Assessment of salivary urea as a less invasive alternative to serum determinations.

OBJECTIVE: Experimental studies describe how urea is excreted through salivary glands and correlates with serum levels independently of salivary flow rate. This study confirms that salivary urea (SaU) is a reliable biomarker of uraemic state. In order to validate the SaU methodology, the following factors were taken into account: the independence of urea levels from saliva flow rate in healthy subjects and patients with chronic renal failure and the agreement between SaU and serum urea (U) levels in the entire population. In addition, reference intervals and cut-off values for SaU and U were established. MATERIAL AND METHODS: Urea levels were determined in 268 matched whole saliva (SaU) and serum (U) samples obtained simultaneously from 78 healthy individuals and 154 patients with chronic renal failure. A serum enzymic colorimetric assay was adapted to SaU determinations. RESULTS: SaU was independent of salivary flow rate. The agreement between SaU and U was confirmed by Bland-Altman analysis with a significant correlation between them (r = 0.91, p = 0.0001). The reference interval of SaU ranged from 1.66 to 7.5 mM. The cut-off values for SaU and U were 7.5 mM and 8.2 mM, respectively (sensitivity and specificity 100% for both). CONCLUSIONS: SaU testing is harmless and useful for ruling out azotemic states in outpatients. Our results support the inclusion of SaU as a diagnostic test in the clinical laboratory.

Diagnostic value of salivary cortisol in Cushing's syndrome (CS).

OBJECTIVE: The diagnosis of Cushing's syndrome (CS) remains a challenge in clinical endocrinology. The aim of this study was to determine the reproducibility and diagnostic value of late-night salivary cortisol (SAF(23)) for CS and its utility along the follow-up of treated patients. In addition, using the same radioimmunoassay reactives, the cut-off values for saliva and serum cortisol, assessed synchronically after the overnight 1 mg dexamethasone suppression test (DST), were defined. DESIGN: Twenty-one patients with confirmed CS and 121 volunteers were studied. All the subjects collected 24-h urine for cortisol (UFC). On the same day whole saliva was obtained from the subjects at 23 h for SAF(23). The intraclass coefficient of correlation (ICC) of SAF(23) was estimated in 47 subjects (21 CS and 26 C). At 8 h, after DST, simultaneous saliva and serum samples for cortisol (SAF(dex) and F(dex), respectively) were obtained in 51 subjects (17 CS and 34 C). After specific therapy, 18 patients with CS were followed with SAF(23) measurements. SAF and F were expressed as nM. RESULTS: The intraclass coefficient of correlation of SAF(23) was 0.89 in CS and 0.83 in C. SAF(23) > 3.8 nM showed a sensitivity and specificity of 100% and 97.5%, respectively, for diagnosing CS. SAF(23) correlated positively with UFC (r = 0.685; P = 0.0001). After DST, SAF(dex) significantly correlated with F(dex) (r = 0.61, P < 0.0001). A cut-off value of SAF(dex) > 2.0 nM and F(dex) > 50.0 nM detected CS with 100% sensitivity and specificity. After successful surgical therapy, 13 patients with CS had SAF(23) levels < 3.8 nM (1.4 +/- 0.8 nM). CONCLUSIONS: SAF(23) and SAF(dex) seem to be good screening tools based on their noninvasive nature, remarkable reproducibility and diagnostic performances.

[Predictors of intrahospitalary mortality in the upper gastrointestinal variceal bleeding due to chronic liver disease treated endoscopically]. / Predictores de mortalidad hospitalaria en la hemorragia digestiva alta variceal por hepatopatía crónica tratada endoscópicamente.

UNLABELLED: Upper gastrointestinal variceal bleeding is one of the most serious complications in patients with chronic liver disease. The aim of this trial is to identify in hospital mortality predictors in this illness. MATERIAL AND METHODS: 106 hospitalizations due to this disease from October 2001 to April 2006 in cohort design. In hospital mortality was confronted with age, sex, liver disease etiology, Apache II score at admission, variceal severity, severity of the hepatic failure evaluated according to the Child Pugh's classes, a history of variceal bleeding, initial endoscopic treatment failure, haemostatic failure within the first 48 hours, and rebleeding after 48 hours from admission. In order to identify independent mortality predictors, all the variables correlated significantly with hospital mortality were selected. For the quantitative variable APACHE II score at admission, the best mortality discrimination value was chosen. RESULTS: independent in hospital mortality predictors were: initial endoscopic treatment failure (p = 0.005), haemostatic failure in the first 48 hours (p = 0.012), and Child Pugh C class (p = 0.024). Although male sex, Apache II score at admission and rebleeding after 48 hours were also significantly related to mortality by univaried model, they did not qualify as independent predictors. CONCLUSIONS: the independent predictors of intrahospitalary mortality in patients with variceal bleeding due to chronic liver disease, and first-line of endoscopic treatment were: 1) Initial haemostatic endoscopic treatment failure, 2) Haemostatic failure in the first 48 hs, and 3) Child Pugh C class hepatic failure at admission.

Predictores de mortalidad hospitalaria en la hemorragia digestiva alta variceal por hepatopatía crónica tratada endoscópicamente / Predictors of intrahospitalary mortality in the upper gastrointestinal variceal bleeding due to chronic liver disease treated endoscopically

La hemorragia digestiva alta variceal es una de las complicaciones más graves en la hepatopatía crónica. El objetivo de este trabajo es identificar variables que predicen mortalidad hospitalaria. Material y métodos: 106 internaciones por esta patología desde octubre de 2001 hasta abril de 2006 en diseño de cohortes. Se confrontó mortalidad hospitalaria con edad, sexo, etiología de la hepatopatía, score APACHE II al ingreso, imensión de las várices evaluada endoscópicamente, severidad de la insuficiencia hepática evaluada por clases de Child Pugh, antecedente de hemorragia variceal, fracaso de la terapia endoscópica inicial, fracaso hemostático en las primeras 48hs y resangrado posterior a 48hs. Para identificar predictores independientes de mortalidad se seleccionaron todas las variables que correlacionaron significativamente con muerte hospitalaria. Para la variable cuantitativa score APACHE II de ingreso se consideró el valor que mejor discriminó mortalidad. Resultados: los predictores independientes de muerte hospitalaria fueron: el fracaso de la terapia endoscópica inicial (p=0,005), el fracaso hemostático en las primeras 48hs (p=0,012) y la clase C de Child Pugh (p=0,024). Si bien en el sexo masculino el score APACHE II al ingreso y el resangrado con posterioridad a las 48hs también correlacionaron con mortalimortalidad, no calificaron como predictores independientes. Conclusión: en portadores de hepatopatía crónica con hemorragia digestiva alta variceal y primera línea de tratamiento endoscópico, resultaron predictores independientes de muerte hospitalaria: 1) el fracaso de la terapia endoscópica hemostática inicial, 2) el fracaso hemostático en las primeras 48hs, y 3) la clase C de Child Pugh al ingreso.

Upper gastrointestinal variceal bleeding is one of the most serious complications in patients with chronic liver disease. The aim of this trial is to identify in hospital mortality predictors in this illness. Material and methods: 106 hospitalizations due to this disease from October 2001 to April 2006 in cohort design. In hospital mortality was confronted with age, sex, liver disease etiology, Apache II score at admission, variceal severity, severity of the hepatic failure evaluated according to the Child Pugh’s classes, a history of variceal bleeding, initial endoscopic treatment failure, haemostatic failure within the first 48 hours, and rebleeding after 48 hours from admission. In order to identify independent mortality predictors, all the variables correlated significantly with hospital mortality were selected. For the quantitative variable APACHE II score at admission, the best mortality discrimination value was chosen. Results: independent in hospital mortality predictors were: initial endoscopic treatment failure (p = 0,005), haemostatic failure in the first 48 hours (p = 0,012), and Child Pugh C class (p = 0,024). Although male sex, Apache II score at admission and rebleeding after 48 hours were also significantly related to mortality by univaried model, they did not qualify as independent predictors. Conclusions: the independent predictors of intrahospitalary mortality in patients with variceal bleeding due to chronic liver disease, and firstline of endoscopic treatment were: 1) Initial haemostatic endoscopic treatment failure, 2) Haemostatic failure in the first 48hs, and 3) Child Pugh C class hepatic failure at admission.

Effect of translocator protein (18 kDa)-ligand binding on neurotransmitter-induced salivary secretion in rat submandibular glands.

BACKGROUND INFORMATION: TSPO (translocator protein), previously known as PBR (peripheral-type benzodiazepine receptor), is a ubiquitous 18 kDa transmembrane protein that participates in diverse cell functions. High-affinity TSPO ligands are best known for their ability to stimulate cholesterol transport in organs synthesizing steroids and bile salts, although they modulate other physiological functions, including cell proliferation, apoptosis and calcium-dependent transepithelial ion secretion. In present study, we investigated the localization and function of TSPO in salivary glands. RESULTS: Immunohistochemical analysis of TSPO in rat salivary glands revealed that TSPO and its endogenous ligand, DBI (diazepam-binding inhibitor), were present in duct and mucous acinar cells. TSPO was localized to the mitochondria of these cells, whereas DBI was cytosolic. As expected, mitochondrial membrane preparations, which were enriched in TSPO, exhibited a high affinity for the TSPO drug ligand, (3)H-labelled PK 11195, as shown by B(max) and K(d) values of 10.0+/-0.5 pmol/mg and 4.0+/-1.0 nM respectively. Intravenous perfusion of PK 11195 increased the salivary flow rate that was induced by muscarinic and alpha-adrenergic agonists, whereas it had no effect when administered alone. Addition of PK 11195 also increased the K(+), Na(+), Cl(-) and protein content of saliva, indicating that this ligand modulated secretion by acini and duct cells. CONCLUSIONS: High-affinity ligand binding to mitochondrial TSPO modulates neurotransmitter-induced salivary secretion by duct and mucous acinar cells of rat submandibular glands.

Diagnostic value of salivary cortisol in end stage renal disease.

OBJECTIVES: Salivary cortisol has been proposed a surrogate marker for free serum cortisol measurements. The aim of this study was to ascertain the diagnostic value of basal and stimulated salivary cortisol for the detection of adrenal insufficiency (AI) in hypotensive end stage renal disease (ESRD) patients. Basal salivary cortisol and basal total serum cortisol were studied in order to determine the accuracy of both biomarkers in predicting AI. PATIENTS AND METHODS: Twenty-nine ESRD patients with sustained hypotension were investigated for possible AI. Salivary cortisol was assessed at baseline and 30min after 25microg ACTH i.m. (LDTs). The dosage of salivary aldosterone was performed in salivary cortisol hypo-responders. Basal blood samples were drawn for steroids, renin and ACTH measurements. RESULTS: A clear separation between patients with normal and impaired adrenal function was obtained through salivary cortisol levels at 30min after ACTH. AI was detected in six cases (21%) through impaired salivary cortisol responses; stimulated salivary aldosterone helped to differentiate primary (n=3) from secondary AI (n=3). ROC curves showed that cutoff values for basal SAF < or =4.4nM and serum cortisol < or =232.0nM suggest AI (sensitivities: 93% and 69%; specificities: 86.4% and 91%, respectively). CONCLUSIONS: We conclude that ACTH stimulated SAF is an accurate biomarker for the diagnosis of AI in hypotensive ESRD patients. Neither basal salivary cortisol nor serum cortisol showed 100% sensitivities for the detection of AI.

Salivary testosterone: a reliable approach to the diagnosis of male hypogonadism.

OBJECTIVE: This study was to demonstrate that Sal-T is a reliable biomarker of androgen status in the diagnosis of male hypogonadism. DESIGN: In order to validate the salivary testosterone assay (Sal-T), its reproducibility, the agreement with serum free testosterone levels (Free-T), the correlation with other circulating androgen markers (bioavailable testosterone, total testosterone) and cut-off values were defined. PATIENTS AND METHODS: We studied 52 eugonadic (E) and 20 hypogonadic (Hy) men. Sal-T was assayed using an adapted radioimmunoassay for serum testosterone. Sal-T concentrations were compared in nine cases before and after citric acid stimulation of salivary flow rate. Free-T and bioavailable testosterone (Bio-T) were calculated by Vermeulen equation and SHBG were determined by binding assay. RESULTS: Sal-T did not depend on salivary flow rate and morning samples from 07.00 h to 09.00 h were stable. Agreement between Sal-T and Free-T measurements was confirmed in all subjects. Sal-T levels correlated positively with all circulating androgens, showing the best correlation with Free-T in E (r = 0.92) as well as in Hy (r = 0.97). A cut-off value of Sal-T < or = 0.195 nm showed 100% sensibility and specificity to rule out hypogonadism. CONCLUSIONS: Our data showed that Sal-T is a reliable marker of testosterone bioavailability. The results support the inclusion of this biomarker as a noninvasive approach in the diagnosis of male androgen deficiency.

Assessment of adrenal function by measurement of salivary steroids in response to corticotrophin in patients infected with human immunodeficiency virus.

OBJECTIVE: Adrenal insufficiency has been reported among critically ill HIV-infected patients. This is the first study that attempts to detect subclinical hypoadrenal states in non-critical HIV patients through salivary steroids in response to intramuscular low-dose ACTH injection. PATIENTS AND METHODS: We studied 21 ambulatory adult HIV-infected patients without specific clinical signs or symptoms of adrenal insufficiency. Normal salivary flow-rate and salivary alpha-amylase activity confirmed adequate salivary gland function. Salivary cortisol (SAF) and salivary aldosterone (SAL) were obtained at baseline and 30 min after the injection of 25 microg of ACTH in the deltoid muscle (LDT(s)). Assessment of salivary steroids after stimulation with 250 microg of intramuscular ACTH (HDT(s)) was performed on those who hyporesponded to LDT(s). Basal blood samples were drawn for steroids, renin and ACTH measurements. RESULTS: At baseline SAF and SAL correlated significantly (p=0.0001) with basal serum cortisol and aldosterone (r=0.70 and 0.91, respectively). Plasma ACTH and renin concentrations were within the normal range in all patients. Eight of the twenty-one HIV(+) patients were LDT(s) hyporesponders in either SAF (n:1) or SAL (n:7). LDT(s) repeated in six cases after a year reconfirmed the impairment of aldosterone secretion. LDT(s) hyporesponders had normal steroid responses to HDT(s). CONCLUSIONS: LDT(s) is a simple, safe, well-accepted and non-invasive approach to assess adrenal function in HIV-infected ambulatory patients. It revealed subnormal cortisol (5%) and aldosterone responses (33%) when HDT(s) results were normal.

Quantitative study of salivary secretion in Parkinson's disease.

We examined basal and reflex salivary flow rate and composition in 46 patients with Parkinson's disease (PD), both in off and on conditions, compared to 13 age-matched controls without underlying disease or treatment affecting autonomic function. Whole saliva was collected 12 hours after withdrawal of dopaminergic drugs and at the peak of levodopa-induced motor improvement. Twenty-three of the 46 PD patients had received domperidone a week before the study. Basal salivary flow rate was significantly lower in PD patients in the off state compared to controls (P<0.005). Levodopa increased salivary flow rate (P<0.05) both in the domperidone-pretreated and untreated groups. Citric acid stimulated salivary flow rate in both the off and on states in PD patients. This effect was higher in the domperidone-pretreated patients. Salivary concentration of sodium, chloride, and amylase was higher in PD patients than in controls and was not affected by levodopa or domperidone treatment. Levodopa stimulates both basal and reflex salivary flow rate in PD. The mechanism appears to be central, as the effect is not blocked by domperidone. Domperidone may have a peripheral effect that potentiates reflex salivary secretion. Salivary composition is abnormal in PD and is not affected by levodopa treatment.

Standardization of a simple method to study whole saliva: clinical use in different pathologies.

The present study describes a methodology to assess the salivary flow rate in humans. Whole saliva was obtained from the floor of the mouth with a plastic dental ejector and a vacuum pump. Forty healthy subjects of both sexes and 51 patients with different pathologies (Sjögren Syndrome, Thyroid Dysfunction, Diabetes Mellitus) were included in the study. It was demonstrated that basal salivary flow rate was stable five minutes after the insertion of the oral ejector Salivary flow rate did not show significant differences between sexes and was independent of the negative pressure level of the vacuum pump. Stimulated salivary flow rate was quantified over a period of 3 minutes, starting 5 minutes after the introduction of the oral device. The stimulus was paper filter disks soaked in citric acid (2%) placed on the tongue dorsum. The use of this method confirmed the reduction of salivary flow rate in patients with Sjiigren Syndrome. In addition, a significant reduction in salivary flow rate was observed in patients with primary thyroid insufficiency and peripheral neurpathy secondary to Diabetes Mellitus.

Standardization of a simple method to study whole saliva: clinical use in different pathologies

En este trabajo se describe la normatización de un método paradeterminar flujo salival en humanos utilizando saliva total obtenida del piso de la boca mediante un eyector dental descartable y una bomba de vacío (equipo dental). En este estudio se evaluaron 40 sujetos sanos de ambos sexos y 51 pacientes con diversas patologías (Síndrome de Sj§gren, disfunción Tiroidea, Diabetes Mellitus).Se demostró que el flujo salival basal era estable a partir de los primeros 5 minutos de colocado el eyector en la cavidad bucal. No se encontraron diferencias significativas en el flujo salival basal comparando los sexos, siendo independiente de la intensidaddel vacío efectuado por la bomba. El flujo de saliva total estimulada fue determinado durante 3 minutos, luego de los primeros 5 minutos de colocado el eyector en la boca. El estímulo se efectuó adosando en la cara dorsal de la lengua discos de papel absorbente, embebidos en ácido cítrico al 2 por ciento. El uso de este método en pacientes con Síndrome de Sj§grenconfirmó la reducción del flujo salival respecto a los sujetos sanos. Los pacientes hipotiroideos y con neuropatía diabética demostraron disminución del flujo salival (AU)

The present study describes a methodology to assess the salivary flow rate in humans. Whole saliva was obtained from the floor of the mouth with a plastic dental ejector and a vacuum pump. Forty healthy subjects of both sexes and 51 patients with different pathologies (Sj÷gren Syndrome, Thyroid Dysfunction, Diabetes Mellitus) were included in the study. It was demonstrated that basal salivary flow rate was stable five minutes after the insertion of the oral ejector. Salivary flow rate did not show significant differences between sexes and was independent of the negative pressure level of the vacuum pump Stimulated salivary flow rate was quantified over a period of 3 minutes, starting 5 minutes after the introduction of the oral device. The stimulus was paper filter disks soaked in citric acid (2%) placed on the tongue dorsum. The use of this method confirmed the reduction of salivary flow rate in patients with Sj÷gren Syndrome. In addition, a significant reduction in salivary flow rate was observed in patients with primary thyroid insufficiency and peripheral neuropathy secondary to Diabetes Mellitus.(AU)

Standardization of a simple method to study whole saliva: clinical use in different pathologies

En este trabajo se describe la normatización de un método paradeterminar flujo salival en humanos utilizando saliva total obtenida del piso de la boca mediante un eyector dental descartable y una bomba de vacío (equipo dental). En este estudio se evaluaron 40 sujetos sanos de ambos sexos y 51 pacientes con diversas patologías (Síndrome de Sjõgren, disfunción Tiroidea, Diabetes Mellitus).Se demostró que el flujo salival basal era estable a partir de los primeros 5 minutos de colocado el eyector en la cavidad bucal. No se encontraron diferencias significativas en el flujo salival basal comparando los sexos, siendo independiente de la intensidaddel vacío efectuado por la bomba. El flujo de saliva total estimulada fue determinado durante 3 minutos, luego de los primeros 5 minutos de colocado el eyector en la boca. El estímulo se efectuó adosando en la cara dorsal de la lengua discos de papel absorbente, embebidos en ácido cítrico al 2 por ciento. El uso de este método en pacientes con Síndrome de Sjõgrenconfirmó la reducción del flujo salival respecto a los sujetos sanos. Los pacientes hipotiroideos y con neuropatía diabética demostraron disminución del flujo salival

The present study describes a methodology to assess the salivary flow rate in humans. Whole saliva was obtained from the floor of the mouth with a plastic dental ejector and a vacuum pump. Forty healthy subjects of both sexes and 51 patients with different pathologies (Sjögren Syndrome, Thyroid Dysfunction, Diabetes Mellitus) were included in the study. It was demonstrated that basal salivary flow rate was stable five minutes after the insertion of the oral ejector. Salivary flow rate did not show significant differences between sexes and was independent of the negative pressure level of the vacuum pump Stimulated salivary flow rate was quantified over a period of 3 minutes, starting 5 minutes after the introduction of the oral device. The stimulus was paper filter disks soaked in citric acid (2%) placed on the tongue dorsum. The use of this method confirmed the reduction of salivary flow rate in patients with Sjögren Syndrome. In addition, a significant reduction in salivary flow rate was observed in patients with primary thyroid insufficiency and peripheral neuropathy secondary to Diabetes Mellitus.

Modulation by thyroid hormones of rat parotid amylase secretion stimulated by 5-hydroxytryptamine.

The effects of 5-hydroxytryptamine (5-HT) upon amylase secretion by rat parotid glands were studied in three groups of animals: (a) intact control rats (euthyroid rats); (b) hypothyroid rats obtained by surgical thyroidectomy 2 wk before the experiments; and (c) hyperthyroid rats obtained by the administration of sodium l-triiodothyronine for 2 wk before the experiments. Hyperthyroid rats showed significantly higher baseline amylase release than control rats. When the glands were stimulated with 5-HT (30 micro m), amylase release was significantly lower in the hypothyroid group and higher in the hyperthyroid rats than in control group. Addition of cholinergic, adrenergic or substance P antagonists did not modify 5-HT-stimulated amylase activity. The effects of 5-HT were partly but significantly blocked by the addition of 10 micro m methysergide (HT1/2/7 receptor blocker) in the three groups of rats. In contrast, 10 micro m ketanserine (HT2A receptor blocker) partly blocked the response to 5-HT only in the hyperthyroid animals. It was concluded that 5-HT induces amylase secretion by rat parotid glands through specific serotoninergic receptors, and that thyroid status modulates the 5-HT effect.

Sialoquímica en el síndrome de SjIgren : nuevo índice para el diagnóstico / Sialochemistry in the SjIgrens syndrome : new index for the diagnosis

El síndrome de SjIgren (SS) está caracterizado por una inflamación crónica de las glándulas lagrimales y salivales con infiltración linfocitaria, provocando sequedad ocular y bucal. Además de la disminución del flujo salival se han observado alteraciones en diversos parámetros bioquímicos de la saliva. El objetivo del presente trabajo consistió en evaluar la sialometría basal (saliva total) y estimulada (saliva parotídea), y cuantificar diversos parámetros sialoquímicos en 62 pacientes con SS y 28 pacientes controles, con el fin de clarificar su aptitud diagnóstica. La sialometría basal tomada en forma temporal (7 meses) en algunos pacientes, demostró ser efectiva sólo para la evaluación de la xerostomía y evidenció la existencia de picos esporádicos de secreción. La saliva parotídea estimulada presentó una disminución del flujo (0.89ñ0.09 vs. 0.48ñ0.06 mL/min.), amilasa (602.40ñ76.70 vs. 436.10ñ53.80 AU), y proteínas totales (152.04ñ9.80 vs. 116.50ñ8.30 mg/dL), y un aumento de las concentraciones de Na+(22.75ñ3.52 vs. 43.46ñ3.22 mEq/L), e IgG (0.40ñ0.13 vs. 3.91ñ1.01 mg/dL) y/o IgM (0.40ñ0.12 vs. 1.54ñ0.31 mg/dL). No en todos los pacientes se registró un aumento simultáneo de IgG e IgM, pero siempre apareció elevada una de ellas. Como el índice salival que resulta del producto de las concentraciones de IgG por IgM es siempre mayor a 0.25 en los pacientes con SS, y menor o igual a este valor en el grupo control, creemos que, sumado al carácter no invasivo del método de extracción, sería una herramienta complementaria de gran utilidad en el diagnóstico de este síndrome. (AU)

Sialoquímica en el síndrome de SjÖgren : nuevo índice para el diagnóstico / Sialochemistry in the SjÖgren's syndrome : new index for the diagnosis

El síndrome de SjÖgren (SS) está caracterizado por una inflamación crónica de las glándulas lagrimales y salivales con infiltración linfocitaria, provocando sequedad ocular y bucal. Además de la disminución del flujo salival se han observado alteraciones en diversos parámetros bioquímicos de la saliva. El objetivo del presente trabajo consistió en evaluar la sialometría basal (saliva total) y estimulada (saliva parotídea), y cuantificar diversos parámetros sialoquímicos en 62 pacientes con SS y 28 pacientes controles, con el fin de clarificar su aptitud diagnóstica. La sialometría basal tomada en forma temporal (7 meses) en algunos pacientes, demostró ser efectiva sólo para la evaluación de la xerostomía y evidenció la existencia de picos esporádicos de secreción. La saliva parotídea estimulada presentó una disminución del flujo (0.89ñ0.09 vs. 0.48ñ0.06 mL/min.), amilasa (602.40ñ76.70 vs. 436.10ñ53.80 AU), y proteínas totales (152.04ñ9.80 vs. 116.50ñ8.30 mg/dL), y un aumento de las concentraciones de Na+(22.75ñ3.52 vs. 43.46ñ3.22 mEq/L), e IgG (0.40ñ0.13 vs. 3.91ñ1.01 mg/dL) y/o IgM (0.40ñ0.12 vs. 1.54ñ0.31 mg/dL). No en todos los pacientes se registró un aumento simultáneo de IgG e IgM, pero siempre apareció elevada una de ellas. Como el índice salival que resulta del producto de las concentraciones de IgG por IgM es siempre mayor a 0.25 en los pacientes con SS, y menor o igual a este valor en el grupo control, creemos que, sumado al carácter no invasivo del método de extracción, sería una herramienta complementaria de gran utilidad en el diagnóstico de este síndrome.

Manual de fisiología digestiva / Fisiology digestive manual

Motilidad, Secreción general, Salival, Gástrica, Pancreática, Biliar, Intestinal.- Digestión y absorción.- Inmunidad.- Función hepática.- Hormonas digestivas.- Modelos de ejercitación

Manual de fisiología digestiva / Fisiology digestive manual

Motilidad, Secreción general, Salival, Gástrica, Pancreática, Biliar, Intestinal.- Digestión y absorción.- Inmunidad.- Función hepática.- Hormonas digestivas.- Modelos de ejercitación

Synthesis and contents of pancreatic exportable enzymes: effect of oleic acid intraduodenal administration

Ratas Sprague-Dawley fueron estimuladas intraduadernalmente con ácido oleico y sacrificadas 20, 40, 60 y 80 m luego de la instilación. En todos los grupos se administró, 10m antes del sacrifício, 50 uCi de 3H-fenilalanina (3H-F) intraperitoneal. Se cuantificaron los niveles intrapancreáticos de Am, Chtg, Tg y Li y la incorporación de 3H-F en las proteínas secretoras. A los 40 m de la administración de ácido oleico se registró la máxima estimulación de ácido oleico se registró la máxima estimulación para Chtg (45%), Tg (38%) y Li (23%) por sobre los valores controles, no modificándose la Am. Todos los valores enzimáticos cayeron por debajo de los controles a los 60 y 80 minutos. La incorporación 3H-F fue máxima a los 40 m decayendo a tiempos más prolongados. En el presente trabajo demostramos que la administración intraduodenal de ácido oleico genera un aumento no paralelo en el nivel intrapancreático de algunas enzimas exportables, y que dichos valores caen a partir de los 40 m post-instilación, siendo la síntesis proteica afectada de manera similar (AU)

Synthesis and contents of pancreatic exportable enzymes: effect of oleic acid intraduodenal administration

Ratas Sprague-Dawley fueron estimuladas intraduadernalmente con ácido oleico y sacrificadas 20, 40, 60 y 80 m luego de la instilación. En todos los grupos se administró, 10m antes del sacrifício, 50 uCi de 3H-fenilalanina (3H-F) intraperitoneal. Se cuantificaron los niveles intrapancreáticos de Am, Chtg, Tg y Li y la incorporación de 3H-F en las proteínas secretoras. A los 40 m de la administración de ácido oleico se registró la máxima estimulación de ácido oleico se registró la máxima estimulación para Chtg (45%), Tg (38%) y Li (23%) por sobre los valores controles, no modificándose la Am. Todos los valores enzimáticos cayeron por debajo de los controles a los 60 y 80 minutos. La incorporación 3H-F fue máxima a los 40 m decayendo a tiempos más prolongados. En el presente trabajo demostramos que la administración intraduodenal de ácido oleico genera un aumento no paralelo en el nivel intrapancreático de algunas enzimas exportables, y que dichos valores caen a partir de los 40 m post-instilación, siendo la síntesis proteica afectada de manera similar