Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2018-07-11T11:29:52Z No. of bitstreams: 1 Disserta??o Krist1107.pdf: 2340518 bytes, checksum: c4a07ad9b25622d62d44660937fb1ea0 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-07-16T11:22:39Z (GMT) No. of bitstreams: 1 Disserta??o Krist1107.pdf: 2340518 bytes, checksum: c4a07ad9b25622d62d44660937fb1ea0 (MD5) / Made available in DSpace on 2018-07-16T11:30:20Z (GMT). No. of bitstreams: 1 Disserta??o Krist1107.pdf: 2340518 bytes, checksum: c4a07ad9b25622d62d44660937fb1ea0 (MD5) Previous issue date: 2017-03-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Made available in DSpace on 2014-12-17T14:13:40Z (GMT). No. of bitstreams: 1 ArianoJFO_TESE.pdf: 4702952 bytes, checksum: 4c768ba0623fffd6e9b8beb9419b70d5 (MD5) Previous issue date: 2011-09-05 / Diversion colitis is a chronic inflammatory process affecting the dysfunctional colon, after a colostomy. It is postulated that nutritional deficiency of the colonic epithelium by the absence of short-chain fatty acids (SCFA) is one of the factors responsible for the appearance of DC and that their employment could reverse the morphological changes of the mucosa. The treatment of choice for fecal diversion colitis (DC) is the reconstruction of the intestinal tract, although they suggested therapeutic options using enemas. This study evaluates the effect of SCFA in atrophy and inflammation in excluded colonic segments before and after the installation DC. Forty Wistar rats were divided into four groups (n = 10 for each group), submitted colostomy with distal colon exclusion. Two control groups (A1 and B1) received rectally administered physiological saline, whereas two experimental groups (A2 and B2) received rectally administered short-chain fatty-acids. The A groups were prophylactically treated (5th to 40th days postoperatively), whereas the B groups were therapeutically treated (after postoperative day 40), for 07 days. Histological sections stained with HE were used for histological analysis of the thickness of the colonic mucosa excluded (t- Student p ≤0.05). Inflammatory reaction of the lamina propria and mucosa were measured with scores previously established (Mann Whitney p ≤ 0.05). There was a significant thickness recovery of the colonic mucosa in group B2 animals (p = 0.0001), which also exhibited a significant reduction in the number of eosinophilic polymorphonuclear cells in the lamina propria (p = 0.0126) and in the intestinal lumen (p = 0.0256). Group A2 did not prevent the mucosal atrophy and significant increases in the numbers of lymphocytes (p=0.0006) and 50 eosinophilic polymorphonuclear cells in the lamina propria of the mucosa (p = 0.0022). Therapeutic use of short-chain fatty-acids significantly reduced eosinophilic polymorphonuclear cell numbers in the intestinal wall and in the colonic lumen; it also reversed the atrophy of the colonic mucosa. Prophylactic use did not impede the development of mucosal atrophy / Colite de deriva??o fecal (CD) ? um processo inflamat?rio cr?nico que acomete o segmento intestinal desfuncionalizado, ap?s a confec??o de colostomia. Postula-se que a defici?ncia nutricional do epit?lio col?nico pela aus?ncia de ?cidos graxos de cadeia curta (AGCC) seja um dos fatores respons?veis pelo surgimento da CD e que o emprego deles poderia reverter as altera??es morfol?gicas da mucosa. O tratamento de elei??o para a colite por deriva??o fecal (CD) ? a reconstru??o do tr?nsito intestinal, embora sejam sugeridas terap?uticas opcionais empregando enemas. O presente estudo visou estudar o efeito dos AGCC na atrofia e inflama??o de segmentos col?nicos exclu?dos, antes e depois da instala??o da CD. Quarenta ratos Wistar foram divididos em quatro grupos (n=10 para cada grupo), todos submetidos a colostomia com exclus?o do c?lon distal. Nos dois grupos controle instilou-se solu??o salina 0,9% por via retal (grupos A1 e B1) e nos dois grupos teste (grupos A2 e B2) AGCC foram instilados por via retal. O grupo A foi submetido a interven??o profil?tica, entre o 5? e o 40? dia de p?s-operat?rio (DPO), enquanto o grupo B foi submetido a interven??o terap?utica a partir o 40? DPO, durante 07 dias. Sec??es histol?gicas coradas com HE foram usadas para an?lise histol?gica da espessura da mucosa do c?lon exclu?do (t de Student com p≤0,05). Rea??o inflamat?ria da l?mina pr?pria e mucosa foi quantificada com escores previamente estabelecidos (teste de Mann Whitney p≤0,05). Houve significante recupera??o da espessura da mucosa col?nica dos animais do grupo B2 (p=0,0001), que, tamb?m, apresentou significativa redu??o da presen?a de xii polimorfonucleares eosin?filos (PNE) na l?mina pr?pria (p=0,0126) e na luz intestinal (p=0,0256). O Grupo A2 n?o preveniu a atrofia da mucosa e mostrou significativo aumento do n?mero de linf?citos (p = 0.0006) e da quantidade de PNE na l?mina pr?pria da mucosa (p = 0.0022). Concluiu-se que o emprego terap?utico de AGCC reduz significativamente o n?mero de polimorfonucleares eosin?filos na parede intestinal e na luz do c?lon, e tamb?m reverte a atrofia da mucosa col?nica. Entretanto, o emprego profil?tico dos AGCC n?o impede o desenvolvimento da atrofia da mucosa