Made available in DSpace on 2014-06-11T19:27:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-07-20Bitstream added on 2014-06-13T19:56:22Z : No. of bitstreams: 1 cezimbra_im_me_jabo.pdf: 403634 bytes, checksum: 681b906dd316ae6be3a89341b3d7a0cc (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Os objetivos foram avaliar diferentes formas de dosagem de indicadores (infusão contínua 24h, e duas doses diária de indicador) e verificar sua precisão e acurácia para estimativa do fluxo duodenal de matéria seca (MS), consumo de concentrado, consumo de volumoso, produção fecal e digestibilidade aparente da MS em bovinos. No experimento 1, seis animais receberam os indicadores Cr-EDTA e YbCl3 através de uma bomba de infusão contínua, via fístula ruminal durante seis dias de adaptação nos dois períodos de 17 dias, enquanto os outros seis animais receberam os mesmos indicadores em duas dosagens diárias (8h e às 19h). No experimento 2, doze animais receberam os indicadores Cr-EDTA, YbCl3, LIPE®LÍQUIDO, FDNi e FDAi, em duas doses diárias que foram utilizados nas estimativas do fluxo duodenal de matéria seca (MS) pelo método de único e duplo indicador. Os indicadores TiO2 e LIPE®LÍQUIDO foram utilizados para estimativa do consumo de concentrado, produção fecal, digestibilidade aparente e os indicadores internos, FDNi e FDAi para estimar consumo de volumoso, produção fecal e digestibilidade. No experimento 1, o delineamento utilizado foi inteiramente casualisado em parcelas subdivididas com dois tratamentos em dois períodos. No experimento 2, o delineamento foi o de blocos em parcelas subdivididas. As médias foram comparadas pelo teste tukey a 5%. No experimento 1 não foram observadas diferenças entre as formas de fornecimento dos indicadores (P>0,05). No experimento 2, a FDNi estimou o fluxo de digesta no duodeno e a produção fecal e o consumo de volumoso. A estimativa do consumo de volumoso através do FDNi e FDAi foram semelhantes ao observado (P>0,05). O TiO2 e LIPE®LÍQUIDO foram acurados na estimativa do consumo de concentrado / The objectives of this study were to evaluate by two metabolism trials different ways to dose markers (by continuous infusion for 24 hours and by two doses of marker per day) and also to study the accuracy and reliability of differents markers to estimate duodenal flow of nutrients concentrate intake, roughage intake, fecal production and apparent digestibility of dry matter (DM) in cattle. Twelve crossbred heifers were used in both experiments with average body weight of 361.7kg ± 59 and approximately 24 months of age, cannulated in the rumen and duodenum. In experiment 1, six animals received the markers Cr-EDTA, YbCl3 by continuous infusion via ruminal fistula in two periods of 17 days, while the other six animals received the same markers in twice daily dosing (8 and 7hours). In experiment 2, animals received the twelve markers twice daily during the experimental periods. Markers Cr-EDTA, YbCl3, LIPE®LIQUID, iNDF and iADF were used in the estimation of duodenal flow of nutrients by the method of single and double markers. Markers TiO2 and LIPE®LIQUID were used to estimate concentrate intake, fecal output, digestibility of DM and internal markers, iNDF and iADF to estimate forage intake, digestibility and fecal production. In experiment 1, a split plot design was used with two treatments (supply), six replicates in two periods. In experiment 2, the experimental design was randomized blocks in split plots, where the markers were considered as treatments. In both experiments, the means were compared by Tukey test at 5%. In experiments 1, there were no differences between the ways to supply the marker (P>0.05). In experiment 2, the iNDF was the best variable to predict digest flow in the duodenum and fecal production. iNDF and iADF were not d significantly different when the average intake of roughage were compared with the observed. The TiO2 was not significantly different... (Complete abstract click electronic access below)

Este sumário apresenta o resumo e os resultados deste estudo experimental do Fechamento do Coto Duodenal, em um e dois planos de sutura, realizado em 48 cães submetidos a uma gastrectomia Billroth II, com a finalidade de estudar comparativamente, o processo de cicatrização, macro e microscópico da sutura deste Coto. Os aspectos mais relevantes deste estudo de cicatrização de feridas macroscópicas e microscópicas no coto duodenal foram os seguintes: A) Estudo macroscópico: Com o objetivo de realizar um estudo macroscópico de fechamento do coto duodenal, foi realizada uma gastrectomia BII, em 48 cães, divididos em dois grupos: Grupo 1 - composto por 24 cães em que a sutura do coto duodenal foi realizada em um plano extra-mucoso. Estes animais foram divididos em dois subgrupos de 12 animais cada: i1 - cães sacrificados no período pós-operatório imediato, ou seja, no primeiro, quarto e sétimo dia após a operação; e M1 - cães sacrificados em um período pós-operatório mais tardio, ou seja, no décimo quarto, vigésimo primeiro e vigésimo oitavo dia, após a operação. Grupo 2 - Composto por 24 animais, em que a sutura do coto duodenal foi realizada em 2 planos (total e seromuscular). Também estes animais foram distribuídos em subgrupos, i2 e M2, de forma idêntica como no Grupo 1. Um estudo comparativo foi feito quanto aos resultados de fechamento do coto duodenal em 1 e 2 planos, levando em consideração seus aspectos macroscópicos, obtendo-se as seguintes conclusões: o Em nenhum dos cães, em ambos os grupos, ocorreu deiscência do coto duodenal ou quaisquer outras complicações pós-operatórias; o O diâmetro externo do coto duodenal ao nível da sutura foi significativamente maior no grupo com 2 planos de sutura. No entanto, a 5 e 10 cm distalmente à sutura do coto, esta medida foi semelhante em ambos os grupos. o Aderências ao coto duodenal foram semelhantes em ambos os métodos de sutura, exceto por uma incidência significativamente maior de aderências de epíplon no grupo com um plano de sutura, durante os primeiros 7 dias. o A inflamação da mucosa foi significativamente maior no grupo com 2 planos de sutura, durante os primeiros 7 dias; o O esporão formado no fechamento do coto em 2 planos de sutura foi significativamente maior que o formado em um plano de sutura. o A distância entre a superfície mucosa do coto duodenal e a papila maior e papila menor do duodeno, foi significativamente maior nos cotos fechados com 1 plano de sutura. B) O estudo histológico: Um estudo histológico de fechamento do coto duodenal foi feito, após gastrectomia Billroth II em 48 cães, divididos em dois grupos iguais. No Grupo 1, o fechamento foi realizada em um plano, enquanto no Grupo 2 foi feito em dois planos (total e seromuscular). Em cada grupo, os animais foram divididos em dois subgrupos; i1 - cães sacrificados no início do período pós-operatório, ou seja, no primeiro, quarto e sétimo dias; e M1 - cães sacrificados no pós-operatório tardio, ou seja, no décimo quarto, vigésimo primeiro e vigésimo oitavo dia. Não houve um único caso de deiscência em qualquer animal. As conclusões relativas aos aspectos histológicos mostraram os seguintes aspectos: o Houve um esporão invertido para o lúmen do intestino, em todos os animais do grupo 2, enquanto que um pseudoesporão foi observado em apenas 37% nos animais do Grupo 1 ; o Sinais inflamatórios agudos foram mais intensos no grupo 2, na primeira semana de pós-operatório; o A formação de neofibrose do tecido conjuntivo e a regeneração da \"muscularis mucosae\" foi semelhante nos dois grupos. No entanto, a regeneração da mucosa ocorreu mais precocemente no grupo 1 , ao passo que a regeneração das fibras musculares ocorreu mais precocemente no grupo 2 / An experimental study of duodenal stump closure in one and two suture layers was performed in 48 dogs submitted to a Billroth II Gastrectomy, in order to study comparatively Macroscopic and Histological wound healing aspects. The most relevant aspects of this Macroscopic and Histological wound healing study in the duodenal stump, were the following ones: A) Macroscopic study: A comparative study was made as to the results of duodenal stump closure in 1 and 2 layers, taking in consideration its macroscopic aspects. Billroth II gastrectomy was performed in 48 dogs divided in two groups: a. Group 1 - consisted of 24 dogs in which the duodenal stump suture was performed in one extra-mucous layer. These animals were distributed into 2 subgroups of 12 animals each: i1 - dogs sacrificed in the early postoperative period, that is, on the first, fourth and seventh day after the operation; and M1 - dogs sacrificed at a later postoperative period, that is, on the fourteenth, twenty-first and twenty-eighth day after the operation. b. Group 2 - consisted of 24 dogs, in which the suture of the duodenal stump was performed in 2 layers (total and seromuscular ones). Also these animals were distributed in i2 and M2 sub-groups, identically as in group 1. The following conclusions were obtained, concerning the macroscopic aspects: o Dehiscence of the duodenal stump or any other postoperative complications occurred in none of the dogs in both groups; o The external diameter of the duodenal stump at the level of the suture was significantly larger in the group with 2 suture layers. However, at 5 and 10 cm distally from the suture, this measure was similar in both groups. o Adherences to the duodenal stump were similar in both suturing methods, except for a significantly higher incidence of epiplon adherence in the 1 layer group during the first 7 days. o Mucosal inflammation was significantly greater in the 2 suture layers group during the first 7 days; o The spurs formed in the 2 layers stump closure was significantly larger than that formed in 1 layer suture. o The distance from the mucosal surface of the stump suture to the Major and Minor papilla of the duodenum was significantly greater in the stumps closed with 1 layer sutures. B) Histological study: A histological study of duodenal stump closure was made, following a Billroth II gastrectomy in 48 dogs, divided in two equal groups (1 and 2) and its subgroups (i1 and M1; i2 and M2), as mentioned above. The conclusions concerning to histological aspects showed the following characteristics: o There was an inverted spur toward the lumen of the bowel, in all group 2 animals, whereas a pseudo- spur was also observed in only 37% in group 1 animals; o Acute inflammatory signs were more intense in group 2 in the first week of recovery; o The formation of young connective tissue fibrosis and muscularis mucosae fibers regeneration was similar in both groups. However, mucosal regeneration occurred earlier in group 1, while regeneration of muscle fibers occurred more precociously in group 2

Foram realizados dois ensaios experimentais a fim de avaliar o fornecimento de dieta úmida para frangos de corte e poedeiras comerciais. Os experimentos foram realizados nos galpões experimentais de frangos de corte e galpões de postura do setor de avicultura do Campus de Pirassununga da Universidade de São Paulo. Para frangos de corte, foram utilizados 960 animais distribuídos em delineamento inteiramente casualizado, com 6 tratamentos (nível de inclusão de água na dieta: 0%, 10%, 20%, 30%, 40% e 50%), com 4 repetições de 40 aves cada uma, sendo avaliados ganho de peso, conversão alimentar e consumo de ração. No dia do alojamento e aos 7 e 21 dias, duas aves por repetição foram abatidas para a avaliação histológica da morfologia intestinal. Para as poedeiras, foram utilizadas 192 aves, também distribuídas em delineamento inteiramente casualizado e divididas conforme o nível de inclusão de água na dieta, com 4 repetições de 8 aves por parcela experimental. Neste caso, foram determinados consumo de ração, conversão alimentar, produção de ovos, gravidade específica, espessura da casca e peso dos ovos. Semanalmente foi monitorada a temperatura corporal de duas aves por repetição de ambos os experimentos. A dieta úmida proporcionou uma melhor redução no consumo de ração e melhor conversão alimentar em ambos os experimentos. / Two experimental rehearsals were accomplished in order to evaluate the supply of wet feed for broilers chickens and commercial layers. The experiments were ccomplished at the experimental hangars of male chickens and posture the section of aviculture of the University of São Paulo - Campus of Pirassununga. Nine hundred sixty male chickens were used distributed, with 6 treatments (level of inclusion of water in the diet: 0%, 10%, 20%, 30%, 40% and 50%), were randomly assigned, with four repetitions of fourty birds each a, being appraised body weight gain, feed conversion and feed intake. In the day of the lodging and to the 7 and 21 days, two birds for repetition were abated for the evaluation of the intestinal morphology. For the layers, 192 birds were used, also distributed entirely in delineamento casualizado and divided according to the level of inclusion of water in the diet, were randomly assigned with four repetitions of eight birds each. In this case, they were certain feed intake, feed conversion, eggs production, specific gravity, thickness of the peel and eggs weight. The corporal temperature of two birds was weekly monitored by repetition of both experiments. The wet feed provided a better reduction in the feed intake and better alimentary conversion in both experiments.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-10-05T17:26:27Z No. of bitstreams: 1 nathaliasaberdeandrade.pdf: 489327 bytes, checksum: 26e5218f3326304fb6e2eae34a98c1a5 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-10-09T19:58:47Z (GMT) No. of bitstreams: 1 nathaliasaberdeandrade.pdf: 489327 bytes, checksum: 26e5218f3326304fb6e2eae34a98c1a5 (MD5) / Made available in DSpace on 2017-10-09T19:58:47Z (GMT). No. of bitstreams: 1 nathaliasaberdeandrade.pdf: 489327 bytes, checksum: 26e5218f3326304fb6e2eae34a98c1a5 (MD5) Previous issue date: 2017-08-24 / Introdução: Esofagogastroduodenoscopia (EGD) convencional é o melhor método para avaliação do trato gastrointestinal superior (TGI), mas apresenta limitações para identificação da papila duodenal maior (PDM), mesmo após emprego da manobra de retificação. Exame completo da PDM está indicado nos pacientes de alto risco para adenocarcinoma da PDM. Objetivo: avaliar a utilização da pinça de biópsia (PB) durante EGD convencional como ferramenta adicional à manobra de retificação, na avaliação da PDM. Métodos: Foram estudados 671 pacientes entre 2013-2015 com busca ativa da PDM em três etapas: endoscópio não retificado, endoscópio retificado e uso da PB após retificação. Em todas elas registrou-se se: PDM foi totalmente visualizada (Posição A), parcialmente visualizada (Posição B) ou não visualizada (Posição C). Caso PDM não tenha sido completamente visualizada, paciente foi direcionado para etapa seguinte. Resultados: 341 eram sexo feminino (50,8%) com idade média de 49 anos. Dos 671 pacientes, em 324(48,3%) PDM foi identificada na posição A, 112(16,7%) em posição B e 235(35%) em posição C. Dos 347 pacientes submetidos à manobra de retificação, posição A foi encontrada em 186(53,6%), posição B em 51(14,7%) e posição C em 110(31,7%). Dos 161 pacientes restantes que utilizaram a PB, posição A foi vista em 94(58,4%), posição B em 14(8,7%) e posição C em 53(32,9%). A taxa acumulativa de visualização completa da PDM foi de 90%. Conclusão: O uso da PB aumentou a taxa de visualização completa da PDM em 14%, alcançando 604/671(90%) dos pacientes (P<0,01) avaliados e pode ser facilmente incorporada aos exames endoscópicos de rotina do TGI. / Introduction: Conventional esophagogastroduodenoscopy (EGD) is the best method for evaluation of the upper gastrointestinal tract (UGT), but it has limitations for the identification of the major duodenal papilla (MDP), even after the use of the straightening maneuver. Side-viewing duodenoscope is recommended for optimal examination of MDP in patients at high risk for lesions in this region. Objective: to evaluate the use of the biopsy forceps during conventional EGD as an additional tool to the straightening maneuver, in the evaluation of the MDP. Methods: A total of 671 patients were studied between 2013 and 2015, with active MDP search in three endoscope steps: not straightened, straightened and use of the biopsy forceps after straightening. In all of them it was recorded whether: MDP was fully visualized (Position A), partially visualized (Position B) or not visualized (Position C). If MDP was not fully visualized, patients continued to the next step. Results: 341 were female (50.8%) with mean age of 49 years. Of the 671 patients, 324 (48.3%) MDP was identified in position A, 112 (16.7%) in position B and 235 (35%) in position C. In the 347 patients who underwent the straightening maneuver, position A was found in 186 (53.6%), position B in 51 (14.7%) and position C in 110 (31.7%). Of the 161 remaining patients and after biopsy forceps use, position A was seen in 94 (58.4%), position B in 14 (8.7%) and position C in 53 (32.9%). The overall rate of complete visualization of MDP was 90%. Conclusion: the use of the biopsy forceps significantly increased the total MDP visualization rate by 14%, reaching 604/671 (90%) of the patients (P<0.01) and it can be easily incorporated into the routine endoscopic examination of the UGT.

No description available.

Eighty-four patients who were endoscopically confirmed to have healed duodenal ulcers were entered into this 1 year, double-blind, placebo-controlled trial of sucralfate, lg twice daily, in the prevention of duodenal ulcer recurrence. Patients remained in the study until recurrence of ulceration was endoscopically confirmed. Sixty-one patients could be evaluated for efficacy of treatment. Within 6 months, 23 of 31 placebo patients (74%) and 6 of 30 sucralfate patients (20%) had ulcer recurrence. At 12 months, 25 of 31 placebo patients (80%) and 8 of 30 receiving sucralfate (27%) had ulcer recurrence. The lower rate of ulcer recurrence in patients receiving sucralfate was significant (p = 0.0001). Survival curves also showed that sucralfate was significantly more effective in preventing relapse (p = 0.0001). Three patients were judged as experiencing drug-related side effects, two of which were in the placebo group. The results indicate that sucralfate is significantly more effective than placebo in the prevention of recurrence of duodenal ulcer disease.

Background: The prevalence of H. pylori is greater than 50% in low development countries. In children, infection with H. pylori produces effects such as low height, impairment in growth especially in pubertal age. Polymerase Chain Reaction has a high sensitivity and specificity of 89.6% and 100% respectively, compared to other invasive methods. The objective of this study is to determine the frequency of patients with presence of H. pylori in asymptomatic children in a rural community in the north of Peru, using PCR technique in stool samples. Methods: A cross-sectional study with a convenience sampling was performed, resulting in 147 children aged between 6-14 years old of the district of San Pablo in Cajamarca, Peru. Using stool samples H. pylori DNA was obtained, then PCR amplification was done, and sequencing those with positive results, in an agreement with Macrogen, Seoul - Korea. Results: It was found a frequency of H. pylori positive cases of 21.1% with a CI 95% of 14.8 to 28.6. It was found a frequency (p=0.01) of positive for H. pylori among males (29% IC95: 19.1- 40.5) compared to women (12.7%; IC95: 6.0-22.7). There was no statistically significant differences between those positive and negative patients with H. pylori compared to age (p = 0.57), presence of overweight (p = 0.09), or excreta disposal (p = 0.71). It was not found significance difference among other variables. Conclusion: Our study found a high frequency of H. pylori determined by a molecular test with high sensitivity and specificity, demonstrating the feasibility of its implementation in rural communities. It can be considered as a tool for surveillance in areas of high prevalence of H. pylori infection. / Tesis

This thesis is concerned with the use of some of the newer techniques in a study of some of the effects of cigarette smoking on gastric secretion and gastric motility in normal subjects and in patients with active duodenal ulcers.

Acute cholecystitis is the inflammation of the gallbladder, classically caused by gall stones obstructing the cystic duct. In contrast, acalculous cholecystitis is a gallbladder inflammation occurring in the absence of cholelithiasis with a reported prevalence of 10% of all cases of acute cholecystitis. Reactive acalculous cholecystitis is an extremely rare subset of this disease that results from an adjacent inflammatory or infectious intra-abdominal process that may lead to gallbladder stasis, ischemia, and subsequent wall inflammation. Many factors have been associated with acalculous cholecystitis, including (but not limited to) hemodynamic instability, altered immunity, and biliary tree anomalies. Lack of specific signs and symptoms of this particular entity often delays the diagnosis. Herein, we present a rare case of acute, reactive, acalculous cholecystitis secondary to a perforated duodenal ulcer found incidentally during laparoscopic cholecystectomy.

Colorectal cancer is one of the leading causes of cancer related deaths in western world. While most common site for metastasis for colon cancer is liver, lung, and the peritoneum, metastasis to various other organs such as brain, bones and thyroid has been reported. Metastatic lesions to the small bowel are more common than primary lesions and most common primary neoplasms that metastasize to the duodenum are lung cancer, renal cell carcinoma, breast cancer, and malignant melanoma. We report a very rare case of recurrent adenocarcinoma of colon metastasizing to duodenum after 2 years of curative resection of primary cancer. Surgical resection for curative intent as well as palliative management is recommended.