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1.
Pesqui. vet. bras ; 42: e06961, 2022. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1356551

ABSTRACT

Baccharis vulneraria Backer is a sub-shrub frequently found in southern Brazil, which leads to gastrointestinal tract intoxication. The objective of this study is to describe epidemiological, clinical and anatomopathological aspects of two cases of B. vulneraria poisoning in cattle. Two bovines from two different municipalities in the Itajaí Valley, Santa Catarina, Brazil were necropsied and performed the histopathological evaluation and botanical classification of the plant found in the pasture. Bovine 1 had dehydration, ruminal atony, diarrhea, congested mucous membranes and hypothermia for 20 hours, and died during clinical care. At necropsy, there was moderate multifocal detachment and reddening of the forestomachs mucosa. Bovine 2 presented anorexia, dry feces, ruminal atony, vocalization and muscle tremors for ten days, unresponsive to treatments, evolving to death. At necropsy were seen loosening of the mucosa with marked diffuse reddening and transmural edema. The microscopic exam revealed degeneration, necrosis, vesiculation, and detachment of the forestomachs' mucosa, associated with moderate multifocal neutrophilic infiltrate (Bovine 1); marked diffuse transmural necrosis, edema, hemorrhage, and marked fibrinous exudation (Bovine 2). A large amount of B. vulneraria was found in the pastures, with signs of consumption. In this report, a case of subacute evolution of B. vulneraria poisoning was observed, since the poisoning by this plant is usually acute. More knowledge about poisoning by this plant is necessary for the prevention and control, avoiding new mortality cases.(AU)


Baccharis vulneraria Backer é um subarbusto frequentemente encontrado no sul do Brasil, que leva a um quadro de intoxicação nocivo ao trato gastrointestinal. O objetivo deste trabalho é descrever aspectos epidemiológicos, clínicos e anatomopatológicos de dois casos de intoxicação por B. vulneraria em bovinos. Foram necropsiados dois bovinos de dois municípios do Vale do Itajaí, Santa Catarina, Brasil, com avaliação histopatológica dos órgãos e classificação botânica dos exemplares da planta localizada nos piquetes. No exame clínico do Bovino 1 foram constatados desidratação, atonia ruminal, diarreia, mucosas congestas e hipotermia durante 20 horas, com morte durante atendimento clínico. Na necropsia, havia desprendimento e avermelhamento multifocais moderados na mucosa dos proventrículos. Já o Bovino 2 teve manifestações clínicas de anorexia, fezes secas, atonia ruminal, vocalização e tremores musculares por 10 dias, não responsivas a tratamento, evoluindo para óbito. Na necropsia, havia desprendimento da mucosa dos proventrículos, com avermelhamento e edema transmural difusos acentuados. No exame histológico havia degeneração e necrose da mucosa proventricular, vacuolização e desprendimento do epitélio, infiltrado neutrofílico multifocal moderado (Bovino 1), e necrose transmural difusa acentuada, edema, hemorragia e exsudação fibrinosa acentuados (Bovino 2). Grande quantidade de B. vulneraria foi encontrada nas pastagens dos bovinos, com sinais de consumo. É relatado um caso de evolução subaguda de intoxicação por B. vulneraria, visto que a intoxicação por essa planta geralmente tem curso agudo. Conhecimentos acerca desta planta são necessários para prevenção e controle da intoxicação, evitando novos casos de mortalidade.(AU)


Subject(s)
Animals , Cattle , Plant Poisoning/pathology , Plant Poisoning/veterinary , Cattle Diseases/pathology , Baccharis/poisoning , Gastrointestinal Tract/pathology , Plants, Toxic , Fatal Outcome
2.
Saude e pesqui. (Impr.) ; 14(Supl. 1): e8410, Dez. 2021.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1367910

ABSTRACT

Objetivou-se avaliar a suplementação com acetil-L-carnitina (ALC) sobre os neurônios mioentéricos do íleo de ratos após a indução de diabetes. Foram usados animais diabéticos suplementados com ALC (DC), diabéticos (D), normoglicêmicos suplementados com ALC (CC) e normoglicêmicos (C). Neurônios NADPH-d foram quantificados e mensurados. Observou-se redução na glicemia e na ingestão de água no grupo DC. A densidade neuronal em 12,72mm² de íleo foi semelhante nos quatro grupos (p>0,05): DC (558,8 ± 220,2), D (513,4 ± 72,01), CC (645,2 ± 144,9) e C (934 ± 248,5). A área média do corpo celular dos neurônios (µm²) nos animais diabéticos, DC (303,9 ± 114,2) e D (285,4 ± 111,8), foram maiores que nos grupos normoglicêmicos, CC (173,6 ± 53,78) e C (158,4 ± 53,73). A área do íleo (mm²) também mostrou-se maior nos animais dos grupos diabéticos, DC (190,96) e D (171,62) quando comparados aos normoglicêmicos: CC (138,04) e C (130,06). Entretanto no grupo DC, ambas as áreas foram maiores que no D (P<0,05). Assim, pode se inferir discreto incremento na população neuronal. Os dados indicaram que a ALC não interferiu nos mecanismos que promovem aumento na produção de óxido nítrico (NO) pelos neurônios mioentéricos do íleo e que a maior dilatação do íleo no grupo DC poderia ser resultante de efeito colateral da dose de carnitina empregada.


The objective was to evaluate supplementation with acetyl-L-carnitine (ALC) on myenteric neurons of the ileum of rats after induction of diabetes. Diabetic animals supplemented with ALC (DC), diabetic (D), normoglycemic animals supplemented with ALC (CC) and normoglycemic (C) were used. NADPH-d neurons were quantified and measured. There was a reduction in blood glucose and water intake in the DC group. The neuronal density in 12.72mm² of ileum was similar in the four groups (p>0.05): DC (558.8 ± 220.2), D (513.4 ± 72.01), CC (645.2 ± 144.9) and C (934 ± 248.5). The mean cell body area of neurons (µm²) in diabetic animals, DC (303.9 ± 114.2) and D (285.4 ± 111.8), were greater than in the normoglycemic groups, CC (173.6 ± 53.78) and C (158.4 ± 53.73). The ileum area (mm²) was larger in animals of the diabetic groups, CD (190.96) and D (171.62) compared to the normoglycemic groups: CC (138.04) and C (130.04). However, in the DC group, both areas were larger than in D (p<0.05). Thus, a slight increase in neuronal population can be inferred. The data indicated that ALC did not interfere with mechanisms that promote an increase in the production of nitric oxide (NO) by myenteric neurons of the ileum and that the greater dilation of the ileum in the DC group could be the result of a side effect of the dose of carnitine used.

3.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1356713

ABSTRACT

RESUMEN La infección por SARS-CoV-2 afecta principalmente el sistema respiratorio; pero, también se han observado múltiples manifestaciones extrapulmonares en diversos sistemas y órganos. Las células epiteliales del tubo digestivo y árbol hepatobiliar expresan ECA2 y TMPRSS2 necesarios para el ingreso viral, por otro lado, el ARN viral ha sido detectado en muestras de heces, incluso después de haberse negativizado en muestras respiratorias. La presencia de manifestaciones clínicas digestivas se asocia a mayor carga viral y en ocasiones pueden ser las únicas manifestaciones de COVID-19, incluso en ausencia de síntomas respiratorios. Los síntomas más comunes son anorexia y diarrea, náuseas, vómitos y dolor abdominal, siendo este último característico de pacientes gravemente enfermos. Es muy poco frecuente la presencia de hemorragia gastrointestinal, colitis hemorrágica o hepatitis aguda. Ante un paciente con manifestaciones gastrointestinales debe considerarse a COVID-19 dentro del diagnóstico diferencial.


ABSTRACT SARS-CoV-2 infection mainly affects the respiratory system; but, multiple extrapulmonary manifestations have also been observed in various systems and organs. The epithelial cells of the digestive tract and hepatobiliary tree express ECA2 and TMPRSS2 necessary for viral entry, on the other hand, viral RNA has been detected in stool samples, even after having become negative in respiratory samples. The presence of clinical digestive manifestations is associated with a higher viral load and can sometimes be the only manifestations of COVID-19, even in the absence of respiratory symptoms. The most common symptoms are anorexia and diarrhea, nausea, vomiting, and abdominal pain, the latter being characteristic of seriously ill patients. Gastrointestinal bleeding, hemorrhagic colitis, or acute hepatitis are very rare. In a patient with gastrointestinal manifestations, COVID-19 should be considered within the differential diagnosis.

4.
Rev. colomb. cir ; 36(4): 719-725, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1291270

ABSTRACT

Introducción. Los quistes gástricos de duplicación son malformaciones congénitas muy infrecuentes del tracto gastrointestinal. Se definen como una lesión quística tapizada por epitelio gastrointestinal que comparte una capa de músculo liso con la pared gástrica. Se han propuesto diferentes teorías sobre su patogénesis, sin embargo, los eventos embriológicos que conducen a la malformación no han logrado ser dilucidados. Debido a su localización y presentación clínica, el diagnóstico se realiza con mayor frecuencia durante los primeros años de vida y existen pocos casos reportados en adultos, en quienes el hallazgo suele ser incidental. Caso clínico. Se presenta el caso de una mujer de 65 años quien consultó por dolor abdominal crónico y síntomas digestivos inespecíficos. Por medio de Tomografía Axial Computarizada se evidenció una lesión quística en contacto con el páncreas y la pared gástrica. Se realizó exploración quirúrgica que, junto con los hallazgos histopatológicos, confirmó el diagnosticó de quiste de duplicación gástrico. Discusión. Los quistes de duplicación gástrica son anomalías excepcionales que se localizan más frecuentemente en la curvatura mayor. Su tratamiento es quirúrgico y la confirmación del diagnóstico se realiza mediante la histología


Introduction. Gastric duplication cysts are very rare congenital malformations of the gastrointestinal tract. They are defined as a cystic lesion lined by gastrointestinal epithelium that shares a layer of smooth muscle with the gastric wall. Different theories have been proposed about its pathogenesis, however, the embryological events that lead to the malformation have not been elucidated. Due to its location and clinical presentation, the diagnosis is made more frequently during the first years of life and there are few cases reported in adults, in whom the finding is usually incidental. Clinical case. We present the case of a 65-year-old woman who consulted for chronic abdominal pain and nonspecific digestive symptoms. A CT scan evidenced a cystic lesion in contact with the pancreas and the gastric wall. A surgical exploration was performed which, along with the histopathological findings, confirmed the diagnosis of a gastric duplication cyst. Discussion. Gastric duplication cysts are exceptional anomalies that are more frequently located in the greater curvature. Its treatment is surgical and the confirmation of the diagnosis is made by histology


Subject(s)
Humans , Cysts , Gastrointestinal Tract , General Surgery , Histology
5.
Rev. cienc. med. Pinar Rio ; 25(3): e4902, 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1289142

ABSTRACT

RESUMEN Introducción: el síndrome malformativo de manos y pies hendidos, es un defecto congénito poco frecuente con patrón de herencia autosómico dominante, de forma simétrica. Presentación de caso: se presenta una lactante de tres meses que nace a las 36 semanas, con peso de 2 450 gramos, talla 50 cm, Apgar 8-9. Se detecta al nacimiento, hendidura mediana en ambas manos y pies con ectrodactília de 2do y 3er dedo de todos sus miembros, no otras malformaciones. El servicio de neonatología del hospital pediátrico provincial solicita valoración por genética clínica que después de un examen físico exhaustivo, llega al diagnóstico sindrómico. Es el primer caso de la provincia. Conclusiones: el método clínico es primordial para realizar el diagnóstico con la ayuda de los estudios radiológicos y clasificar el tipo de ectrodactília. Se mantiene con seguimiento multidisciplinario por ortopédicos, psicólogos, fisiatras y genetista clínico, quienes brindan un adecuado asesoramiento genético, así como la información de futuras operaciones que mejorarán la funcionalidad de sus miembros y elevarán su calidad de vida.


ABSTRACT Introduction: malformation of cleft hand and foot syndrome is a rare congenital defect with autosomal dominant inheritance pattern, symmetrical in shape. Case presentation: a three-month-old female infant born at 36 weeks, weighing 2450 grams, height 50 cm, Apgar 8-9, detected at birth median cleft in both hands and feet with ectrodactyly of the 2nd and 3rd fingers of all limbs, no other malformations. The neonatology service of the provincial pediatric hospital requests assessment by clinical genetics that after an exhaustive physical examination leads to the syndromic diagnosis, resulting in the first case in the province. Conclusions: considering of great value the clinical method to conduct the diagnosis with the help of radiological studies to be able to classify the type of ectrodactyly. The patient is kept with multidisciplinary follow-up by orthopedics, psychologists, physiatrists and clinical geneticist, providing adequate genetic counseling, as well as information on future operations that will improve the functions of her limbs and improve her quality of life.

6.
Gac. méd. boliv ; 44(1): 15-18, jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1286593

ABSTRACT

Objetivos: los trastornos motores, hormonales, neuroendocrinos y el estado de inmunodepresión que presenta el paciente celíaco conlleva al desarrollo de alteraciones digestivas, por lo que el presente estudio pretende determinar si la celiaquía se asocia al desarrollo de lesiones preneoplásicas del tubo digestivo superior y comparar dichos resultados con un grupo control (no celíaco). Métodos: se realizó un estudio observacional, analítico de casos y controles, en el Instituto Gastroenterológico Boliviano Japonés, Cochabamba, Bolivia. De forma aleatoria simple se obtuvo una muestra de 297 pacientes, para el grupo caso y control. Se utilizó el programa IMB SPSS v- 20, el análisis estadístico con la prueba de Chi cuadrado (con un valor de p=<0,05; 95% IC) y el análisis epidemiológico con el cálculo el Odds ratio (OR). Resultados: se observó una asociación estadística y epidemiológica significativa para el grupo celíaco con lesiones preneoplásicas en el tubo digestivo alto (p= 0,0001) OR 7,23 (IC 95% 5,387 -9,722) en comparación al grupo control que presenta una asociación estadística (p=0,03); pero con una significancia epidemiológica negativa OR 0,708 (IC 95% 0,639-0,783). Conclusiones: existe mayor prevalencia de pacientes celíacos con lesiones preneoplásicas (metaplasia intestinal esofágica y gástrica, atrofia gástrica, displasias), frente al grupo no celíaco. Esto demuestra la importancia del diagnóstico y pesquisa temprana de esta entidad, evitando el desarrollo de lesiones que podrían considerarse irreversibles en el sistema digestivo.


Objectives: the digestive, hormonal and neuroendocrine disorders and the state of immunosuppression that the celiac patient presents, leads to the development of digestive alterations, the present study aims to determine whether celiac disease is associated with the development of preneoplastic lesions of the upper gastrointestinal tract and compares the results with a control group (non-celiac). Methods: during the period January 2016 to January 2018 at Instituto de Gastroenterología Boliviano Japones - Cochabamba, Bolivia an observational study was conducted, subtype analytical case-control, where 297 samples were obtaining of patients in a simple random way, both for the case and control group. The IMB SPSS v-20 program was used, the statistical analysis was performed using the Chi square test (with p value = <0,05; 95% IC) and the epidemiological analysis with the calculation of the Odds ratio (OR). Results: a statistically and epidemiological significant association was observed for the celiac group with preneoplastic lesions in the upper gastrointestinal tract (p = 0,001) OR 7,23(IC 95% 5,387 -9,722) compared to the control group that presents a statistical association (p = 0,03); but with a negative epidemiological significance OR 0,708 (IC 95% 0,639 -0,783). Conclusions: there is a higher prevalence of celiac patients with preneoplastic lesions (esophageal and gastric intestinal metaplasia, gastric atrophy, dysplasia), compared to the non-celiac group. This demonstrates the importance of early diagnosis and investigation of this entity, avoiding the development of lesions that could be considered irreversible in the digestive system.


Subject(s)
Celiac Disease
7.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 8(1): e301, jun. 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1248718

ABSTRACT

Cada vez más los pacientes diagnosticados con anemia son referidos al gastroenterólogo para su evaluación. La necesidad de realizar un adecuado planteo clínico y una correcta interpretación de las pruebas de diagnóstico ha motivado la revisión de este tema. Varios trastornos gastroenterológicos, con frecuencia, conducen a anemia como resultado de pérdidas sanguíneas, inflamación, malabsorción o a consecuencia de las terapias farmacológicas. En algunas patologías como la cirrosis, EII o neoplasias las causas son a menudo multifactoriales. Esta revisión, pretende proporcionar un enfoque útil para la práctica clínica. Para ello se ha revisado la información actualizada acerca de la patogénesis, diagnóstico y tratamiento de la anemia vinculada a patologías digestivas y se han confeccionados cuadros y algoritmos para facilitar su comprensión.


More and more patients diagnosed with anemia are referred to the gastroenterologist for evaluation. The need to carry out an adequate clinical approach and a correct interpretation of diagnostic tests has motivated this review. Several digestive diseases frequently lead to anemia because of blood loss, inflammation, malabsorption, or drug therapies. In some of them such as cirrhosis, IBD or neoplasms, the etiology is multifactorial. This review is intended to provide a useful approach to clinical practice. To this aim, updated information on the pathogenesis, diagnosis, and treatment of anemia related to digestive diseases has been reviewed, and tables and algorithms have been built to favor its understanding.


Cada vez mais pacientes diagnosticados com anemia são encaminhados ao gastroenterologista para avaliação. A necessidade de realizar uma abordagem clínica adequada e uma interpretação correta dos testes de diagnóstico motivou a revisão deste tema. Vários distúrbios gastroenterológicos freqüentemente levam à anemia como resultado de perda de sangue, inflamação, má absorção ou pelas próprias terapias farmacológicas. Em algumas patologias como cirrose, DII ou neoplasias, as causas costumam ser multifatoriais. Esta revisão visa fornecer uma abordagem útil à prática clínica. Para esse fim, foram revisadas informações atualizadas sobre a patogênese, o diagnóstico e o tratamento da anemia associada à patologia digestiva e foram elaboradas tabelas e algoritmos para facilitar seu entendimento.


Subject(s)
Humans , Anemia, Iron-Deficiency/etiology , Gastrointestinal Diseases/complications , Anemia, Megaloblastic/etiology , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/therapy , Anemia, Megaloblastic/diagnosis , Anemia, Megaloblastic/therapy
8.
Rev. colomb. gastroenterol ; 36(supl.1): 42-46, abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251545

ABSTRACT

Resumen El cáncer de endometrio es la neoplasia ginecológica maligna más frecuente en el sexo femenino. Su presentación metastásica se limita principalmente a los órganos vecinos y ganglios cercanos, y es infrecuente la invasión al tubo digestivo superior. En el presente artículo se presenta una paciente que ingresó al servicio de urgencias con cuadro de hemorragia de vías digestivas altas, enfocado inicialmente como un tumor estromal gastrointestinal (GIST) de la pared gástrica, pero que luego de la realización de una adecuada historia clínica, complementada con imágenes diagnósticas y avances ecoendoscópicos, se logró el diagnóstico de metástasis de cáncer de endometrio.


Abstract Endometrial cancer is the most common gynecologic malignancy in women. Its metastatic presentation is mainly limited to neighboring organs and nearby lymph nodes, and infiltration of the upper digestive tract is uncommon. This case report depicts a patient admitted to the emergency department with upper gastrointestinal bleeding symptoms. Initially, a gastrointestinal stromal tumor (GIST) of the gastric wall was suspected, but endometrial cancer metastasis was discovered after a thorough medical examination, diagnostic imaging, and echoendoscopes.


Subject(s)
Humans , Female , Aged , Endometrial Neoplasms , Gastrointestinal Tract , Gastrointestinal Stromal Tumors , Hemorrhage , Neoplasm Metastasis , Women
9.
Rev. colomb. cir ; 36(3): 514-519, 20210000.
Article in Spanish | LILACS | ID: biblio-1254383

ABSTRACT

Introducción. El linfoma puede afectar el tracto gastrointestinal de manera primaria o secundaria, y representa hasta el 2 % de todas las neoplasias malignas del intestino delgado y colon. El tracto gastrointestinal es la ubicación extraganglionar primaria más común en el linfoma no Hodgkin. Métodos. Se realizó una búsqueda de la literatura en las principales bases de datos académicas, con revisión de textos publicados sobre el tema en los últimos 5 años. Discusión. La presentación clínica del linfoma con compromiso gastrointestinal es inespecífica y, hasta en la mitad de los pacientes, se puede presentar de manera inicial con complicaciones que requieran manejo quirúrgico. Entre las principales se encuentran la perforación intestinal, el sangrado digestivo y la obstrucción intestinal


Introduction. Lymphoma can affect the gastrointestinal tract, primarily or secondarily, and accounts for up to 2% of all malignant neoplasms of the small intestine and colon. The gastrointestinal tract is the most common primary extranodal location in non-Hodgkin lymphoma. Methods. A literature search performed in the main academic databases, with a review of texts published on the subject in the last 5 years.Discussion. The clinical presentation of lymphoma with gastrointestinal involvement is nonspecific and, in up to half of the patients, it can present initially with complications that require surgical management. Among the main ones are intestinal perforation, digestive bleeding and intestinal obstruction.


Subject(s)
Humans , Gastrointestinal Neoplasms , Lymphoma , Gastrointestinal Tract , Intestinal Obstruction , Intestinal Perforation , Intussusception
10.
Rev. colomb. gastroenterol ; 36(1): 103-108, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251529

ABSTRACT

Resumen La malacoplaquia es una enfermedad inflamatoria rara, granulomatosa y crónica, caracterizada por infiltrados agregados de histiocitos conocidos como inclusiones de Michaelis-Gutmann. El sistema urinario es el sitio afectado más común, seguido del tracto gastrointestinal. El pronóstico de la enfermedad depende de la extensión, la localización y la salud subyacente del paciente. Caso: se describe un caso clínico de un paciente masculino de 15 años de edad, sin antecedentes de salud de importancia, que inicialmente presenta la enfermedad a partir de los 7 años con hematoquecia y dolor abdominal de leve intensidad que mejoraba después de la defecación. Se realizó una colonoscopia en la que se visualizaron lesiones pseudopolipoideas en el colon sigmoide, las cuales fueron biopsiadas y reportaron pólipos inflamatorios con focos de agudización, numerosos histiocitos (cuerpos de Michaelis-Gutmann) y cambios reactivos del epitelio que diagnosticaron malacoplaquia. Conclusión: la malacoplaquia es una enfermedad muy rara en personas jóvenes sin enfermedad subyacente. Su prevalencia es desconocida, pero se han descrito más de 700 casos. Puede darse en todas las edades, con edad media al diagnóstico de 50 años. Los casos pediátricos son raros. Existe una mayor incidencia en hombres y no tiene predilección por la raza. El 60% a 80% de los casos afecta al tracto urinario (vejiga, riñones y uretra); el 15%, al tracto digestivo (colon izquierdo, sigma, recto y estómago); y en menor porcentaje, otras zonas menos frecuentes como piel, pulmones y sistema nervioso central. El pronóstico de la enfermedad es generalmente bueno. Presentamos un caso de un joven sano de 15 años de edad sin enfermedad asociada evidente, que ilustra la rareza de esta presentación y la necesidad de un alto nivel de sospecha clínica para diagnosticar la enfermedad.


Abstract Malacoplakia is a rare, granulomatous, chronic inflammatory disease characterized by foamy histiocytic infiltrations known as Michaelis-Gutmann inclusions. The urinary system is the most commonly affected site, followed by the gastrointestinal tract. The prognosis of the disease depends on the extent, location, and underlying health status of the patient. This is the clinical case of a 15-year-old male patient with no significant health history. At age 7, the patient presented with hematochezia and mild abdominal pain that improved after defecation. A colonoscopy was performed, finding pseudopolypoid lesions in the sigmoid colon. Biopsy samples were taken, and the report showed inflammatory polyps with exacerbation foci, numerous histiocytes (Michaelis-Gutmann bodies), and reactive epithelial changes that lead to diagnose malacoplakia. Conclusion: Malacoplakia is a very rare disease in young people with no underlying disease. Its prevalence is unknown, but more than 700 cases have been reported. It can occur at all ages, with a mean age at diagnosis of 50 years. Pediatric cases are rare. There is a higher incidence in men, and it has no racial predilection. Between 60% and 80% of cases involve the urinary tract (bladder, kidneys, and urethra); 15% involve the digestive tract (left colon, sigmoid colon, rectum, and stomach); and, to a lesser extent, other areas such as skin, lungs, and central nervous system may be affected. The prognosis of the disease is usually good. This is the case of a healthy 15-year-old male with no apparent associated disease that illustrates the rarity of this presentation and the need for a high level of clinical suspicion to diagnose the disease.


Subject(s)
Humans , Male , Adolescent , Malacoplakia , Colon , Gastrointestinal Tract
11.
Rev. cienc. med. Pinar Rio ; 25(2): e4483, 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1289119

ABSTRACT

RESUMEN Introducción: El pioderma gangrenoso corresponde a una dermatosis crónica inflamatoria rara, cuya etiología y patogénesis es aún incierta, aunque factores inmunológicos y disfunción neutrofílica parecen desempeñar un papel importante. Se presenta en la mayoría de los casos asociada a enfermedad sistémica no infecciosa, como artritis reumatoide, malignidad hematológica y enfermedad inflamatoria intestinal. Presentación de caso: Paciente femenina de la raza blanca de 26 años de edad con antecedentes de colitis ulcerosa y ahora con ocho semanas de gestación, que se presenta a consulta de gastroenterología del Hospital General Docente "Abel Santamaría Cuadrado", remitido de su área de salud, por presentar diarreas con flemas y sangre, además de lesiones nodulares, pápulas y vesículas múltiples con bordes irregulares, en miembros inferiores, superiores y región posterior del tronco, muy dolorosas. Conclusiones: La evolución de la colitis ulcerosa y la gestación se correlacionan con la actividad de la enfermedad en el momento de la concepción, de forma que la existencia de brote de actividad en este momento se ha asociado a un mayor riesgo de aborto y a una peor respuesta al tratamiento médico.


ABSTRACT Introduction: pyoderma gangrenosum is a rare chronic inflammatory dermatosis, which etiology and pathogenesis is still uncertain, although immunological factors and neutrophilic dysfunction seem to play an important role. In most cases, it occurs associated with non-infectious systemic disease, such as rheumatoid arthritis, hematological malignancy and inflammatory bowel disease. Case report: a 26 year-old white female patient with a history of ulcerative colitis and eight weeks pregnant, who presented herself to the gastroenterology office at Abel Santamaria Cuadrado General Teaching Hospital, she was referred from her health area, presenting diarrhea with phlegm and blood, in addition to nodular lesions, papules and multiple vesicles with irregular edges in lower limbs, upper limbs and posterior region of the trunk, very painful. Conclusions: the evolution of ulcerative colitis and pregnancy are correlated with the activity of the disease at the time of conception, so that the existence of an outbreak at this time has been associated with a higher risk of abortion and a worse response to medical treatment.

12.
Article in Chinese | WPRIM | ID: wpr-882076

ABSTRACT

Objective To evaluate the pharmacokinetics of the new mesalazine enteric-coated sustained-release granules in SD rats and their distribution in the gastrointestinal tract, and to understand the preclinical pharmacokinetics and gastrointestinal distribution characteristics of the preparation. Methods Rats were administered orally to determine the drug concentrations in plasma samples and in the gastrointestinal tract. The commercially available mesalazine sustained-release granule was used as a reference to self-developed one to evaluate the process of absorption and elimination in vivo, relative bioavailability, and distribution in the gastrointestinal tract. Results The relative bioavailability of mesalazine enteric-coated sustained-release granule and non-enteric-coated one characterized by mesalazine was 89.62% ± 9.36%. After oral administration of mesalazine enteric-coated sustained-release granules, the drug has a high concentration distribution in the stomach within 2-8 hours, and gradually enters and remains in the jejunum, ileum and colon over time for 6-12 hours and then reaching a high concentration distribution in the colon. This help for the absorption of mesalazine, as well as the fixed-point release of the drug to produce a therapeutic effect. Conclusion The absorption and elimination process of mesalazine enteric sustained-release granule showed linear kinetic characteristics. There was no significant difference in pharmacokinetic parameters from the commercially available formulations, and it had a certain fluidity in the gastrointestinal tract. Good gastrointestinal distribution characteristics help the absorption of drugs in the body and the targeted release of the site of action

13.
Pesqui. vet. bras ; 41: e06800, 2021. tab, graf, mapas
Article in English | LILACS, VETINDEX | ID: biblio-1279542

ABSTRACT

Diseases of the bovine digestive system make up an important group of diseases, often being responsible for significant economic losses in the livestock sector. The current work aimed to carry out a retrospective study of the diseases of the digestive system in cattle diagnosed at the "Clínica de Bovinos de Garanhuns", "Universidade Federal Rural de Pernambuco", from January 1999 to December 2018. In this period, a total of 9,343 cattle were admitted to the CBG-UFRPE, of which 2,238 (24.0%) were diagnosed with diseases of the digestive system. In two decades, the total number of cattle admitted annually by the institution almost doubled as well as the number of cases of digestive diseases. The diseases categorized as mechanical/motor were the most prevalent (33.6%), followed by fermentative (28.4%), gastroenteritis (16.0%), esophageal diseases (9.7%), and diseases of the oral cavity (4.5%). Lesions of the rectum and anus, congenital alterations, and other digestive diseases showed relative frequencies below 4%. Traumatic reticulitis and its sequelae (14.5%) are the most prevalent disorders, followed by simple indigestion (10.1%), esophageal and intestinal obstructive disorders (9.0%), non-specific gastroenteritis (8.6%), displaced abomasum (RDA and LDA) (5.5%), and frothy bloat, ruminal lactic acidosis, and impaction of the forestomach and abomasum, which represented approximately 5% each. In general, these diseases presented a lethality rate of 46.0%, with emphasis on mechanical/motor diseases with a lethality rate of 73.8%. In general, diseases were more prevalent in females, crossbreeds, aged over 24 months, and raised in a semi-intensive system. Diseases of the digestive system increased over the years studied, representing a considerable portion of the diseases that affect cattle raised in this region, which makes up the main milk basin in the State of Pernambuco, confirming its economic and social impact in the region.(AU)


As enfermidades do sistema digestório dos bovinos compõem importante grupo de doenças frequentemente responsáveis por perdas econômicas significativas no setor pecuário. Este trabalho teve por objetivo realizar um estudo retrospectivo das enfermidades do sistema digestório dos bovinos diagnosticadas na Clínica de Bovinos de Garanhuns, Universidade Federal Rural de Pernambuco, no período de janeiro de 1999 a dezembro de 2018. Neste período foi atendido um total de 9.343 bovinos dos quais 2.238 (24,0%) foram diagnosticados com enfermidades do sistema digestório. Em duas décadas, o número total de bovinos atendidos anualmente pela instituição quase dobrou, assim como o número de casos de doenças digestivas. As enfermidades categorizadas como de natureza mecânica/motora foram as mais prevalentes (33,6%), seguidas das fermentativas (28,4%), das gastroenterites (16,0%), das enfermidades esofágicas (9,7%) e das enfermidades da cavidade oral (4,5%). As lesões do reto e ânus, as alterações congênitas e outras enfermidades digestórias apresentaram frequências relativas inferiores a 4%. As reticulites traumáticas e suas sequelas (14,5%) destacaram-se como as doenças mais prevalentes, seguidas das indigestões simples (10,1%), dos transtornos obstrutivos esofágicos e intestinais (9,0%), das gastroenterites inespecíficas (8,6%), dos deslocamentos de abomaso (DAD e DAE) (5,5%) e do timpanismo espumoso, acidose láctica ruminal e compactações dos pré-estômagos e abomaso, que representaram aproximadamente 5% cada. No geral estas enfermidades apresentaram taxa de letalidade de 46,0%, com destaque para as enfermidades de natureza mecânica/motora cuja letalidade foi de 73,8%. De maneira geral as enfermidades foram mais prevalentes em fêmeas mestiças, com idade superior a 24 meses, criadas em sistema semi-intensivo. As enfermidades do sistema digestório, crescentes ao longo dos anos estudados, representaram parcela considerável das doenças que acometem os bovinos criados na região que compõe a principal bacia leiteira do Estado de Pernambuco, ratificando seu impacto econômico e social para a região.(AU)


Subject(s)
Animals , Cattle , Seasons , Retrospective Studies , Digestive System , Livestock , Gastroenteritis , Universities
14.
Chinese Journal of School Health ; (12): 106-108, 2021.
Article in Chinese | WPRIM | ID: wpr-862606

ABSTRACT

Objective@#To explore the correlation between BMI and gut microbiota of college students in Inner Mongolia,and to provide a reference basis for revealing the relationship between intestinal flora and obesity.@*Methods@#Totally 88 college students from Inner Mongolia Medical University were enrolled, Height and weight were measured,and the feces samples were collected. The bacterial metagenome was extracted from dry feces samples for the concentration detection in per gram of dry feces,expressed as μg/μL. Correlation between BMI and metagenomics concentration of gut microbiota was statistically analyzed. Meanwhile,the metagenomics concentration of gut microbiota in different BMI groups was compared with each other.@*Results@#There was a negative correlation between BMI and the metagenomics concentration of gut microbiota(r=-0.27,P<0.05). Significant difference in the concentration of gut microflora was observed between the normal group and the obesity group,the normal group and the overweight/obesity group(F=3.62,P<0.05). Among the female volunteers,there were significant differences between normal group and overweight group,between normal group and obesity group(F=1.87,P<0.05). No significant differences in metagenomics concentration of gut microbiota were found in different BMI groups(F=0.60, P>0.05).@*Conclusion@#There is a correlation between BMI and gut microbiota of college students in Inner Mongolia,the concentration of gut microflora metagenome in overweight and obese people decreased significantly.

15.
Article in Chinese | WPRIM | ID: wpr-911963

ABSTRACT

Objective:To investigate the development and maturation process of intestinal organoids in neonatal mice so as to provide a new model for research on perinatal/neonatal intestinal epithelial development and related diseases.Methods:Intestinal tissue of 3-day-old C57BL/6 mice were collected and cultured for mouse intestinal organoids (MIOs) under standard conditions down to the fifth generation. The morphological changes of MIOs were observed and recorded using inverted phase contrast microscope. Real-time fluorescent quantitative polymerase chain reaction and immunofluorescence technique were used to detect the expression and location of markers of intestinal stem cells and differentiated cells of intestinal epithelium among different generations of MIOs (Selected marker genes: Lgr5 for intestinal stem cells, Tpm2 and Gja1 for fetal intestinal progenitor cells, Villin for intestinal epithelial cells, Lyz1 for Paneth cells, Muc2 for goblet cells, Chga for endocrine cells; Selected marker proteins: villin for intestinal epithelial cells, mucin 2 for goblet cells, chromaffin A for endocrine cells, lysozyme for Paneth cells). One-way analysis of variance and Bonferroni test were adopted for statistical analysis. Results:Two types of MIOs were observed, immature spheroid and mature organoids with crypt-villus structure. Spheroid was the main form in the primary culture. From primary to the second generation, the proportion of spheroids decreased from (96.61±1.36)% to (8.93±1.50)%, and so did the size ( F=12.88, P<0.001). During the second to the fifth generation, mature organoid, as the main form, increased from (91.07±1.50)% to (95.56±2.14)%. The expression of intestinal stem cell marker Lgr5 in the second generation decreased to 0.40±0.06 times of the primary one ( F=76.75, P<0.001) and then increased after this period. The expression of fetal intestinal progenitor markers Tpm2 decreased significantly during the passage (primary generation: 1.00±0.11, the fifth generation: 0.003±0.001, F=148.00, P<0.001); And the expression of Gja1 decreased from primary generation (1.00±0.14) to the second generation (0.06±0.04) ( F=197.10, P<0.001), but kept stable from the second to fifth genetation ( F=2.20, P=0.13). The expressions of gene markers of differentiated cells in intestinal epithelium, including enterocytes, goblet cells, endocrine cells, and Paneth cells, increased after the second generation (the second generation: Villin: 0.46±0.11; Muc2: 0.68±0.29; Chga: 2.53±0.16; Lyz1: 0.98±0.21; the fifth generation: Villin: 1.02±0.05; Muc2: 8.79±0.61; Chga: 4.32±0.45; Lyz1:3.81±0.36; all P<0.05). Immunofluorescence showed that villin, the intestinal epithelial cell marker protein, was distributed along the villus-side of MIOs in primary and the fifth generation culture. Mucin 2 from goblet cell and chromaffin A from endocrine cell expressed at a very low level in the primary generation, while higher in the fifth generation. In the primary culture, lysozyme from Paneth cell was evenly distributed in organoid cells, and high fluorescent dot-shaped expression was observed in the fifth generation. Conclusions:The development and maturation of immature intestinal epithelium can be simulated by continuous culture of neonatal MIOs. MIOs between the primary and second generation could be used as a research model for development of perinatal intestinal epithelium, and the second to the fifth generation as a model for neonatal intestinal diseases studies.

16.
Article in Chinese | WPRIM | ID: wpr-911721

ABSTRACT

From January 2018 to August 2019, 87 children aged 2 to 8 years with upper gastrointestinal ulcer bleeding were admitted to the Department of Pediatrics of Shangqiu First People′s Hospital. Patients were randomly assigned in two groups, 45 cases received omeprazole for treatment (group A) and 42 cases received ulinastatin and omeprazole for treatment (group B). The omeprazole 10 mg/d was administrated orally for 2 to 4 weeks in two groups, while in group B additional ulinastatin injection (10 000-50 000 IU·kg -1·d -1 was given for 1 week. The effective rate in group B was 95.2% (40/42), which was significantly higher than that in group A (80.0%, 36/45) (χ2=4.567, P=0.03). After treatment, gastroscopy showed that the time of hemostasis, the time of stopping hematemesis, the time of fecal occult blood turning negative, and the length of hospital stay in group B were significantly shorter than those in group A ( P<0.05). The results of flow cytometry showed that the percentages of CD3 + and CD4 + increased and the percentages of CD8 + decreased significantly after treatment in the two groups, while the changes in group B were more marked than those in group A ( P<0.05). Serum inflammatory factors (serum procalcitonin, high-sensitivity C-reactive protein and tumor necrosis α) were significantly reduced after treatment in the two groups, while the above indicators in group A were significantly lower than those in group A (all P<0.05). In group A, there was 1 case of nausea and vomiting, 1 case of abdominal pain and diarrhea, and 1 case of lethargy; in group B, there was 1 case of nausea and vomiting and 1 case of abdominal pain and diarrhea. The study suggests that ulinastatin combined with omeprazole has a better effect than omeprasole alone in treatment of children with upper gastrointestinal ulcer bleeding without increasing adverse effects.

17.
Article in Chinese | WPRIM | ID: wpr-910781

ABSTRACT

Objective:To explore the potential value of interim 18F-fluorodeoxyglucose (FDG) PET/CT combined with B-cell lymphoma-2 (Bcl-2)/MYC protein dual expression (DE) status in the prognostic stratification for patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL). Methods:Forty-six patients (21 males, 25 females; age 20-83 years) with newly diagnosed PGI-DLBCL from June 2012 to May 2019 in Nanjing Drum Tower Hospital were enrolled in this retrospective study. Immunohistochemistry for Bcl-2 and MYC protein expression was performed. All patients underwent baseline and interim (after 2-4 cycles of cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab (R-CHOP) regimen) 18F-FDG PET/CT scans for assessment. Interim 18F-FDG PET/CT results were determined based on Deauville 5-point scale (DS) and changing rate of maximum standardized uptake value (ΔSUV max%) in 18F-FDG PET/CT images. Kaplan-Meier survival analysis, Cox proportional hazards regression model (single factor, multiple factors analysis) were used to analyze the prognosis (3-year progression free survival (PFS) and overall survival (OS) rates). Results:Patients were followed up for 6-84 months, and 14 showed disease progression and 9 died. The PFS rate and OS rate were 69.6% and 80.4%, respectively. DE, DS as well as ΔSUV max% were significant predictors of PFS (hazard ratio ( HR) values: 3.280, 5.120, 9.167, all P<0.05); lactate dehydrogenase (LDH), MYC protein expression, DS and ΔSUV max% were significant predictors of OS ( HR values: 4.091, 9.618, 7.697, 11.151, all P<0.05). Multivariate analysis revealed that DS and ΔSUV max% were independent predictors of PFS and OS ( HR values: 4.370-9.244, all P<0.05). In the DS negative (-) group, patients with DE positive (+ ) had lower PFS and OS rates than those with DE- (PFS rate: 50.0% vs 88.9%; OS rate: 66.7% vs 96.3%; χ2 values: 6.050, 4.966, both P<0.05). In ΔSUV max%<90% group, patients with DE+ had lower PFS rate than those with DE- (12.5% vs 68.8%; χ2=6.649, P=0.01). Conclusions:Interim PET/CT analysis using DS and ΔSUV max% is able to predict survival in PGI-DLBCL patients. The combination of DS, ΔSUV max% and DE can risk-stratify PGI-DLBCL patient more effectively.

18.
Article in Chinese | WPRIM | ID: wpr-908686

ABSTRACT

Objective:To explore the clinical characteristics and etiology of children with alimentary tract hemorrhage so as to optimize the diagnosis and treatment.Methods:The clinical data of 2 054 children with alimentary tract hemorrhage in Kunming Children′s Hospital from January 2014 to December 2018 were retrospectively analyzed.Results:Among 2 054 children with alimentary tract hemorrhage, males was in 1 274 cases, females was in 780 cases, and the ratio of males to females was 1.6∶1; <3.0 years old was in 647 cases (31.5%), 3.0 to 5.9 years old was in 488 cases (23.8%), 6.0 to 8.9 years old was in 413 cases (20.1%), 9.0 to 11.9 years old was in 281 cases (13.7%), and ≥12 years old was in 225 cases (11.0%); upper alimentary tract hemorrhage was in 991 cases, lower alimentary tract hemorrhage was in 1063 cases. The top three causes of children with upper alimentary tract hemorrhage were acute or chronic gastritis/ gastric ulcer, anaphylactoid purpura and systemic serious infection; the top three causes of children with lower alimentary tract hemorrhage were intestinal polyps, anaphylactoid purpura and food protein allergic colitis. A rare causes of alimentary tract hemorrhage had Peutz-Jeghers syndrome, cavernous transformation of portal vein, Bartter syndrome, systemic lupus erythematosus, Budd-Chiari syndrome, annular pancreas, Reye syndrome, Klippel-Trenaunay syndrome, Evans syndrome and perianal angiectasia and so on.Conclusions:Alimentary tract hemorrhage is a common disease in pediatrics. With the increase of age, the proportion of children with alimentary tract hemorrhage decreased. The main causes of upper and lower alimentary tract hemorrhage are different in different age stages. In addition to paying attention to common causes, the rare causes of alimentary tract hemorrhage should be vigilant and recognized.

19.
Acta Pharmaceutica Sinica B ; (6): 2798-2818, 2021.
Article in English | WPRIM | ID: wpr-888888

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic intestinal disease with painful clinical manifestations and high risks of cancerization. With no curative therapy for IBD at present, the development of effective therapeutics is highly advocated. Drug delivery systems have been extensively studied to transmit therapeutics to inflamed colon sites through the enhanced permeability and retention (EPR) effect caused by the inflammation. However, the drug still could not achieve effective concentration value that merely utilized on EPR effect and display better therapeutic efficacy in the inflamed region because of nontargeted drug release. Substantial researches have shown that some specific receptors and cell adhesion molecules highly expresses on the surface of colonic endothelial and/or immune cells when IBD occurs, ligand-modified drug delivery systems targeting such receptors and cell adhesion molecules can specifically deliver drug into inflamed sites and obtain great curative effects. This review introduces the overexpressed receptors and cell adhesion molecules in inflamed colon sites and retrospects the drug delivery systems functionalized by related ligands. Finally, challenges and future directions in this field are presented to advance the development of the receptor-mediated targeted drug delivery systems for the therapy of IBD.

20.
Acta Pharmaceutica Sinica B ; (6): 2449-2468, 2021.
Article in English | WPRIM | ID: wpr-888869

ABSTRACT

Orally administered drug entities have to survive the harsh gastrointestinal environment, penetrate the enteric epithelia and circumvent hepatic metabolism before reaching the systemic circulation. Whereas the gastrointestinal stability can be well maintained by taking proper measures, hepatic metabolism presents as a formidable barrier to drugs suffering from first-pass metabolism. The pharmaceutical academia and industries are seeking alternative pathways for drug transport to circumvent problems associated with the portal pathway. Intestinal lymphatic transport is emerging as a promising pathway to this end. In this review, we intend to provide an updated overview on the rationale, strategies, factors and applications involved in intestinal lymphatic transport. There are mainly two pathways for peroral lymphatic transport-the chylomicron and the microfold cell pathways. The underlying mechanisms are being unraveled gradually and nowadays witness increasing research input and applications.

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