Barrier proteins and eosinophilic esophagitis in children: the role of E-cadherin and filaggrin.

This study aimed to assess the protein expression of E-cadherin and filaggrin (FLG) in the oesophagus of paediatric and adolescent patients diagnosed with eosinophilic esophagitis (EoE). It is a cross-sectional study conducted with 24 patients with EoE and 17 control patients, from June 2015 to June 2018. The histological analyses were performed by a trained pathologist. The protein expression of E-cadherin and FLG in oesophageal biopsy fragments was determined using an immunohistochemical technique. The epidemiological data were retrieved from medical records. There were no statistical differences in age and sex between case-patients and control patients. Food allergy was significantly higher in patients with EoE, as was the number of eosinophils present in the oesophageal biopsy materials. The immunohistochemical studies did not indicate FLG expression in any patient from the two groups. E-cadherin showed significantly reduced expression in patients with EoE. We concluded that FLG did not seem to play an important role in the mucosal alteration in EoE and that E-cadherin under expression could be a promising marker of epithelial damage in these patients.

Dyspeptic symptoms in patients with type 1 diabetes: endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors.

OBJECTIVES: To evaluate, in a group of patients with long-standing type 1 diabetes (DM1), an association of dyspepsia symptoms with: changes in the gastroduodenal mucosa, infection by Helicobacter pylori, glycemic control, and psychological and nutritional factors. SUBJECTS AND METHODS: A total of 32 patient with DM1 were studied (age: 38 ± 9 years; females: 25; diabetes duration: 22 ± 5 years). All patients answered a standardized questionnaire for the evaluation of gastrointestinal symptoms and underwent upper gastrointestinal endoscopy, with gastric biopsies for the evaluation of Helicobacter pylori infection. The presence of anxiety and depression was evaluated by the HAD scale. Nutritional parameters were BMI, arm and waist circumference, skinfold measurement, and body fat percentage. RESULTS: Upper endoscopy detected lesions in the gastric mucosa in 34.4% of the patients, with similar frequency in those with (n = 21) and without dyspepsia (n = 11). The patients with dyspepsia complaints showed greater frequency of depression (60% vs. 0%; p = 0.001), higher values for HbA1c (9.6 ± 1.7 vs. 8.2 ± 1.3%; p = 0.01) and lower values for BMI (24.3 ± 4.1 vs. 27.2 ± 2.6 kg/m2; p = 0.02), body fat percentage (26.6 ± 6.2 vs. 30.8 ± 7.7%; p = 0.04), and waist circumference (78.7 ± 8 vs. 85.8 ± 8.1 cm; p = 0.02). No association was found between the symptoms and the presence of Helicobacter pylori. CONCLUSIONS: Dyspepsia symptoms in patients with long-standing DM1 were associated with glycemic control and depression, and they seem to negatively influence the nutritional status of these patients.

Dyspeptic symptoms in patients with type 1 diabetes: endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors

Objectives To evaluate, in a group of patients with long-standing type 1 diabetes (DM1), an association of dyspepsia symptoms with: changes in the gastroduodenal mucosa, infection by Helicobacter pylori, glycemic control, and psychological and nutritional factors. Subjects and methods A total of 32 patient with DM1 were studied (age: 38 ± 9 years; females: 25; diabetes duration: 22 ± 5 years). All patients answered a standardized questionnaire for the evaluation of gastrointestinal symptoms and underwent upper gastrointestinal endoscopy, with gastric biopsies for the evaluation of Helicobacter pylori infection. The presence of anxiety and depression was evaluated by the HAD scale. Nutritional parameters were BMI, arm and waist circumference, skinfold measurement, and body fat percentage. Results Upper endoscopy detected lesions in the gastric mucosa in 34.4% of the patients, with similar frequency in those with (n = 21) and without dyspepsia (n = 11). The patients with dyspepsia complaints showed greater frequency of depression (60% vs. 0%; p = 0.001), higher values for HbA1c (9.6 ± 1.7 vs. 8.2 ± 1.3%; p = 0.01) and lower values for BMI (24.3 ± 4.1 vs. 27.2 ± 2.6 kg/m2; p = 0.02), body fat percentage (26.6 ± 6.2 vs. 30.8 ± 7.7%; p = 0.04), and waist circumference (78.7 ± 8 vs. 85.8 ± 8.1 cm; p = 0.02). No association was found between the symptoms and the presence of Helicobacter pylori. Conclusions Dyspepsia symptoms in patients with long-standing DM1 were associated with glycemic control and depression, and they seem to negatively influence the nutritional status of these patients. .

Delayed small intestinal transit in patients with long-standing type 1 diabetes mellitus: investigation of the relationships with clinical features, gastric emptying, psychological distress, and nutritional parameters.

BACKGROUND: Studies on small intestinal transit in type 1 diabetes mellitus have reported contradictory results. This study assessed the orocecal transit time (OCTT) in a group of patients with type 1 diabetes mellitus and its relationships with gastrointestinal symptoms, glycemic control, chronic complications of diabetes, anthropometric indices, gastric emptying, small intestinal bacterial overgrowth (SIBO), and psychological distress. SUBJECTS AND METHODS: Twenty-eight patients with long-standing (>10 years) type 1 diabetes mellitus (22 women, six men; mean age, 39 ± 9 years) participated in the study. The lactulose hydrogen breath test was used to determine OCTT and the occurrence of SIBO. The presence of anxiety and depression was assessed by the Hospital Anxiety and Depression scale. Gastric emptying was measured by scintigraphy. Anthropometric indices included body mass index, percentage body fat, midarm circumference, and arm muscle area. RESULTS: There was a statistically significant increase in OCTT values in diabetes patients (79 ± 41 min) in comparison with controls (54 ± 17 min) (P=0.01). Individual analysis showed that OCTT was above the upper limit (mean+2 SD) in 30.8% of patients. All anthropometric parameters were significantly decreased (P<0.05) in patients with prolonged OCTT in comparison with those with normal OCTT. In contrast, there was no statistically significant association between prolonged OCTT and gastrointestinal symptoms, peripheral neuropathy, diabetic retinopathy, glycated hemoglobin, delayed gastric emptying, SIBO, anxiety, or depression. CONCLUSIONS: Small bowel transit may be delayed in about one-third of patients with long-standing type 1 diabetes mellitus. This abnormality seems to have a negative effect on nutritional status in these patients.

Evaluation of the hypotensive potential of bovine and porcine collagen hydrolysates.

Angiotensin-converting enzyme (ACE) inhibitory activity and antihypertensive activity of bovine and porcine collagen hydrolysates in spontaneously hypertensive rats (SHR) were investigated. The hydrolyzed collagens were subjected to ultrafiltration using membranes with cutoffs of 30-50 kDa (permeate P1), 5-8 kDa (permeate P2), or 1-2 kDa (permeate P3) in order to obtain products with a narrower range of molecular size. The hydrolyzed bovine and porcine collagens and their permeates showed low ACE inhibitory activity (50% inhibitory concentration [IC(50)] = 5.42-15.58 mg of protein/mL). However, after in vitro gastrointestinal digestion, a significant increase in the ACE inhibitory potency of the hydrolyzed collagens was observed (IC(50) = 0.97-4.02 mg of protein/mL). Permeates had a higher ACE inhibitory activity and hypotensive activity than non-ultrafiltered hydrolysates. The P1 permeate of bovine and porcine collagen and the P3 fraction of the porcine collagen hydrolysate exhibited the best antihypertensive activity in vivo, promoting a maximum reduction in blood pressure of 22 mm Hg, 21.33 mm Hg, and 21.33 mm Hg, respectively, while lisinopril promoted a maximum reduction of 51.00 mm Hg. These results suggest that the commercial collagen hydrolysates of bovine and porcine origin may be a potential source of bioactive peptides.

Fístula traqueoesofágica isolada do tipo H no recém-nascido. Diagnóstico precoce / Tracheoesophageal fistula of H type in infant

É relatado um caso de recém-nascido com fístula esofagotraqueal em H. O quadro clínico, o diagnóstico com RX constratado de esôfago, a traqueobroncospia e a esofagoscopia confirmaram o diagnóstico. A fístula esofagotraqueal em H (FTEH) foi dividida através de acesso cirúrgico cervical no lado esquerdo do pescoço devido à posiçäo da fístula, com bom resultado

Síndrome da cimitarra: aspectos da endoscopia respiratória / Scimitar syndrome: endoscopic respiratory aspects

Apresenta-se o caso de uma paciente de 10 anos de idade, sexo feminino, assintomática, encaminhada ao serviço com diagnóstico de dextrocardia. A investigaçäo observou-se o sinal radiológico da cimitarra. A broncoscopia e a broncografia evidenciaram ausência de lobos superior e médio e anormalidades na segmentaçäo brônquica do lobo inferior direito. O cateterismo confirmou a drenagem anômala da veia pulmonar direita para a veia cava inferior, configurando a síndrome da cimitarra