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[PMID]:29317209
[Au] Autor:Gong Y; Zhu Y; Zhu B; Si X; Heng D; Tang Y; Sun X; Lin L
[Ad] Endereço:Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
[Ti] Título:LncRNA MALAT1 is up-regulated in diabetic gastroparesis and involved in high-glucose-induced cellular processes in human gastric smooth muscle cells.
[So] Source:Biochem Biophys Res Commun;496(2):401-406, 2018 02 05.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent years, widespread long non-coding RNAs (lncRNAs) were identified and known as regulator of gene expression. Diabetic gastroparesis (DGP) is one of the most common chronic complications of diabetes mellitus. There was no research reported the role of lncRNAs in DGP. In this study, we firstly established a rat model of DGP by STZ injection. Then, we detected the expression of MALAT1 and found that expression of MALAT1 was up-regulated in rat model of DGP, comparing to the control group (P < .01). Furthermore, we revealed that MALAT1 expression was increased in the samples from diabetic patients with DGP symptoms, in comparison with the control. In addition, we demonstrated that the inhibition of MALAT1 increased the expression of α-SMA and SM myosin heavy chains, reduced the cell viability, inhibited the potential of cell migration and induced cell apoptosis in human gastric smooth muscle cells (SMCs). Ultimately, we found that the regulation of MALAT1 expression modulated the function of high-glucose stimulation in human gastric SMCs. Therefore, our study firstly indicated that MALAT1 was up-regulated in DGP and played an important role in the pathogenesis of DGP.
[Mh] Termos MeSH primário: Diabetes Mellitus Experimental/genética
Neuropatias Diabéticas/genética
Gastroparesia/genética
Miócitos de Músculo Liso/metabolismo
RNA Longo não Codificante/genética
Estômago/metabolismo
[Mh] Termos MeSH secundário: Actinas/genética
Actinas/metabolismo
Animais
Apoptose/efeitos dos fármacos
Apoptose/genética
Movimento Celular/efeitos dos fármacos
Proliferação Celular/efeitos dos fármacos
Diabetes Mellitus Experimental/induzido quimicamente
Diabetes Mellitus Experimental/complicações
Diabetes Mellitus Experimental/metabolismo
Neuropatias Diabéticas/induzido quimicamente
Neuropatias Diabéticas/complicações
Neuropatias Diabéticas/metabolismo
Esvaziamento Gástrico
Gastroparesia/induzido quimicamente
Gastroparesia/complicações
Gastroparesia/metabolismo
Regulação da Expressão Gênica
Glucose/farmacologia
Seres Humanos
Masculino
Miócitos de Músculo Liso/efeitos dos fármacos
Miócitos de Músculo Liso/patologia
Cadeias Pesadas de Miosina/genética
Cadeias Pesadas de Miosina/metabolismo
Cultura Primária de Células
RNA Longo não Codificante/metabolismo
Ratos
Ratos Sprague-Dawley
Transdução de Sinais
Estômago/efeitos dos fármacos
Estômago/patologia
Estreptozocina
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (ACTA2 protein, human); 0 (Actins); 0 (MALAT1 long non-coding RNA, human); 0 (RNA, Long Noncoding); 5W494URQ81 (Streptozocin); EC 3.6.4.1 (Myosin Heavy Chains); IY9XDZ35W2 (Glucose)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE


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[PMID]:29262509
[Au] Autor:Zhou Q; Zuo MH; Li QW; Tian YT; Xie YB; Wang YB; Yang GY; Ye YJ; Guo P; Liu JP; Liu ZL; An C; Zhou T; Tian Z; Liu CB; Hu Y; Chi XY; Shen Y; Xia Y; Hu KW
[Ad] Endereço:Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China.
[Ti] Título:[Efficacy of Weitan Waifu patch on the postsurgical gastroparesis syndrome of gastrointestinal cancer: a multi-center trial].
[So] Source:Zhonghua Zhong Liu Za Zhi;39(12):919-925, 2017 Dec 23.
[Is] ISSN:0253-3766
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the safety and efficacy of the Weitan Waifu patch on the postsurgical gastroparesis syndrome (PGS) of gastrointestinal cancer. The multi-center, double-blind, randomized controlled trial was conducted with superiority design. Patients with PGS of gastrointestinal cancer diagnosed in 4 AAA hospitals and the abdominal symptom manifested as cold syndrome by Chinese local syndrome differentiation were recruited. These patients were randomly divided into two groups according to 1∶1 proportion. Placebo or Weitan Waifu patch was applied in control group or intervention group, respectively, based on the basic treatments, including nutrition support, gastrointestinal decompression, promoting gastric dynamics medicine.Two acupuncture points (Zhongwan and Shenque) were stuck with placebo in control group or patch in treatment group. The intervention course was 14 days or reached the effective standard. From July 15, 2013 to Jun 3, 2015, 128 participants were recruited and 120 eligible cases were included in the full analysis set (FAS), and 60 cases in each group. 88 cases were included in the per-protocol set (PPS), including 45 cases in the treatment group and 43 cases in the control group. In the FAS, the clinical effective rate in the treatment group was 68.3%, significantly superior than 41.7% of the control group ( =0.003). The medium time of effective therapy in the treatment group was 8 days, significantly shorter than 10 days in the control group ( =0.017). In the FAS, 3 adverse events occurred in the treatment group, including mild to moderate decrustation, pruritus and nausea. The incidence rate of adverse events was 5.0% (3/60) and these symptoms were spontaneously remitted after drug withdrawal. No severe adverse events were observed in the control group. There was no significant difference between these two groups ( =0.244). Weitan Waifu patch is a safely and effectively therapeutic method for patients with PGS (cold syndrome) of gastroenterological cancer. International Standard Randomized Controlled Trial Number Register, ISRCTN18291857.
[Mh] Termos MeSH primário: Medicamentos de Ervas Chinesas/uso terapêutico
Neoplasias Gastrointestinais/cirurgia
Gastroparesia/tratamento farmacológico
Complicações Pós-Operatórias/tratamento farmacológico
Adesivo Transdérmico
[Mh] Termos MeSH secundário: Pontos de Acupuntura
Método Duplo-Cego
Seres Humanos
Síndrome
Adesivo Transdérmico/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Drugs, Chinese Herbal)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3766.2017.12.008


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[PMID]:29019886
[Au] Autor:Su W; Lu F; Zhang X; Li G; Chen W; Ma T; Gao S; Lou J; Bai X; Liang T
[Ad] Endereço:aDepartment of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine bKey Laboratory of Pancreatic Disease of Zhejiang Province, Hangzhou cZhejiang University, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
[Ti] Título:A hospital-to-home evaluation of an enhanced recovery protocol for elective pancreaticoduodenectomy in China: A cohort study.
[So] Source:Medicine (Baltimore);96(41):e8206, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Enhanced recovery after surgery (ERAS) programs have been shown to decrease postoperative complications and hospital stay in pancreaticoduodenectomy. However, no studies concerned recovery after discharge except readmission. This study evaluated an ERAS program for pancreaticoduodenectomy from hospital to home.A prospective ERAS cohort undergoing elective pancreaticoduodenectomy was compared with a retrospective control group in terms of postoperative complications and hospital stay, and home recovery after discharge. Propensity-score matching was used to balance their baselines.Two groups of 31 patients with similar propensity scores were established. Postoperative morbidities were 18 of 31 and 26 of 31 in the ERAS and control groups, respectively (P = .06). Patients in the ERAS group suffered from fewer cardiovascular complications (3/31 vs 11/31; P = .04) and intestinal dysbacteriosis (4/31 vs 13/31; P = .04). Median postoperative hospital stay was shorter in the ERAS group (8 vs 16 days; P < .001). Although the 2 groups were similar in terms of sleep, defecation, vigor, performance status, and pain control in first month after discharge, patients in the ERAS group enjoyed better food intake recovery (18/31 vs 5/31 in first week, P = .002; 22/31 vs 9/31 in second week, P = .008; 23/31 vs 13/31 in fourth week, P = .01) and fewer weight loss (10/31 vs 19/31; P = .05). Multivariate analyses showed that both improvements were associated with no bowel preparation.ERAS implementation in selected patients undergoing pancreaticoduodenectomy could promise better outcomes, not only in the hospital but also at home in the short term.
[Mh] Termos MeSH primário: Gastroparesia
Pancreaticoduodenectomia/reabilitação
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Feminino
Gastroparesia/etiologia
Gastroparesia/prevenção & controle
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Readmissão do Paciente/estatística & dados numéricos
Assistência Perioperatória/métodos
Avaliação de Programas e Projetos de Saúde
Recuperação de Função Fisiológica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008206


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[PMID]:28847163
[Au] Autor:Chedid V; Camilleri M
[Ad] Endereço:a Department of Medicine, Division of Gastroenterology and Hepatology , Mayo Clinic , Rochester , MN , USA.
[Ti] Título:Relamorelin for the treatment of gastrointestinal motility disorders.
[So] Source:Expert Opin Investig Drugs;26(10):1189-1197, 2017 Oct.
[Is] ISSN:1744-7658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Current treatments for gastroparesis are limited. Chronic idiopathic constipation (CIC) has more treatment options, but none are efficacious for severe cases. Areas covered: Molecular targets to accelerate GI motility are being identified, and relamorelin, a synthetic ghrelin analog, has been promising. In humans, relamorelin increases growth hormone levels and accelerates gastric emptying. Relamorelin was superior to placebo for symptom relief in phase IIA studies for diabetic gastroparesis (DG) and CIC. In phase IIB studies in DG, relamorelin did not significantly reduce vomiting frequency when compared to placebo, but it reduced four symptoms of DG (nausea, fullness, bloating and abdominal pain) and accelerated gastric emptying. To date, relamorelin has been well tolerated and safe in humans without cardiac or neurologic adverse effects. It is still in clinical trial stages and not yet approved by the Food and Drug Administration. Phase III studies are underway. Expert opinion: Relamorelin shows promise in treating DG, with a reduction in core symptoms. Relative to available treatments, it appears to be efficacious and well tolerated. The absence of neurological or cardiovascular adverse effects places it at an advantage over other available therapies. Once approved, it will likely become the drug of first choice for DG.
[Mh] Termos MeSH primário: Constipação Intestinal/tratamento farmacológico
Gastroparesia/tratamento farmacológico
Oligopeptídeos/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Doença Crônica
Constipação Intestinal/fisiopatologia
Complicações do Diabetes/tratamento farmacológico
Complicações do Diabetes/fisiopatologia
Desenho de Drogas
Motilidade Gastrointestinal/efeitos dos fármacos
Gastroparesia/fisiopatologia
Seres Humanos
Terapia de Alvo Molecular
Oligopeptídeos/efeitos adversos
Oligopeptídeos/farmacologia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Oligopeptides); BIW199E18V (relamorelin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1080/13543784.2017.1373088


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[PMID]:28840395
[Au] Autor:Soghomonyan S; Abdel-Rasoul M; Zuleta-Alarcon A; Grants I; Davila V; Yu J; Zhang C; Whitaker EE; Bergese SD; Stoicea N; Arsenescu R; Christofi FL
[Ad] Endereço:Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH, 43210, USA.
[Ti] Título:Clopidogrel IBS Patients Have Higher Incidence of Gastrointestinal Symptoms Influenced by Age and Gender.
[So] Source:Dig Dis Sci;62(10):2728-2743, 2017 Oct.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Clopidogrel is an irreversible antagonist of P2Y receptors (P2Y Rs) used as an antiplatelet drug to reduce risk of thrombosis. P2Y Rs are expressed in gastrointestinal (GI) tract where they might regulate GI function. AIM: To evaluate if blockade of P2Y Rs by clopidogrel is associated with higher incidence of GI symptoms in patients with irritable bowel syndrome (IBS). METHODS: A retrospective analysis of our institutional database was conducted for a 13-year period. IBS patients were identified, and their demographics, GI symptoms and clopidogrel therapy were collected. Logistic regression models were used to characterize symptoms in clopidogrel versus no-clopidogrel IBS-groups, adjusting for Age and Sex differences. An additional study characterized the P2Y R distribution in human gut. RESULTS: The search identified 7217 IBS patients (6761 no-clopidogrel/456 clopidogrel). There were a higher proportion of patients with GI symptoms on clopidogrel (68%) compared to controls (60%, p = 0.0011) that were Females (70 vs. 60%, p = 0.0003) not Males (61 vs. 60%; p = 0.8312). In Females, clopidogrel was associated with higher incidence of GI symptoms (Age adjusted; p < 0.0001) for pain, constipation, gastroparesis (p ≤ 0.0001) and psychogenic pain (p = 0.0006). Age or Sex (adjusted models) influenced one or more GI symptoms (i.e., pain, p < 0.0001; constipation, p < 0.0001/p = 0.008; diarrhea, flatulence, p = 0.01). P2Y R immunoreactivity was abundant in human ENS; glial-to-neuron ratio of P2Y Rs expressed in Females â‰« Males. CONCLUSIONS: Irreversible blockade of P2Y R by clopidogrel is associated with higher incidence of GI symptoms in Female IBS patients, although Age or Sex alone contributes to symptomatology. Prospective studies can determine clinical implications of P2Y Rs in IBS.
[Mh] Termos MeSH primário: Sistema Nervoso Entérico/efeitos dos fármacos
Intestinos/inervação
Síndrome do Intestino Irritável/epidemiologia
Inibidores da Agregação de Plaquetas/efeitos adversos
Antagonistas do Receptor Purinérgico P2Y/efeitos adversos
Ticlopidina/análogos & derivados
[Mh] Termos MeSH secundário: Dor Abdominal/induzido quimicamente
Dor Abdominal/epidemiologia
Adolescente
Adulto
Fatores Etários
Idoso
Constipação Intestinal/induzido quimicamente
Constipação Intestinal/epidemiologia
Bases de Dados Factuais
Diarreia/induzido quimicamente
Diarreia/epidemiologia
Registros Eletrônicos de Saúde
Sistema Nervoso Entérico/química
Sistema Nervoso Entérico/fisiopatologia
Feminino
Flatulência/induzido quimicamente
Flatulência/epidemiologia
Gastroparesia/induzido quimicamente
Gastroparesia/epidemiologia
Seres Humanos
Incidência
Síndrome do Intestino Irritável/diagnóstico
Síndrome do Intestino Irritável/fisiopatologia
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Receptores Purinérgicos P2Y12/análise
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
Ticlopidina/efeitos adversos
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (P2RY12 protein, human); 0 (Platelet Aggregation Inhibitors); 0 (Purinergic P2Y Receptor Antagonists); 0 (Receptors, Purinergic P2Y12); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4707-7


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[PMID]:28737574
[Au] Autor:Santacruz CA; Quintairos A; Righy C; Crippa IA; Couto L; Imbault V; Wasineeart M; De Ryckere M; Preiser JC
[Ad] Endereço:1Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium. 2Department of Critical and Intensive Care Medicine, Academic Hospital Fundación Santa Fé de Bogota, Bogota, Colombia. 3Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium.
[Ti] Título:Is There a Role for Enterohormones in the Gastroparesis of Critically Ill Patients?
[So] Source:Crit Care Med;45(10):1696-1701, 2017 Oct.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Delayed gastric emptying occurs in critically ill patients and impairs the delivery, digestion, and absorption of enteral feeding. A pathophysiologic role of the enterohormones peptide YY and ghrelin is supported by preclinical data. To compare the circulating plasma levels of peptide YY and ghrelin in control subjects and in critically ill patients, during feeding and fasting, and to search for a correlation with gastric emptying. DESIGN: A prospective observational trial. SETTINGS: Mixed ICU of an academic hospital. SUBJECTS: Healthy volunteers and patients expected to stay in ICU for at least 3 days in whom enteral nutrition was indicated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Plasma peptide YY and ghrelin (enzyme-linked immunosorbent assay) were measured once in 10 fasting volunteers (controls) and daily from admission until day 5 of the ICU stay in 30 critically ill patients (median [interquartile range] age 63 [57-67] yr, median [interquartile range] Acute Physiology and Chronic Health Evaluation II score 21 [14-24]). Eight patients could not be fed (fasting group). In fed patients, 13 never had a gastric residual volume higher than 250 mL (low gastric residual volume group), in contrast to the high gastric residual volume group (n = 9). The plasma levels of peptide YY did not differ between patients (6.4 [0-18.1] pg/mL) and controls (4.8 [0.3-17.7] pg/mL). Ghrelin levels were lower in patients than in control (213 [54.4-522.7] vs 1,435 [1,321.9-1,869.3] pg/mL; p < 0.05). Plasma peptide YY or ghrelin did not differ between fasting and fed patients or between the high and low gastric residual volume groups. CONCLUSIONS: In critically ill patients, plasma concentration of ghrelin significantly differs from that of controls, irrespective of the feeding status. No correlation was found between the temporal profile of ghrelin or peptide YY plasma concentration with bedside functional assessment of gastric emptying.
[Mh] Termos MeSH primário: Estado Terminal
Gastroparesia/sangue
Grelina/sangue
Peptídeo YY/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Casos e Controles
Nutrição Enteral
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Ghrelin); 106388-42-5 (Peptide YY)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170725
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002625


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[PMID]:28687510
[Au] Autor:Khan AS; Williams G; Woolsey C; Liu J; Fields RC; Doyle MMB; Hawkins WG; Strasberg SM
[Ad] Endereço:Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO.
[Ti] Título:Flange Gastroenterostomy Results in Reduction in Delayed Gastric Emptying after Standard Pancreaticoduodenectomy: A Prospective Cohort Study.
[So] Source:J Am Coll Surg;225(4):498-507, 2017 Oct.
[Is] ISSN:1879-1190
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Delayed gastric emptying (DGE) is a common serious problem after pancreaticoduodenectomy (PD). Flange gastrojejunostomy (FL-GE) is a previously described technique that creates an internal flange in a hand-sewn gastroenterostomy. Results of FL-GE on incidence and severity of DGE after PD are presented. STUDY DESIGN: Data were extracted from a prospective database of PD. Standard PD with antrectomy were performed with flange gastroenterostomy (FL-GE) or other techniques (NonFL-GE) at a single institution. The International Study Group of Pancreatic Surgery (ISGPS) definition of DGE was used, and DGE severity was graded based on the ISGPS grading system and the Modified Accordion Grading System (MAGS). RESULTS: There were 215 standard PDs performed. Sixty-eight (32%) were FL-GE and 147 (68%) were NonFL-GE. Delayed gastric emptying rates in FL-GE and NonFL-GE were 9% and 23%, respectively (p = 0.012). Differences in severity of DGE were even more prominent: 29% of DGEs in the NonFL-GE group were ISGPS grade C vs 0% in FL-GE. Also, 35% of DGEs in the NonFL-GE group were MAGS 3 vs 0% in FL-GE. Because of some differences in sex and inflammatory complications between groups, a propensity score analysis was performed, creating 57 matched patients in the FL-GE and NonFL-GE groups. The incidence of DGE remained significantly different in the groups (5% in FL-GE vs 18% in NonFL-GE; p = 0.039). CONCLUSIONS: In this cohort study, the flange technique was associated with a marked reduction in the incidence of DGE after PD.
[Mh] Termos MeSH primário: Esvaziamento Gástrico
Gastroenterostomia/métodos
Gastroparesia/prevenção & controle
Pancreatopatias/cirurgia
Pancreaticoduodenectomia/efeitos adversos
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Feminino
Gastroparesia/epidemiologia
Seres Humanos
Incidência
Tempo de Internação
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170709
[St] Status:MEDLINE


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[PMID]:28601331
[Au] Autor:Zhang L; Hou SC; Miao JB; Lee H
[Ad] Endereço:Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Risk factors for delayed gastric emptying in patients undergoing esophagectomy without pyloric drainage.
[So] Source:J Surg Res;213:46-50, 2017 Jun 01.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The incidence of delayed gastric emptying (DGE) after esophagectomy is 10%-50%, which can interfere with postoperative recovery in the short-term and result in poor quality of life in the long term. Pyloric drainage is routinely performed to prevent DGE, but its role is highly controversial. The aim of this study was to report the rate of DGE after esophagectomy without pyloric drainage and to investigate its risk factors and the potential effect on recovery. MATERIALS AND METHODS: Between January 2010 and January 2015, we analyzed 285 consecutive patients who received an esophagectomy without pyloric drainage. Possible correlations between the incidence of DGE and its potential risk factors were examined in univariate and multivariate analyses, respectively. The outcomes of DGE were reviewed with a follow-up of 3 mo. RESULTS: The overall rate of DGE after esophagectomy was 18.2% (52/285). Among perioperative factors, gastric size (gastric tube versus the whole stomach) was the only significant factor affecting the incidence of DGE in the univariate analysis. The patients who received a whole stomach as an esophageal substitute were more likely to develop DGE than were patients with a gastric tube (13.2% versus 22.4%; P = 0.05). No independent risk factor for DGE was found in the multivariate analysis. The incidence of major postoperative complications, including anastomotic leak, respiratory complications, and cardiac complications, was also not significantly different between both groups, with or without DGE. Within 3 mo of follow-up, most patients could effectively manage their DGE through medication (39/52) or endoscopic pyloric dilation (12/52), with only one patient requiring surgical intervention. CONCLUSIONS: In our study, the overall incidence of DGE is about 20% for patients undergoing esophagectomy without pyloric drainage. Compared with prior findings, this does not result in a significantly increased incidence of DGE. In patients with symptoms of DGE after esophagectomy, prokinetic agents and endoscopic balloon dilation of the pylorus can be effective, as indicated by the high success rate and lack of significant complications.
[Mh] Termos MeSH primário: Drenagem
Esofagectomia/métodos
Gastroparesia/etiologia
Complicações Pós-Operatórias/etiologia
Piloro/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Gastroparesia/epidemiologia
Gastroparesia/terapia
Seres Humanos
Incidência
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/terapia
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170612
[St] Status:MEDLINE


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[PMID]:28577248
[Au] Autor:Bashashati M; Moraveji S; Torabi A; Sarosiek I; Davis BR; Diaz J; McCallum RW
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center/Paul L. Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX, 79905, USA. Bashashati.md@gmail.com.
[Ti] Título:Pathological Findings of the Antral and Pyloric Smooth Muscle in Patients with Gastroparesis-Like Syndrome Compared to Gastroparesis: Similarities and Differences.
[So] Source:Dig Dis Sci;62(10):2828-2833, 2017 Oct.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gastroparesis (GP)-like syndrome presents with the symptoms of GP but without delayed gastric emptying (GE). Whether GP-like syndrome is part of a spectrum of GP is not clear. This study aimed to compare the histopathological features of antral and pyloric smooth muscle tissue in GP and GP-like syndrome. METHODS: Full-thickness antral and/or pyloric biopsies were obtained from 37 GP and 18 GP-like syndrome patients who underwent abdominal surgery to place a gastric electrical stimulator or jejunal feeding tube and/or pyloroplasty. The tissues were stained with H&E, C-Kit, and trichrome. Based on previous control data, an interstitial cells of Cajal (ICC) count of <10 per high power field in the antrum and/or pylorus was considered depletion. Baseline total symptom score (TSS) was recorded. RESULTS: Twenty-four GP and 7 GP-like patients had pyloric biopsies. Pyloric ICC loss was observed in 20/24 (83.3%) GP and 2/7 (28.6%) GP-like patients (p < 0.01). Fibrosis was detected in the pyloric tissue of 20/24 (83.3%) GP and 2/7 (28.6%) GP-like patients who had pyloric trichrome staining (p < 0.01). Seventeen out of 24 (70.8%) GP patients with pyloric biopsies had concomitant pyloric ICC loss and fibrosis, while only one GP-like patient had ICC loss and simultaneous pyloric fibrosis. GP patients had a greater TSS compared to GP-like patients. In GP patients, those with pyloric ICC loss had a greater TSS compared to those with normal ICC. GP patients with pyloric fibrosis had a higher TSS compared to those without pyloric fibrosis. CONCLUSIONS: Compared to GP-like patients, the pyloric histopathological findings of ICC loss and fibrosis are common in GP and predict a greater symptom score. These pathological findings might be considered as markers of "pyloric dysfunction" and explain delayed GE in GP.
[Mh] Termos MeSH primário: Gastroenteropatias/patologia
Gastroparesia/patologia
Músculo Liso/patologia
Antro Pilórico/patologia
Piloro/patologia
[Mh] Termos MeSH secundário: Adulto
Biópsia
Feminino
Fibrose
Seres Humanos
Células Intersticiais de Cajal/patologia
Masculino
Meia-Idade
Coloração e Rotulagem
Síndrome
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170604
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4629-4


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[PMID]:28577245
[Au] Autor:Bielefeldt K
[Ad] Endereço:George E. Wahlen VA Medical Center, Salt Lake City Specialty Care Center of Innovation and University of Utah, 500 Foothill Dr., Salt Lake City, UT, 84148, USA. Klaus.Bielefeldt@va.gov.
[Ti] Título:From Harmful Treatment to Secondary Gain: Adverse Event Reporting in Dyspepsia and Gastroparesis.
[So] Source:Dig Dis Sci;62(11):2999-3013, 2017 Nov.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Medical management of gastroparesis and functional dyspepsia remains difficult with several recent trials showing limited or no benefit. If treatment comes with only marginal improvements, concerns about adverse events become more relevant. We therefore examined the type and outcomes of side effects submitted to a public repository. METHODS: We searched the Federal Adverse Event Reporting System for reports associated with the treatment of dyspepsia or gastroparesis. Demographic data, medications used and implicated, side effects, and outcomes were abstracted for the years 2004-2015. RESULTS: Acid-suppressive agents and prokinetics were the most commonly listed medications with a stronger emphasis on prokinetics in gastroparesis. Submissions related to metoclopramide by far exceeded reports about other agents and mostly described tardive dyskinesia or other neurological concerns. They peaked around 2012, driven by submissions through legal workers. Most reports about metoclopramide described short-term use to prevent or treat nausea and vomiting. Concerns about acid-suppressive medications increased over time and spanned a wide spectrum of potential problems, including osteoporosis, worsening renal function, or cardiac events. CONCLUSION: Despite biasing factors, such as pending legal action, the voluntary repository of adverse events provides insight into current medical practice and its associated risk. Knowing about common and uncommon, but potentially serious risks may enable patients and providers to decide on effective and safe management strategies.
[Mh] Termos MeSH primário: Sistemas de Notificação de Reações Adversas a Medicamentos
Transtornos de Deglutição/tratamento farmacológico
Fármacos Gastrointestinais/efeitos adversos
Gastroparesia/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Antieméticos/efeitos adversos
Bases de Dados Factuais
Transtornos de Deglutição/diagnóstico
Transtornos de Deglutição/fisiopatologia
Antagonistas dos Receptores de Dopamina D2/efeitos adversos
Feminino
Gastroparesia/diagnóstico
Gastroparesia/fisiopatologia
Seres Humanos
Masculino
Metoclopramida/efeitos adversos
Meia-Idade
Segurança do Paciente
Inibidores da Bomba de Prótons/efeitos adversos
Medição de Risco
Fatores de Risco
Discinesia Tardia/induzido quimicamente
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiemetics); 0 (Dopamine D2 Receptor Antagonists); 0 (Gastrointestinal Agents); 0 (Proton Pump Inhibitors); L4YEB44I46 (Metoclopramide)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170604
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4633-8



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