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Biomedical subjects

R A Godoy

Publications and source records attributed to R A Godoy.

At least 19 recordsLinked to original sources
PubMed2005

Physical growth and nutritional status of Tsimane' Amerindian children of lowland Bolivia.

This study examines patterns of growth and nutritional status of indigenous Tsimane' children under 9 years of age (n = 199 boys and 210 girls), based on a cross-sectional sample from 58 villages from the Beni Deparment of lowland Bolivia. Compared with US children, Tsimane' children are quite short, with linear growth tracking at or below the US 5th centile in both sexes. The prevalence of low height-for-age ("stunting;" HA Z-scores </=-2) is 52% in boys and 43% in girls. In contrast, weight-for-height in Tsimane' children approximates the US median, with the prevalence of low weight-for-height ("wasting"; WH Z-scores </=-2) being only 4% and 6% in boys and girls, respectively. Tsimane' boys and girls are leaner than their US peers, but their levels of body fatness are not so low as to indicate severe energy stress. Arm muscularity of Tsimane' children is similar to that of their US age peers, and this suggests that they are not experiencing acute protein malnutrition. Variation in measures of nutritional status of Tsimane' children is modestly correlated with village-level differences. Degree of isolation, as measured by distance to urban centers or to primary forest, was not a strong predictor of children's anthropometric status. Rather, in both boys and girls, nutritional status was most strongly associated with number of teachers in the village, a measure of access to education. Comparative analyses indicate that high levels of statural growth stunting are common among indigenous populations throughout lowland South America. This problem appears to be largely attributable to poor dietary quality (diets low in key micronutrients) and high disease loads. Further research is needed to identify the specific causes and potential interventions for the high rates of childhood growth stunting in this region.

Age Distribution↗
PubMed2005

Predictors of C-reactive protein in Tsimane' 2 to 15 year-olds in lowland Bolivia.

Infectious disease is a major global determinant of child morbidity and mortality, and energetic investment in immune defenses (even in the absence of overt disease) is an important life-history variable, with implications for human growth and development. This study uses a biomarker of immune activation (C-reactive protein) to investigate an important aspect of child health among the Tsimane', a relatively isolated Amerindian population in lowland Bolivia. Our objectives are twofold: 1) to describe the distribution of CRP by age and gender in a cross-sectional sample of 536 2-15-year-olds; and 2) to explore multiple measures of pathogen exposure, economic resources, and acculturation as predictors of increased CRP. The median blood-spot CRP concentration was 0.73 mg/l, with 12.9% of the sample having concentrations greater than 5 mg/L, indicating a relatively high degree of immune activation in this population. Age was the strongest predictor of CRP, with the highest concentrations found among younger individuals. Increased CRP was also associated with higher pathogen exposure, lower household economic resources, and increased maternal education and literacy. The measurement of CRP offers a direct, objective indicator of immune activation, and provides insights into a potentially important pathway through which environmental quality may shape child growth and health.

Acculturation↗
PubMed1990

Lower esophageal sphincter pressure in Chagas' disease.

It is known that lower esophageal sphincter (LES) pressure in patients with idiopathic achalasia is higher than in normal subjects, but in patients with Chagas' disease, who have esophageal disease with similar clinical, manometric, and radiologic results, studies of LES pressure show contradictory findings. We measured the LES pressure in 118 patients with chronic Chagas' disease, 14 patients with idiopathic achalasia, and 50 control subjects using a perfused catheter and the stationary pull-through (SPT) technique. The patients with Chagas' disease had normal esophageal radiologic examination (group A, N = 50), delay in esophageal clearance without dilatation (group B, N = 41), or delay in esophageal clearance with dilatation (group C, N = 27). The LES pressure of Chagas' disease patients of group A (18.6 +/- 9.1 mm Hg, mean +/- SD), group B (17.8 +/- 9.7 mm Hg), and group C (21.6 +/- 10.1 mm Hg) was lower (P less than 0.001) than the LES pressure of the controls (24.9 +/- 10.2 mm Hg). In patients with idiopathic achalasia, the LES pressure (40.7 +/- 17.8 mm Hg) was higher than in control subjects (P less than 0.01) and Chagas' disease patients (P less than 0.001). We conclude that the LES pressure of patients with Chagas' disease tended to be lower than that of control subjects and achalasia patients.

Adolescent↗
PubMed1987

Chronic Chagas' heart disease in the elderly: a clinicopathologic study.

A retrospective study of the medical records of our hospital from 1965 to 1985 was carried out to characterize for the first time chronic Chagas' heart disease in the elderly (more than 70 years old). A total of 25 patients (mean age = 76) were suitable for the study. Congestive heart failure, sudden cardiac death, thromboembolism and atypical chest pain were found in 68, 16, 8 and 8% of cases, respectively. Ventricular premature contractions (60%), right bundle branch block (32%), left anterior hemiblock (28%), atrial fibrillation (28%) and right bundle branch block associated with left anterior hemiblock (20%) were the ECG changes most frequently found. A morphological study was performed on 8 (32%) patients. All of them showed cardiac abnormalities, with apical aneurism being detected in 100% of cases. At autopsy, pulmonary embolism was observed in 3(37%) of these patients who presented with congestive heart failure, ventricular premature contractions and/or intraventricular conduction defect and/or atrial fibrillation. Thus, the characteristics of chronic Chagas' heart disease in the elderly are similar to those found in middle-aged patients. We suggest that these patients are important for the study of the pathogenesis of chronic Chagas' heart disease because they may have less aggressive pathophysiologic mechanisms than middle-aged patients.

Aged↗
PubMed1987

Cholinergic innervation of the lower esophageal sphincter in Chagas' disease.

1. The effect of 12 micrograms/kg iv atropine on the lower esophageal sphincter (LES) pressure was studied by continuous perfusion manometry in 14 Chagasic patients, 9 controls, and 3 patients with achalasia, and the effect of 3 ml iv saline was studied in 7 Chagasic patients. 2. Resting LES pressure did not differ between Chagasic patients (11.5 +/- 4.1 mmHg) and controls (15.9 +/- 4.9 mmHg, P greater than 0.05). 3. Atropine caused a significant decrease in LES pressure in both Chagasics and controls, but the reduction in controls was significantly greater (56%) than in Chagasics (25%). 4. Saline did not change the LES pressure of Chagasics. Atropine caused a similar reduction of LES pressure in achalasia patients (49%) and in controls (56%). 5. These results suggest that the cholinergic excitatory nerves are impaired in Chagas' disease, but not in achalasia, where they were either normal or only minimally impaired.

Adult↗
PubMed1986

Effect of CCK-OP and intraduodenal administration of essential amino acids on intraluminal pressures of sigmoid and rectum in patients with Chagasic megacolon.

The motility of the sigmoid colon and rectum was studied by manometry in patients with Chagasic megacolon and in control individuals using two different experimental procedures: (1) intravenous infusion of saline, followed by intravenous infusion of cholecystokinin octapeptide (OP-CCK) at the dose of 20 ng/kg/hr; and (2) intraduodenal instillation of saline followed by a solution of essential amino acids at a flow of 10 ml/min. CCK-OP induced an increase in motility index in the sigmoid colon (P less than 0.05) and rectum (P less than 0.05) in the controls, whereas intraduodenal infusion of amino acids produced a significant increase in motility index exclusively in the sigmoid colon (P less than 0.005). A significant increase (P less than 0.05) in sigmoid colon motility also occurred in the control group after duodenal saline infusion was interrupted. The release of other substances in addition to CCK must have been responsible for the different behavior of sigmoid colon and rectum in response to the stimuli used. Neither procedure caused significant changes in the motility of the sigmoid colon or the rectum of the Chagasic patients. The extensive intramural denervation occurring in Chagasic megacolon probably destroys the neural pathway through which OP-CCK and the substances released by the duodenum by the infusion of essential amino acids activate the motor cells of the human terminal intestine.

Adult↗
PubMed1986

Effect of nifedipine on the lower esophageal sphincter pressure in chagasic patients.

The effect of 10 mg of sublingual nifedipine on the lower esophageal sphincter pressure (LESP) was studied by continuous perfusion manometry in 15 Chagasic patients and 9 controls. Resting LESP was lower in Chagasic patients (13.51 +/- 2.37 mmHg) than in controls (19.60 +/- 2.51 mmHg, P less than 0.02). Nifedipine caused a gradual decrease in the LESP in both Chagasics and controls. Maximal reductions occurred 50 minutes after the drug administration when LESP was reduced to 60% of the resting LESP in the control group and to 43% in the Chagasic group. These results indicate that the striking abnormalities found in the intramural plexuses of the alimentary canal of Chagasic patients do not affect the responsiveness of LESP to nifedipine, and that nifedipine may be useful to reduce LESP in Chagasic megaesophagus.

Adult↗
PubMed1985

Chronic Chagas' heart disease in children and adolescents: a clinicopathologic study.

A retrospective study of the medical records filed at the University Hospital from 1965 to 1983 and of 18456 autopsies carried out in the Department of Pathology of this Institution from 1953 to 1983, referring to patients aged less than 18 years was performed in an attempt to fully characterize chronic Chagas' heart disease in children and adolescents. Only 19 of these patients fulfilled the criteria for inclusion in the present study (12 cases with only clinical information and 7 cases with clinical and pathological information). We noted that the clinical manifestations of chronic Chagas' heart disease are congestive heart failure, thromboembolism and sudden death. Radiologic, electrocardiographic and anatomo-pathological findings demonstrated serious myocardial involvement. This set of alterations is also detected in adults with chronic Chagas' heart disease. Among adolescents, however, the disease exhibits relevant peculiarities such as rapid evolution to death within a short period of time (128 days), diagnostic difficulty related to the presence of significant mitral regurgitation (61% erroneous initial diagnosis), and low frequency of right bundle branch block (11% of cases). These findings suggest that among children and adolescents, chronic Chagas' heart disease may be of a peculiar type and therefore may be useful to clarify the pathogenetic mechanism of the disease.

Adolescent↗
PubMed1985

Plasma gastrin and gastric acid responses to insulin hypoglycemia in Chagas' disease.

Plasma gastrin and gastric acid responses to intravenous injection of insulin (0.2 IU/kg) were measured in 8 patients with Chagas' disease, which is known to be associated with extensive reduction of the intramural neurons of the digestive tract, and in 6 control subjects. All subjects developed hunger, sweating and tachycardia, and exhibited less than 50 mg/dl venous blood glucose. Plasma gastrin responses in Chagas' disease patients (median: 3.60 nmol L-1 min-1; range: 1:12 to 10.60 nmol L-1 min-1) were significantly higher than for control subjects (median: 0.52 nmol L-1 min-1; range: 0.25 to 1.09 nmol L-1 min-1). Gastric acid output was significantly lower in Chagas' disease patients (median: 3.5 mmol/h; range: 2.1 to 13.6 mmol/h) than in controls (median: 30.3 mmol/h; range: 7.3 to 38.2 mmol/h). These data show that chagasic patients have abnormally high gastrin release and low gastric acid secretion in response to insulin, and thus indicate that loss of intrinsic innervation of the stomach does not abolish the gastrin response to insulin hypoglycemia.

Adult↗
PubMed1984

Fasting and food-stimulated plasma gastrin levels in chronic Chagas' disease.

Chagas' disease is known to be associated with extensive lesions of the intramural neurons of the digestive tract. In order to evaluate the contribution of the intramural plexuses to the control of plasma gastrin levels in man, we performed the following measurements: (a) fasting plasma gastrin in 18 chagasic patients and 16 control subjects; (b) integrated gastrin response to food in 9 chagasic patients and 10 controls, (c) basal acid secretion and gastric acid responses to graded doses of pentagastrin in 14 chagasic and 13 controls. Fasting plasma gastrin levels and integrated gastrin response were significantly higher in chagasics than in controls. Basal and maximal acid secretion and responsiveness of acid-secreting gastric cells were lower in chagasics. These results indicate that the intramural plexuses play a role in the control of gastrin release in man.

Adult↗
PubMed1984

Gastric accommodation to distension and early gastric emptying in diabetics with neuropathy.

Gastric accommodation to distension and gastric emptying were assessed in diabetics with neuropathy and in control subjects. Gastric accommodation was measured by recording intragastric pressures during the air insufflation of the stomach and gastric emptying was measured by the double sample test meal after intragastric instillation of 500 ml of saline into the empty stomach. Maximal intragastric pressures during air insufflation were significantly higher in diabetics (N = 6) than in control subjects (N = 15), 16.2 +/- 4.5 vs 10.8 +/- 2.6. The liquid volumes in the stomach five minutes after the instillation of the test meal was significantly smaller in diabetics (N = 10) than in control subjects (N = 17), 208 +/- 90 vs 294 +/- 48 ml, but no differences in volume were detected thereafter. We conclude that diabetics with neuropathy have an impaired gastric accommodation to distension and, probably as a consequence, a rapid early phase of liquid meal gastric emptying.

Adult↗
PubMed1983

Effect of pentagastrin on the motor activity of the dilated and nondilated sigmoid and rectum in Chagas' disease.

In order to evaluate the effect of pentagastrin on the motor activity of the sigmoid and rectum in patients with Chagas' disease, manometric studies were performed on 22 chagasic patients, 11 without and 11 with megacolon, and 11 control subjects. Pentagastrin had a stimulating effect on the sigmoid and rectum in control subjects as well as in chagasic patients without megacolon. In chagasic patients with megacolon, pentagastrin had no effect on sigmoid or rectum motility, probably as a result of the intrinsic denervation known to occur in this disease. The findings suggest that the motor effect of pentagastrin on the human sigmoid and rectum depends on the myenteric nervous pathways.

Adolescent↗
PubMed1982

Acid and pepsin secretion in chronic Chagas' disease patients in response to graded doses of pentagastrin and pentagastrin plus bethanecol.

Gastric acid and pepsin secretory responses to graded doses of pentagastrin were measured in 12 Chagas' disease patients and 18 control subjects, and in 7 Chagas' disease patients and 6 controls the study was repeated with an infusion of bethanecol. Calculated maximal outputs of acid and pepsin (Vmax) and responsiveness (D50) of the acid- and pepsin-secreting cells to pentagastrin were lower in the chagasics. Bethanecol had no significant effect on pentagastrin-stimulated gastric secretions in controls. The impairment of responsiveness of the gastric secretory cells in Chagas' disease patients was fully corrected by bethanecol.

Adolescent↗
PubMed1980

Lower oesophageal sphincter response to pentagastrin in chagasic patients with megaoesophagus and megacolon.

Intraluminal manometric studies were performed in 14 chagasic patients with megaoesophagus, 10 chagasic patients with megacolon, and 15 control subjects. Basal lower oesophageal sphincter pressure was 20.27+/-1.16 mmHg (mean+/-SEM) in controls as compared wtih 15.16+/-1.53 mmHg in chagasics with megaoesophagus and 14.38+/-1.50 mmHg in chagasics with megacolon. Dose-response studies to intravenous pentagastrin showed that the chagasic patients exhibited a lower sensitivity to the stimulant than did the controls, as demonstrated by shifting of the dose-response curve to the right and higher individual values of the dose for half maximal contraction (D50). No difference was noted between the calculated maximal contraction (Vmax) of oesophageal sphincter of controls and chagasics. These data are compatible with the hypothesis of an interaction between pentagastrin and cholinergic nervous excitation on oesophageal sphincteric smooth muscle.

Adolescent↗