Effect of glutamine supplementation on left colon healing in rats with extrahepatic biliary obstruction

PURPOSE: To evaluate the influence of glutamine and obstructive jaundice on left colon healing in rats. METHODS: Sixteen male rats were allocated across four groups: LG - Common bile duct ligation followed by colotomy and bowel suture on postoperative day 7. Supplementation with glutamine 2% from day 4 after duct ligation until euthanasia. L - Common bile duct ligation followed by colotomy and bowel suture on postoperative day 7. No glutamine supplementation. M - Common bile duct manipulation followed by colotomy and bowel suture on postoperative day 7. No glutamine supplementation. MG - Common bile duct manipulation followed by colotomy and bowel suture on postoperative day 7. Supplementation with glutamine 2% from day 4 after duct manipulation until euthanasia. On the day of euthanasia, bursting pressure of the sutured bowel segment was measured and samples were collected for histopathological analysis. RESULTS: There were no differences in bursting pressure among groups : LG vs. M (110 ± 28 vs. 173 ± 12; p = 0.08). Groups L and MG were not different from group M (156 ± 12 and 118 ± 22. Glutamine supplementation was associated with less edema, polymorphonuclear lymphocyte infiltration, bacterial colonies, and abscess formation, as well as with increased collagen formation. CONCLUSION: Obstructive jaundice had no negative effect and glutamine supplementation had no positive effect on colonic scar strength in rats. .

Effect of vitamin K1 supplementation on left colon healing in rats with extrahepatic biliary obstruction

PURPOSE: To evaluate the effects of vitamin K1 on wound healing in the left colon of rats with experimental biliary obstruction. METHODS: Sixteen male rats, divided into four groups of four animals each (L, M, LK, and MK), underwent colostomy followed by bowel suture in the left colon. Seven days before, animals in the L and LK groups had undergone common bile duct ligation. The animals in groups MK and LK received vitamin K1 supplementation. On day 7 after bowel suture, repeat laparotomy was performed for evaluation of colonic healing by burst pressure measurement and collection of samples for histopathological analysis. Changes in body weight were evaluated in the four groups. RESULTS: Weight loss was lower in animals supplemented with vitamin K. No significant differences were observed in burst pressure among the four groups (p>0.05). Histological analysis showed more hemorrhage and congestion in the biliary obstruction groups. Supplemented animals exhibited increased collagen formation and less edema and abscess formation. CONCLUSION: Vitamin K supplementation attenuated weight loss and improved colonic wound healing in rats. .

Impact of bariatric surgeries on diabetes outcomes / Impacto da cirurgia bariátrica no resultado do diabetes

Obesity and type 2-diabetes (T2D) are associated to dramatically high morbidity and mortality, and their incidence and prevalence are increasing rapidly. Bariatric surgeries, including a variety of gastrointestinal surgical procedures achieve substantial and sustained weight loss in morbidly obese patients, strongly improves diabetes and hypertension control or prevalence, quality of life, decreases incidence of stroke, myocardial infarction and obstructive sleep apnea among other favorable clinical outcomes. Most important, mortality rates decreases. The objectives of this narrative review were the effectiveness of bariatric procedures on diabetes remission or improvement and the implicated mechanisms. It was found that bariatric surgeries induce high rates of short and long-term diabetes remission (from 60 to 95% or improved control), according to the surgical intervention, with low frequency of perioperative and postoperative complications. Rates of diabetes recurrence are not well known, but the time free-of-disease should ameliorate diabetes complications and mortality. The mechanisms are still not completely understood; encompass improved insulin action, better b-cell function, higher adiponectin, lower inflammation and complex changes of hormones of the entero-insular axis, GLP-1 and glucose dependent insulinotropic polypeptide (GIP). Insulin action improves proportionally to weight loss (WL), in most types of surgery, but normalizes after Bilio-pancreatic diversion even in still obese people. b-cell function improves more after bypass than after restrictive surgeries, but does not normalize and baseline function predicts diabetes remission. Efforts to understand mechanisms and predictive factors for diabetes remission may optimize surgical interventions for metabolic disorders even in less obese patients. Finally and more important, they might drive the development of new clinical approaches for T2D...