ABSTRACT
In this work, we report a nonaqueous one-step method to synthesize polystyrene macroporous magnetic nanocomposites through high internal phase emulsions (HIPEs) formulated with the deep eutectic solvent (DES) composed of urea:choline chloride (U:ChCl, in a 2:1 molar ratio) as the internal phase and co-stabilized with mixtures of Span 60 surfactant and non-functionalized magnetite nanoparticles (Fe3O4 NPs). The porous structure and the magnetic and lipophilic properties of the nanocomposite materials were easily tailored by varying the amount of Fe3O4 NPs (0, 2, 5 and 10 wt %) and the surfactant Span 60 (0, 5, 10, and 20 wt %) used in the precursor emulsion. The resultant nanocomposite polyHIPEs exhibit high sorption capacity toward different oils (hexane, gasoline, and vegetable oil) due to their high porosity, interconnectivity, and hydrophobic surface. It was observed that the oil sorption capacity was improved when the amount of surfactant decreased and Fe3O4 NPs increased in HIPE formulation. Therefore, polyHIPE formulated with 5 and 10 wt % Span 60 and Fe3O4 NPs, respectively, showed the highest oil sorption capacities of 4.151, 3.556, and 3.266 g g-1 for gasoline, hexane, and vegetable oil, respectively. In addition, the magnetic monoliths were reused for more than ten sorption/desorption cycles without losing their oil sorption capacity.
ABSTRACT
OBJECTIVE: To describe the anorectal manometry results in the pediatric population with chronic constipation and acquired anorectal disease. MATERIALS AND METHODS: We reviewed the records of children who were referred to the Motility and Pelvic Floor Laboratory of the Hospital San Jose Tecnologico de Monterrey between 2004-2016 for further evaluation with anorectal manometry and who presented acquired anorectal disease. RESULTS: We reviewed 170 records. The mean age was 7.18 ± 4.51 years old. The prevalence of anorectal disease was 73%. The symptoms more frequently presented were difficult evacuation (78%), painful defecation (67%), large and hard stool (50%) and fecal soiling (49%). 44% of patients with hypotonic external anal sphincter (EAS) presented with soiling and 74% of those had diminished critical volume. Significant manometric values (p<0.05) were EAS resting pressure, maximal squeeze pressure, and critical volume. 97.7% of those who underwent abdomino pelvic coordination evaluation had pelvic floor dyssynergia (anismus). CONCLUSIONS: Contrary to adult population, the manometric values in children with acquire anorectal pathology were within normal values except for the EAS resting pressure and critical volume that were diminished. This could suggest a different mechanism in the pediatric population. Pelvic floor dyssynergia could explain chronic constipation in these patients.
Subject(s)
Anal Canal/physiopathology , Constipation/physiopathology , Rectal Diseases/physiopathology , Rectum/physiopathology , Child , Child, Preschool , Chronic Disease , Constipation/complications , Cross-Sectional Studies , Female , Humans , Male , Manometry , Rectal Diseases/complications , Rectal Diseases/diagnosis , Rectal Diseases/epidemiologyABSTRACT
Objetivos: Describir los resultados de las manometrías anorrectales (MAR) en pacientes pediátricos con estreñimiento crónico y patología anorrectal adquirida. Materiales y métodos: Se revisaron los expedientes de pacientes pediátricos referidos entre 2004 y 2016 al Laboratorio de Motilidad Gastrointestinal del Hospital San José Tec de Monterrey para evaluación por manometría anorrectal y que presentaron patología anorrectal adquirida. Resultados: Se revisaron 170 expedientes. Edad 7,18 ± 4,51 años. La prevalencia de patología anorrectal (PA) fue de 73%. Síntomas con mayor incidencia: dificultad para evacuar (78%), dolor al evacuar (67%), heces duras (50%) e incontinencia fecal asociado (49%). El 44% de los pacientes con esfínter anal externo (EAE) hipotónico presentaron incontinencia y 74% estos últimos, presentaron menor volumen máximo tolerable (VMT). Los valores manométricos con mayor significancia: presión en reposo del EAE (promedio ± DE) 14,16 ± 10,19 en PA y de 26,08 ± 13,65 en SPA; presión en contracción del EAE 48,4 ± 34,1 en PA y 68,3 ± 37,7 en SPA; VMT 120,8 ± 60,4 en PA y de 173,2 ± 78,0 en SPA. El 97,97% de los pacientes en los que se evaluó la coordinación abdomino-pélvica tuvieron disinergia del piso pélvico. Conclusiones: A diferencia de la población adulta, los valores manométricos de niños con patología anorrectal se encontraron dentro de rangos normales excepto por el EAE y el VMT los cuales estuvieron disminuidos. Esto puede sugerir un mecanismo diferente en la población pediátrica. La disinergia del piso pélvico podría explicar el estreñimiento crónico en estos pacientes.
Objective: To describe the anorectal manometry results in the pediatric population with chronic constipation and acquired anorectal disease. Materials and methods: We reviewed the records of children who were referred to the Motility and Pelvic Floor Laboratory of the Hospital San Jose Tecnologico de Monterrey between 2004-2016 for further evaluation with anorectal manometry and who presented acquired anorectal disease. Results: We reviewed 170 records. The mean age was 7.18 ± 4.51 years old. The prevalence of anorectal disease was 73%. The symptoms more frequently presented were difficult evacuation (78%), painful defecation (67%), large and hard stool (50%) and fecal soiling (49%). 44% of patients with hypotonic external anal sphincter (EAS) presented with soiling and 74% of those had diminished critical volume. Significant manometric values (p<0.05) were EAS resting pressure, maximal squeeze pressure, and critical volume. 97.7% of those who underwent abdomino pelvic coordination evaluation had pelvic floor dyssynergia (anismus). Conclusions: Contrary to adult population, the manometric values in children with acquire anorectal pathology were within normal values except for the EAS resting pressure and critical volume that were diminished. This could suggest a different mechanism in the pediatric population. Pelvic floor dyssynergia could explain chronic constipation in these patients.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Anal Canal/physiopathology , Rectal Diseases/physiopathology , Rectum/physiopathology , Constipation/physiopathology , Rectal Diseases/complications , Rectal Diseases/diagnosis , Rectal Diseases/epidemiology , Chronic Disease , Cross-Sectional Studies , Constipation/complications , ManometryABSTRACT
Introducción: En la literatura se describe poca utilización y conocimiento de las pruebas de hidrógeno en aliento por la comunidad médica. Este trabajo busca aportar datos cuantitativos sobre el conocimiento y uso de este tipo de pruebas en la comunidad médica de Monterrey, Nuevo León, México. Materiales y Métodos: Se elaboró y valido mediante metodología DELPHI una encuesta que evaluó los conocimientos y uso de pruebas de hidrógeno en aliento. Para el análisis de datos se utilizaron estadísticas descriptivas. Resultados: Se obtuvieron 158 encuestas siendo la mayor parte de los encuestados pediatras (34%). La mayoría de los encuestados refirió no conocer las pruebas (69%), no haberlas indicado (93%) y desconocer su costo (95,6%). El 67,1% de los encuestados refirieron el desconocimi ento como factor limitante para la indicación de estas pruebas en su práctica. Los médicos consideraron útiles las pruebas de hidrógeno en aliento para el diagnóstico de intolerancia a carbohidratos (38,6%), síndrome de sobrecrecimiento bacteriano intestin al (31,6%) y ninguna opción (32,9%). Discusión : Los resultados indican que las pruebas son poco utilizadas y se tiene un considerable desconocimiento sobre ellas en nuestro medio. Esto indica la necesidad de dar mayor difusión y educar a la comunidad médic a sobre su utilidad.
Introduction: In the literature, it is reported an underuse and limited knowledge of hydrogen breathe tests by the medical community. This work aim to provide quantitative data about the knowledge and use hydrogen breath test in the medical community of Monterrey, Nuevo León, México. Materials and methods: A survey was developed and validated thought DELPHI methodology. The survey evaluated knowledge and use of hydrogen breath tests. For the data analysis, descriptive statistics was used. Results: A total of 158 surveys was obtained. Most of the survey physicians were pediatricians (34%). Most of the survey physicians referred not knowing hydrogen breath tests (69%), have not indicated the breath tests (93%), and not knowing the cost (95,6%). 67,1% of the survey physicians described ignorance has the limiting factor for not indicating this kind of test in their practice. Physicians considered hydrogen breath test useful for the diagnosis of carbohydrates intolerance (38,6%), intestinal overgrowth bacterial syndrome (31,6%), and not useful (32,9%). Discussions : There is a considerable ignorance in the medical community about hydrogen breath test. Even further, this diagnostic resource is underutilized in our context. The results present the necessity to give more diffusion and to educate medical community about hydrogen breath tests.
ABSTRACT
BACKGROUND: Hydrogen breath tests (HBT) are used to confirm the diagnosis of carbohydrate intolerance or small intestinal bacterial overgrowth (SIBO). OBJECTIVE: Determine the existence of a correlation between the presence and intensity of symptoms experimented by the patient after the ingestion of a carbohydrate load and the test result. MATERIALS AND METHODS: This is an observational, retrospective and analytic study, in which all patients' files from year 2008 to 2014 containing a report of a HBT performed at Hospital San José TEC de Monterrey were revised. Using a visual analogue scale (VAS), the patient reported the intensity of gastrointestinal symptoms during the test. Descriptive statistics were obtained, and exclusively for lactose HBTs, Pearson's correlation coefficient (r) between maximum hydrogen concentration in breath and symptom intensity was calculated. RESULTS: A HBT was performed in 33 patients: 23 with lactose, 5 with fructose, and 5 with lactulose as substrate. Of these, 10, 2, and 5 tests were positive, respectively. For lactose HBTs, the symptom with most sensitivity was flatulence (80%), which also had the greatest likelihood ratio for a positive test (1.73). Diarrhea had the greatest specificity (84.6%). A tendency for positivity was observed when patients presented symptoms. A moderately positive correlation between hydrogen ppm and symptom intensity was found (r=0.427, p=0.023). CONCLUSIONS: A correlation between symptom intensity and test positivity was found in patients with lactose intolerance. The presence of flatulence after lactose loading may be indicative of a positive test.
