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Biomedical subjects

F Mora

Publications and source records attributed to F Mora.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Value of long-term ambulatory pH-metry in the assessment of patients with reflux esophagitis].

The aim of this study is to analyze different reflux-patterns by 24-hour ambulatory pH-metry and to correlate them with clinical symptoms and intensity of esophagitis. 115 patients (50 males/65 females) with a median age of 47 +/- 16 years, typical reflux symptoms have been studied and classified attending to the grade of esophagitis microscopically only 17 cases and endoscopically (grade I = 29, grade II = 44 and grade III/IV = 25 patients). Demeester's score has been used for clinical evaluation. Ambulatory pH-metry has been done with a Holter Synectics Digitrapper MK II, which registered intraesophageal pH-variations every 4 seconds during 24 hours. 28 normal subjects (13 males/15 females) with a median age of 51 +/- 16 years are referred as the control group. Clinical symptoms became more intensified when pH-metric alterations resulted more evident. Thoracic pain was noted in 12 from 115 patients, increasing its frequency in parallel fashion to that of the degree of esophagitis (6% in grade 0, 9% in grades I/II and 20% in grades II/IV). With increasing grades of esophagitis all parameters departed from normality, with significant differences between median values of the different parameters (to the exception of reflux episodes) when comparing patients with low-grade esophagitis (O/I) and high-grade esophagitis (II/III/IV). There is an excellent correlation between severity of esophagitis and % of time to acid exposure (Spearman's correlation coefficient). Only 5% of the patients with esophagitis presented normal pH-metry values and corresponded to esophagitis grade O/I. No patient had only a night reflux pattern, but 10% of our patients had only a day reflux pattern, the mixed pattern being the most frequent one (85%). The fact that 82% of our patients with microscopical esophagitis had a pathological pH-metry recommends the use this method in patients with clinical reflux symptoms and with normal endoscopy.

Adult↗
PubMed1993

[Metoclopramide versus cinitapride in the treatment of functional dyspepsia].

In 20 patients with diagnosis of functional dyspepsia due to dysmotility and/or reflux, the effectivity and tolerance of two prokinetic drugs--metochlopramide (MCP) (10 mg. three daily doses, vo) and cinitrapide (CTP) (1 mg., 3 daily doses, vo)--were assessed using a protocol of a propective and cross-sectional study after a blank period. Following the treatment with MCP and CTP, statistically significant improvements were observed in the intensity/severity of postprandial epigastric fullness, flatulence, epigastralgia, pyrosis, active regurgitations and anorexia. The MCP was more effective for the improvement of vomiting in these patients; however, the number of defecations per week increased significantly only after the CTP therapy. The therapeutical effectivity of both drugs, according to a subjective and objective global assessment was similar, with good results of 60-65% for MCP and 55-60% for CTP. Tolerance of both drugs was good. None of the patients spontaneously referred to the presence of side effects and only 3 patients (15%) treated with MCP and 2 patients (10%) treated with CTP mentioned some of the suggested side effects, which were absent before the onset of treatment. Both drugs produced an increase in the levels of Prolactine, but their average values were within the normal range. Only in two patients treated with MCP and in one patient treated with CTP, values slightly higher than the upper normal limit were observed. No significant differences were observed when comparing the results obtained with MCP therapy and CTP therapy.

Adult↗
PubMed1992

[Colonic transit time (segmental and total) in healthy subjects and patients with chronic idiopathic constipation].

BACKGROUND: The efficacy of the treatment of patients with chronic idiopathic constipation not responding to normal therapeutic measures depends on correct functional diagnosis. The study of the segmentary and total colonic transit time with radioopaque markers is the most economic technique in everyday clinic ambience for functionally evaluating these patients. METHODS: Segmental and total colonic transit time was calculated with the use of radioopaque markers in 23 healthy subjects (12 men and 11 women) and in 13 women with severe idiopathic constipation. Twenty markers were administered daily for three consecutive days and simple x-rays of the abdomen were made on the fourth, seventh and in some cases on the tenth day. In addition, the symptomatology of 9 patients was collected by means of a 30 day diary. RESULTS: The maximum values of transit time (mean + 2SD) obtained in the healthy subjects were 17, 25, 26, and 49 hours for the right colon, left colon, rectosigmoid and the whole colon, respectively. The time of left colon transit was significantly lower in the women. The transit time in constipated patients permitted the differentiation of three functional patients: a) slowing of the right and left colon possibly associated to rectosigmoid slowing in 5 patients; b) isolated slowing in the left colon in 4 patients and c) isolated rectosigmoid slowing in 4 patients. Group a) was characterized by long total colonic transit times while these were normal in 2 patients of group b) and in one patient of group c). No differences were seen in the symptomatology of the groups. CONCLUSIONS: The calculation of segmentary and total colonic transit time with radioopaque markers is a simple technique which permits the detection of different subgroups of patients with chronic idiopathic constipation refractory to normal treatment. The exact typification of the functional anomaly is an important basis for the individualization of treatment.

Adult↗
PubMed1992

[Oropharyngeal functional assessment in patients with Zenker's diverticulum. Manometric and isotopic study].

Twenty patients with the diagnosis of Zenker's diverticulum were studied clinically and manometrically. In 8 patients oropharyngeal clearance of liquid isotopic markers was done. In three, esophageal emptying of a marked meal was also studied. Clinically, sixteen patients had oropharyngeal dysphagia, while for remained asymptomatic. Dysphagia was severe in only five patients. In half of the patients there were signs of hiatus hernia and/or reflux. Pharyngo-sphincteric incoordination was present in 70% of cases with a mean resting pressure of the LES significantly lower than in controls. There were no differences among patients with or without reflux. Isotopic esophageal clearance was not useful as a test, as there were no significant differences with the control group. On the other hand, esophageal emptying of solid isotopic meals may show the persistence of food in the diverticular sac long time after the meal.

Deglutition Disorders↗
PubMed1991

[Oropharyngeal dysphagia due to a primary change in the pharyngeal musculature. A manometric and isotopic study].

Twenty-five patients with oropharyngeal dysphagia due to a variety of disorders (4 with muscular dystrophy, 4 with myasthenia gravis and 13 with inflammatory myopathies) were studied clinically by esophageal manometry and isotopic clearance. Clinically patients had moderate dysphagia and 45% other symptoms such as nasal regurgitation, bronchial aspiration, etc. The most important manometric abnormality was the feeble contractions of the pharyngeal musculature, more pronounced in patients with severe dysphagia (grade II). Isotopic clearance of the oropharynx showed slowing of the pharyngeal emptying curve and an increased residual activity in this area. Isotopic oropharyngeal clearance is a useful, comfortable and noninvasive test for determining the clinical improvement which accompanies the manometric recovery of the pharyngeal muscular contraction.

Deglutition Disorders↗
PubMed1991

Chronic idiopathic constipation: the importance of transit time studies.

Chronic idiopathic constipation includes a very heterogeneous group of alterations which cannot be correctly defined only by their clinical appearance and require an examination of the colonic transit time. This test is performed by using a specific number of radiopaque markers and a fixed number of X-ray observations. By means of transit time study, we can classify the constipated patients into 4 groups: a) patients with stasis in the right colon (17-53% of cases) which implies an alteration of propulsive forces or absence of mass movements and segmentary motor activity; b) stasis in the left colon (13-27% of cases) which could be due to a "reflux" of colonic contents or to a hyperactive sigmoid; c) rectosigmoid stasis (20-33% of cases) which is secondary to a megarectum. Internal anal sphincter (IAS) and/or external anal sphincter (EAS) function failure and d) normal transit time (greater than 40 of cases) which is commonly due to psychological problems or to a low-fiber-content diet. We can conclude that transit time study is not necessary in mild constipation, but it is advised for those patients who do not respond to standard medical therapy or when surgery is being contemplated.

Anal Canal↗
PubMed1991

Alteration of recto-anal motility in chronic idiopathic constipation.

We studied anorectal function in 10 controls and 13 constipated patients (chronic idiopathic constipation, outlet obstruction and inertia coli). We did not find any difference among the 3 groups as regards the internal anal sphincter (IAS) basal tone, the recto-anal inhibitory reflex (RAIR) and the maximal voluntary contraction, whereas some significant differences were observed in the sensitivity threshold. In fact, we observed that all patient groups required larger volumes in order to perceive the minimum sensation. Moreover, the patients with distal obstruction showed higher threshold for a permanent defecation stimulus. The reduction of rectal sensitivity in these patients was confirmed by the infusion of 1500 cc of saline solution. On the basis of our experience constipated patients are characterized by both normal IAS tone, RAIR appearance, squeezing capacity, and lower rectal sensitivity.

Adult↗
PubMed1991

The irritable bowel syndrome: diagnostic strategies.

The irritable bowel syndrome (IBS) is characterized by abdominal pain, abdominal distension and altered bowel habits. The diagnosis is usually made by excluding other diseases. The diagnosis of IBS must be based on a) medical history (i.e. symptoms, bowel habits, normal physical examination, absence of intestinal infections or parasites) b) physiopathological evaluation (hyperactivity of the distal colon, hypersensitivity to stimuli, stress), and c) physiological evaluation of the patient. The diagnosis of IBS can be supposed in patients with typical symptoms in the absence of other diseases that were excluded by complementary examinations.

Abdominal Pain↗
PubMed1991

Colonic sensitive-motor alterations in the irritable bowel syndrome.

The pathogenetic factors involved in the genesis of the irritable bowel syndrome (IBS) has not been fully explained yet. The abnormalities observed in these patients are a hypersensitivity to distension and an amplification of painful sensations. The motor activity of sigmoid colon shows an increased motility index in IBS patients with constipation and a low motility index in those with diarrhea. An hypercaloric meal induces a hypermotility in these patients. In our experience rectal distension evokes abdominal pain in 78% of cases at volumes of 100ml (less than than controls and constipated patients). The perfusion of rectum induces continuous abdominal pain in 89% of IBS patients. We can say that the motility of the whole colon over prolonged periods of time may represent an important progress in understanding the motor function in these patients.

Abdominal Pain↗
PubMed1991

[Reoperations after esophagomyotomy in esophageal motility disorders].

Out of 96 patients with the diagnosis of primary esophageal motor disorders and treated by esophagomyotomy, a group of 9 patients is reported in whom reoperation was necessary because of persistence or worsening of the previous symptoms (8 patients) or persistent reflux esophagitis (one patient). Clinical and laboratory examinations together with the operative findings allowed classification of these patients: incomplete myotomy proximally (4 patients) or distally (one patient), fibrotic scar at the site of previous myotomy (2 patients), persistence of intact muscle fibers (one patient) and reflux esophagitis for lack of an antireflux intervention during myotomy. Treatment consisted of completing myotomy proximally or distally, resection of the fibrous tissue and an antireflux operation when indicated. Clinical results were excellent in 6 patients (66.6%), fair in 2 patients (22.2%) and bad in one case (11.1%). Fair or bad results were seen in patients with total absence of motor response to deglutition. After operation there was disappearance of vigorous contractions in the esophagus, as shown by manometry and recovery of esophageal peristalsis in another patient. We conclude that in order to improve the results of the surgical treatment of motor esophageal disorders it is essential to correctly classify the type of disorder present by means of manometry and to add a partial funduplication to ensure absence of reflux without dysphagia.

Adolescent↗
PubMed1990

[Bacterial interaction in periodontal diseases].

The aim of this review is to study the different interactions between human oral bacteria which, through specific mechanisms such as coaggregation, contribute to increase periodontal disease.

Humans↗
PubMed1989

The role of the lateral cortico-cortical prefrontal pathway in self-stimulation of the medial prefrontal cortex in the rat.

Effects of electrolytic and kainic acid lesions at several stereotaxic planes of the lateral cortico-cortical prefrontal efferent pathway on self-stimulation of the medial prefrontal cortex were investigated. Electrolytic bilateral lesion of the sulcal prefrontal cortex, the first terminal area of this pathway, produced no effects on self-stimulation of the medial prefrontal cortex. However, bilateral electrolytic lesion of this pathway at the rostral part of the external capsule produced a permanent abolition of self-stimulation of the medial prefrontal cortex. These effects seemed selective since operant behaviour to obtain water, similar to that performed for self-stimulation and used as a control, was not affected by the lesion except on the 1st, 3rd (P less than 0.01) and 5th (P less than 0.05) days postlesion. Interestingly, bilateral microinjections of kainic acid (10 nmol in 0.8 microliters) at the same stereotaxic planes of the external capsule where electrolytic lesion was produced, had no effects on self-stimulation. These results suggest that fibres-of-passage through the external capsule are responsible for the abolition of self-stimulation. Bilateral electrolytic lesion of the entorhinal cortex, one of the caudal terminal areas of this descending set of fibres, produced a short transient decrease of self-stimulation of the medial prefrontal cortex. These results are discussed on the basis that complex, rather than single circuits are involved in maintaining self-stimulation in this neocortical area.

Animals↗
PubMed1988

Plasma and CSF levels of immunoreactive beta-endorphin in algic peaks of patients with herniated intervertebral discs.

Plasma and CSF levels of beta-Endorphin (beta-End) were measured by radioimmunoassay in three groups of human subjects. The first group consisted of healthy adults, and only plasma beta-End was determined. The second group consisted of patients showing non-painful neurological diseases. The third group consisted of patients suffering from acute pain due to herniated intervertebral discs. In the last two groups, beta-End levels were measured in plasma and CSF. The results showed that plasma levels of beta-End were similar in the first two groups of patients. In contrast, patients with acute pain showed significantly increased levels of beta-End in plasma. CSF levels of beta-End did not show significant differences among the groups. The results suggest that the increase in plasma levels of beta-End was a consequence of the stress produced by acute pain.

Humans↗