Potencialidades e fragilidades da rede de cuidado da pessoa com HIV/Aids / Potencialidades y fragilidades de la red de cuidado de las personas con VIH/SIDA / Potentialities and weaknesses in the care network of people with HIV/AIDS

RESUMOObjetivo:compreender as potencialidades e fragilidades da rede de cuidado da pessoa com HIV/Aids em um serviço de referência do Estado de Santa Catarina-SC.Método:participaram oito sujeitos e sua rede de cuidado, totalizando 18 participantes. Os dados foram coletados através de entrevistas e examinados por análise de conteúdo, sustentados teoricamente pelo interacionismo simbólico.Resultado:a análise resultou nas categorias: A rede ofertando o cuidado à pessoa com síndrome da imunodeficiência adquirida e Enfrentando Barreiras no cuidar, que refletem as potencialidades e fragilidades, na rede de cuidado. A primeira retrata a oferta de cuidado afetivo e humanizado e a segunda, uma rede pouco ampliada, constituída por profissionais de saúde e algum membro familiar.Conclusão:a rede de cuidado profissional é importante, mesmo diante do aumento dos atendimentos numa estrutura física e número de profissionais que já não comportam a crescente demanda.

RESUMENObjetivo:comprender las fortalezas y debilidades de la red de atención de la persona con VIH/SIDA en un centro de referencia en el estado de Santa Catarina-SC.Metodo:ocho participantes sujetos y su red de atención, por un total de 18 participantes. Los datos fueron recolectados a través de entrevistas y se examinaron mediante análisis de contenido, en teoría, con el apoyo de la interacción simbólica.Resultados:el análisis resultó en las siguientes categorías: La red de ofrecer atención a las personas con síndrome de inmunodefi ciencia adquirida y tropezando con obstáculos a la atención, que refl ejan las fortalezas y debilidades en la red de atención. El primero representa la prestación de atención emocional y humano y la segunda un poco más amplia, incluyendo la red de profesionales de la salud y un miembro de la familia.Conclusión:la red de atención profesional es importante, a pesar del aumento de las llamadas en una estructura física y el número de profesionales que ya no se comportan de la creciente demanda.

ABSTRACTObjective:to understand the strengths and weaknesses in the care network of people with HIV/AIDS in a referral center in the state of Santa Catarina-SC.Method:participants were eight subjects and their care network, totaling 18 participants. Data were collected through interviews and examined by content analysis, theoretically supported by symbolic interaction.Results:the analysis resulted in the following categories: The network offering care to people with acquired immunodefi ciency syndrome, and Facing Barriers in care, which refl ect the strengths and weaknesses in the care network. The fi rst depicts the provision of emotional and humanized care, and the second a restricted network formed by health professionals and a family member.Conclusion:the professional care network is important, despite the increased number of assistances in a physical structure and amount of professionals who no longer meet the growing demand.

Endocápsula olympus: reporte inicial de su uso en Venezuela / Endocápsula olympus: initial report of its use in Venezuela

Introducción: En 2001 se introdujo la cápsula endoscópica de Given Imaging® como un método no invasivo que permite realizar enteroscopia total. Recientemente Olympus® desarrolló una cápsula endoscópica para intestino delgado con características diferentes en el sistema óptico, tiempo de carga de batería, tiempo de grabación y descarga de imágenes, además de contar con un sistema que monitorea en tiempo real la localización de la cápsula. Objetivo: Reportar la experiencia inicial con la Endocápsula Olympus® en Venezuela. Pacientes y métodos: De julio a septiembre de 2009 se evaluaron 24 pacientes con sospecha de patología del intestino delgado con este dispositivo. Se registraron datos demográficos, indicación del procedimiento, tiempo de pase gástrico, intestinal, hallazgos y complicaciones. Resultados: 24 pacientes: 11 masculinos y 13 femeninos. Las principales indicaciones fueron: sangrado digestivo oscuro (n=15) y diarrea crónica (n=4). El tiempo gástrico promedio fue de 71,03 + SD minutos y el intestinal de 267,9 + SD minutos. En 1 paciente la cápsula se colocó con el gastroscopio y en 3 no alcanzó el ciego (12,5%). En 11 casos el estudio fue normal (45,83%). Hubo hallazgos positivos en 13 (54,16%): angiectasias (n=6), enfermedad celiaca (n=1), tumor subepitelial ulcerado (n=1), intususcepción (n=1), sangre roja en ileon (n=1), erosiones (n=1), linfangiectasia (n=2). El 84,61% de los hallazgos se relacionaba con la indicación. No hubo complicaciones. Conclusión: La Endoscápsula Olympus® es útil en la evaluación del intestino delgado con un alcance diagnóstico similar al reportado en la literatura para la Cápsula de Given Imaging®. El menor tiempo requerido para cargar la batería, descargar imágenes y el sistema de tiempo real, la convierte en una alternativa para su uso en patología urgente. Estudios prospectivos comparativos son necesarios.

Introduction: In 2001, the Given Imaging® endoscopic capsule was introduced as a noninvasive method that allows total enteroscopy. Olympus® recently developed a small bowel capsule endoscopy with different characteristics in the optical system, battery charging time, recording and image download times, in addition to a system that monitors real-time location of the capsule. Objective: To report the initial experience with Olympus® Endocapsule in Venezuela. Patients and methods: 24 patients with suspected small bowel pathology were evaluated between July and September 2009 using Olympus® Endocapsule. Demographic data, indication for the procedure, gastric time pass, intestinal transit, findings and complications were recorded. Results: 24 patients: 11 male and 13 female. The main indications were obscure gastrointestinal bleeding (n = 15) and chronic diarrhea (n = 4). The average gastric time was 71.03 + SD minutes and intestinal time was 267.9 + SD minutes. In 1 patient the capsule was placed with the gastroscope and in 3 it did not reach the cecum (12.5%). In 11 cases the study was normal (45.83%). There were positive findings in 13 (54.16%) angiectasias (n=6), celiac disease (n=1), subepithelial ulcerated tumor (n=1), intussusception (n 1), red blood in the ileum (n=1), erosions (n=1), lymphangiectasia (n=2). 84.61% of the findings were related to the indication. There were no complications. Conclusion: The Olympus® Endocapsule is useful for diagnosis of small intestine and has a diagnostic yield similar to that reported in the literature for the Given Imaging videocapsule. The shorter time required for charging the battery, download images and the real time system, makes it an alternative for using in emergency conditions. Comparative prospective studies are needed.

Motilidad intestinal y microflora / Intestinal motility and microflora

La microflora es el conjunto de colonias microbacterianas que cubren la superficie del tubo digestivo. Cada sujeto humano alberga unos 100 billones de colonias de unas 400 especies distintas, biodiversidad que facilita la vida y el desarrollo del conjunto. La concentración de bacterias va aumentando a lo largo del tubo digestivo, alcanzando concentraciones de 1012 UFC/ml. en el colon. La motilidad del intestino delgado es propulsiva con una fase de barrido que no permite el crecimiento de bacterias. Por el contrario, la motilidad del colon es muy lenta y no propulsiva durante el ayuno y el sueño. Sólo en vigilia y en período postprandial existen ondas de contracción de alta amplitud y rápidamente progresivas en dirección oral-anal. La interacción entre las bacterias presentes en el lumen y las ondas de contracción motora es muy difícil de evaluar. Este efecto se ha estudiado en base a los fármacos que alteran la motilidad y que al aumentar ésta, barren con la flora bacteriana presente. En ese sentido se sabe que el uso de cisaprida acelera el tránsito, reduciendo la densidad de bacterias metanogénicas con un aumento de la excreción de hidrógeno. En cambio, loperamida disminuye el tránsito, aumentando la flora metanogénica (hecho que representa lo que sucede a pacientes constipadas, que tienen flora mayoritariamente productora de metano). Conclusión: La interacción entre motilidad y flora bacteriana es compleja y está poco estudiada fundamentalmente debido a dificultades técnicas.

Microflora is the set of microbacterium colonies covering the digestive tract surface. Each human subject hosts ca. 100 billions of colonies of 400 different species, b23wiodiversity that facilitates life and development of the whole. Bacteria concentration increases throughout the digestive tract, reaching concentrations of 1012 CFU/ml in the colon. Motility of the small intestine is propulsive with a sweeping phase, allowing for the growth of bacteria. On the contrary, motility of the colon is very slow and non-propulsive during fasting and sleeping. Only during wakefulness and postprandial period there are wide-ranging and quickly progressive contraction waves in oral-anal direction. Interaction between bacteria present in lumen and the contraction waves is very hard to assess. This effect has been studied based on drugs that alter motility, and when it increases, they sweep the existing gut flora. In this sense, it is known that the use of cisapride accelerates the transit, reducing the density of methanogenic bacteria with an increase in the hydrogen excretion. On the other hand, loperamide slows down transit, causing an increase of the methanogenic flora (which represents what happens to constipated patients with flora that produces mainly methane). Conclusion: Interaction between motility and gut flora is complex and has not been enough studied mainly due to technical difficulties.

Estrangulação de intestino delgado devido a divertículo de Meckel e banda mesodiverticular em égua gestante – relato de caso / Strangulation of the small intestine by Meckel´s diverticulum and mesodiverticular band in a pregnant mare – Case Report

O objetivo deste trabalho é descrever a ocorrência de cólica por estrangulação intestinal ocasionada por banda mesodiverticular (BMD) e divertículo de Meckel (DM) em uma égua no terço final de gestação com histórico de 20 horas de cólica moderada contínua sem resposta à administração de analgésicos. Pela celiotomia constatou-se a presença de BMD e DM medindo 15cm a partir da borda anti-mesentérica, ocasionando estrangulação intestinal distante 150cm do orifício ileocecal. Realizaramse enterectomia de 290cm de alça necrosada, drenagem do conteúdo enegrecido e fétido do intestino remanescente, seguida de by pass do ceco por jejuno-colonostomia. Durante o pós-operatório, o quadro se manteve refratário à terapia intensiva instituída. O animal voltou a ter refluxo pela sonda nasogástrica e ocorreu abortamento após seis dias, sendo praticada a eutanásia após 24 horas. A BMD e o DM são estruturas remanescentes dos componentes onfalomesentéricos vitelinos, e sua ressecção deve ser considerada sempre que essas estruturas forem diagnosticadas durante a cirurgia abdominal em equinos. A égua deste relato viveu cinco anos sem consequências aparentes, até que tais alterações provocaram a estrangulação intestinal.

The objective of this report is to describe the occurrence of intestinal strangulation caused by mesodiverticular band (MDB) and Meckel´s diverticulum (MD) in a mare at the latter third of gestation with a 20 hours history of moderate colic unresponsive to analgesic medication. The celiotomy revealed the presence of 5.9 inches long MD and MDB causing intestinal strangulation 59 inches from the ileocecal valve. It was performed an enterectomy of 115 inches of necrotic loop, drainage of the dark and fetid content of the remaining intestine, followed by cecum bypass through jejunocolostomy. Despite the intensive therapy established during postoperative, the gastric reflux through the nasogastric tube came back, the mare suffered abortion after six days, and the euthanasia was performed after 24 hours. MDB and MD are remaining structures of vitelline omphalomesenteric components and their resection should be considered whenever these structures are diagnosed during abdominal surgery in equines. The mare on this report lived five years without apparent consequences; until the moment these alterations caused intestinal strangulation.

Sobrecrecimiento bacteriano intestinal / Small intestinal bacterial overgrowth. An update

Small intestinal bacterial overgrowth (SIBO) is characterized by nutrient malabsorption, associated with an excessive number of bacteria in the proximal small intestine. Unfortunately, the diagnosis of bacterial overgrowth presents several difficulties and limitations, and as yet there is not a widespread agreement on the best diagnostic test. SIBO occurs when there are alterations in intestinal anatomy, gastrointestinal motility, or a lack of gastric acid secretion. The true association between SIBO and irritable bowel syndrome and celiac disease remains uncertain. The treatment usually consists in the eradication of bacterial overgrowth with repeated courses of antimicrobials, nutritional support and when it is possible, the correction of underlying predisposing conditions.

Effects of the combined use of glutamine and growth hormone in the intestinal adaptation after massive resection of the small bowel in rats

OBJETIVO: Investigar os efeitos do uso combinado da glutamina (GL) e do hormônio do crescimento (GH) no intestino de ratos submetidos a ressecção de 80% do intestino delgado. MÉTODOS: Vinte e quatro ratos Wistar foram randomizados para receber uma a dieta padrão- grupo controle (GC, n=12) ou a mesma dieta adicionada de glutamina 4% (isocalórica, isoproteica) - grupo glutamina- hormônio do crescimento (GL-GH, n=12) após a enterectomia à 80%. Este último grupo recebeu por via sub-cutânea, 0,6 UI/dia de GH. Grupos de seis ratos cada foram sacrificados no 5º e 14º dias. As seguintes variáveis foram estudadas: peso corporal, peso de mucosa, histomorfometria e conteúdo de DNA no segmento ressecado inicialmente e no intestino adaptado coletado após o sacrifício. RESULTADOS: Todos os animais perderam peso até o 5º dia, estabilizando-se após esta data em ambos os grupos. Não houve diferença estatística no peso da mucosa associada a grupos ou datas. O peso da mucosa do íleo diminuiu dos dados iniciais para os finais, quando comparados a mucosa jejunal (p<0.02). O conteúdo de DNA aumentou dos dados iniciais para os finais (p=0.001) em ambos os grupos, porém, o aumento foi maior nos animais do grupo GL-GH (CG = 0.53 [95% CI, 0.44-0.62] g/cm-1 vs. GL-GH= 0.85 [95%CI, 0.76-0.94] g/cm-1; p<0.01), especialmente no 14º dia. O conteúdo de DNA no íleo foi significativamente maior que no jejuno (p=0.01). Houve um aumento significativo na espessura da parede e na profundidade da cripta, no grupo controle (p<0.01). CONCLUSÃO: A adaptação intestinal após ressecção extensa é melhorada com o uso combinado de glutamina e GH.

Alteraciones motoras gastrointestinales en la enfermedad de Chagas / Gastrointestinal motility disturbances in Chagas disease

Serum antibodies against Trypanosoma Cruzi have been observed in 19 percent of the Chilean population. Marked differences in organ involvement have been reported in patients with Chagas disease. Chagas disease is rarely an aetiological factor for achalasia in Chile, which is different from reports in other countries of South America. In contrast, a high incidence of megacolon among these patients have been reported. Aim: To study the incidence of gastric and small intestinal motor disorders among these patients and their relationship to esophageal and colon motility disorders. Patients and Methods: We studied 18 patients, 12 women (mean age 45 years); with positive antibodies against T Cruzi. Seven had radiological evidence of megacolon and no one had radiological or manometric evidence for achalasia. Non specific motor esophageal abnormalities were found in 11 patients. Nine had an abnormal electrocardiogram, suggesting a myocardial disease. A questionnaire for gastrointestinal symptoms, an electrogastrography and a small intestinal motility study, were performed in each patient. Results: All patients had evidences of abnormalities in at least one segment of the digestive tract. Twelve patients had an abnormal electrogastrographic study, with bradygastria as the most common finding. Nine had an abnormal small intestinal manometry with a myophatic pattern evidenced by a decreased amplitude of contractions (18.5±3 mmHg). Also an increased number of clustered contractions was observed. Conclusions: Gastric dysrhythmias and small intestinal motor abnormalities are frequently associated to non specific esophageal motor disorders and megacolon in patients with Chagas disease (Rev Méd Chile 2004; 132: 939-4).

Ultrasonographic observation of intestinal mobility of dogs after acupunctural stimulation on acupoints ST-36 and BL-27

The objectives of this study were to observe normal peristalsis and mixing (or segmental movements) and to evaluate an acupuncture stimulation (ST-36 and BL-27) on the intestinal (duodenum) motility in normal dogs using duplex Doppler sonography. Fifteen healthy Beagle dogs were used for this experiment after the administration of warm saline and pellet feeding. The duodenal motility was examined using duplex Doppler sonography. Six hours after the pellet feeding, an electroacupuncture stimulation at ST-36 and BL-27 was applied and the duodenal motility was examined using duplex Doppler sonography pre-stimulation, during the stimulation and post-stimulation. After saline and pellet administration, the duplex Doppler sonograms showed 3 types of peristalsis and a mixing type (or segmental movement) of duodenum motility. In the peristalsis types, most yielded high-amplitude signals which had one high peak (type-1), two high peaks (type-2), and three high peaks (type-3) and lasted more than 1.3 seconds. Mixing type of duodenum motility had weak signals and were lasted more than 1.5 seconds. Among the peristalsis types, the type 1 and type 2 were predominant and the type 3 was rarely observed. The frequency of intestinal motility stimulated by ST-36 acupoint was increased during the acupuncture stimulation (20% increase compared to the basal value) and decreased (7% decrease compared to the basal value) after stimulation. The frequency of intestinal motility stimulated by BL-27 acupoint was decreased during the acupuncture stimulation (31% decrease compared to the basal value) and increased (18% increase compared to the basal value) after stimulation. There was a significant increase(p<0.01) between the value found in during and the post-stimulation tests. We conclude that duplex Doppler studies permit a graphic visualization of intestinal movements which can be qualitatively and quantitatively analyzed using this technique, it is possible to evaluate the gastrointestinal motility after an acupuncture stimulation.

Valor de la manometría intestinal en la patología gastrointestinal / Value of intestinal manometry in gastrointestinal disorders

Background: Small intestinal manometry is a relatively simple technique. However, its use is usually limited to very few centers and mainly related to research studies. Aim: To report our experience with small intestinal motility studies in a group of normal controls and patients with symptoms suggesting a gastrointestinal motor disorder. Patients and methods: Seventy three studies were performed in 71 subjects: 18 asymptomatic controls and 55 patients presenting with symptoms characterized by abdominal pain, vomiting, bloating, constipation and diarrhea. In 33 patients the same symptoms remained without diagnosis, in spite of extensive laboratory studies. In 10 of these, dilated small intestinal loops were observed and intestinal pseudoobstruction was suspected. Twenty two additional patients with systemic disorders such as scleroderma, diabetes and previous vagotomies, were studied. Motility was assessed by means of perfused catheters connected to external transducers for a mean lapse of 280 min. Results: An abnormal pattern of small intestinal motility suggesting neuropathic, myopathic or a mixed disorder was observed in 76 percent of all studied patients, with the exception of patients with scleroderma, in whom only myopathic and mixed alterations were observed. In 82 percent of patients, the results of manometry were useful for the management of the clinical condition. Conclusions: small intestinal manometry is a relatively simple technique that, when used in selected groups of patients, provides useful information for clinical management

Vólvulo primario de intestino delgado en adultos en el Hospital Honorio Delgado de Arequipa 1960 - 1995

El presente trabajo se realizó en el Hospital Honorio Delgado de Arequipa sobre un total de 39 pacientes, cuyo diagnóstico postoperatorio fue confirmado como vólvulo de intestino delgado en el período comprendido entre los años 1960 a 1995. Mediante este estudio se evalúan algunos aspectos importantes relacionados con esta patología, encontrándose que en nuestro medio representa el 2.2 por ciento de todos los casos de obstrucción intestinal; siendo una patología que afecta predominantemente a varones entre la cuarta y sexta década de la vida, cuya ocupación habitual son las labores agrícolas y otras que por lo general demandan esfuerzo físico. El cuadro clínico se caracteriza por dolor abdominal intermitente, acompañado de nauseas y vómitos, distensión abdominal asimétrica a predominio de hemiabdomen superior y fosa ilíaca izquierda. El diagnóstico clínico, radiológico y laboratorial es siempre difícil y no hay signos patognomónicos, sin embargo algunos datos pueden orientarnos hacia la presencia de isquemia y necrosis del asa intestinal y estos están dados por la disminución o abolición de los ruidos hidroaereos, leucositosis con desviación izquierda y la presencias de taquicardia. El diagnóstico de vólvulo de intestino delgado en el preoperatorio se planteo en sólo 3 casos lo que confirma la dificultad que hay para llegar al mismo y proponerlo. El tratamiento quirúrgico fue orientado hacia la desvolvulación simple en casi todos los casos no complicados y hacia la resección y anastomosis en los casos complicados con isquemia y necrosis. El segmento intestinalo comprometido fundamentalmente es el ileon terminal y en unos pocos casos se hallo torsión total del mesenterio, y en otros volvulo de sigmoides simultáneamente. Por otro lado se hallo un importante porcentaje de ganglios mesentéricos inflamados. El tiempo de hospitalización en promedio fue de 28.3 días, el cual nos parece prolongado. No obstante podriamos decir que este valor esta sesgado por cuatro casos en los que las complicaciones los obligaron a permanecer entre cincuenta y ciento ochenta días. El uso de antibióticos fue limitado y fueron prescritos fundamentalmente para tratar las complicaciones. La complicación más importante es la infección de herida operatoria, seguida de ileo de más de cuatro días y el desequilibrio hidroelectrolítico. La mortalidad fue de 17.95 por ciento, y la causa probable más frecuente fue la sepsis seguida del desequilibrio hidroelectrolítico y bronconeumonia.

Análise morfométrica do intestino delgado de esquistossomóticos / Morphometric studies on the mucosa from thje small intestine of schistosomiasic patients with portal hypertension

Foram estudados aspectos histológicos e morfométricos da mucosa do intestino delgado de 22 pacientes esquistossomótiocs hépato-esplêncos antes e após cirurgia de reduçÝo da pressÝo portal, sendo analisados aspectos histológicos gerais como congestÝo, edema, infiltraçÝo inflamatória, fibrose e número de granulomas da mucosa, e morfométricos como número, disposiçÝo e forma das vilosidades, alturas da mucosa e das vilosidades, número de células caliciforme e de Paneth e densidade de eosinófilos. Na análise histológica, verificou-se uma reduçÝo na congestÝo e edema da mucosa após a cirurgia. No estudo morfométrico, constatou-se posteriormente à cirurgia, o aumento estatísticamente significativo, no número de vilosidades digitiformes e foliáceas, e a tendendica à reduçÝo, nas formas em clava e achatadas. Conclui-se que o esquistossomótico hépato-esplênico apresenta alteraçSes estruturais na mucosa do intestino delgado, no entanto, há uma tendência para recuperaçÝo do padrÝo mucoso normal após a reduçÝo da pressÝo portal

Water permeability properties of the human small intestine in vitro: effects of Escherichia coli heat-stable enterotoxin

The net absorptive water flux (Jw), the transepithelial potential difference (PD) and the short-circuit current (Isc) were simultaneously measured in the human small intestine in vitro with the following results: 1) An absorptive Jw was observed when the jejunum or the ileum were mounted between two identical standard solutions in the presence of an hydrostatic pressure gradient (delta P) of 13 cm of water (mucosal side positive). 2) The absorptive Jw was a linear function of the applied delta P or the imposed osmotic transepithelial gradient (deltaOsm) in both intestinal segments. The hydrostatic (Phydr) and osmotic (Posm) permeabilities to water for jejunum and ileum were: 0.349 ñ 0.049 cm/s vs. 0.156 ñ 0.022 cm/s and 0.0012 ñ 0.0001 cm/s vs. 0.0019 ñ O.0003, respectively. 3) A fraction of this absorptive Jw was independent of the presence of any hydrostatic, osmotic or chemical gradient and represented the transport associated to movement of water (Jwt). 4) PD and Isc values were similar in the jejunum and in the ileum but the transepithelial resistance (Rt) was significantly greater in ileum than in jejunum. 5) 2 mug/ml of E. coli heat-stable enterotoxin (STa) caused a significant inhibition of the absorptive Jw without modification of Phydr, Posm or Isc. 6) After STa treatment, the absorptive Jwt reverted to a secretory one in the jejunum. In the ileum, STa action caused a 48 per cent decrease in the absorptive Jwt values.

The effect of capsaicin on the small intestinal absorption of glucose and alanine in the rat.

Chilli (containing the active ingredient capsaicin) forms an important flavouring agent in the preparation of meals in the tropics. Previous studies have shown that capsaicin in high doses causes gross structural and functional changes in the gut. The present study investigates the effect of pure capsaicin on the absorption of glucose, water and alanine by the small intestine of the rat. Perfusion studies were carried out using a 10 cm jejunal segment. Absorption rates of glucose, water and alanine from a control solution containing the nutrient and from a test solution containing added capsaicin were compared. Recovery of absorptive function of the intestinal mucosa after exposure to capsaicin was also studied. Absorption of water, glucose and alanine was found to be significantly reduced in the presence of capsaicin. Recovery of absorptive function occurred when capsaicin was withdrawn from the perfusate. It was concluded that capsaicin adversely affected absorption of nutrients from the rat small intestine; this effect was reversible at least in the case of some nutrients.

Relación entre síntomas funcionales del aparato digestivo y motilidad del intestino delgado / Small intestine motility and functional gastrointestinal symptoms

Although abnormalitiew of intestinal motility are usually considered to underly functional gastrointestinal symptoms, objective evidence of such a relation is controversial. We performed manometric studies using perfused catheters in 26 patients with such symptoms. A marked variation in duration of cyclic motor activity (tange 34 to 168 min) was observed, motivity was absent in 5 patients. No clear relation between symptoms and motility pattern was demonstrated. Thus, altered intestinal motility is not clearly related to functional gastrointestinal complaints

Estudo da motilidade intestinal em ratos enterectomizados / Study of bowel motility in enterectomized rats

Foram investigados os efeitos da ressecçäo intestinal de 80% de jejuno-íleo, na motilidade do intestino remanescente de ratos. Após período experimental de 100 dias, avaliamos o peristaltismo intestinal de 3cm de duodeno e de 3cm de delgado. O registro da motilidade desses segmentos foi feito através de alavancas isotônicas. Os registros de ondas foram analisados de acordo com a freqüência e amplitudes. Em relaçäo ao segemtno duodenal näo observamos diferença significante entre os animais enterectomizados e os animais controle, porém em relaçäo ao segmento de delgado verificamos que a média das amplitudes das ondas intestinais dos animais controle (0,444cm) foi significantemente maior do que a dos animais ressecados (0,241cm). A presente investigaçäo permitiu concluir que a ressecçäo intestinal extensa provoca uma diminuiçäo do peristaltismo do intestino remanescente, o que é um fator importante na diminuiçäo da diarréia e suas conseqüências