[Functional evaluation of the exocrine pancreas in patients with chronic Chagas' disease].
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Biomedical subjects
Publications and source records attributed to A M Sipahi.
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The seric levels of gastrin, pancreatic glucagon, pancreatic polypeptide, enteroglucagon, motilin and cholecistokinin were evaluated in ten patients with chronic Chagas' disease and compared with those observed in nine normal control subjects. The seric values of all the hormones were determined on basal stimulation, after continuous intravenous secretin infusion and infusion of stepwise increased concentrations of caerulein (direct stimulation), and after intravenous secretin administration followed by intraduodenal instilation of increased concentrations of phenylalanina (combined stimulation). All the hormones, basal and after direct stimulation, showed similar values, except gastrin that in the chagasic group presented higher levels than in control subjects. Phenylalanine and pancreatic polypeptide showed significantly higher values in the control group than in the one of patients with Chagas' disease. The hormonal response in patients with chronic Chagas' disease suggested a neural impairment of the enteropancreatic axis.
Sulfasalazine is one of the most used drugs in the clinical management of inflammatory bowel disease. Nevertheless up to 30% of the patients experiment side effects related to the drug and end up having the drug diminished or withdrawn. The new salicylic-derivate compounds emerge as a reliable alternative for these patients. The authors review the new preparations and discuss their characteristics, indications and side effects.
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Cholesterol and triglyceride plasma levels are usually increased in cholestasis. The excess of cholesterol and that of triglyceride are carried in abnormal low-density lipoproteins (LP) named LP-X and beta 2-LP respectively. It has been assumed that chylomicron metabolism is involved in these alterations. To gain insight into the LP disturbances in this pathology, artificial chylomicrons (AC) were prepared in protein-free aqueous solutions containing lecithin, cholesteryl-oleate, cholesterol and triolein. AC were labelled simultaneously with cholesteryl--14C-oleate (14C-CO) and 3H-triolein (3H-TO) and pulse injected intra-arterially in rats subjected to total obstruction of the bile duct for 48 hours and sham-operated rats. Blood was collected at 2-minute intervals during 10 minutes for radioactivity determination. Fractional clearance rates of 3H-TO and 14C-CO were diminished. Since plasma decay of 3H-TO reflects predominantly the rate of lipolysis (L) whereas chylomicron remnant removal (CRR) by the liver is represented by the 14C-CO decay, our data suggest that in cholestasis both L and CRR are defective.
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Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.
In order to gain some insight into the possible influence of gastric emptying on gallbladder hypomotility in patients with Crohn's disease, the gastric emptying time (GET) was measured by means of ultrasonography in 10 healthy controls and 10 patients with Crohn's disease. No significant difference was observed between both mean values for GET studies (GET: controls, 165.0 min +/- 12.8; Crohn, 142.0 min +/- 11.5; p = 0.208) after ingestion of a liquid meal. Thus, the gallbladder hypomotility described in patients with Crohn's disease, after a liquid fatty-meal stimulus, can not be explained by prolonged gastric emptying time.
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