Thoracoabdominal manifestations of immunoglobulin G4-related disease.

Immunoglobulin G4-related disease (IgG4-RD) comprises a group of immune-mediated diseases that, until recently, were considered separate entities. These entities have a similar clinical presentation, serological findings, and pathogenesis, so they are currently considered a single multisystemic disease. The common characteristic is the infiltration of involved tissues by plasma cells and lymphocytes that are positive for IgG4. Three major criteria have been proposed for the diagnosis of IgG4-RD: clinical, laboratory, and histological. The pancreas is the organ that is most affected by IgG4-RD, which can simulate a tumor. In this respect, a series of signs could help us suspect that the pancreatic findings do not reflect a tumor (halo sign, duct-penetrating sign, absence of vascular invasion, etc.). The differential diagnosis is important to avoid unnecessary surgical interventions.

Dietary fiber and its interaction with drugs.

As the intake of purified dietary fibers is increasing in the society, it is necessary to know how these fibers interact with simultaneously administered drugs, in order to ensure adequate therapeutic effects, minimizing the risk for adverse effects. This paper reviews the literature on the interactions between different types of purified fibers and several drugs.

Genotypes of Streptococcus mutans in saliva versus dental plaque.

OBJECTIVE: The aim of this study was to investigate whether genotypes of Streptococcus mutans strain can be detected as effectively in saliva samples as in plaque samples from buccal surfaces and occlusal surface fissures of permanent first molars. DESIGN: The study included 20 school children aged 6-7 years who were positive for mutans streptococci. Samples of stimulated saliva and of dental plaque on buccal surfaces and occlusal surface fissures of permanent first molars were collected. Samples were cultivated in MSB agar. Up to nine isolates compatible with mutans streptococci were obtained and identified by means of biochemical tests. All isolates identified as S. mutans were genotyped by arbitrarily primed polymerase chain reaction. RESULTS: A total of 28 genotypes of S. mutans were isolated: 23 in saliva samples, 23 in buccal surface plaque samples, and 16 in plaque samples from occlusal surface fissures. CONCLUSIONS: Although, saliva sampling did not reveal all genotypes isolated, it was equally as effective as plaque sampling from the buccal surfaces of permanent first molars, and more effective than plaque sampling from fissures on their occlusal surfaces.

[Glucomannan: properties and therapeutic applications]. / Glucomanano: propiedades y aplicaciones terapéuticas.

Glucomannan is a dietary fiber employed quite frequently in the western countries since two decades now, as its ingestion plays an important role in human health. However, eastern people have used this fiber for more than a thousand years. This dietary fiber is the main polysaccharide obtain from the tubers of the Amorphophallus konjac plant, a member of the family Araceae found in east Asia. The chemical structure of glucomannan consists, mainly, in mannose and glucose in the ratio 8:5 linked by beta (1-->4) glycosidic bonds. This soluble fiber has a extraordinarily high waterholding capacity, forming highly viscous solutions when dissolved in water. It has the highest molecular weight and viscosity of any known dietary fiber. It has been demonstrated that this product is highly effective in the treatment of obesity due to the satiety sensation that it produces; as a remedy for constipation, because it increases the faeces volume; as hypocholesterolemic agent, interfering in the transport of cholesterol and of bile acids and as hypoglycemic and hypoinsulinemic agent, probably, by delaying gastric emptying and slowering glucose delivery to the intestinal mucosa. To the beneficial properties of this fiber, several disadvantages can be added as the production of flatulence, abdominal pain, esophageal obstruction, lower gastrointestinal obstruction or even the possible modification of the bioavailability of other drugs. This paper reviews the main characteristics of glucomannan, as well as its properties, physiologic effects and therapeutic uses.

[Effect of Ispaghula husks on postprandial glycemia in healthy female volunteers]. / Influencia de las cutículas de semillas de Plantago ovata (Ispaghula husk) en la glucemia posprandial en voluntarias sanas.

OBJECTIVES: To evaluate the influence of Ispaghula husk in the postprandial glucose concentrations in serum in healthy volunteers. MATERIAL AND METHODS: This study is divided in two assays and 7 healthy women with ages ranging from 35 to 45 years participated in both assays. Assay 1. Administration of 50 g of glucose dissolved in 125 ml of water (followed by other 150 ml of water). Assay 2. It was carried out one week later in the same women and conditions as assay 1 but adding 10.5 g of Ispaghula husk to the dissolution. In both assays, blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90 and 120 minutes after administration and glucose concentration was determined in serum. RESULTS: The value of the area under the mean glucose concentration-time curve obtained in assay 2 (in the presence of fiber) was a 13.6% lower than that obtained in assay 1 (significant difference, p < or = 0.05). Individual concentration-time curves obtained in assay 1 can be considered as normal in 4 of the 7 volunteers. Abnormalities observed in the other 3 curves were due to: her history of prediabetic in one of them (glucose concentration values over 180 mg/100 ml); diabetic patients in her family in other of them (2 values over 180 mg/100 ml) and hypoglycaemia in two of the volunteers. When we administered glucose with fiber in assay 2, in all cases, the maximum concentration reached was lower, the variations in glycaemia values were also lower along the different sampling times (peaks disappear or are less marked) and no hypoglycaemia appeared.