Survival of the nematophagous fungus Duddingtonia flagrans to in vitro segments of sheep gastrointestinal tract.

The nematophagous fungus Duddingtonia flagrans is used in integrated management of gastrointestinal nematodes in ruminants. The chlamydospores of the fungus, orally administered, pass through the segments of the ruminant digestive tract and, in the feces, capture the nematodes preventing their migration to grasslands. The drastic conditions of the gastrointestinal segments can negatively affect the fungus' biocontrol activity. The aim of this study was to assess the effect of in vitro conditions of the sheep's main gastrointestinal segments on the concentration, viability and nematode predatory ability of D. flagrans chlamydospores. The segments evaluated separately in vitro were the oral cavity, rumen, abomasum, and small intestine. The results showed that chlamydospores concentration was not affected by exposure to the different segments. The viability of the chlamydospores after exposure to the oral cavity (2.53 × 106 CFU/mL) and small intestine (1.24 × 105 CFU/mL) was significantly lower than its control treatment, with values of 6.67 × 106 CFU/mL and 2.31 × 105 CFU/mL respectively. Nematode predatory ability after rumen exposure was reduced by 7% compared to the control treatment, by 25% after abomasum exposure and by 17% after small intestine. This study revealed the individual in vitro effect of each segment of ovine gastrointestinal tract on the integrity of this strain of the fungus D. flagrans affecting its viability and nematode predatory ability under the evaluated conditions. Delivery systems could be designed to protect chlamydospores considering the impact of each gastrointestinal segment.

Alteration of the renal regulatory hormonal pattern during experimental obstructive jaundice.

OBJECTIVE: The alteration of hormones regulating sodium and water status is related to renal failure in obstructive jaundice (OJ). EXPERIMENTAL DESIGN: OJ was induced by common bile duct ligation. Samples were obtained from the control (SO) and OJ groups at 24 and 72 hours, and at 7 days. Different parameters related to biliary obstruction, liver and renal injury, and vasoactive mediators such as renin, aldosterone, endothelin-1 (ET-1) and prostaglandin E2 (PGE2) were studied. RESULTS: Bile duct ligation caused an increase in total bilirubin (p < 0.001) and alkaline phosphatase (AP) (p < 0.001). The SO and OJ groups had the same values for diuresis, renin, and creatinine clearance at 24 h. However, animals with OJ had a lower sodium concentration in urine than SO animals (p < 0.01), as well as an increase in aldosterone levels (p < 0.03). ANP levels were moderately increased during OJ but did not reach statistical significance when compared to the SO group. In contrast, OJ animals showed a rise in serum ET-1 concentration (p < 0.001) and increased PGE2 in urine (p < 0.001). CONCLUSIONS: Biliary obstruction induced an increase in ET-1 release and PGE2 urine excretion. These hormones might play a role during the renal complications associated with renal disturbances that occur during OJ.

Alteration of the renal regulatory hormonal pattern during experimental obstructive jaundice

Objective: the alteration of hormones regulating sodium andwater status is related to renal failure in obstructive jaundice (OJ).Experimental design: OJ was induced by common bile ductligation. Samples were obtained from the control (SO) and OJgroups at 24 and 72 hours, and at 7 days. Different parametersrelated to biliary obstruction, liver and renal injury, and vasoactivemediators such as renin, aldosterone, endothelin-1 (ET-1) andprostaglandin E2 (PGE2) were studied.Results: bile duct ligation caused an increase in total bilirubin(p < 0.001) and alkaline phosphatase (AP) (p < 0.001). The SOand OJ groups had the same values for diuresis, renin, and creatinineclearance at 24 h. However, animals with OJ had a lowersodium concentration in urine than SO animals (p < 0.01), as wellas an increase in aldosterone levels (p < 0.03). ANP levels weremoderately increased during OJ but did not reach statistical significancewhen compared to the SO group. In contrast, OJ animalsshowed a rise in serum ET-1 concentration (p < 0.001) and increasedPGE2 in urine (p < 0.001).Conclusions: biliary obstruction induced an increase in ET-1release and PGE2 urine excretion. These hormones might play arole during the renal complications associated with renal disturbancesthat occur during OJ(AU)

[The megacystis-microcolon-intestinal hypoperistalsis syndrome: apropos of a case with prolonged survival]. / Síndrome de megavejiga-microcolon-hipoperistalsis intestinal: a propósito de un caso de supervivencia prolongada.

Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is a severe congenital disease with autosomal recessive inheritance, characterized by vesical distension and intestinal hypoperistalsis what causes intestinal obstruction in newborn, with other abnormalities associated. It presents a low incidence, about a hundred cases are reported in the bibliography. Life expectancy doesn't reach a year because of the sepsis failure generally. In our study the survival is higher than the majority of the cases reported, with good cuality of life and acceptable ponderal development. Home parenteral nutrition with the following and multidisciplinary collaboration in a strict way, establish the success' key in this pathology.

Internet, un medio de comunicación bidireccional con el paciente externo infrautilizado en nuestro país / No disponible

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Carney's triad: case report and review.

INTRODUCTION: Carney's triad is a rare pathogenic entity which consists of the association in young women of multiple condromatosis in the lung, gastric leiomyosarcoma, and extradrenal paraganglioma; although the presence of three at the same time is not required for its diagnosis. CASE REPORT: We present the case of a 27-year-old woman who was diagnosed of pulmonary multiple hamartomatosis and gastric stromal tumor. DISCUSSION: A review of the literature shows the most important prognosis factors and therapeutic options. Surgery for gastrointestinal stromal tumors and extradrenal paraganglioma seems to be the best treatment up to date.

[Parenteral nutrition in hematopoietic stem cell transplantation]. / La nutrición parenteral en el trasplante de células progenitoras hematopoyéticas.

Haematopoietic stem cell transplantation (HSCT) is a sophisticated procedure used in the treatment of solid tumors, haematological diseases and autoimmune disorders, which were characterized by an extremely poor prognosis only a few years earlier. Thousands of patients receive high-dose chemotherapy and radiotherapy around the world every year in order to treat these diseases. Therapy can induce aggressive changes associated with multiple organ failure, which is usually reversible, that can lead to special nutritional and metabolic conditions. Artificial nutrition, total parenteral nutrition in particular, is provided to patients undergoing HSCT to help minimize nutritional consequences of both conditioning regimens (mucositis, malabsorption, etc.) as well as complications resulting from the procedure (graft versus host disease, venoocclusive disease of the liver). This study reviews published guidelines for the use of parenteral nutrition in HSCT and includes important aspects for nutritional support in children, including controversy on potential benefits of special nutrients (glutamine, antioxidants, etc.) and furthermore discusses future trends. This paper also addresses the pharmacists role and the necessity for multidisciplinary teams to develop specific protocols.

La nutrición parenteral en el trasplante de células progenitoras hematopoyéticas / Parenteral nutrition in hematopoietic stem cell transpalantation

El trasplante de células progenitoras hematopoyéticas (TCPH) es una técnica usada en el tratamiento de tumores sólidos, enfermedades hematológicas y patologías autoinmunes, que hasta hace pocos años se caracterizaban por un pésimo pronóstico. En estos tratamientos deben de administrarse altas dosis de quimioterapia y radioterapia a miles de personas cada año. Estas terapias inducen cambios muy agresivos asociados con fallos multiorgánicos generalmente reversibles y que provocan estados metabólicos y nutricionales especiales. La nutrición artificial y la NP en particular, ayudan a minimizar las consecuencias que en los pacientes sometidos a TCPH, provocan estos tratamientos citados (mucositis, malabsorción, etc.) y las complicaciones resultantes (enfermedad de injerto contra el huésped, enfermedad venoclusiva hepática).Esta revisión aborda las líneas para el uso de la NP en el TCPH e incluye los aspectos más importantes del paciente en edad pediátrica, los controvertidos beneficios de algunos nutrientes (glutamina, antioxidantes, etc.) y las futuras tendencias. Por último se expone la función del farmacéutico y la necesidad de desarrollar protocolos específicos a través de equipos interdisciplinares (AU)

[Evaluation of anorexia in patients with bile duct obstruction]. / Evaluación de la anorexia en enfermos con obstrucción de la vía biliar.

INTRODUCTION: Obstructive jaundice is often accompanied by protein-caloric malnutrition. The objective of the present study is to analyze the incidence and the degree of alterations in the food ingestion of patients with obstructive jaundice. MATERIAL AND METHODS: In a prospective, cross-sectional study 50 patients with obstructive jaundice (19 benign and 31 malignant) were evaluated. The anorexia was evaluated using Welch's test (subjective evaluation) and by means of quantifying the caloric ingestion. An anthropometric parameter (ideal weigh < 95%) and two biochemical ones (albumin < 3.5 g/dl and pre-albumin < 17 mg/dl) were used to define the degree of malnutrition. RESULTS: 96% of the patients presented alterations in the Welch test and in 72% of the patients the caloric ingestion was below the estimated needs. Overall, the ingestion of food was reduced by 76.3 +/- 30% of the estimated needs (84.7 +/- 28% in the benign cases and 70.9 +/- 32% in the malignant cases). Both the Welch test (r = 0.59; p = 0.01) and the caloric ingestion (r = 0.53; p < 0.001) were inversely correlated with the serum bilirubin. In patients with malnutrition criteria, the caloric ingestion was reduced by 30% against the 12% reduction in the non-malnourished patients (p < 0.05). There was a direct correlation between the two methods used in the assessment of the anorexia (r = 0.71; p < 0.001). CONCLUSIONS: Obstructive jaundice is associated with an important reduction in the caloric ingestion, and this is manifested in both biliary obstructions of a benign origin, and in those of neoplasic origins.

[Evaluation of body fluid compartments and their relationship with water-electrolyte changes in obstructive jaundice]. / Evaluación de los compartimientos corporales y su relación con las alteraciones hidroelectrolíticas en la ictericia obstructiva.

BACKGROUND: The alteration of the mechanisms of water and sodium preservation may be an important factor in the development of acute postoperative renal failure in obstructive jaundice (OJ). Experimental OJ has been associated with a depletion of the extracellular volume and alteration of the mechanisms of regulation of hydrosaline metabolism. The aim of this study was to evaluate the distribution of the body volumes and the regulating hormones of hydrosaline metabolism in human OJ. PATIENTS AND METHOD: A prospective, clinical study evaluating 18 patients with OJ (9 females and 9 males) with a mean age of 69 +/- 8.9 years was performed. The plasma levels of antinatriuretic peptide (ANP), aldosterone and renin were determined. The body volumes were evaluated by tetrapolar bioimpedanciometry. The results of the patients with OJ were compared with a control group (CG) of 12 healthy subjects, matched for age and sex (6 females and 6 males with a mean age of 64.5 +/- 14 years). RESULTS: High ANP values were observed in 87.5% of the patients. The results of the hormonal studies compared with the CG were: ANP (117.33 +/- 37.7 vs 41.31 +/- 16.8 pg/ml; p < 0.001), aldosterone (185.68 +/- 82.1 vs 44.3 +/- 21.6 pg/ml; p < 0.001) and renine (57.18 +/- 69.9 vs 16.08 +/- 9.7 microU/ml; p < 0.05). Depletion of extracellular volume was found in 75% of the patients. CONCLUSIONS: Human obstructive jaundice is associated with an important alteration in the hormonal mechanisms of water and sodium regulation. This alteration is accompanied by a marked depletion of extracellular volume.