Two types of irritable bowel syndrome: pathophysiologic and pharmacological considerations / Dos tipos del síndrome de intestino irritable: consideraciones patofisiológicas and farmacológicas

The investigation performed in 18 diarrheid and 24 spastic patients showed adrenal glands hyperactivity in the former and hypoactivity in the latter. The central noradrenergic system was unresponsive to glucose in both groups: probably due to glucose-insulin failure to rise in diarrheics, whereas a hyperactive parasympathetic system may have been resposible in spactics. Diarrheics had the lowest sigmoidal tone with rectal hyperactivity and the highest plasma catecholamines + cortisol + glucose + insulin values. Spastic patients, in turn, had the highest sigmoidal tone and the lowest catecholamine values. Plasma glucose, insulin, platelet serotocin and sigmoidal tone rose in spactics, after glucose ingestion, but failed to do so in diarrheics. Further, in spactic patients, sigmoidal tone correlated positively with platelet serotonin and negatively with noradrenaline. The clonidine test showed hyperresponsivenes of growth hormone, cortisol and diastolic blood pressure in diarrheics, compared to a normal response in spastics, alpha-adrenergic antagonists suppressed diarrhea and renal hiperactivity. Alpha adrenergic agonists (wich also deplete plattelet-and myentericplexa serotonin) reduced signoidal tone to zero, increased rectal activity and provoked diarrhea. These findings suggest that peripheral sympathetic activity (prevalent in diarrheics) and hyperparasympathetic activity (prevalent in spactics) trigger these physiological disorders by respectively suppressing and reinforcing the serotonin-plexa level functioning

Efecto de tres esquemas terapéuticos en base a penicilina G sobre la evolución clónica y bacteriológica de faringoamigdalitis por estreptococos grupo A en niños / Effects of three therapeutic schemes based in penicillin G on the clinic and bacteriologic evolution of streptococcal pharingo tonsillites groupe A in children

En un grupo de 59 niños con faringoamigdalitis causada por estreptococos grupo A, se cuantificó la frecuencia de ocurrencia de fiebre, dolor faríngeo, malestar general, dolor abdominal, cefalea, vómitos, eritema faríngeo, linfadenopatía cervical, exudado faríngeo purulento, lengua saburral, petequias en paladar, exantema y lengua en fresa, y escarlatina. Al comparar en forma abierta el efecto de tres esquemas de tratamiento con penicilina G procaína, penicilina G Benzatínica o una combinación de penicilina G benzatínica, procaína y cristalina sobre la evolución de los signos y sintomas presentados por los pacientes, se observó que dichos tratamientos tenían una efectividad similar, tanto desde el punto de vista clínico como de erradición bacteriológica a los 10 días de iniciados los tratamientos. La coagulación demostró ser un método útil en la detección de estreptococos grupo A en exudado faríngeo, con una sensibilidad cercana a la del cultivo en agar-sangre