ABSTRACT
INTRODUCTION AND AIMS: The solid test meal (STM) is a challenge test that is done during esophageal manometry and appears to increase the diagnostic yield of the study. The aim of our analysis was to establish the normal values for STM and evaluate its clinical utility in a group of Latin American patients with esophageal disorders versus healthy controls. MATERIAL AND METHODS: A cross-sectional study was conducted on a group of healthy controls and consecutive patients that underwent high-resolution esophageal manometry, in which STM was done at the final part of the study and consisted of asking the subjects to eat 200â¯g of precooked rice. The results were compared during the conventional protocol and the STM. RESULTS: Twenty-five controls and 93 patients were evaluated. The majority of the controls (92%) completed the test in under 8â¯min. The STM changed the manometric diagnosis in 38% of the cases. The STM diagnosed 21% more major motor disorders than the conventional protocol; it doubled the cases of esophageal spasm and quadrupled the cases of jackhammer esophagus, whereas it demonstrated normal esophageal peristalsis in 43% of the cases with a previous diagnosis of ineffective esophageal motility. CONCLUSIONS: Our study confirms the fact that complementary STM during esophageal manometry adds information and enables a more physiologic assessment of esophageal motor function to be made, compared with liquid swallows, in patients with esophageal motor disorders.
ABSTRACT
INTRODUCTION AND AIM: In recent years, probiotics have been used in functional gastrointestinal disorders, including chronic constipation (CC). The effect of Bifidobacterium infantis strain 35624 on the gut microbiota of CC patients has not been previously studied. Our aim was to analyze the fecal microbiota of constipated patients, before and after consuming a single-strain probiotic (B. infantis strain 35624). MATERIALS AND METHODS: We used 16S rRNA gene high-throughput sequencing to analyze the fecal microbiota of female patients (n=13) with CC. Patients were instructed to ingest one capsule of Alflorex® (containing 1×109 CFUs/g B. infantis strain 35624) daily for eight weeks. Fecal samples were obtained at the baseline and end (final) of probiotic administration. RESULTS: Alpha diversity metrics did not differ between the baseline and final periods. The butyrate producer, Oscillospira, was the taxon most strongly correlated with amplicon sequence variants (R2=0.55, p<0.0001). Except for a few bacterial taxa, there were no significant differences in relative abundance between the baseline and final periods. Beta-diversity measures also showed limited evidence for the differences between the two time periods. CONCLUSIONS: The results suggest that the fecal bacterial microbiota remains stable in constipated women consuming a single-strain probiotic. Those findings may be helpful in better understanding probiotic functioning in patients with digestive disorders.
ABSTRACT
Zooarchaeological collections from shell mounds in Rio de Janeiro (2,470-4,632 cal BP) contain a high prevalence of swollen fish bones belonging to the Atlantic spadefish (Chaetodipterus faber), crevalle jack (Caranx hippos) and fat snook (Centropomus parallelus). Given the lack of knowledge of the bone degenerative process in senile fishes, this study analysed hyperostotic bone in zooarchaeological and modern specimens to obtain high-resolution morphology and microstructure reconstruction. We used microCT as well as X-ray diffraction to characterize the crystallographic changes associated with fish senility. Our results showed that trabecular microstructures in hyperostotic bones were consistent with estimated values of the per cent bone volume-to-total volume ratio (BV/TV) and were greater than 60% in cortical bone. Hyperostotic bones indicated a high radiograph density, and X-ray diffractograms showed a decrease in hydroxyapatite [Ca10 (PO4 )6 (OH)2 ] and calcite (CaCO3 ) neocrystallization. These crystalline and density changes revealed an advanced stage of fish senile and indicate the vulnerability of ageing fish populations.
Subject(s)
Bone and Bones/anatomy & histology , Fishes/anatomy & histology , Aging , Animals , Archaeology , Bone and Bones/ultrastructure , Brazil , Calcium Carbonate/chemistry , Durapatite/chemistry , History, Ancient , X-Ray Diffraction , X-Ray MicrotomographyABSTRACT
On the Southeastern coast of Brazil the presence of many archaeological shellmounds offers a great potential for studying the radiocarbon marine reservoir effect (MRE). However, very few such studies are available for this region. These archaeological settlements, mostly dating from 5 to 2 kyr cal BP, include both terrestrial and marine remains in good stratigraphic context and secure association, enabling the comparison of different carbon reservoirs. In a previous study the chronology of the Sambaqui da Tarioba, located in Rio de Janeiro state, Brazil, was established based on marine mollusc shells and charcoal samples from hearths, from several layers in two excavated sectors. We now compare the different materials with the aim of studying the MRE in this region. Calibration was performed with Oxford software OxCal v4.2.3 using the marine curve Marine13 with an undetermined offset to account for local corrections for shell samples, and the atmospheric curve SHCal13 for charcoal samples. The distribution of results considering a phase model indicates a ΔR value of -127 ± 67 (14)C yr in the 1 sigma range and the multi-paired approach leads to a mean value of -110 ± 94 (14)C yr.
Subject(s)
Animal Shells/chemistry , Carbon Radioisotopes/analysis , Mollusca/chemistry , Radiometric Dating , Animals , Archaeology , Brazil , CalibrationABSTRACT
Hospitalized adult patients frequently have sleep complaints. The majority of studies have principally focused in ICU patients. However, many medical and surgical disorders can disrupt the normal sleep architecture. Sleep disorders in hospitalized patients are susceptible to be successfully treated with hypnotics and control of ambient factors. We reviewed papers published in the Medline between 1997 2012, those considered relevant are be discussed in this review.
Subject(s)
Humans , Male , Female , Adult , Inpatients , Sleep Apnea Syndromes , Sleep Disorders, Circadian Rhythm , Sleep Initiation and Maintenance Disorders , Sleep-Wake Transition Disorders , Sleep Wake Disorders/classification , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/prevention & control , Sleep Wake Disorders/therapyABSTRACT
BACKGROUND: Celiac disease (CD) is predominant in women and young people. Atypical, non-enteric symptoms are more common among adults. There is also an association between CD and neurological disorders, especially with cerebellar ataxia, polyneuropathy and epilepsy. AIM: To study the frequency of CD in a group of adults with cryptogenic epilepsy. MATERIAL AND METHODS: Twenty one patients with cryptogenic epilepsy, aged 20 to 65 years (14 women) were studied, measuring IgA-anti transglutaminase antibodies and deamidated gliadin peptide (DGP) IgG and IgA antibodies. RESULTS: One patient had elevated titers of both types of antibodies. Small bowel biopsy showed villous atrophy and lymphocytic infiltration compatible with CD. CONCLUSIONS: One of 21 adult patients with cryptogenic epilepsy had a silent CD.
Subject(s)
Antibodies, Anti-Idiotypic/blood , Celiac Disease/diagnosis , Epilepsy/complications , Gliadin/immunology , Transglutaminases/immunology , Adolescent , Adult , Aged , Celiac Disease/complications , Celiac Disease/immunology , Female , Gliadin/blood , Humans , Immunoglobulin A/blood , Immunoglobulin A/immunology , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Middle Aged , Transglutaminases/blood , Young AdultABSTRACT
Background: Celiac disease (CD) is predominant in women and young people. Atypical, non-enteric symptoms are more common among adults. There is also an association between CD and neurological disorders, especially with cerebellar ataxia, polyneuropathy and epilepsy. Aim: To study the frequency of CD in a group of adults with cryptogenic epilepsy. Material and Methods: Twenty one patients with cryptogenic epilepsy, aged 20 to 65years (14 women) were studied, measuring IgA-anti transglutaminase antibodies and deamidated gliadin peptide (DGP) IgG and IgA antibodies. Results: One patient had elevated titers of both types of antibodies. Small bowel biopsy showed villous atrophy and lymphocytic infiltration compatible with CD. Conclusions: One of 21 adult patients with cryptogenic epilepsy had a silent CD.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Anti-Idiotypic/blood , Celiac Disease/diagnosis , Epilepsy/complications , Gliadin/immunology , Transglutaminases/immunology , Celiac Disease/complications , Celiac Disease/immunology , Gliadin/blood , Immunoglobulin A/blood , Immunoglobulin A/immunology , Immunoglobulin G/blood , Immunoglobulin G/immunology , Transglutaminases/bloodABSTRACT
Episodic hypersomnia, compulsive excessive eating and erotic behaviour, with schizophreniclike mental symptoms are the hallmarks of the rare KleineLevin syndrome. Many patients may not necessarily fulfill minimum criteria described for diagnosis. We report a 19 years young man with incomplete presentation the KleineLevin syndrome and briefly reviewed the most relevantaspects of this disorder, its epidemiology, clinical symptoms and complementary diagnostic examinations. Known therapeutic options and prognosis are also discussed.
Subject(s)
Humans , Male , Adult , Disorders of Excessive Somnolence , Kleine-Levin Syndrome , Sleep Disorders, IntrinsicABSTRACT
Aim. To assess the efficiency of topiramate (TPM), an antiepileptic medication which possesses multiple mechanisms of action, a wide therapeutic spectrum and good pharmacokinetics in the management of status epilepticus (SE), especially in refractory. Several reports have shown that TPM presents different efficacy in the management of different types of refractory status epilepticus, both adults and children. Also present our experience with two patients with SE who responded early without TPM oral complications. Conclusions. TPM oral as drug associated, is an antiepileptic medication that has shown therapeuticefficacy in cases reports and observational studies the management SE of different types and nature. This efficacy has not been contrasted with randomized controlled trials and prospective studies, therefore, future studies with larger numbers of patients are needed to confirm published reports.
Subject(s)
Humans , Male , Middle Aged , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Anticonvulsants/pharmacokinetics , Epilepsy , Status EpilepticusABSTRACT
Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available
Subject(s)
Humans , Male , Adult , Subacute Sclerosing Panencephalitis/etiology , SSPE Virus/pathogenicity , Subacute Sclerosing Panencephalitis/diagnosis , Subacute Sclerosing Panencephalitis/drug therapy , SSPE Virus/drug effects , Inosine Pranobex/therapeutic use , Myoclonus/etiology , Myoclonus/drug therapy , Valproic Acid/therapeutic use , Magnetic Resonance SpectroscopyABSTRACT
The features of refractory epilepsies and the role of functional surgery and new antiepileptic drugs is reviewed. Among the latter, gabapentin, a drug with peculiar pharmacokinetic properties, is highlighted as a therapeutic alternative in refractory epilepsies and eventually for epileptic patients without previous treatment. A new type of relationship between the pharmaceutical industry and physicians, that privileges clinical research is discussed
Subject(s)
Humans , Epilepsy/drug therapy , Anticonvulsants/pharmacology , Drug Interactions/physiology , Epilepsy/surgery , gamma-Aminobutyric Acid/analogs & derivativesSubject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Cerebrovascular Disorders/diagnosis , Emergency Service, Hospital , Prognosis , Aged, 80 and over , Case-Control Studies , Cerebrovascular Disorders/drug therapy , Cerebrovascular Disorders/epidemiology , Retrospective Studies , Diagnosis-Related GroupsABSTRACT
Se revisan las características farmacológicas clínicas de la Carbamazepina y se hace hincapié en las dificultades de índole práctica que ocasiona el uso de este fármaco antiepiléptico
Subject(s)
Pregnancy , Humans , Female , Carbamazepine/pharmacology , Carbamazepine/adverse effects , Drug InteractionsSubject(s)
Adult , Middle Aged , Humans , Male , Female , Epilepsy/drug therapy , Status Epilepticus/drug therapy , Phenytoin/administration & dosage , Phenytoin/bloodABSTRACT
Se estudiaron 78 casos clínicos hospitalizados por infección respiratoria aguda baja durante los años 1983 a 1986. En todos se confirmó Adenovirus (Ad.) por aislamiento viral, detección de antígeno en aspirado nasofaríngeo o serología pareada. De las técnicas para diagnóstico virológico empleadas, el aislamiento viral fue la de mayor positividad (66/78 casos). Se analizaron las características personales de los pacientes, factores de riesgo de adquirir infección grave por Ad., manifestaciones clínicas y resultados virológicos obtenidos. De los 78 casos estudiados, el 69,2% eran menores de un año. En el 43,6% de los enfermos ocurrió infección viral mixta, la que prevaleció significativamente también en menores de un año. Uno de los factores de riesgo presente con mayor frecuencia fue el antecedente de patología respiratoria, ya sea ambulatoria, hospitalaria o ambas. La evolución clínica fue generalmente larga y con las características ya conocidas para las infecciones por Ad. Entre los exámenes de laboratorio destacan: lo poco característico del hemograma, la tendencia a la hipoxemia y las alteraciones radiológicas con una alta frecuencia de imágenes de neumonitis, condensación e hiperinsuflación pulmonar. La letalidad de los casos estudiados fue de 7,7% (6 casos)
Subject(s)
Infant, Newborn , Infant , Child , Adolescent , Humans , Male , Female , Adenoviridae Infections/diagnosis , Adenoviruses, Human/pathogenicity , Respiratory Tract Infections/etiologyABSTRACT
Un análisis crítico es realizado en 15 pacientes operados por enfermedad de peyronie, en los que se emplearon dos técnicas quirúrgicas: injerto autógeno en 6 pacientes y técnica de Nesbit en 9 pacientes. El seguimiento mínimo fue de 3 meses y el máximo de 17. Cuatro pacientes sufrieron complicaciones y correspondió el 20 porciento de éstas, a los operados con injerto autógeno. Concluimos que el tratamiento quirúrgico acorta favorablemente la evolución natural de la enfermedad, se obtienen buenos resultados con la técnica de Nesbit, y son mínimas las complicaciones con la misma(AU)
Subject(s)
Penile Induration/surgeryABSTRACT
Se le practican pruebas ergometricas a hipertensos arteriales marginales. Se examinan los cambios de la frecuencia cardiaca y la tension arterial durante el ortostatismo, el ejercicio y la recuperacion. Se observo que durante el ejercicio se comportaban como los hipertensos estables y durante la recuperacion como los normotensos, el ortostatismo provoco en la mayoria un aumento exagerado del tono simpatico.Estos hallazgos permiten establecer criterios diagnosticos ergometricos para hipertensos marginales