[Differences of involvement of peristalsis between the upper and lower parts of the esophagus in Chagas' disease].
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Adolescent↗
Biomedical subjects
U G Meneghelli
Publications and source records attributed to U G Meneghelli.
[Crohn disease associated with Turner's syndrome (a possible physiopathological mechanism)].
We describe a patient with Turner's syndrome who has developed chronic diarrhea, anal fissures, rectovaginal and perianal fistulas. Radiological study of the ileum and rectal mucosa biopsy have confirmed the diagnosis of Crohn's disease. Like the majority of patients previously described with similar pathological association, the intestinal disease in our patient starts at the time wherein the pubertal pituitary crisis happens. The lack of gonadal counter-regulation following the pubertal pituitary crisis leads to an hormonal imbalance with elevated FSH and LH levels. We suppose that this hormonal imbalance can activate immunopathogenic mechanisms related to Crohn's disease.
Adult↗
Segmental absence of contraction in the upper third of the esophagus.
In a manometric study of esophageal motility, segmental absence of contraction was encountered in the upper third of the esophagus in five patients, although only two of them had complained about dysphagia. If the manometric patterns were identical in the patients with and without dysphagia, it is difficult to explain this symptom in all the cases.
Adult↗
[Lactose malabsorption in adult patients at the Hospital das Clínicas de Ribeirão Preto].
A standard oral lactose tolerance test (LTT) was performed in 32 white and 18 non-white hospitalized Brazilian adults. A flat LTT was found in 22 (68,75%) white and in 17 (97,45%) non-white patients indicating a 78% overall rate of lactose malabsorption, Both lactose absorbers and malabsorbers showed a modal milk ingestion of less than a 1 glass/day. Symptoms related to milk consumption or lactose administration were more common among lactose malabsorbers. Estimations of disaccharidase activity in intestinal mucosa specimens obtained by peroral biopsy in 28 patients confirmed a high prevalence of lactose deficiency, and disclosed only one false result, in the patient with a flat LTT and high intestinal lactase levels.
Adolescent↗
[Esophageal contractility in Chagas' patients with peristalsis and aperistalsis].
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Adolescent↗
Basal motility of dilated and non-dilated sigmoid colon and rectum in Chagas' disease.
The basal motility of the sigmoid colon and rectum was evaluated manometrically over 3 consecutive 10-minute periods in 29 control subjects, 14 chagasic patients without megacolon, and 32 chagasic patients with megacolon. The results indicated that the sigmoid colon of both chagasic groups had a lower motility index and lower wave frequency than that of the controls. Reduced wave frequency was observed in the rectum of patients with megacolon, out the rectum of the chagasic patients without megacolon showed manometric characteristics similar to those for the controls. The abnormalities observed were attributed to intramural denervation of the viscera under study. Waves of long duration were observed very frequently in megacolon, and were assumed to be caused by dilatation in itself and not by abnormal contraction of muscle fibers.
Adolescent↗
Achalasia occurring years after acute poliomyelitis.
We present a case of a 19 year old female patient with dysphagia for 4 months. Radiologic, endoscopy and manometric examinations were compatible with the diagnosis of idiopathic achalasia. Clinical, epidemiologic and serologic investigation was negative for Chagas' disease. When she was three years old she had acute poliomyelitis that left muscular atrophy in her left leg. It is possible that lower esophageal sphincter achalasia was the consequence of lesion in the dorsal motor nucleus of the vagus nerve caused by poliomyelitis. The association between poliomyelitis and achalasia supports the infective hypothesis as the cause of achalasia.
Adult↗
Abnormalities of the interdigestive migrating motor complex in a patient with carcinoid syndrome.
Intraluminal pressures of the gastric antrum, duodenum and jejunum were recorded for 206 min after a 12 h fast in a patient with carcinoid syndrome due to neoplasia of enterochromaffin cells of the ileum and with hepatic metastases. The most conspicuous alteration was a tachyrrhythmia of 16 waves/min predominating in the activity fronts of both duodenum and jejunum. Periods of 11-12 waves/min frequency appeared irregularly and the simultaneous occurrence of frequencies of 11 waves/min and 16 waves/min was also recorded. The gastric antrum was fully quiescent throughout the study. The alterations observed are presumed to be produced by substances secreted by the carcinoid tumor.
Duodenum↗
[Hydrochloric acid and pepsin secretion and the structure of the stomach in experimental protein malnutrition].
In adult male rats submitted during 12 weeks to a diet containing 2,5% protein the amount of hydrochloric acid and of pepsin was determined and the macro and microscopic morphology of the stomach was studied. A group fed a diet containing 20% protein was used as control. The statistical analysis of the data obtained showed that the apparent differences in the secretion of acid as well as pepsin could be attributed to the different body weights of the two groups. The morphological examination showed papillomas, frequently ulcerated occurring in the forestomach of the undernourished rats. In these areas, histological examination revealed hyperkeratosis and acanthosis. The glandular epithelium showed neither macroscopic nor microscopic alterations.
Animals↗
[Small bowel bacterial overgrowth syndrome in chagasic megajejunum: report of 2 cases].
We report two cases of Chagas' disease with megacolon who presented with chronic diarrhea. One of the patients also had evidence of malabsorption, such as steatorrhea and hypocalcemia. Barium meal follow-through showed remarkable dilation of the jejunum in both cases and, in one of them, an associated megaduodenum. Manometric studies of gastrointestinal motility showed abnormally slow propagation of the interdigestive migrating motor complex, which was also excessively prolonged. Cultivation of jejunal aspirates revealed strict anaerobic bacterial growth in both cases. Oral antibiotic therapy led to substantial improvement in symptoms. The two cases herein reported indicate that clinical manifestations of small bowel bacterial overgrowth, possibly caused by motor disturbances associated with megajejunum, may occasionally include the clinical picture of gastrointestinal involvement in Chagas' disease.
Adult↗
[Miguel Dias Pimenta (1661-1715) and the history of chagasic megaesophagus and megacolon].
In the present study an attempt was made to analyse from a clinical viewpoint the descriptions in the book "Noticias do que he o achaque do bicho" by Miguel Dias Pimenta (1661-1715), which are considered by some authors to be the first reference to the chagasic megaesophagus and megacolon that appeared in history. In descriptions considered to refer megaesophagus, although dysphagia, the major symptom of this disease, is not recognized, typical manifestations of a irritating, inflammatory or ulcerative condition are identified, not affecting the esophagus but the stomach. In the description considered to refer to megacolon, the signs and symptoms suggest the diagnostic possibility of hemorrhoids and of the "achaque do bicho" itself, and do not recall the clinical picture of the chagasic megacolon in an absolute manner. On this basis, there is no reason to maintain the book "Noticias do que he o achaque do bicho" within the history of the digestive form of Chagas' disease.
Chagas Disease↗
[A missing name in the history of chagasic megaesophagus: Joseph Cooper Reinhardt (1809/10-1873)].
The book entitled "Brazil and the Brasilians", written by the Reverends Kidder and Fletcher and firstly published in the United States in 1857, reports the travels of these two missionaries throughout Brazil and includes a section entitled "A new disease". This section contains data regarding the clinical picture, the natural history and the epidemiology of a commom disease in Brazilian hinterland, which was known as "mal de engasgo". These informations were collected in 1855 by Rev. Fletcher from an anonymous North American physician, who worked in Limeira, State of São Paulo, and is called in the book merely as "Dr.-". The present work reports the results of an investigation carried out aiming at the identification of "Dr.-" and discloses documental evidence that "Dr.-" was actually Dr. Joseph Cooper Reinhardt (1809/10-1883). Dr. Reinhardt worked for many years in the citites of Limeira and Campinas, State of São Paulo, and probably had an extensive knowledge regarding the main features of this particular disease, which would be known, nearly 100 years later, as chagasic megaesophagus. The authors point out that, from now on, any account of the history of chagasic megaesophagus must include the name of Dr. Joseph Cooper Reinhardt.
Brazil↗