Biomedical subjects
Ricardo Guilherme Viebig
Publications and source records attributed to Ricardo Guilherme Viebig.
[Recommended diet for reflux spectrophotometry].
BACKGROUND: The spectrophotometric probe, which uses bilirubin as a marker for the detection of duodenoesophagic reflux is subject to interference from strongly colored foods, which can cause erroneously high bilirubin absorbance readings. To overcome this problem it is necessary to ingest a diet that is free from such substances. OBJECTIVE: To test the absorbance of 48 different food substances in an in vitro environment. MATERIAL AND METHOD: Dry foods were blended with water or milk and non-dry solid foods were blended undiluted. It was utilized the proper calibration recipient to test them. RESULTS: The absorbance of weakly colored foods was usually lesser than the commonly accepted threshold of 0.14, and the absorbance of strongly colored foods was usually above this. Thirty-two from the 48 substances tested are suitable when the absorbance threshold is set at 0.14, but scrambled eggs, lacteous flour mush, green beans, beetroot, carrot, chayote, squash, "baroa" potato, boiled corn, orange, cashew, purple grape, avocado, mango, papaya and peach can alter the results and must be avoided. CONCLUSION: From the foods evaluated, enough are suitable at the 0.14 threshold to enable a suitable diet to be constructed for most patients during Bilitec studies.
[The diagnostic challenges in fecal incontinence].
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Simultaneous bilimetry and pHmetry in GERD and Barrett's patients.
BACKGROUND/AIMS: Despite the progressive development of technology and better knowledge of physiopathology, GERD diagnosis remains a medical problem. The aim of the study is to verify whether the measurement of bile reflux can increase the diagnostic accuracy of GERD. METHODOLOGY: 6 healthy volunteers adhered to a standard protocol, 11 Barrett's patients and 15 GERD patients (endoscopic erosive esophagitis) were fasted for 6 h before any examinations and the patients ceased acid suppression medications 72 h earlier. Manometric study was performed to localize the LES. Then The Bilitec 2000 fiberoptic probe (Synectics, Medtronics) and an antimony pH probe attached to a Digitrapper Mark III pH recorder (Synectics, Medtronics), together, were inserted through the nostril and positioned 5cm above the LES. They received an uncolored diet and after around 24 h, both Bilitec and pH data were downloaded simultaneously to a personal computer for analysis, using the Synectics software. Absorbance threshold was set at 0.14 absorbance units and acceptable esophageal pH at 4, to verify fraction of time of bile reflux (absorbance > 0.14) and DeMeester score. RESULTS: Except controls, in whom DeMeester and Johnson scoring and fraction time of absorbance were always normal, all patterns of combined results were observed in GERD and Barrett's patients, showing possibilities of "normal" pHmetry in patients with detectable bile reflux, normal fraction time of absorbance with pathologic pH recording and both normal in GERD (40%) and Barrett's patients (only 18%). CONCLUSIONS: This study showed that Bilitec measurements combined with 24-hour monitoring of intraluminal pH can offer other diagnostic and screening contributions in GERD and Barrett's patients, but cases of normal pHmetry and spectrophotometry demonstrate that none is definitive in characterization of reflux.