"Pastillas para la tensión". La repercusión de la familia en el adolescente / "Medicines for stress". The impact of the family on the adolescent

Las relaciones padre/cuidador y niño son fundamentales y tienen un impacto significativo sobre la salud de los individuos. Estas relaciones pueden tener efectos en la protección de la salud, ser neutras o tener resultados perjudiciales. En casos extremos, estas relaciones pueden incluir maltrato o abandono, lo que tendrá consecuencias médicas y psicológicas para el individuo (1). Estas relaciones pueden llamar la atención clínica por ser el motivo de consulta del individuo o por ser un problema que afecte al curso, pronóstico o tratamiento de otro trastorno. Presentamos el caso clínico de una paciente que ingresa en la Unidad de Psiquiatría Infanto-Juvenil con la finalidad de suspender la medicación antipsicótica con la que lleva 8 años y la valoración de la sintomatología durante el proceso, tras el fracaso de los intentos de retirada de forma ambulatoria. En la discusión exponemos las patologías psiquiátricas relacionadas con la familia y el caso

Parent / caregiver and child relationships are critical and have a significant impact on the health of individuals. These relationships can have effects on health. They can protect it, be neutral or have detrimental results. In extreme cases, these relationships may include abuse or neglect, which will have medical and psychological consequences for the individual (1). These relationships can be the reason for consulting the individual or they can be a problem that affects the course, prognosis or treatment of another disorder. We present the case of a patient who entered the Unit of Child and Adolescent Psychiatry with the purpose of suspending the antipsychotic medication with which it takes 8 years and the evaluation of the symptomatology during the process. In the discussion we expose the psychiatric pathologies related to the family and the case

Genetic characterization of a reciprocal translocation present in a widely grown barley variety.

Artificially induced translocation stocks have been used to physically map the barley genome; however, natural translocations are extremely uncommon in cultivated genotypes. Albacete is a barley variety widely grown in recent decades in Spain and carrying a reciprocal translocation which obviously does not affect its agronomical fitness. This translocation has been characterized by a combination of cytological and molecular genetic approaches. Firstly, recombination frequencies between markers on chromosomes 1H and 3H were estimated to determine the boundaries of the reciprocal interchange. Secondly, 1H-3H wheat barley telosome addition lines were used to assign selected markers to chromosome arms. Thirdly, fluorescence in situ hybridization (FISH) with rDNA probes (5S and 18S-5.8S-26S) and microsatellite probes [(ACT)(5), (AAG)(5) and (CAG)(5)] was used to determine the locations of the translocation breakpoints more precisely. Fourthly, fine-mapping of the regions around the translocation breakpoints was used to increase the marker density for comparative genomics. The results obtained in this study indicate that the translocation is quite large with breakpoints located on the long arms of chromosomes 1H and 3H, between the pericentromeric (AAG)(5) bands and above the (ACT)(5) interstitial distal bands, resulting in the reciprocal translocation 1HS.1HL-3HL and 3HS.3HL-1HL. The gene content around the translocation breakpoints could be inferred from syntenic relationships observed among different species from the grass family Poaceae (rice, Sorghum and Brachypodium) and was estimated at approximately 1,100 and 710 gene models for 1H and 3H, respectively. Duplicated segments between chromosomes Os01 and Os05 in rice derived from ancestral duplications within the grass family overlap with the translocation breakpoints on chromosomes 1H and 3H in the barley variety Albacete.

Esplenosis abdominal: una entidad frecuentemente infradiagnosticada / Abdominal splenosis: an often underdiagnosed entity

La esplenosis se define como el autotrasplante heterotópico de tejido esplénico como resultado de una rotura del bazo por trauma o cirugía. Es una condición benigna y de hallazgo casual, aunque en ciertas ocasiones las pruebas de imagen puedan orientar a malignidad simulando tumores renales, linfomas abdominales y endometriosis, entre otros. Presentamos el caso de un varón de 42 años al que, tras un estudio por dolor abdominal, se le realiza una resonancia magnética en la que se observan múltiples adenopatías en el abdomen que pueden orientar a un síndrome linfoproliferativo. Como antecedente importante, presenta esplenectomía por trauma abdominal a los 9 años. Tras varios estudios, se decide realizar una gammagrafía con hematíes desnaturalizados marcados con tecnecio-99m que muestra múltiples depósitos patológicos distribuidos por todo el abdomen e, incluso, la pelvis, siendo este hallazgo compatible con esplenosis(AU)

Splenosis is defined as the heterotopic autotransplantation of splenic tissue because of a ruptured spleen due to trauma or surgery. It is a benign and incidental finding, although imaging tests may sometimes orient toward malignancy simulating renal tumors, abdominal lymphomas, endometriosis, among other. We report the case of a 42-year old male in whom a MRI was performed after a study due to abdominal pain. Multiple enlarged lymph nodes were observed in the abdomen, suggestive of lymphoproliferative disease. As an important background, splenectomy was carried out due to abdominal trauma at age 9. After several studies, it was decided to perform a 99mTc-labeled heat-damaged red blood cell scintigraphy that showed multiple pathological deposits distributed throughout the abdomen, and even the pelvis, being consistent with splenosis(AU)

[Abdominal splenosis: an often underdiagnosed entity]. / Esplenosis abdominal: una entidad frecuentemente infradiagnosticada.

Splenosis is defined as the heterotopic autotransplantation of splenic tissue because of a ruptured spleen due to trauma or surgery. It is a benign and incidental finding, although imaging tests may sometimes orient toward malignancy simulating renal tumors, abdominal lymphomas, endometriosis, among other. We report the case of a 42-year old male in whom a MRI was performed after a study due to abdominal pain. Multiple enlarged lymph nodes were observed in the abdomen, suggestive of lymphoproliferative disease. As an important background, splenectomy was carried out due to abdominal trauma at age 9. After several studies, it was decided to perform a (99m)Tc-labeled heat-damaged red blood cell scintigraphy that showed multiple pathological deposits distributed throughout the abdomen, and even the pelvis, being consistent with splenosis.

Linkage map construction involving a reciprocal translocation.

This paper is concerned with a novel statistical-genetic approach for the construction of linkage maps in populations obtained from reciprocal translocation heterozygotes of barley (Hordeum vulgare L.). Using standard linkage analysis, translocations usually lead to 'pseudo-linkage': the mixing up of markers from the chromosomes involved in the translocation into a single linkage group. Close to the translocation breakpoints recombination is severely suppressed and, as a consequence, ordering markers in those regions is not feasible. The novel strategy presented in this paper is based on (1) disentangling the "pseudo-linkage" using principal coordinate analysis, (2) separating individuals into translocated types and normal types and (3) separating markers into those close to and those more distant from the translocation breakpoints. The methods make use of a consensus map of the species involved. The final product consists of integrated linkage maps of the distal parts of the chromosomes involved in the translocation.

Gammagrafía con análogos de la somatostatina en el diagnóstico y el seguimiento del carcinoide bronquial pediátrico / Somatostatin receptor scintigraphy in pediatric bronchial carcinoid tumor

IntroducciónEl tumor carcinoide es una rara neoplasia de origen neuroendocrino con localizaciones diversas, siendo las más frecuentes en la edad pediátrica el apéndice y el pulmón. La gammagrafía con 111In-DTPA-d-Phe1-octreótido ha supuesto un considerable avance en el diagnóstico de extensión de pacientes con tumor carcinoide. Presentamos tres pacientes pediátricos con carcinoide bronquial (CB) explorados con gammagrafía con análogos de la somatostatina (GRSS).La primera paciente (9 años) fue estudiada mediante GRSS tras cirugía por tumoración carcinoide en el lóbulo inferior derecho (LID), que objetivó resto tumoral (más evidente en el estudio tomográfico). Nuevos estudios de control con GRSS demostraron el aumento de tamaño del resto tumoral, la existencia de metástasis óseas, hepáticas y otro foco pulmonar de forma más precoz que las otras técnicas de imagen realizadas.La segunda paciente (10 años) acudió por tumoración endobronquial en el lóbulo inferior izquierdo (LII) junto con atelectasia del lóbulo superior izquierdo y enfisema del LII. Las técnicas de imagen radiológicas planteaban el diagnóstico diferencial entre tumor carcinoide endobronquial o granulomas de células plasmáticas o a cuerpo extraño. La GRSS mostró un depósito anormal de actividad en el hemitórax izquierdo compatible con tumoración carcinoide. No se visualizaron otras áreas sugestivas de metástasis. Tras la cirugía (resección endobronquial), los nuevos controles con GRSS mostraron ausencia de enfermedad.El tercer paciente (12 años) acudió tras lobectomía (lóbulo superior derecho) por CB. La GRSS no mostró áreas anormales de actividad. En un control posterior (3 meses) se visualizó un depósito de actividad en el tercio medio del hemitórax derecho, tras lo que se realizó lobectomía (LID y lóbulo medio), que objetivó pequeños restos de carcinoide neuroendocrino. Los controles posteriores fueron negativos...(AU)

IntroductionCarcinoid tumor is a rare neuroendocrine neoplasm with different locations, the most frequent ones during the pediatric age being the appendix and lung. Scintigraphy with 111In-DTPA-d-Phe1-octreotide has led to an importance advance in the diagnosis of extension in carcinoid tumor patients. We present three pediatric patients with bronchial carcinoid studied with somatostatin analogue scintigraphy (SSRS).Clinical casesThe first patient (9 years) was studied using the SSRS after surgery due to carcinoid tumor in the right lower lobe in which tumor remains was observed (this being clearer in the tomography study).The second patient (10 years) presented due to endobronchial tumor in the left lower lobe together with atelectasis of the LUL and emphysema of the LLL. Radiology imaging techniques suggested the differential diagnosis between the endobronchial carcinoid tumor or plasma cells or foreign body gramuloma. The SSRS showed an abnormal deposit of activity in the left hemithorax consisted with carcinoid tumor. No other areas suggesting metastasis were observed. After the surgery (endobronchial resection), new controls with SSRS showed absence of disease.The third patient (12 years) came after a lobectomy (RUL) due to bronchial carcinoid. The SSRS did not show any abnormal areas of activity. In the subsequent control (3 months), a deposit of activity was observed in the middle third of the right hemithorax, after which a lobectomy was performed (RLL and ML) that showed small remains of neuroendocrine carcinoid. Subsequent controls were negative.ConclusionThe SSRS has demonstrated great utility in the diagnosis, follow-up and staging of pediatric patients, carriers of neuroendocrine carcinoid tumors(AU)

[Somatostatin receptor scintigraphy in pediatric bronchial carcinoid tumor]. / Gammagrafía con análogos de la somatostatina en el diagnóstico y el seguimiento del carcinoide bronquial pediátrico.

INTRODUCTION: Carcinoid tumor is a rare neuroendocrine neoplasm with different locations, the most frequent ones during the pediatric age being the appendix and lung. Scintigraphy with (111)In-DTPA-d-Phe(1)-octreotide has led to an importance advance in the diagnosis of extension in carcinoid tumor patients. We present three pediatric patients with bronchial carcinoid studied with somatostatin analogue scintigraphy (SSRS). CLINICAL CASES: The first patient (9 years) was studied using the SSRS after surgery due to carcinoid tumor in the right lower lobe in which tumor remains was observed (this being clearer in the tomography study). The second patient (10 years) presented due to endobronchial tumor in the left lower lobe together with atelectasis of the LUL and emphysema of the LLL. Radiology imaging techniques suggested the differential diagnosis between the endobronchial carcinoid tumor or plasma cells or foreign body gramuloma. The SSRS showed an abnormal deposit of activity in the left hemithorax consisted with carcinoid tumor. No other areas suggesting metastasis were observed. After the surgery (endobronchial resection), new controls with SSRS showed absence of disease. The third patient (12 years) came after a lobectomy (RUL) due to bronchial carcinoid. The SSRS did not show any abnormal areas of activity. In the subsequent control (3 months), a deposit of activity was observed in the middle third of the right hemithorax, after which a lobectomy was performed (RLL and ML) that showed small remains of neuroendocrine carcinoid. Subsequent controls were negative. CONCLUSION: The SSRS has demonstrated great utility in the diagnosis, follow-up and staging of pediatric patients, carriers of neuroendocrine carcinoid tumors.

[Interstitial nephritis demonstrated by 67Ga-citrate scintigraphy within a diagnosis of fever of unknown origin]. / Nefritis intersticial demostrada mediante gammagrafía con 67Ga-citrato en el contexto de fiebre de origen desconocido.

We present a clinical case of a 54-year-old woman that was admitted in our hospital with the diagnosis of fever of unknown origin. All the laboratory tests and imaging techniques did not manage to establish the fever's aetiology until a (67)Ga-citrate scan was performed and kidney uptake was observed, which lead to the clinical suspicion of drug-induced interstitial nephritis. The renal biopsy confirmed the diagnosis. This finding allowed corticoid therapy and cure.

Nefritis intersticial demostrada mediante gammagrafía con 67Ga-citrato en el contexto de fiebre de origen desconocido / Interstitial nephritis demonstrated by 67Ga-citrate scintigraphy within a diagnosis of fever of unknown origin

Exponemos el caso de una paciente mujer de 54 años que ingresó en nuestro hospital para estudio de fiebre de origen desconocido.Todas las pruebas de laboratorio y de imagen no lograron establecer la causa de la fiebre y, al realizar una gammagrafía con 67Ga-citrato, se objetivó captación patológica en los riñones, lo que llevó a la sospecha clínica de nefritis intersticial inducida por medicamentos. La biopsia renal confirmó el diagnóstico. Este hallazgo permitió el tratamiento con corticoides y la curación de la enferma(AU)

We present a clinical case of a 54-year-old woman that was admitted in our hospital with the diagnosis of fever of unknown origin.All the laboratory tests and imaging techniques did not manage to establish the fever's aetiology until a 67Ga-citrate scan was performed and kidney uptake was observed, which lead to the clinical suspicion of drug-induced interstitial nephritis. The renal biopsy confirmed the diagnosis. This finding allowed corticoid therapy and cure(AU)

Accessibility and ion exchange stoichiometry of ionized carboxylic groups in the active layer of FT30 reverse osmosis membrane.

We have experimentally determined the concentration of Ba2+ that associates with the accessible ionized R-COO- groups in the polyamide active layer of the FT30 reverse osmosis membrane in the pH range 3.42-10.30. Ba2+ concentrations in the active layer ([Ba2+]) were measured using the ion-probing/Rutherford backscattering spectrometry procedure reported in our previous work. We found that at all but the lowest experimental pH 3.42, [Ba2+] was lower than the corresponding total concentrations of R-COO- groups; their difference was consistent with steric and charge effects determining the accessibility and association, respectively, of Ba2+ to R-COO- groups. Accordingly, we propose two descriptors, the accessibility ratio (AR) and the neutralization number (NN), to account for the observed difference. AR, the fraction of R-COO- groups accessible to Ba2+ ions, and NN, the average number of R-COO- groups neutralized per Ba2+ ion, were determined experimentally performing Ag(+)-Ba2+ ion-exchange tests. The resulting AR = 0.40 indicated that on average only 40% of ionizable carboxylic groups were accessible to Ba2+. [Ba2+] values calculated using R-COO- concentrations and the AR and NN concepts were in agreement with experimental [Ba2+] results.

Time-to-positivity in patients with Escherichia coli bacteraemia.

The time from the start of incubation to a positive reading of blood cultures (time-to-positivity; TTP) is related to the concentration of bacteria in blood. Information concerning the correlation of TTP with clinical parameters, and its usefulness as a prognostic factor in patients with Escherichia coli bacteraemia, is limited. To investigate the relationship of TTP to clinical parameters, 459 cases of monomicrobial E. coli bloodstream infections from a single institution between 1997 and 2005 were reviewed. All cases involved patients who were not undergoing antibiotic treatment at the time of blood sampling. The in-hospital mortality rate was 6.3%. Median TTP was significantly shorter for patients who died than for those who survived (9.7 h, inter-quartile range 7.85-11.05 h vs. 11.2 h, inter-quartile range 10.1-11.4 h; p <0.001). Patients with TTP in the lowest quartile were more likely to be female, to have a non-urinary tract or an unknown origin of bacteraemia, to have severe sepsis or shock, and to subsequently die. In a multivariable Cox regression model, the hazard ratio for death from any cause for patients with a short TTP was 3.13 (95% CI 1.28-7.64; p 0.01). TTP in patients with E. coli bacteraemia provides prognostic information beyond that provided by the presence of haematological illness, a Charlson score > or =3, a non-urinary tract origin of bacteraemia, and the presence of severe sepsis or shock.

Pulmonary artery dissection and conservative medical management.

Pulmonary artery dissection is a rare clinical entity, which has been related to pulmonary arterial hypertension. It is frequently presented as cardiogenic shock or sudden death, so diagnosis is often made at autopsy. The management with best results is surgery. We report a case of pulmonary artery dissection associated with previous aortic valve replacement with a favourable outcome, using conservative medical therapy.

Risk factors for bacteremia in patients with limb cellulitis.

The aim of this study was to identify the risk factors for bacteremia in patients with limb cellulitis. Using the administrative and microbiology laboratory databases of a community teaching hospital, a review was conducted of all cases of community-acquired limb cellulitis that occurred during the period 1997-2004 and in which blood cultures had been performed. A comparison of demographical, clinical, and analytical data of patients with bacteremia versus patients without bacteremia was performed by univariate and multivariate analyses. Of 2,678 patients with cellulitis who presented to the hospital's emergency department, 308 were diagnosed with limb cellulitis and had blood cultures. Of these, 57 (18.5%) had bacteremia. In 24 of the 57 (42.1%) patients with bacteremia, the microorganism isolated in blood cultures was non-group-A beta-hemolytic Streptococcus, and in another 14 (24.6%), the microorganism identified was a gram-negative bacterium. Staphylococcus aureus was determined as the cause of bacteremia in just 6 (10.5%) patients and group A Streptococcus in 2 (3.5%). By logistic regression analysis, the following factors were associated with bacteremia: absence of previous antibiotic treatment (OR 5.3, 95% CI 1.4-20.3), presence of two or more comorbid factors simultaneously (OR 4.3, 95% CI 1.6-11.7), length of illness<2 days OR 2.44, 95% CI 1.07-5.56), and proximal limb involvement (OR 6, 95% CI 3.03-12.04). Patients with limb cellulitis who exhibit any of these characteristics are at increased risk of bacteremia. In such patients, it is imperative that blood cultures be performed.

[Relative renal function based on DMSA uptake corrected for volume: normalized relative renal function]. / Función renal relativa basada en captación de ácido dimercaptosuccínico corregida por volumen: función renal relativa normalizada.

OBJECTIVE: Relative renal function (RRF) quantification based on dimercaptosuccinic acid (DMSA) uptake is an established method for determining differential renal function. An abnormal kidney size may lead to an alteration in its RRF value, although it has no dysfunction. Therefore, it is useful to correct RRF values taking into account relative renal volumes, thus obtaining the normalized relative renal function (NRRF). The feasibility of the method used for volume correction, differences with respect to usual quantification and different normality intervals were studied. MATERIAL AND METHODS: A total of 187 DMSA renal scintigraphies (130 children and 57 adults) were studied. RRF was quantified and volume corrected to obtain NRRF. Patients were classified as normal or pathological using various normality intervals for NRRF. A second classification was performed depending on how the diagnostic changed after volume correction. RESULTS: An increase of pathological diagnosis was observed after volume correction, mainly in children. Using an intermediate estimation for the normality interval, 53% of the initially pathological diagnosis for children may be caused simply by different renal volumes. CONCLUSIONS: NRRF provides complementary information to RRF and helps to distinguish between a smaller kidney and a really hypofunctioning one in cases with abnormal RRF.

Función renal relativa basada en captación de ácido dimercaptosuccínico corregida por volumen: función renal relativa normalizada / Relative renal function based on DMSA uptake corrected for volume: normalized relative renalfunction

Objetivo. La cuantificación de la función renal relativa (FRR) basada en la incorporación de ácido dimercaptosuccínico (DMSA) es un método establecido para la determinación del nivel de funcionamiento renal. Un tamaño anormal del riñón puede producir una alteración en el valor de su FRR, aunque no tenga disfunción alguna. Por tanto, resulta de utilidad corregir por volumen renal relativo los valores de la FRR, obteniendo así la función renal relativa normalizada (FRRN). En este trabajo se estudiará la viabilidad del método utilizado para la corrección por volumen, las diferencias respecto a la cuantificación habitual, y la influencia del margen de normalidad a aplicar. Material y métodos. Se estudiaron las gammagrafías renales con 99mTc-DMSA de 187 pacientes, 130 infantiles y 57 adultos. Se cuantificó la FRR y se corrigió por volumen para evaluar la FRRN. Se clasificaron los pacientes en normales o patológicos estableciendo varios márgenes de normalidad para la FRRN. Se realizó una segunda clasificación de los casos según cómo cambió su valoración al corregir por volumen. Resultados. Se observó un aumento de los diagnósticos patológicos al corregir por volumen, sobre todo en niños. Para el margen de normalidad aceptado se observó que del total de casos infantiles diagnosticados como patológicos inicialmente, el 53 % puede ser debido simplemente a una diferencia de volumen renal. Conclusiones. La FRRN proporciona una información complementaria a la FRR y ayuda a distinguir entre un riñón de menor tamaño y uno realmente hipocaptante en el caso de que la FRR resulte fuera de la normalidad

Objective. Relative renal function (RRF) quantification based on dimercaptosuccinic acid (DMSA) uptake is an established method for determining differential renal function. An abnormal kidney size may lead to an alteration in its RRF value, although it has no dysfunction. Therefore, it is useful to correct RRF values taking into account relative renal volumes, thus obtaining the normalized relative renal function (NRRF). The feasibility of the method used for volume correction, differences with respect to usual quantification and different normality intervals were studied. Material and methods. A total of 187 DMSA renal scintigraphies (130 children and 57 adults) were studied. RRF was quantified and volume corrected to obtain NRRF. Patients were classified as normal or pathological using various normality intervals for NRRF. A second classification was performed depending on how the diagnostic changed after volume correction. Results. An increase of pathological diagnosis was observed after volume correction, mainly in children. Using an intermediate estimation for the normality interval, 53 % of the initially pathological diagnosis for children may be caused simply by different renal volumes. Conclusions. NRRF provides complementary information to RRF and helps to distinguish between a smaller kidney and a really hypofunctioning one in cases with abnormal RRF

Papel del sobrecrecimiento bacteriano intestinal y de la motilidad intestinal en la traslocación bacteriana en un modelo experimental de cirrosis / Role of intestinal bacterial overgrowth and intestinal motility in bacterial translocation in experimental cirrhosis

Introducción: el sobrecrecimiento bacteriano intestinal (SBI) está relacionado con la motilidad del intestino delgado y diferentes trabajos con modelos experimentales han sugerido su relación con el desarrollo de traslocación bacteriana (TB). Tanto el sobrecrecimientobacteriano intestinal como la traslocación bacteriana soneventos frecuentes en la cirrosis hepática. Objetivos: los objetivos de este estudio han sido analizar lapoblación cecal de bacterias aerobias y el tránsito intestinal en un modelo de ratas cirróticas y su relación con la TB. Material y métodos: el estudio se ha realizado en un modelo experimental de cirrosis inducida por tetracloruro de carbono por vía oral en ratas Sprague-Dawley. Se llevaron a cabo cultivos microbiológicosconvencionales a partir de ganglios linfáticos mesentéricos (GLM), sangre portal y periférica, hígado, bazo, y muestras cecales de todos los animales. Además se determinó el tiempo de tránsito intestinal en 10 ratas cirróticas y en 10 controles. Resultados: la prevalencia de la traslocación bacteriana en los animales cirróticos fue de un 56%. La población de gérmenes aerobios en el ciego en las ratas cirróticas fue significativamentemayor (p < 0,01) que en las ratas controles. Las ratas cirróticas con TB presentaron un población bacteriana intestinal más elevada que las ratas sin TB (p < 0,05). La prevalencia de SBI en los animales cirróticos fue de un 67% frente a un 0% en los animales control (p < 0,01); también el SBI fue más frecuente en las ratas cirróticas con TB que en las cirróticas sin TB (93 vs. 33%) (p <0,01). De las bacterias que traslocaron un 95,6% presentaban sobrecrecimiento en ciego. El tránsito intestinal fue más lento en las ratas cirróticas (60,5 ± 12,7 vs. 81,2 ± 5,7 cm) que en los animales controles (p < 0,01). Conclusiones: estos resultados sugieren que el sobrecrecimiento bacteriano es frecuente en ratas cirróticas y predispone al desarrollo de traslocación bacteriana intestinal. Además, este sobrecrecimientoprobablemente está favorecido por la existencia deuna dismotilidad intestinal, frecuente en este modelo de cirrosis experimental

Background: intestinal bacterial overgrowth (IBO) is related to small bowel motility and has been involved in the pathogenesis of bacterial translocation (BT) in experimental models, and both overgrowing gut flora and translocating bacteria to mesenteric lymph nodes are common features in cirrhosis. Objectives: the aims of this study were to analyze cecal aerobic bacteria and intestinal transit in cirrhotic rats, and their relationship with BT, evaluating the role of intestinal bacterial overgrowth and small bowel dismotility in the development of BT in experimental cirrhosis. Material and methods: we included twenty-seven male Sprague-Dawley rats with carbon tetrachloride-induced cirrhosis without ascites and ten controls. Cultures of mesenteric lymph nodes (MLN), peripheral and portal blood, liver, spleen and cecal samples were carried out. Small intestinal transit was determined in ten cirrhotic rats and in ten control rats. Results: the prevalence of bacterial translocation was 56%. Total cecal aerobic bacteria count was significantly higher in cirrhotic rats than in control rats (p < 0.001). Cirrhotic rats with translocated bacteria had higher total aerobic intestinal counts than culture-negative MLN bacteria (p < 0.05). The prevalence of total intestinal bacterial overgrowth in cirrhotic animals was 67%, and 0% in control animals (p < 0.001). According to BT, total IBO was more frequent in cirrhotic rats with BT versus those without BT (93 vs. 33%) (p < 0.001). Of the translocating bacteria, 95.6% were found to be overgrown in the cecum. The mallintestinal transit was slower in cirrhotic rats (60.5 ± 12.7 cm vs. 81.2 ± 5.7 cm) than in control animals (p < 0.001). Conclusions: these results suggest that the increase of intestinal aerobic bacteria in experimental cirrhosis is associated with translocation. In addition, IBO is frequent in cirrhotic rats, and is supposed to play an important role in the development of BT. Impaired motility of the small intestine is a common feature in cirrhosis and may be implicated in the pathogenesis of IBO

Role of intestinal bacterial overgrowth and intestinal motility in bacterial translocation in experimental cirrhosis.

BACKGROUND: Intestinal bacterial overgrowth (IBO) is related to small bowel motility and has been involved in the pathogenesis of bacterial translocation (BT) in experimental models, and both overgrowing gut flora and translocating bacteria to mesenteric lymph nodes are common features in cirrhosis. OBJECTIVES: The aims of this study were to analyze cecal aerobic bacteria and intestinal transit in cirrhotic rats, and their relationship with BT, evaluating the role of intestinal bacterial overgrowth and small bowel dismotility in the development of BT in experimental cirrhosis. MATERIAL AND METHODS: We included twenty-seven male Sprague-Dawley rats with carbon tetrachloride-induced cirrhosis without ascites and ten controls. Cultures of mesenteric lymph nodes (MLN), peripheral and portal blood, liver, spleen and cecal samples were carried out. Small intestinal transit was determined in ten cirrhotic rats and in ten control rats. RESULTS: The prevalence of bacterial translocation was 56%. Total cecal aerobic bacteria count was significantly higher in cirrhotic rats than in control rats (p < 0.001). Cirrhotic rats with translocated bacteria had higher total aerobic intestinal counts than culture-negative MLN bacteria (p < 0.05). The prevalence of total intestinal bacterial overgrowth in cirrhotic animals was 67%, and 0% in control animals (p < 0.001). According to BT, total IBO was more frequent in cirrhotic rats with BT versus those without BT (93 vs. 33%) (p < 0.001). Of the translocating bacteria, 95.6% were found to be overgrown in the cecum. The small-intestinal transit was slower in cirrhotic rats (60.5 +/- 12.7 cm vs. 81.2 +/- 5.7 cm) than in control animals (p < 0.001). CONCLUSIONS: These results suggest that the increase of intestinal aerobic bacteria in experimental cirrhosis is associated with translocation. In addition, IBO is frequent in cirrhotic rats, and is supposed to play an important role in the development of BT. Impaired motility of the small intestine is a common feature in cirrhosis and may be implicated in the pathogenesis of IBO.