Risques et bénéfices d'une approche interventionnelle face aux corps étrangers digestifs [Digestive foreign body management].

Foreign body (FB) ingestion is a frequent reason for gastroenterology consulting. Eighty percent of these ingestions are accidental and observed among paediatric subjects. However, intentional repetitive ingestions are also observed, especially amongst prisoners or psychiatric patients. Most FBs pass throughout the digestive tract without any complication and without any need for surgical or endoscopic intervention. Nevertheless, around 10-20% of cases require an endoscopy examination and 1% will lead to a surgical intervention. Management approaches should favor inter-disciplinarity, balance benefits and risks of FB removal based on its location, and integrate psychiatric comorbidities into the decision process.

Insulin-Like growth-factor 1 myocardial expression decreases in chronic alcohol consumption

Background Chronic alcohol ingestion may cause severe biochemical and pathophysiological derangements to skeletal muscle. Unfortunately, these alcohol-induced events may also prime skeletal muscle for worsened, delayed, or possibly incomplete repair following acute injury. As alcoholics may be at increased risk for skeletal muscle injury, our goals were to identify the effects of chronic alcohol ingestion on components of skeletal muscle regeneration. To accomplish this, age- and gender-matched C57Bl/6 mice were provided normal drinking water or water that contained 20% alcohol (v/v) for 18-20 wk. Subgroups of mice were injected with a 1.2% barium chloride (BaCl2) solution into the tibialis anterior (TA) muscle to initiate degeneration and regeneration processes. Body weights and voluntary wheel running distances were recorded during the course of recovery. Muscles were harvested at 2, 7 or 14 days post-injection and assessed for markers of inflammation and oxidant stress, fiber cross-sectional areas, levels of growth and fibrotic factors, and fibrosis. Results Body weights of injured, alcohol-fed mice were reduced during the first week of recovery. These mice also ran significantly shorter distances over the two weeks following injury compared to uninjured, alcoholics. Injured TA muscles from alcohol-fed mice had increased TNFα and IL6 gene levels compared to controls 2 days after injury. Total protein oxidant stress and alterations to glutathione homeostasis were also evident at 7 and 14 days after injury. Ciliary neurotrophic factor (CNTF) induction was delayed in injured muscles from alcohol-fed mice which may explain, in part, why fiber cross-sectional area failed to normalize 14 days following injury. Gene levels of TGFβ1 were induced early following injury before normalizing in muscle from alcohol-fed mice compared to controls. However, TGFβ1 protein content was consistently elevated in injured muscle regardless of diet. Fibrosis was increased in injured, muscle from alcohol-fed mice at 7 and 14 days of recovery compared to injured controls. Conclusions Chronic alcohol ingestion appears to delay the normal regenerative response following significant skeletal muscle injury. This is evidenced by reduced cross-sectional areas of regenerated fibers, increased fibrosis, and altered temporal expression of well-described growth and fibrotic factors.

Response of hexokinase enzymes and the insulin system to dietary carbohydrates in the common carp, Cyprinus carpio.

The response of the common carp to diets with varying amounts of digestible starch, provided either as pea meal (LP, HP, 30 and 46% peas, respectively) or as cereal (LW, HW, 30 and 46% wheat, respectively), was studied and compared with the response to a carbohydrate-free protein-rich diet (CF). Here we focused on the utilisation of dietary carbohydrates by examining the relationship between dietary starch intake, hepatic hexokinase activities, circulating insulin and muscle insulin receptor system. Plasma glucose concentration and hepatic high Km hexokinase (glucokinase, GK) activity were not affected by the content of digestible starch, but 6 h after feeding enzyme activity was higher in the fish fed carbohydrate diets. Similarly, low Km hexokinase (HK) activity was also higher in the fish 24 h after feeding. Fat gain and protein retention were significantly improved by increased digestible starch intake, especially in the HP group, which in turn, presented the highest plasma insulin levels. Glycogen stores were moderately increased by the ingestion of digestible starch. The number of insulin receptors was greater in the CF group than in fish on carbohydrates, except the HP group. Our results confirmed that the common carp uses dietary carbohydrates efficiently, especially when there are provided by peas. This efficiency might be related to the enhanced response of postprandial insulin observed in the HP group.

Carotenoid-based colours reflect the stress response in the common lizard.

Under chronic stress, carotenoid-based colouration has often been shown to fade. However, the ecological and physiological mechanisms that govern colouration still remain largely unknown. Colour changes may be directly induced by the stressor (for example through reduced carotenoid intake) or due to the activation of the physiological stress response (PSR, e.g. due to increased blood corticosterone concentrations). Here, we tested whether blood corticosterone concentration affected carotenoid-based colouration, and whether a trade-off between colouration and PSR existed. Using the common lizard (Lacerta vivipara), we correlatively and experimentally showed that elevated blood corticosterone levels are associated with increased redness of the lizard's belly. In this study, the effects of corticosterone did not depend on carotenoid ingestion, indicating the absence of a trade-off between colouration and PSR for carotenoids. While carotenoid ingestion increased blood carotenoid concentration, colouration was not modified. This suggests that carotenoid-based colouration of common lizards is not severely limited by dietary carotenoid intake. Together with earlier studies, these findings suggest that the common lizard's carotenoid-based colouration may be a composite trait, consisting of fixed (e.g. genetic) and environmentally elements, the latter reflecting the lizard's PSR.

An unusual cause of high anion gap metabolic acidosis: pyroglutamic acidemia. A case report.

Pyroglutamic acidemia is an uncommon metabolic disorder, which is usually diagnosed at early ages. The mechanism of action is thought to be glutathione depletion, and its clinical manifestations consist of hemolytic anemia, mental retardation, ataxia, and chronic metabolic acidosis. However, an acquired form has been described in adult patients, who usually present with confusion, respiratory distress, and high anion gap metabolic acidosis (HAGMA). It is also associated with many conditions, including chronic acetaminophen consumption. A 68-year-old white male, with chronic acetaminophen use presented to our service on multiple occasions with severe HAGMA. The patient was admitted to the intensive care unit and required mechanical ventilation and aggressive supportive measures. After ruling out the most frequent etiologies for his acid-base disorder and considering the long history of Tylenol ingestion, his 5-oxiproline (pyroglutamic acid) levels were sent to diagnose pyroglutamic acidemia. Clinicians need to be aware of this cause for metabolic acidosis since it might be a more common metabolic disturbance in compromised patients than would be expected. Subjects with HAGMA that cannot be explained by common causes should be tested for the presence of 5-oxoproline. Discontinuation of the offending drug is therapeutic.

A contaminação dos oceanos por radionuclídeos antropogênicos

Several hundreds of artificial radionuclides are produced as the result of human activities, such as the applications of nuclear reactors and particle accelerators, testing of nuclear weapons and nuclear accidents. Many of these radionuclides are short-lived and decay quickly after their production, but some of them are longer-lived and are released into the environment. From the radiological point of view the most important radionuclides are cesium-137, strontium-90 and plutonium-239, due to their chemical and nuclear characteristics. The two first radioisotopes present long half life (30 and 28 years), high fission yields and chemical behaviour similar to potassium and calcium, respectively. No stable element exists for plutonium-239, that presents high radiotoxicity, long half-life (24000 years) and some marine organisms accumulate plutonium at high levels. The radionuclides introduced into marine environment undergo various physical, chemical and biological processes taking place in the sea. These processes may be due to physical dispersion or complicated chemical and biological interactions of the radionuclides with inorganic and organic suspend matter, variety of living organisms, bottom sediments, etc. The behaviour of radionuclides in the sea depends primarily on their chemical properties, but it may also be influenced by properties of interacting matrices and other environmental factors. The major route of radiation exposure of man to artificial radionuclides occuring in the marine environment is through ingestion of radiologically contamined marine organisms. This paper summarizes the main sources of contamination in the marine environment and presents an overview covering the oceanic distribution of anthropogenic radionuclides in the FAO regions. A great number of measurements of artificial radionuclides have been carried out on various marine environmental samples in different oceans over the world, being cesium-137 the most widely measured radionuclide. Radionuclide concentrations vary from region to region, according to the specific sources of contamination. In some regions, such as the Irish Sea, the Baltic Sea and the Black Sea, the concentrations depend on the inputs due to discharges from reprocessing facilities and from Chernobyl accident. In Brazil, the artificial radioactivity is low and corresponds to typical deposition values due to fallout for the Southern Hemisphere.

Refletindo sobre o caso celobar®

By mid 2003, the Brazilian people accompanied astonished, in the press, the news about the death of more than 20 persons due to ingestion of a pharmaceutical product containing a suspension of barium sulfate (Celobar®) commonly used as a radiological contrast. Analysis of the product indicated the presence of barium carbonate (about 13% weight/weight) which reacts easily with the hydrochloric acid in the stomach liberating barium ions, a severe poison. In this article, we briefly discuss the possible economic, personal and technical causes that led to this disaster.

Interesterificação química: alternativa para obtenção de gorduras zero trans

The function of lipids in human nutrition has been intensively debated in the last decade.This context reinforces the concern about controlling the trans fat ingestion, due to its negative implications on health. Interesterification provides an important alternative to modify the consistency of oils and fats without causing formation of trans isomers. This article reports research done towards production of zero trans fats by chemical interesterification, for different industrial purposes. Aspects related to the effect of trans fats on diet, their impact on health and modifications in Brazilian legislation are also covered.

Teor de fluoretos em infusões de chá verde (Camellia sinensis)

The aim of this work was to study the influence of green tea consumption on fluoride ingestion. The extraction conditions of fluorides from green tea infusions were defined and nine brands of green tea available in Portugal were analyzed. The quantification of fluorides in the green tea was preceded by the implementation and validation of the potentiometric method (commercial fluoride selective electrode). The concentration of fluorides in the samples ranged from 0. 8 to 2. 0 mg L-1.

Ensaios para determinar a (Bio)disponibilidade de chumbo em solos contaminados: revisão

Incidental ingestion of contaminated soils is a major route of Pb uptake by humans, especially by children. Lead speciation in soils controls its bioavailability. Bioavailability assessment requires the determination of the amount of absorbed lead if a contaminated soil is ingested. In vivo tests, which employ animals, are considered the best model to infer absorption of Pb. But they have some logistic limitations and several authors proposed in vitro methods, which simulate conditions of human digestion. Many of them present results which correlate with in vivo essays. Several authors consider in vitro tests a good and reliable alternative to infer lead bioavailability.

Validação de métodos cromatográficos por clae para análise das vitaminas B1, B2, B6 e niacina naturalmente presentes em farinha de cereais

Complex B vitamins are present in some cereal foods and the ingestion of enriched products contributes to the recommended dietary intake of these micronutrients. To adapt the label of some products, it is necessary to develop and validate the analytical methods. These methods must be reliable and with enough sensitivity to analyze complex B vitamins naturally present in food at low concentration. The purpose of this work is to evaluate, with validated methods, the content of vitamins B1, B2, B6 and niacin in five cereal flours used in food industry (oat, rice, barley, corn and wheat).

Determination of polyphenol contents and antioxidant capacity of no-alcoholic red grape products (vitis labrusca) from conventional and organic crops

The polyphenol contents and antioxidant capacity of Brazilian red grape juices and wine vinegars were analyzed. Additionally, it was analyzed the human polyphenol absorption and acute effect in plasmatic oxidative metabolism biomarkers after juice ingestion. The organic Bordo grape juice (GBO) presented a higher level of trans-resveratrol, quercitin, rutin, gallic acid, caffeic acid and total flavonoids then other juices and vinegars as well as antioxidant capacity. The plasmatic polyphenol increased 27.2% after GBO juice ingestion. The results showed that juices and vinegars from Brazilian crops present similar chemical and functional properties described in studies performed in other countries.

Pharmacokinetics of Oxycodone and Paracetamol in the Elderly. Clinical Pharmacokinetic Study on Orthopaedic Surgical Patients and Healthy Volunteers

The proportion of elderly people over 65 years of age in Finland is expected to grow to over 25% by the 2025. It has been estimated that elderly people today consume nearly 40% of all drugs. Age brings about number of physiological changes that may affect the disposition, metabolism and excretion of drugs. The function of heart, lungs, liver and kidneys decreases even in healthy people, as they get older. The proportion of total body water decreases and the relative fat percentage increases. Also several other factors such as concurrent diseases, concomitant medication and nutritional factors have an effect on drug therapy in elderly. Age increases the risk of adverse drug reactions, which most often are dose-dependent. Despite all this there are not enough studies involving the elderly people and the elderly are most often excluded from clinical trials. Oxycodone is a strong opioid analgesic, which is used to treat moderate or severe pain. Paracetamol is a widely used nonopioid analgesic, which has become popular in the treatment of pain in many patient groups. In this series of studies the pharmacokinetics of oral and intravenous oxicodone as well as intravenous paracetamol in the elderly and young adult patients were investigated. Also a study investigating the interaction of oral antibiotic clarityhromycin, a known cytochrome P450 (CYP) 3A4 inhibitor, with oxycodone pharmacokinetics and pharmacodynamics in elderly and young healthy volunteers was carried out. The pharmacokinetics of oxycodone showed a clear age depency. Patients over 70 years had 50-80% higher mean exposure to oral oxycodone and a twofold greater plasma concentration than young adults 12 h after ingestion of the drug. Elderly patients had 40-80% greater exposure to intravenous oxycodone and patients over 80 years had over twofold greater plasma concentrations 8 h post dose than the young adults. The elderly patients had also greater exposure to intra venous paracetamol compared to young adults. Clarithromycin increased the exposure to oral oxycodone in both young and elderly volunteers. The elderly had marked interindividual variation in the pharmacokinetics and pharmacodynamics when clarithromycin was given concomitantly with oxycodone. Because the pharmacokinetics of oxycodone and intravenous paracetamol depend on the age of the subject, it is important to titrate the analgesic dose individually in the elderly.

Physiological responses of caprines raised under different types of covering

Thermal discomfort inside facilities is one of the factors responsible for low productivity of caprines in the Brazilian Northeast region, because inadequate weather conditions can cause elevated rectal temperature, increased respiratory rate, decreased food ingestion and reduced production. The present paper aimed to study the behavior of physiological thermoregulation of the animals (respiratory rate - RR and rectal temperature - RT) at four different times of the day (8 a.m., 11 a.m., 2 p.m. and 5 p.m.) and their relation to bioclimatic indexes (Temperature Humidity Index - THI, Black Globe Humidity Index - BGHI and Radiant Heat Load - RHL) in order to determine whether the type of covering used in the animals facilities (ceramic covering - CC, asbestos cement covering - AC and straw covering - SC) interferes with the physiology of thermoregulation. The time of data collection was related to the values of environmental and physiological variables. At 2 p.m. it was found the highest values of Radiant Heat Load on the three types of covering. The values of RT and RR were higher at 11 a.m. and 2 p.m., and the straw tile provided better thermal conditions of microclimate for the animals. The increased RR maintained the caprines homeothermy.

Corpo estranho no ceco retirado por colonoscopia

The foreign body ingestion ocurrs often with children, olds, psychiatrics patients, prisoners or after excessive alcoholic ingestion. Most of foreign bodies (80-90%) passes spontaneously, 10 a 20% have to be removed by endoscopy and only one per cent (1%) needs to be removed by surgery. The authors report a case of a 49-year-old woman who swallowed a needle which impacted in cecum. The patient had psychosis maniac-depressive and swallowed the foreign body aiming self-damage. The presence of foreign body in cecum is rare because of physiologic straitments in the gastrointestinal tract. The ingestion of needle corresponds six percent (6%) of swallowed objects aiming self-damage. Colonoscopy served for localization the foreign body and its withdrawal with success. Colonoscopy for removing foreign bodies is a safe and cheap procedure.