Biomedical subjects

U Fagundes-Neto

Publications and source records attributed to U Fagundes-Neto.

At least 55 records · Page 3Linked to original sources

PubMedDate not supplied

Can bacterial translocation be a beneficial event?

Infection is a major concern in intestinal transplant recipients. Bacterial migration to extraintestinal sites is a central component of the gut hypothesis of sepsis. However, some studies have cited the beneficial effects of bacterial translocation (BT) on the host acquired immune system. We evaluated the role of previous BT on a subsequent BT challenge, examined the BT index in organs as well as changes in white blood cell (WBC) count in mesenteric lymph and blood for correlation with outcomes. Wistar rats (n = 60) were divided into a BT group (n = 20), which underwent inoculation of 10 mL of 10(10) CFU/mL Escherichia coli R-6 confined to the small intestine as opposed to a BT1-14 group (n = 20), which underwent the BT procedure on days 1 and 14 or a S1-BT14 group (n = 20) that received 10 mL of saline on day 1 and the BT procedure on day 14. Half of the animals were killed 2 hours following the BT procedure. Samples from different compartments were collected for culture. Mesenteric lymph and peripheral blood were examined for WBC counts. The other half of the hosts was subjected to outcome evaluation concerning weight gain and mortality. Animals undergoing double BT showed a significantly lower index of bacterial recovery (liver, spleen, and blood) compared with those having a single BT (P < .05). The WBC count of mesenteric lymph cells after double BT was similar to naïve animals, but significantly lower than the single BT group (P < .05). The outcome was unchanged among double BT versus other groups. A previous BT challenge was efficient to generate a host-defense mechanism against a second BT episode induced by intestinal overgrowth with the same bacterial strain.

Animals↗

PubMedDate not supplied

[Assessment of gliadin in pharmaceutical products - important information to the orientation of celiac disease patients].

BACKGROUND: Some drugs might contain gliadin which can be dangerous for celiac disease patients. OBJECTIVE: Detect gliadin in pharmaceutical products commonly used in Brazil. METHODS: We analyzed 78 pharmaceutical products selected aleatory from a list of 180 products most frequently sold at Brazilian community pharmacies. The analyzed samples were analgesics (n = 9), anthelmintics (n = 3), antacids (n = 8), antibiotics (n = 13), anticholesteremics (n = 1), anticonvulsants (n = 2), antidepressants (n = 2), antiemetics (n = 3), antihypertensives (n = 3), antihistaminics (n = 3), anti-inflammatories (n = 7), antipyretics (n = 2), bronchodilators (n = 1), laxatives (n = 1), oral contraceptives (n = 5) and vitamins (n = 10). The samples were analyzed by enzyme immunoassay based on monoclonal antibodies omega-gliadins, the elected technique according to the Codex Alimentarius Commission WHO/FAO. All samples were analyzed in duplicate. The sensitivity of this test is 4 mg of gliadin/100 g of product. RESULTS: Only one (1.3%) out of 78 pharmaceutical products contained detectable amounts of gliadin (5.5 mg/100 g). The active ingredient of this drug is ranitidine. According to the Codex Alimentarius Commission WHO/FAO the intake of 10 mg of gliadin/day should not be exceeded by celiac disease patients. Considering the amount of gliadin in each capsule of ranitidine, the ingested quantity would be lower than the maximum allowed for celiac patients. CONCLUSIONS: In this study gliadin was not detected in pharmaceutical products in harmful amount for celiac disease patients.

Brazil↗

PubMedDate not supplied

[Celiac disease: evaluation of compliance to gluten-free diet and knowledge of disease in patients registered at the Brazilian Celiac Association (ACA)].

BACKGROUND: The compliance to a gluten-free diet may prevent the development of both non-malignant and malignant complications. AIM: To evaluate compliance to a gluten-free diet and knowledge of the disease in celiac patients registered at the Brazilian Celiac Association (BCA). METHODS: A structured questionnaire was designed to assess compliance to a gluten-free diet as well as knowledge of the celiac disease. It was mailed to 584 members of BCA. RESULTS: Five hundred and twenty nine (90.6%) of a total of 534 (91.4%) answered questionnaires were analyzed; 69.4% were classified as compliant patients whereas 29.5% were classified as noncompliant. The proportion of patients age 21 or older who consume gluten frequently or without any restriction is larger (17.7%) than those who were younger than 21 years (9.9%). Frequency of dietary compliance was higher when the diagnosis had taken less than 5 years to be established; 82% of the patients replied that the small intestine was the part of the body affected by the disease. The most common symptoms of the disease according to the answers were diarrhea (96.6%), weight loss (93.4%), protuberant abdomen (90.4%), anemia (68.1%) and vomiting (59.6%). Only 59.0% agreed with the existence of genetic predisposition; 90.4% answered that the disease is permanent and 96.2% stated that the diet should exclude gluten absolutely; 67.1% answered that the gluten is a protein and according to 92.1% questionnaires this protein is present in wheat, rye, barley and oat. Greater compliance was observed when there was an understanding of the disease and diet. The small intestine biopsy was considered necessary for just 67.5% of the patients, and greater compliance was observed in patients who had undergone at least one small intestine biopsy. CONCLUSION: Our findings indicate that the more the patients know and understand about the disease, the better able they are to comply with the diet.

Adolescent↗

PubMedDate not supplied

[Celiac disease: clinical characteristics and methods used in the diagnosis of patients registered at the Brazilian Celiac Association]

OBJECTIVE: To evaluate the clinical characteristics and methods used in the diagnosis of patients registered at the Brazilian Celiac Association (BCA). METHODS: A questionnaire about clinical characteristics and diagnostic methods in celiac disease was mailed to 584 members of the BCA. RESULTS: We received 292 responses for 584 questionnaires mailed (49.5%). The clinical characteristics of celiac disease in the sample we analyzed showed that the most frequent type was the classical mode (88.9%), while the atypical mode was present in only 11.1% of patients at the time of diagnosis. Increased incidence of both late diagnosed classical mode (44.5% to 64.2%; P=.004) and atypical mode (5.2% to 16.8%; P=.005) has been observed in the last 5 years. Duration of symptoms before diagnosis was greater than 1 year in 75% patients with atypical manifestation. Intestinal biopsy was not performed in 19% of the cases at the time of diagnosis. It was observed that in the last 5 years intestinal biopsy was not performed for a larger number of patients (24.4%) than in the previous period (only 11.1%) (P=.007). CONCLUSIONS: Classical mode is still the most frequent clinical manifestation of celiac disease. The late diagnosed classical mode is predominant, but our findings show an increase in the proportion of the atypical mode. Although characterization of subtotal or total villous atrophy of the intestinal mucosa is of paramount importance to the diagnosis of celiac disease, 19% of the patients diagnosed for celiac disease did not undergo intestinal biopsy at the time of diagnosis, most notably in the last 5 years.

Journal Article↗

PubMedDate not supplied

[Association of patterns of Escherichia coli adherence to HEp-2 cells with acute and persistent diarrhea].

In Brazil diarrhea is the cause of approximately 15% of death among infants. Enteropathogenic E coli is the most important bacterial agent causing acute diarrhea, which is defined as less than 14 days of duration. About 30% of these cases may evolve to persistent diarrhea, defined as lasting more than 14 days. In this work it was carried out a case-control study including 34 children under 2 years of age, and admitted to hospital facilities in São Paulo for rehydration therapy. Thirty-four age matched children hospitalized in the same facilities, and presenting no gastrointestinal symptoms were included as controls. Stool samples were analyzed for the presence of bacterial pathogens (diarrheagenic E coli, Shigella, Salmonella, Yersinia, and Campylobacter), protoparasytes, rotavirus, and enteric adenovirus. The E coli strains isolated were analyzed for their ability to adhere to HEp-2 cultured cells, in a 3 h adhesion assay. Search for homology with DNA probes for localized adherence (EAF, eaeA probes), AA (enteroagregative adherence) (AA probe), and diffuse adherence (F1845, AIDA-I probes) was carried out by the colony hybridization method. Twenty-four of the cases were acute diarrhea and 10 persistent diarrhea. Strains with localized adherence were associated with acute and persistent diarrhea. About 23.5% of E coli were associated with typical Enteropathogenic E coli strains (EAF+, eaeA+). Enteroaggregative E coli (EAggEC) (AA+) was isolated only from cases and in similar frequency for acute and persistent diarrhea. Diffusely adherent E coli (DAEC) which did not hybridize with the diffuse adherence probes were isolated among cases and controls. E coli eaeA+ with localized-like adherence was isolated from cases in a frequency three times higher than in controls, suggesting that it may really have a pathogenic potential.

Acute Disease↗

PubMedDate not supplied

Absorption of D-xylose in full term newborns adequate for gestational age: prospective study up to third month.

Studies of the D-xylose absorption capacity in newborns are scarce and the results reported are controversial. We evaluated the xylose absorption in full term newborns adequate for gestational age in the first days of life and prospectively up to the third month. D-xylosemia values of the first and second hours at birth and at 3-5 days are significantly lower than on the 15th day at one month and at three months. On the other hand, the values obtained in these last three groups showed no differences among themselves. The comparison of first hour D-xylose values between a control group and those children investigated on the 15th day at one month and at three months, revealed significant differences, but second hour values did not show statistic differences. We concluded that enterocyte absorption capacity is already completely developed at 15 days of life in full term newborns adequate for gestational age.

Humans↗

PubMedDate not supplied

Catch-up growth after the introduction of a gluten-free diet in children with celiac disease.

The rhythm of nutritional recovery in 11 children with celiac disease after the introduction of a gluten-free diet was studied. The mean age of the patients at the moment of the diagnosis was 2.8 +/- 1.2 years and they were followed up for a period of 3.4 +/- 1.9 years. The nutritional status was evaluated by the utilization of the following parameters: the weight-for-age, height-for-age and weight-for-height. It was verified that none child was well nourished at the moment of the diagnosis and during the evolution 9 of them reached a complete recovery of their nutritional status for the weight in a mean period of time of 5.8 +/- 2.7 months; 5 of these children remained well nourished during the follow-up, 3 for 33 months and 1 for just a month. The other 2 children were initially classified as PCM II and turned to PCM I. The height-for-age index revealed that only 6 children had recovered from malnutrition and only 4 remained like this during all the follow-up. The other 2 children suffered nutritional aggravation and turned to be PCM I, but after a mean time of 18.4 months both resumed the rhythm of growth. Nutritional dwarfsism in 45.45% and chronic evoluted malnutrition in 54.55% were the patterns of malnutrition observed in this group of patients.

Body Height↗

PubMedDate not supplied

[Tropical enteropathy: morphologic and functional changes of the small intestine and their effects on nutritional status].

Tropical enteropathy has been described in children and adults that live in developing countries. This disease may be symptomatic or may present without symptoms. We studied 66 patients with tropical enteropathy with special reference to the nutritional status and the intestinal function. The follow-up of the nutritional status revealed that 63 (95.49%) presented current malnutrition. The D-xylose absorption test was significantly lower than those found in the control group. The mean plasmatic triglyceride increment after the margarine load was significantly lower than that found in the control group. Carbohydrate tolerance tests revealed 51.3% lactose malabsorption, 35.07% sucrose malabsorption and 5% glucose malabsorption. Small bowel biopsy showed partial villous atrophy as the most frequent morphological characteristic observed. These children constitute an homogenous group representative of the majority of the population of the Third World.

Child, Preschool↗

PubMedDate not supplied

Malnutrition and malabsorption.

Malnutrition and diarrhea constitute a binomial practically inseparable where the factors of the environmental contamination act in a decisive way to trigger the symptoms due to the derangements in the digestive-absorptive process. Fecal flora bacterial overgrowth in the small bowel lumen induces innumerous modification in the intestinal microecology causing morpohological lesions and bile salt deconjugation and all together leads to decrease of the intestinal absorptive surface, glucose malabsorption, and sodium secretion. These morphological and functional derangements due to the unfavorable environmental conditions constitute the picture designated tropical enteropathy, and the intensity of the symptoms are dependent upon various factors including individual susceptibility.

Diarrhea, Infantile↗

PubMedDate not supplied

Small bowel bacterial flora in normal and in children with acute diarrhea.

The aerobic bacteria microflora of the upper small bowel in normal children and in children with acute diarrhea was studied. Forty one children aging between 2 months and 5 years were divided in 3 groups: Group I--13 wellnourished children with no signs of gastrointestinal abnormalities remained intubated for less than 4 hours; Group II--11 wellnourished children that remained intubated for a period of time varying from 4 to 24 hours; Group III--17 children with acute diarrhea. There was a striking difference in the bacterial pattern between children from groups I and II and these findings were attributed to the prolonged time of intubation. In group I the jejunal fluid was sterile in approximately 40% of the children and in the others there was only growth of a GRAM positive flora while in group II the jejunal fluid never presented as a sterile one, and in approximately 73% of the cases there was a growth of a mixed GRAM positive and GRAM negative microflora, mainly due to Enterobacteria. In group III an aerobic microflora different from that one verified in group I was found in 76,4% of the patients. In 47.05% of the cases a bacterial growth equivalent to the fecal flora has been observed, in 5.89% Pseudomonas aeruginosa was located and in 23.52% yeasts were cultured from the jejunal fluid. These data confirm the hypothesis that bacterial and fungi infections are most prevalent in underdeveloped countries. This is probably due to the poor sanitary conditions observed in these countries associated with a high index of environmental contamination.

Acute Disease↗

PubMedDate not supplied

Hereditary hemorrhagic telangiectasia associated to chronic active hepatitis.

Hereditary hemorrhagic telangiectasia or Rendu-Osler-Weber syndrome (ROWS) is an angiodisplasia characterized clinically by the presence of telangiectasias in the skin and mucosas, particularly on the face, conjunctivas, nose, pharynx and rarely on the thorax. Visceral involvement specially hepatic cirrhosis associated with pulmonary arteriovenous fistulae have been described. We describe a 7 10/12 years old girl with the diagnosis of ROWS associated with chronic active hepatitis with positive HBAg that evolved to hepatic cirrhosis. This is the second case of ROWS associated with chronic active hepatitis reported in the literature, being however, the first one described in the childhood.

Biopsy, Needle↗

PubMedDate not supplied

[Diagnostic limitations of the isolation of trophozoites of Giardia lamblia in duodenal aspirates].

Examination of fecal specimens for detection of Giardia lamblia cysts is known to produce a high percentage of false negative results while it is generally believed that duodenal juice often contains trophozoites even when the stool examination is negative. The aim of this study was to compare the detection of trophozoites in duodenal aspirate with the findings of cysts in stool samples for the diagnosis of asymptomatic giardiasis. Forty five children with iron deficiency anemia (one to six years of age) were studied, 21 with giardiasis and 24 without giardiasis. For each subject, one to five stool samples were examined for cysts of Giardia lamblia employing the formol-ether concentration method. Duodenal juice from all children were examined for the presence of trophozoites of Giardia lamblia. Fecal excretion of cysts was demonstrated in 20 (95%) of the 21 patients with giardiasis; however, only nine (43%) exhibited the presence of trophozoites in their duodenal aspirates. In one child trophozoites were observed in the duodenal aspirate; but the parasitologic investigation was negative for cysts in the feces. All the children without giardiasis had at least three stool samples and duodenal aspirate negative for Giardia lamblia. In conclusion, fecal examination by formol ether concentration method exhibited a greater number of positive results than did the duodenal aspirate microscopy method in the diagnosis of giardiasis.

Animals↗

PubMedDate not supplied

[Transepithelial transport of water, sodium, and glucose of oral hydration solutions in jejunal loops of rats undergoing "in vivo" perfusion].

There are several different oral hydration solutions of variable composition commercially available besides WHO 90. The purpose of this paper was to establish the type of solution more favorable to hydroelectrolytic transport. Water, Na and glucose transport of oral hydration solutions were measured by analysis of 728 samples from perfusions with 7 different solutions in jejunal loops of rats "in vivo". The following solutions were studied: homemade (96), Rehidrat (96), Hydrax (104), WHO 90 (104), WHO 60 (112), Pedyalite 30 (104), Pedyalite 90 (112) and a control solution (144). Hypotonic solutions with a molar ratio Na/glucose 2:1, had the greatest water absorption (homemade and WHO 60), while the solution with 90 mEq/L of Na had the greatest absorption of this ion (Pedyalite 90, WHO 90). Regarding glucose transport, Pedyalite 90 promoted the greater absorption (25 g/L). Solution with 30 mEq/L of Na and high osmolality resulted in water and Na secretion (Pedyalite 30).

Animals↗

PubMedDate not supplied

[Simple and rapid technique of intubation for collection of jejunal secretions].

This study was proposed to introduce a new and fast technique of aspiration to obtain samples of the small bowel juice. The utilization of a guide wire placed within the main probe lumen provides more rigidity to the system. We compared the traditional technique and the new one in 40 infants. The time elapsed for intubation was shorter with the guide wire (mean 15.4 minutes) than with the traditional technique (91.0 minutes (p < 0.05). In order to make the method more feasible the positioning of the tube was assessed by the change in the colour of the intestinal fluid and by the pH measurement of the intestinal aspirate.

Humans↗

PubMedDate not supplied

[Small bowel morphometry in acute and persistent diarrhea due to classic enteropathogenic Escherichia coli].

Enteropathogenic E.coli infection may cause different ranges of abnormalities in the small bowel villi, but there are no morphometric studies about it. Thirty specimens of small intestinal mucosa obtained from children having acute or persistent diarrhea by enteropathogenic E.coli were analysed and then compared to the specimens of the small intestinal biopsy of thirteen patients of the control group. We had the following target in this paper: evaluate the morphological changes of intestinal mucosa using linear morphometry and to verify the number of intra-epithelial lymphocytes/100 enterocytes; search the presence of Gram negative bacteria adhered to the small intestinal mucosa. Gram negative bacteria were present in three patients with acute diarrhea. The morphometric changes were more remarkable in the villosites which were shorter, in the enteropathogenic E.coli group. The total mucosa thickness as well as the villous height and the relation villous/crypt were significantly shorter in the enteropathogenic E.coli group when compared to the control Group. There were no differences between the two groups for the crypt length and for de number of intraepithelial lymphocytes/100 enterocytes.

Acute Disease↗

PubMedDate not supplied

Ultrastructural study of enteropathogenic Escherichia coli O111ab:H2 infection in an infant with acute diarrhea.

Enteropathogenic Escherichia coli is the most important cause of acute diarrhea in developing countries, specially in infants under one year of age. Enteropathogenic Escherichia coli strains are able to induce profound cytoskeletal alterations in the enterocyte known as attaching and effacing lesions, associated with the formation of cuplike pedestals. We report an Enteropathogenic Escherichia coli O11ab:H2 strain isolated from an infant with acute diarrhea, on the eleventh day of disease, that caused attaching and effacing lesion and penetrated the enterocyte, as well as invaded the HeLa cell tissue culture in vitro and the rabbit ileal loop assay in vivo, in the ultrastructural study. This observation indicates that the severe lesions of the small bowel caused by an enteropathogenic Escherichia coli O111ab:H2 strain can occur even in the early stages of the infection.

Acute Disease↗

PubMedDate not supplied

[Hydrogen test (H2) in the air expired for the diagnosis of small bowel bacterial overgrowth].

The small bowel bacterial overgrowth is characterized by the presence of colonic flora in the small bowel, may to lead malabsorption and/or diarrhea and/or weight loss. The small-bowel culture has served as the "gold standard" for diagnosing bacterial overgrowth. The colonic flora is able to ferment carbohydrates that are present in the lumen of the intestinal tract with production of hydrogen, which is subsequently observed and excreted by the breath. Therefore, the hydrogen breath test after oral carbohydrates administration represents an alternative, non-invasive and specific method for diagnosing small bowel bacterial overgrowth.

Breath Tests↗

PubMedDate not supplied

[Intake of dietary fiber and other nutrients by children with and without functional chronic constipation].

The aim of this study was to evaluate the dietary fiber intake and the dietary habits of children with and without functional chronic constipation. We enrolled 58 children with functional chronic constipation and 58 controls without constipation matched for sex and age. Food and fiber intake were evaluated by 24 hour dietary recall and a complete clinical history was performed. The age of onset of constipation occurred during the first year of life in 55.4% of the patients while the median age of evaluation was 78 months. Soiling was found in 41.7% of patients. The median period of exclusive breast feeding was shorter (P = 0.002) in the constipation group (one month) than in the control group (three month). The proportion of constipation was similar for mothers of children of both groups as well as for siblings in both groups. The fathers of children with constipation presented higher frequency of constipation (12.3%) than the fathers of children in control group (1.8%), but the difference did not reach statistical significance (P = 0.06). The amount of food measured by 24 hour recall was similar in both groups. The calorie intake of constipated children (1526 +/- 585 calories/day) was lower (P = 0.07) than in the control group (1712 +/- 513 calories/day) but the difference did not reach statistical significance. The intake of protein, fat and iron was lower in the constipation group than in the control group. The volume of cow's milk intake was similar in both groups. The median of total dietary fiber intake in the constipation group (13.5 g/day) was statistically (P = 0.009) lower than in the control group (16.8 g/day). The daily intake of insoluble dietary fiber was also statistically lower (P = 0.001) in the constipation group (6.3 g) than in the control group (9.4 g). The intake of soluble dietary fiber was similar in both groups. The intake of dietary fiber per 1,000 calories of diet was 10.3 g in the constipation group and 10.4 in the control group (P = 0.41). There was a considerable intersection of individual values in fiber intake of the constipation and control groups, suggesting that low fiber intake acts in association with others factors on the genesis of constipation in children. However, the low intake of insoluble fiber, suggests that it plays an important role on the pathogenesis of chronic constipation in children.

Breast Feeding↗