction improves quality of life in patients with limited life expectancy, which can be evaluated by using a GOO scoring system. (C) 2012 Baishideng. All rights reserved.
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Recent investigation of the intestine following ischemia and reperfusion (I/R) has revealed that nitric oxide synthase (NOS) neurons are more strongly affected than other neuron types. This implies that NO originating from NOS neurons contributes to neuronal damage. However, there is also evidence of the neuroprotective effects of NO. In this study, we compared the effects of I/R on the intestines of neuronal NOS knockout (nNOS(-/-)) mice and wild-type mice. I/R caused histological damage to the mucosa and muscle and infiltration of neutrophils into the external muscle layers. Damage to the mucosa and muscle was more severe and greater infiltration by neutrophils occurred in the first 24 h in nNOS(-/-) mice. Immunohistochemistry for the contractile protein, alpha-smooth muscle actin, was used to evaluate muscle damage. Smooth muscle actin occurred in the majority of smooth muscle cells in the external musculature of normal mice but was absent from most cells and was reduced in the cytoplasm of other cells following I/R. The loss was greater in nNOS(-/-) mice. Basal contractile activity of the longitudinal muscle and contractile responses to nerve stimulation or a muscarinic agonist were reduced in regions subjected to I/R and the effects were greater in nNOS(-/-) mice. Reductions in responsiveness also occurred in regions of operated mice not subjected to I/R. This is attributed to post-operative ileus that is not significantly affected by knockout of nNOS. The results indicate that deleterious effects are greater in regions subjected to I/R in mice lacking nNOS compared with normal mice, implying that NO produced by nNOS has protective effects that outweigh any damaging effect of this free radical produced by enteric neurons.
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Naasal obstruction is a common complaint in the population. When caused by a deviated nasal septum, septoplasty is the procedure of choice for treating these patients. NOSE is a tool for assessing the disease-specific quality of life related to nasal obstruction. Aim: To assess the impact of septoplasty on patients with nasal obstruction secondary to deviated nasal septum based on the disease-specific quality-of-life questionnaire. Design: Prospective. Methods: Patients undergoing septoplasty with/without turbinectomy after no clinical improvement with medical treatment were assessed by the NOSE questionnaire before and 3 months after surgery. We evaluated the surgical improvement based on total score, the magnitude of the surgery in the disease-specific quality of life and the correlation between the preoperative score and postoperatively improvement. Results: Fourty-six patients were included in the study. There was a statistically significant improvement in the preoperative NOSE score (md = 75, IQR = 26) and after three months (md = 10, IQR = 20) (p < 0.001.T-Wilcoxon). The standardized response mean was 3.07. We found a strong correlation between the preoperative score in the NOSE questionnaire and improvements in the postoperative period (r = -0.789, p < 0.001, Spearman). No difference was found in improvement scores by gender. (p = 0.668, U-Mann-Whitney). Conclusion: Septoplasty resulted in a statistically significant improvement in the disease-specific QOL questionnaire.
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The present report describes an 8-year-old gelding presenting with signs of severe abdominal pain. After performing a thorough physical examination, including rectal palpation and additional diagnostic tests, an exploratory laparotomy was recommended. The jejunum was found herniated through the gastrosplenic ligament, and the stomach was severely distended with gas. Given a poor prognosis, the horse was euthanized on the table. At necropsy, the stomach appeared dilated, with an 180 horizontal gastric torsion, from left (lateral) to right (medial), dividing the organ into dorsal and ventral compartments. We believe that the chronic traction exerted by an incarcerated and distended loop of jejunum, in the dorsal aspect of the gastrosplenic ligament, associated with trauma during episodes of intense rolling, enlarged the rent until it ruptured. Because of this rupture, the lateral dorsal aspect of the stomach became unattached, predisposing it to the torsion. (C) 2012 Elsevier Inc. All rights reserved.