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[PMID]:28937980
[Au] Autor:Seo M; Heo J; Yoon J; Kim SY; Kang YM; Yu J; Cho S; Kim H
[Ad] Endereço:C&K Genomics, Seoul National University Research Park, Seoul, Republic of Korea.
[Ti] Título:Methanobrevibacter attenuation via probiotic intervention reduces flatulence in adult human: A non-randomised paired-design clinical trial of efficacy.
[So] Source:PLoS One;12(9):e0184547, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:TRIAL DESIGN: The aim of this study was to investigate which of the gut microbes respond to probiotic intervention, as well as study whether they are associated with gastrointestinal symptoms in a healthy adult human. For the experimental purpose, twenty-one healthy adults were recruited and received probiotic mixture, which is composed of five Lactobacilli strains and two Bifidobacteria strains, once a day for 60 days. Defecation survey and Bioelectrical Impedance Analysis were conducted pre- and post-administration to measure phenotypic differences. Stool samples of the subjects were collected twice. METHODS: The statistical analysis was performed for pair designed metagenome data with 11 phenotypic records of the bioelectrical impedance body composition analyzer and 6 responses of the questionnaires about gastrointestinal symptom. Furthemore, correlation-based network analysis was conducted for exploring complex relationships among microbiome communities. RESULTS: The abundances of Citrobacter, Klebsiella, and Methanobrevibacter were significantly reduced, which are strong candidates to be highly affected by the probiotic administration. In addition, interaction effects were observed between flatulence symptom attenuation and decreasing patterns of the Methanobrevibacter abundance. CONCLUSIONS: These results reveal that probiotic intervention modulated the composition of gut microbiota and reduced the abundance of potential pathogens (i.e. Citrobacter and Klebsiella). In addition, methanogens (i.e. Methanobrevibacter) associated with the gastrointestinal symptom in an adult human.
[Mh] Termos MeSH primário: Flatulência/dietoterapia
Flatulência/microbiologia
Microbioma Gastrointestinal
Methanobrevibacter
Probióticos/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Bifidobacterium/genética
Impedância Elétrica
Fezes/microbiologia
Feminino
Flatulência/complicações
Microbioma Gastrointestinal/genética
Seres Humanos
Lactobacillus/genética
Masculino
Methanobrevibacter/genética
Meia-Idade
Obesidade/complicações
Obesidade/dietoterapia
Obesidade/microbiologia
Fenótipo
Inquéritos e Questionários
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170923
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184547


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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]:28763464
[Au] Autor:Melchior C; Gourcerol G; Bridoux V; Ducrotté P; Quinton JF; Leroi AM
[Ad] Endereço:INSERM U1073, Service de Physiologie Digestive, CHU Rouen, INSERM CIC 0204 Rouen, Rouen, France.
[Ti] Título:Efficacy of antibiotherapy for treating flatus incontinence associated with small intestinal bacterial overgrowth: A pilot randomized trial.
[So] Source:PLoS One;12(8):e0180835, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: An increase in intestinal gas production due to small intestinal bowel overgrowth (SIBO) is a contributing factor for flatus incontinence. The aims of our study were to assess the efficacy of metronidazole in a select population of patients with flatus incontinence associated with SIBO and to compare its efficacy with that of a combination of simethicone and activated charcoal (SC; Carbosylane) in randomized experimental arms. METHODS: Adult patients suffering from flatus incontinence associated with SIBO diagnosed by a glucose breath test were enrolled in the study. They were given metronidazole or Carbosylane (SC) for 10 days. The reduction in the mean daily number of gas leakages reported in a 3-day diary before and at the end of the treatment was used as the primary endpoint. RESULTS: Of 52 consecutive subjects with flatus incontinence, 23 (44%) had SIBO, 16 (33%) of whom were included in and completed the study. The relative reduction in flatus incontinence episodes was significantly higher in the metronidazole than in the SC group (66.8±34.8% vs. 25±50%, P = 0.03), decreasing by more than 50% in 7 (87.5%) of the subjects in the metronidazole group compared with only 1 (12.5%) in the SC group (odds ratio 1.9, 95% confidence interval 0.9-56.9, P = 0.06). CONCLUSION: Our results show a promising trend indicating that metronidazole might significantly improve flatus incontinence associated with SIBO and might be more successful in treating flatus incontinence than gas absorbents.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Bacterianas/tratamento farmacológico
Incontinência Fecal/tratamento farmacológico
Flatulência/tratamento farmacológico
Metronidazol/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Testes Respiratórios
Carvão Vegetal/química
Esquema de Medicação
Incontinência Fecal/microbiologia
Feminino
Flatulência/microbiologia
Gases
Microbioma Gastrointestinal
Glucose/análise
Seres Humanos
Intestino Delgado/microbiologia
Intestino Delgado/fisiopatologia
Masculino
Meia-Idade
Razão de Chances
Projetos Piloto
Estudos Prospectivos
Qualidade de Vida
Simeticone/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Gases); 140QMO216E (Metronidazole); 16291-96-6 (Charcoal); 8050-81-5 (Simethicone); IY9XDZ35W2 (Glucose)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180835


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[PMID]:28508867
[Au] Autor:Malagelada JR; Accarino A; Azpiroz F
[Ad] Endereço:Digestive System Research Unit, University Hospital Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain.
[Ti] Título:Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge.
[So] Source:Am J Gastroenterol;112(8):1221-1231, 2017 Aug.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively. Individual patients may weight differently the impact of bloating and distension on their well-being. Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen. To avoid mishaps, organic bloating, and distension should always be considered first and appropriated assessed. Functional bloating and distension often present in association with other manifestations of irritable bowel syndrome or functional dyspepsia and in that context patients tend to regard them as most troublesome. A mechanism-based management bloating and distension should be ideal but elucidating key operational mechanisms in individual patients is not always feasible. Some clues may be gathered through a detailed dietary history, by assessing bowel movement frequency and stool consistency and special imaging technique to measure abdominal shape during episodes of distension. In severe, protracted cases it may be appropriate to refer the patient to a specialized center where motility, visceral sensitivity, and abdominal muscle activity in response to intraluminal stimuli may be measured. Therapeutic resources focussed upon presumed or demonstrated pathogenetic mechanism include dietary modification, microbiome modulation, promoting gas evacuation, attenuating visceral perception, and controlling abdominal wall muscle activity via biofeedback.
[Mh] Termos MeSH primário: Constipação Intestinal/fisiopatologia
Gastroenteropatias/fisiopatologia
[Mh] Termos MeSH secundário: Parede Abdominal/fisiopatologia
Constipação Intestinal/complicações
Dilatação Patológica/complicações
Dilatação Patológica/fisiopatologia
Dispepsia/complicações
Dispepsia/fisiopatologia
Flatulência/complicações
Flatulência/fisiopatologia
Gastroenteropatias/complicações
Seres Humanos
Síndrome do Intestino Irritável/complicações
Síndrome do Intestino Irritável/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170517
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2017.129


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[PMID]:28481855
[Au] Autor:Read TE; Brozovich M; Andujar JE; Ricciardi R; Caushaj PF
[Ad] Endereço:1 Western Pennsylvania Hospital, Clinical Campus of Temple University School of Medicine, Pittsburgh, Pennsylvania 2 Lahey Hospital and Medical Center, Burlington, Massachusetts 3 Tufts University School of Medicine, Boston, Massachusetts 4 University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 5 Wellstar Kennesrone Regional Medical Center, Marietta, Georgia 6 Hartford Healthcare Medical Group, University of Connecticut School of Medicine, Hartford, Connecticut.
[Ti] Título:Bowel Sounds Are Not Associated With Flatus, Bowel Movement, or Tolerance of Oral Intake in Patients After Major Abdominal Surgery.
[So] Source:Dis Colon Rectum;60(6):608-613, 2017 Jun.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Auscultation for bowel sounds has been advocated by some clinicians as a method to determine the resolution of postoperative ileus. OBJECTIVE: Our primary aim was to prospectively evaluate the relationships between bowel sounds and the ability to tolerate oral intake in patients after major abdominal surgery. Secondarily we aimed to evaluate relationships among bowel sounds, flatus and bowel movement, and oral intake. DESIGN: This was a prospective, blinded observational study. SETTINGS: The study was conducted at Western Pennsylvania Hospital. PATIENTS: A total of 124 adult patients undergoing major abdominal surgery were included. MAIN OUTCOME MEASURES: Data were collected by medical students blinded to the purpose of the study for 10 days postoperatively or until discharge, including the presence of bowel sounds (auscultation for 1 minute), flatus, bowel movement, and tolerance of oral intake (defined as ingestion of ≥1000 mL/24 h and each subsequent day without vomiting). Associations between paired variables were determined using Ï• coefficient testing. RESULTS: The study population consisted of 51 men and 73 women, with a mean age of 64 years (range, 20-92 y). The majority of patients (78/124 (63%)) underwent colorectal resection. The median length of hospital was 6 days. Bowel sounds were not associated with flatus, bowel movement, or tolerance of oral intake throughout the study period. The positive predictive value of bowel sounds in predicting flatus and bowel movement was low in the early postoperative period and remained <25% in predicting tolerance of oral intake throughout the study period. The analysis was repeated, including only those patients undergoing colorectal procedures, and was essentially unchanged. Flatus correlated with bowel movement in the first 6 days postoperation, but neither flatus nor bowel movement was associated with tolerance of oral intake. LIMITATIONS: The rate of tolerance of oral intake was relatively modest throughout the study period. CONCLUSIONS: Bowel sounds are not associated with flatus, bowel movement, or tolerance of oral intake after major abdominal surgery.
[Mh] Termos MeSH primário: Abdome/cirurgia
Auscultação
Intestinos
Período Pós-Operatório
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Defecação
Digestão
Feminino
Flatulência
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Prospectivos
Método Simples-Cego
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000829


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[PMID]:28374085
[Au] Autor:Choghakhori R; Abbasnezhad A; Amani R; Alipour M
[Ad] Endereço:Nutritional Health Research Center, Department of Nutrition, Lorestan University of Medical Sciences, Goledasht Blvd, Khorramabad, 6813833946, Iran.
[Ti] Título:Sex-Related Differences in Clinical Symptoms, Quality of Life, and Biochemical Factors in Irritable Bowel Syndrome.
[So] Source:Dig Dis Sci;62(6):1550-1560, 2017 Jun.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Due to the sex differences in physiological and psychological factors, it can be speculated that clinical presentation of symptoms in male and female patients with irritable bowel syndrome (IBS) might be different. AIM: To evaluate sex-related differences in clinical symptoms, quality of life, and biochemical factors in IBS. METHODS: Ninety IBS patients (29 men, 61 women (45 premenopausal, 16 postmenopausal)) were recruited from the outpatient clinic of the University Hospital. All the patients met the Rome III Diagnostic Criteria. The IBS severity score system (IBS-SSS), gastrointestinal (GI) symptoms, IBS specific quality of life (IBS-QoL), and biochemical factors (IL-17, IL-10, TNFα, malondialdehyde (MDA), total antioxidant capacity (TAC)) were assessed. RESULTS: Diarrhea predominant IBS (IBS-D) was more common in men (44.8%), whereas constipation-predominant IBS (IBS-C) and alternating bowel habits IBS (IBS-A) were more common in women (39.3, 42.6%, respectively). The women had a greater severity of abdominal distention, rumbling, flatulence, and dissatisfaction with bowel habits as compared with men. The scores of IBS-QoL in women were significantly (P < 0.05) lower than those in men. Moreover, pro-inflammatory cytokines (IL-17, TNFα) increased, and anti-inflammatory cytokine (IL-10) decreased in women versus men. In addition, there was no significant difference (P > 0.05) between pre- and postmenopausal women in the severity of symptoms. All of the GI symptoms and IBS-SSS have a significant negative correlation with IBS-QoL in both men and women. CONCLUSIONS: Female with IBS reports a greater severity of IBS symptoms, increased inflammatory cytokines, and has an impaired quality of life compared with male.
[Mh] Termos MeSH primário: Constipação Intestinal/etiologia
Diarreia/etiologia
Síndrome do Intestino Irritável/sangue
Síndrome do Intestino Irritável/complicações
Qualidade de Vida
Fatores Sexuais
[Mh] Termos MeSH secundário: Adulto
Antioxidantes/metabolismo
Feminino
Flatulência/etiologia
Seres Humanos
Interleucina-10/sangue
Interleucina-17/sangue
Masculino
Malondialdeído/sangue
Meia-Idade
Pós-Menopausa
Pré-Menopausa
Índice de Gravidade de Doença
Inquéritos e Questionários
Avaliação de Sintomas
Fator de Necrose Tumoral alfa/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antioxidants); 0 (Interleukin-17); 0 (Tumor Necrosis Factor-alpha); 130068-27-8 (Interleukin-10); 4Y8F71G49Q (Malondialdehyde)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4554-6


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[PMID]:28338159
[Au] Autor:Zhang W; Li K; Zhang W; Liu F; Liu K; Song X; Chen X; Yang K; Hu J
[Ad] Endereço:Department of Gastrointestinal Surgery, Institute of Gastric Cancer, West China Hospital, Sichuan University, Chengdu 610014, China.
[Ti] Título:[Application of multimodal analgesia in radical gastrectomy for gastric cancer patients: a prospective nonrandomized controlled study].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;20(3):270-276, 2017 Mar 25.
[Is] ISSN:1671-0274
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To compare the postoperative analgesia efficacy, rehabilitation parameters and complication between multimodal analgesia and traditional analgesia after radical gastrectomy for gastric cancer patients. METHODS: Patients with gastric cancer who underwent surgery in our hospital from October 2016 to December 2016 were enrolled in this prospective study. According to the non-randomized method, patients were assigned to multimodal analgesia group(n=32) and traditional analgesia group(n=33) in gastric cancer treatment team A and B in Department of Gastrointestinal Surgery, West China Hospital, Sichuan University. The treatment measures of group A were as follows: (1) The ratio of 1/1 diluted ropivacaine (100 mg, 10 ml) was infiltrated around the incision before abdomen closure, with incision sutured layer by layer. (2) Parecoxib sodium (40 mg) was injected intravenously every 12 hours after operation for 5 days. (3) Oxycodone-acetaminophen tablet was given orally on the first day or the second day after operation, 50 mg twice a day. (4) Patient-controlled analgesia was not used after operation. Patients in group B received direct suture of incision and patient-controlled analgesia. The pain score, postoperative rehabilitation and 30-day postoperative complications were collected and analyzed. RESULTS: Multimodal analgesia group had lower pain scores at 1 d (4.8±0.9), 2 d (4.3±1.0), 3 d (2.9±0.8), 4 d (2.4±0.7) and 5 d (1.7±0.7) after surgery, as compared to traditional analgesia group (5.9±0.9, P=0.000), (5.1±0.7, P=0.001), (3.9±0.8, P=0.000), (3.0±0.6, P=0.000), (2.6±0.7, P=0.000), with significant difference. Postoperative hospital stay [(8.2±1.6) days vs. (10.6±2.2) days, P=0.000], time to ambulation [(47.5±13.8) days vs. (66.2±16.8) days, P=0.000], time to first flatus [(76.4±25.2) days vs. (120.0±29.9) days, P=0.000], time to first defecate [(117.3±42.2) days vs. (159.7±30.7) days, P=0.000] and time to first fluid diet [(83.8±21.6) days vs. (141.9±33.9) days, P=0.000] in the multimodal analgesia group were significantly shorter than those in the traditional analgesia group. There was no significant difference between the two groups with respect to 30-day postoperative complication rate(9.4% vs. 9.1%, P=1.000). CONCLUSIONS: Multimodal analgesia can significantly reduce the postoperative pain and is beneficial to rehabilitation, meanwhile it does not increase the risk of postoperative complications. Multimodal analgesia is safe and effective for gastric cancer patients undergoing radical gastrectomy.
[Mh] Termos MeSH primário: Gastrectomia/reabilitação
Manejo da Dor/métodos
Dor Pós-Operatória/tratamento farmacológico
Recuperação de Função Fisiológica/efeitos dos fármacos
Neoplasias Gástricas/cirurgia
[Mh] Termos MeSH secundário: Acetaminofen/administração & dosagem
Acetaminofen/uso terapêutico
Amidas/administração & dosagem
Amidas/uso terapêutico
Analgesia Controlada pelo Paciente
China
Pesquisa Comparativa da Efetividade
Defecação
Combinação de Medicamentos
Ingestão de Alimentos
Flatulência
Seres Humanos
Isoxazóis/administração & dosagem
Isoxazóis/uso terapêutico
Tempo de Internação/estatística & dados numéricos
Oxicodona/administração & dosagem
Oxicodona/uso terapêutico
Complicações Pós-Operatórias
Estudos Prospectivos
Ferida Cirúrgica/reabilitação
Ferida Cirúrgica/terapia
Técnicas de Sutura
Resultado do Tratamento
Caminhada
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Drug Combinations); 0 (Isoxazoles); 0 (oxycodone-acetaminophen); 362O9ITL9D (Acetaminophen); 7IO5LYA57N (ropivacaine); 9TUW81Y3CE (parecoxib); CD35PMG570 (Oxycodone)
[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:170325
[St] Status:MEDLINE


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[PMID]:28279179
[Au] Autor:Hosni A; Rosewall T; Craig T; Kong V; Bayley A; Berlin A; Bristow R; Catton C; Warde P; Chung P
[Ad] Endereço:Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
[Ti] Título:The effect of bowel preparation regime on interfraction rectal filling variation during image guided radiotherapy for prostate cancer.
[So] Source:Radiat Oncol;12(1):50, 2017 Mar 09.
[Is] ISSN:1748-717X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to investigate the tolerability and impact of milk of magnesia (MoM) on interfraction rectal filling during prostate cancer radiotherapy. METHODS: Two groups were retrospectively identified, each consisting of 40 patients with prostate cancer treated with radiotherapy to prostate+/-seminal vesicles, with daily image-guidance in 78Gy/39fractions/8 weeks. The first-group followed anti-flatulence diet with MoM started 3-days prior to planning-CT and continued during radiotherapy, while the second-group followed the same anti-flatulence diet only. The rectum between upper and lower limit of the clinical target volume (CTV) was delineated on planning-CT and on weekly cone-beam-CT (CBCT). Rectal filling was assessed by measurement of anterio-posterior diameter of the rectum at the superior and mid levels of CTV, rectal volume (RV), and average cross-sectional rectal area (CSA; RV/length). RESULTS: Overall 720 images (80 planning-CT and 640 CBCT images) from 80 patients were analyzed. Using linear mixed models, and after adjusting for baseline values at the time of planning-CT to test the differences in rectal dimensions between both groups over the 8-week treatment period, there were no significant differences in RV (p = 0.4), CSA (p = 0.5), anterio-posterior diameter of rectum at superior (p = 0.4) or mid level of CTV (p = 0.4). In the non-MoM group; 22.5% of patients had diarrhea compared to 60% in the MoM group, while 40% discontinued use of MoM by end of radiotherapy. CONCLUSION: The addition of MoM to antiflatulence diet did not reduce the interfraction variation in rectal filling but caused diarrhea in a substantial proportion of patients who then discontinued its use.
[Mh] Termos MeSH primário: Artefatos
Intestino Delgado/fisiologia
Neoplasias da Próstata/radioterapia
Radioterapia Guiada por Imagem/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Flatulência/prevenção & controle
Seres Humanos
Laxantes/uso terapêutico
Masculino
Meia-Idade
Movimento (Física)
Planejamento da Radioterapia Assistida por Computador
Radioterapia de Intensidade Modulada/métodos
Reto/fisiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Laxatives)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE
[do] DOI:10.1186/s13014-017-0787-y


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[PMID]:28233394
[Au] Autor:Wilder-Smith CH; Olesen SS; Materna A; Drewes AM
[Ad] Endereço:Brain-Gut Research Group, Gastroenterology Group Practice, Bern, Switzerland.
[Ti] Título:Predictors of response to a low-FODMAP diet in patients with functional gastrointestinal disorders and lactose or fructose intolerance.
[So] Source:Aliment Pharmacol Ther;45(8):1094-1106, 2017 Apr.
[Is] ISSN:1365-2036
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diets low in fermentable sugars (low-FODMAP diets) are increasingly adopted by patients with functional gastrointestinal disorders (FGID), but outcome predictors are unclear. AIM: To identify factors predictive of an efficacious response to a low-FODMAP diet in FGID patients with fructose or lactose intolerance thereby gaining insights into underlying mechanisms. METHODS: Fructose and lactose breath tests were performed in FGID patients to determine intolerance (positive symptom score) and malabsorption (increased hydrogen or methane concentrations). Patients with fructose or lactose intolerance consumed a low-FODMAP diet and global adequate symptom relief was assessed after 6-8 weeks and correlated with pre-diet clinical symptoms and breath test results. RESULTS: A total of 81% of 584 patients completing the low-FODMAP diet achieved adequate relief, without significant differences between FGID subgroups or types of intolerance. Univariate analysis yielded predictive factors in fructose intolerance (chronic diarrhoea and pruritus, peak methane concentrations and fullness during breath tests) and lactose intolerance (peak hydrogen and methane concentrations and flatulence during breath tests). Using multivariate analysis, symptom relief was independently and positively predicted in fructose intolerance by chronic diarrhoea [odds ratio (95% confidence intervals): 2.62 (1.31-5.27), P = 0.007] and peak breath methane concentrations [1.53 (1.02-2.29), P = 0.042], and negatively predicted by chronic nausea [0.33 (0.16-0.67), P = 0.002]. No independent predictive factors emerged for lactose intolerance. CONCLUSIONS: Adequate global symptom relief was achieved with a low-FODMAP diet in a large majority of functional gastrointestinal disorders patients with fructose or lactose intolerance. Independent predictors of a satisfactory dietary outcome were only seen in fructose intolerant patients, and were indicative of changes in intestinal host or microbiome metabolism.
[Mh] Termos MeSH primário: Dieta com Restrição de Carboidratos
Intolerância à Frutose/dietoterapia
Gastroenteropatias/dietoterapia
Intolerância à Lactose/dietoterapia
[Mh] Termos MeSH secundário: Adulto
Testes Respiratórios
Metabolismo dos Carboidratos/fisiologia
Dieta/efeitos adversos
Feminino
Fermentação
Flatulência/etiologia
Flatulência/prevenção & controle
Frutose/análise
Frutose/metabolismo
Intolerância à Frutose/complicações
Intolerância à Frutose/diagnóstico
Intolerância à Frutose/metabolismo
Gastroenteropatias/complicações
Gastroenteropatias/diagnóstico
Gastroenteropatias/metabolismo
Seres Humanos
Lactose/análise
Lactose/metabolismo
Intolerância à Lactose/complicações
Intolerância à Lactose/diagnóstico
Intolerância à Lactose/metabolismo
Estudos Longitudinais
Masculino
Meia-Idade
Prognóstico
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
30237-26-4 (Fructose); J2B2A4N98G (Lactose)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE
[do] DOI:10.1111/apt.13978


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[PMID]:28127207
[Au] Autor:Cayzeele-Decherf A; Pélerin F; Leuillet S; Douillard B; Housez B; Cazaubiel M; Jacobson GK; Jüsten P; Desreumaux P
[Ad] Endereço:Amélie Cayzeele-Decherf, Fanny Pélerin, Peter Jüsten, Lesaffre Human Care, Lesaffre Group, 59700 Marcq en Baroeul, France.
[Ti] Título: CNCM I-3856 in irritable bowel syndrome: An individual subject meta-analysis.
[So] Source:World J Gastroenterol;23(2):336-344, 2017 Jan 14.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: To confirm previous conclusions on ( ) CNCM I-3856 for irritable bowel syndrome (IBS) management. METHODS: An individual patient data meta-analysis was performed on two randomized clinical trials studying the effect of CNCM I-3856 supplementation on gastrointestinal (GI) symptoms in IBS subjects. A total of 579 IBS subjects were included. Outcomes were the daily Likert scale scores of abdominal pain/discomfort and bloating [area under the curve (AUC) and weekly means], responder status, and bowel movements (stool frequency and consistency). Statistical analyses were conducted in Intent to Treat (ITT) population, IBS-C subjects and IBS-C subjects with an abdominal pain/discomfort score higher than or equal to 2 at baseline ("IBS-C ≥ 2 subpopulation"). RESULTS: CNCM I-3856 significantly improved abdominal pain/discomfort and bloating during the second month of supplementation [AUC (W5-W8)] with improvement up to the minimal clinically relevant threshold of 10%: a 12.3% reduction of abdominal pain/discomfort in the ITT population compared to the Placebo group ( = 0.0134) has been observed. In the IBS-C ≥ 2 subpopulation, there were a 13.1% reduction of abdominal pain/discomfort and a 14.9% reduction of bloating compared to the Placebo group ( = 0.0194 and = 0.0145, respectively). GI symptoms significantly decreased during supplementation but no statistical differences were reported between groups at the end of the supplementation period. Responder status was defined as a subject who experienced a decrease of 1 arbitrary unit (a.u.) or 50% of the abdominal discomfort score from baseline for at least 2 wk out of the last 4 wk of the study. A significant difference between groups was reported in the ITT population, when considering the first definition: subjects in the Active group had 1.510 higher odds to be a responder (reduction of 1 a.u. of abdominal pain/discomfort) compared with subjects in the Placebo group ( = 0.0240). At the end of supplementation period, stool consistency in the Active group of the ITT population was significantly improved and classified as "normal" compared to Placebo (respectively 3.13 ± 1.197 a.u. 2.58 ± 1.020 a.u., = 0.0003). Similar results were seen in the IBS-C ≥ 2 subpopulation (Active group: 3.14 ± 1.219 a.u. Placebo group: 2.59 ± 1.017 a.u., = 0.0009). CONCLUSION: This meta-analysis supports previous data linking I-3856 and improvement of GI symptoms, in IBS overall population and in the IBS-C and IBS-C ≥ 2 subpopulations.
[Mh] Termos MeSH primário: Terapia Biológica/métodos
Síndrome do Intestino Irritável/tratamento farmacológico
Probióticos/uso terapêutico
Saccharomyces cerevisiae/fisiologia
[Mh] Termos MeSH secundário: Dor Abdominal/tratamento farmacológico
Dor Abdominal/etiologia
Adulto
Constipação Intestinal/tratamento farmacológico
Constipação Intestinal/etiologia
Defecação/efeitos dos fármacos
Feminino
Flatulência/tratamento farmacológico
Flatulência/etiologia
Seres Humanos
Síndrome do Intestino Irritável/complicações
Masculino
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170128
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i2.336



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